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Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, and coracoid (the acromial arch) and from the deep surface of the deltoid muscle. [1]
This in turn pushes the acromion and the humeral head out of its usual anatomical position placing pressure downwards at the head of the humerus at the position of the nerve thus causing the impingement syndrome. This is visibly demonstrated by a slightly raised and protracted shoulder girdle. Note: the humerus anteverts in this position ...
The ligaments may be best seen by opening the capsule at the back of the joint and removing the head of the humerus: [2] One on the medial side of the joint passes from the medial edge of the glenoid cavity to the lower part of the lesser tubercle of the humerus.
[2] The shoulder joint is the main joint of the shoulder. It is a ball and socket joint that allows the arm to rotate in a circular fashion or to hinge out and up away from the body. The joint capsule is a soft tissue envelope that encircles the glenohumeral joint and attaches to the scapula, humerus, and head of the biceps.
The greater tubercle projects as the most lateral structure of the humeral head. Medial to this, in turn, is the lesser tubercle of the humeral head. The subscapularis muscle origin is divided from the remainder of the rotator cuff origins as it is deep to the scapula .
The combination of scapulothoracic exercises and glenohumeral exercises allow for a more effective healing process. Scapulothoracic exercises focus on movements of the scapula relative to the thoracic ribcage. Muscle groups such as serratus anterior, trapezius, and rhomboid major/minor need to be strengthened to allow for shoulder function.
The humeral head may migrate upward (high-riding humeral head) secondary to tears of the infraspinatus, or combined tears of the supraspinatus and infraspinatus. [51] The migration can be measured by the distance between: A line crossing the center of a line between the superior and inferior rims of the glenoid articular surface (blue in image).
It is the thickenings of the capsule that passes from the upper part of glenoid to lesser tuberosity and inferior part of the head of humerus. These ligaments are weak unlike its posterior part which is supported by the infraspinatus muscle. [4] Coracohumeral ligament [4] Transverse humeral ligament [4] Coraco-acromial ligament [7]