Pain in the scapula-brachial complex


The scapula-brachial complex is one of the most biomechanically complex structures of the musculoskeletal system, therefore the causes of its ailments, and therefore –
there are many opportunities for improvement. Shoulder girdle pain most often results from pathologies of articular surfaces, articular capsules, ligaments, or muscle.

Pain can occur for no apparent reason, whether it is direct trauma, overwork, muscle imbalance, or rheumatic, cardiological, neurological or cancer disease. Malfunctions of the scapula-brachial complex usually lead to a temporary limitation of motor function, and can also become chronic.


The scapula complex is the name of the functional unit of the upper limb belt. It consists of five joints, which together affect mobility, stability and positioning in the space of the upper limb. These include the following ponds :

  • rib and scapular,
  • shoulder-clavicle,
  • sternoclavicular,
  • brachial.

The rib-blade joint

The shoulder blade-suspended from the chest by 17 muscles-plays an important role in the transfer of muscle energy from the lower limbs and torso to the upper limbs, and allows greater mobility of the entire shoulder blade-arm complex.

The costo-scapular joint (this is the name of this physiological connection) has two sliding planes :

  • between the subscapular muscle and the anterior dentate muscle,
  • between the dentate anterior muscle and the thorax.

In a situation of myofascial balance, the scapula extends from the second to the seventh rib. The medial end of its crest is at the height of the spinous process of the third vertebra, and the medial edge is 5-7 cm from the thoracic spine. The pallet makes an angle of 30° with the front plane. This is a functional plan for visiting the shoulder joint.

In the rib-scapular joint, the movements of elevation and depression, adduction (retraction) and abduction (protraction), upper and lower rotation, internal and external rotation are distinguished. The blade can also be tilted forward. The correct positioning of the scapula depends on the work of muscle pairs – agonists and antagonists.

The correct positioning of the scapula in the movement of elevation and depression is related to the balance between the descending and ascending parts of the trapezius muscle, since although these muscles rotate together upward, in this case they are antagonistic. The clinical elevating muscle of the scapula also often contributes to the heightening of the scapula.

The protraction/retraction correlation of the scapula depends on the adductors (dorsi trapezium and parallelograms) and on the abductors (anterior dentate).
The balance of tensions for upper and lower rotation is guaranteed by the trapezius (upper rotation) and parallelogram (lower rotation) muscles. Muscles such as the elevator of the scapula, pectoralis minor and deltoid also play an important role in supporting the lower rotation. The latissimus dorsi muscle is also an important upper rotator. The toothed anterior muscle, depending on the location of the fibers, is responsible for both the upper and lower rotation.


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