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The scapula is a flat bone located in the upper back, on the dorsal wall of the chest, between the spine and the brachial joint where the upper limb begins. The shoulder blade contributes to this pond. And the mobility of the entire shoulder complex largely depends on the mobility of the scapula. Pain in the area of ​​the shoulder blade may herald problems with the heart, spine or damage to the shoulder blade and the muscles surrounding it.

The spatula makes various movements, increasing, among others, flexibility of the torso, but most of all, significantly increasing the range of motion of the upper limb in the shoulder joint. In addition to articular connections with the shoulder complex (brachiocapular and shoulder-clavicular joints), the scapula also connects via muscles with the ribs, spine, skull, collarbone, humerus and hyoid bone. The variety of movements of the scapula is the result of the interaction of the following muscles:

  • shoulder blade,
  • quadrilateral,
  • pectoral smaller,
  • parallelogram,
  • toothed front.

Łopatka - construction site

The scapula is a flat, thin, triangular bone located on the dorsal wall of the chest, sois the posterior part of the shoulder girdle . The anatomical structure of the scapula is distinguished bytwo surfaces(costal and dorsal) and - as befits a triangle -three angles(upper, lower and lateral) andthree edges(medial, top and lateral). The shoulder blade is freely suspended between the muscles and only laterallyarticulated with the collarbone and with the humerus .

The rib surface of the scapula is concave and forms the so-calledpaddle bottom . The dorsal surface, on the other hand, is convex and separated by a crest which thus forms two indentations:

  • supraspinatus(intended for the supraspinatus);
  • fossa(holds the fossa muscle).

The crest of the scapula tends to the lateral angle, gradually ascending and widening to eventually transform into a strong, tall bone plate that extends beyond the triangles of the scapula and forms ashoulder process . On its medial edge there is aarticular surface for connection to the collarbone .

The raven's appendixbegins on the upper edge of the scapula. It goes forward and up, to at some point twist to the side like a hook and end with a blunt tip. The raven's appendix is ​​thesite of attachment of the three ligaments(raven-clavicular, raven-brachial, raven-brachial) andthree muscles(minor pectoral, raven-brachial and the head of a short two-headed arm).

The shoulder blades are clearly visible through the skin of the back and palpable (especially the medial and lateral edges and the lower angle of the scapula). When the arm is raised above the horizontal, the lower angle of the shoulder blade is even more visible than in the neutral position. The edge of the scapula crest and the shoulder process are also clearly perceptible and visible.

The vast majority of the shoulder is made of a compact substance. The spongy creature is found only in the thickest parts of the bone, in:

  • side angle,
  • crow process,
  • shoulder process,
  • at comb level,
  • along the side edge.

Paddle - features

Originally, in the ancestors of humans, the shoulder blades served mainly as a support. However, evolution has resulted in newfunctions-manipulativeandpostural . This was due to the change in the vertical position of the body and the opening of the upper biokinematic chains. As a result, the scapula, thanks to the ability to perform multi-dimensional movements,can change the position of the acetabulum of the shoulder joint , , thus increasing the range of arm movement . This mechanism is called the shoulder-scapular rhythm.

Spatula - movements

The range of the bend of the arm is 180 degrees , of whichthe first 90 degrees are the movement of the humerus itself , andsubsequent 90 degrees is due topaddle, which deepens this movement so much.In an abduction, the humerus itself only reaches 70 degrees , after whichthe movement to a full 180-degree rise is achieved by activating the shoulder blade .

The shoulder blade makes many movements, not only in the shoulder joint, to which specific muscles respond. Anatomy describes these movements of the scapula as:

  • lifting- levator of the scapula;
  • lowering- trapezius muscle in lower part;
  • external rotation- dentate anterior muscle;
  • internal rotation- pectoral minor muscle;
  • protraction- pectoral minor muscle;
  • retraction- medial trapezius;
  • rotationlower- parallelogram muscle;
  • upper rotation- trapezius muscle upper part;
  • anterior tilt- pectoral muscle;
  • posterior tilt- serrated anterior muscle.

