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Massage Today
December, 2004, Vol. 04, Issue 12

Let's Talk About ... Why Shoulders Are Frequently Injured

By Ben Benjamin, PhD

Multiple Choice Question: Why are rotator cuff tendons so vulnerable to injury?

a) We use them a great deal.
b) The tendons of the shoulder have a double function working part-time as ligaments.
c) They have a poor mechanical advantage

Answer:

b) The tendons of the shoulder have a double function working part-time as ligaments.

In most circumstances, ligaments are the primary structures that hold bones together.

In the ankle, hip and knee joints, there are massive ligaments holding the bones together. In the case of the glenohumeral joint there are only a few. The primary structures that hold the humerus to the glenoid fossa are the rotator cuff tendons. The tendon of the subscapularis muscle reinforces the anterior portion of the shoulder joint; the tendon of the supraspinatus muscle reinforces the lateral aspect of the joint; and the infraspinatus muscle and teres minor secure the posterior portion of the shoulder joint.

These tendons are doing double work. They are responsible for the rotational movements of the shoulder as well as holding the humerus into the glenoid fossa. This anatomical arrangement gives us incredible range of motion - more than any other joint in the body. At the same time, this increases the vulnerability of these structures to injury. One of the basic principles of understanding injury anatomy is that the greater the range-of-motion at a particular joint, the greater the chance of injury, which explains the frequency of rotator cuff injuries.


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