Each of these movements is described conventionally, from the neutral position of the shoulder blade, which can be individually variable. This orientation is considered neutral when the crest of the scapula points towards the third or fourth thoracic vertebrae (Th3 or Th4) and the inferior angle is level with the seventh thoracic vertebra (Th7). The inferior angle should be lateral to the top angle, and the shoulder process should be higher than the top angle.

Maintaining a neutral position, stability and movement of the scapula is due to, on the one hand, the stabilizing muscles of the scapula, such as the trapezius muscle and the toothed anterior muscle, and on the other hand, to the scapula mobilizers, i.e. the levator scapular muscle, the parallelogram muscle and the minor pectoralis muscle.

Scapula movements based on PNF patterns

The mobility of the scapula is so complicated that anatomists and biomechanics are not satisfied with one type of description. PNF lovers and therapists who work with this method derive the movements of the scapula from locomotive chains. According to the assumptions of PNF, neurophysiological patterns of movement run in diagonal (diagonal body planes). According to this methodology, the following are distinguished:

  • front and rear elevation ,
  • anterior and posterior depression .

These patterns, although named and described differently, are a combination of anatomical movements.

Łopatka - pathologies

The pathological position of the scapula usually results from the uneven tension of the numerous muscles that surround it. Both the stabilizers and the scapula mobilizers can be too strong or too weak. This usually translates intopostural disordersorshoulder problems . The main symptom, however, ispain in the shoulder area and the shoulder blade . Its most common reasons include:

  • inhibition of the anterior dentate muscle (especially in people practicing swimming and throwing sports), which causes pain in the shoulder joint;
  • positioning of the scapula in protection and inferior rotation, which contributes to the formation of a sub-shoulder syndrome.

Scapula - pain

Pain in the shoulder blade and its vicinity is a popular ailment, both in physically active people and in those who lead a sedentary lifestyle. The cause of unpleasant sensations inthis area may be, among others :

  • overload,
  • shooting blade syndrome symptom (popping blade syndrome),
  • shoulder,
  • heart attack,
  • problems with the thoracic spine,
  • too high tension of the muscles stabilizing the shoulder blade,
  • damage to the muscles surrounding the shoulder blade,
  • mechanical trauma,
  • neuralgia.

If the pain in the area of ​​the scapula or the restriction of movement persists for a long time, it is advisable to consult a specialist (orthopedist, traumatologist, neurologist, cardiologist). If a heart attack is suspected, an ambulance should be called immediately.

Scapula - fractures

A separate cause of pain in the scapula may be its fracture. It rarely comes from him, but when such a situation already takes place, they may break:

  • shoulder blade,
  • pan,
  • neck,
  • shoulder appendix,
  • the appendix crows.

There are spontaneous fractures as well as those accompanying the collarbone, ribs and even the spine. The shoulder blade may also fracture as a result of dislocation of the shoulder joint or paralysis of the axillary or suprascapular nerve.

In the case of a fracture of the scapular shaft, conservative treatment is usually applied, which consists in immobilizing the entire joint in a triangular cloth or a Desault dressing. However, if there is a fracture of the neck of the scapula (especially with displacement), a dislocated joint fracture or a fracture of one of the appendages, surgery is most often recommended.

Exercise for shoulder blades

Exercises for the shoulder blades usually consist in strengthening the muscles of the back, abdomen and the muscles of the shoulder girdle. When building muscle strength, you should also remember about stretching the muscles, taking care of the proper mobility of the joints and working on the correct figure and posture of the whole body. For more on shoulder blade exercises, see the following articles:

Bibliography

  • Adler S., Beckers D., Buck M., "PNF in practice", DB Publishing Publishing, Warsaw 2014.
  • Bochenek A., Reicher M., "Human Anatomy", volume I, PZWL Medical Publishing, Warsaw 2012.
  • Janicki K., "Home Medical Guide", PZWL Medical Publishing, Warsaw 2003.
  • Urbanowicz Z., "Little encyclopedia of human anatomy", Czelej Publishing House, Lublin 2003.

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Anatomy