Massage & Bodywork

MARCH | APRIL 2021

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L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 57 believe that all arm abduction is generated at the GH joint, then we might come to four conclusions: • There is dysfunction of the GH joint. • Humeral abductors are weak. • Humeral adductors (the antagonists of the motion) are tight (hypertonic/overly facilitated/locked short). • Some other GH joint fascial/ligamentous tissue, including its joint capsule, is taut. This analysis might lead us toward a physical assessment of the GH joint and its myofascial tissues. However, when we broaden our scope to include scapular and clavicular motion, we realize we need to broaden the scope of our physical assessment as well. With this broader view of shoulder function in mind, our physical assessment might expand to include the following: • Palpation and strength assessment of all muscles of humeral abduction, including the deltoid, supraspinatus, biceps brachii long head, and pectoralis major clavicular head. • Palpation of all muscles of humeral adduction, including the pectoralis major, latissimus dorsi, teres major, coracobrachialis, biceps brachii short head, triceps brachii long head, and teres minor. • Palpation and strength assessment of all muscles of scapular upward rotation, including the upper trapezius, lower trapezius, serratus anterior, and teres major. • Palpation of all muscles of scapular downward rotation, including the rhomboids, pectoralis minor, levator scapulae, and deltoid. • Palpation and strength assessment of all muscles of clavicular elevation, including the upper trapezius. • Palpation of all muscles of clavicular depression, including the subclavius, anterior deltoid, and pectoralis major clavicular head. • Motion palpation of the GH, ScC, SC, and AC joints. • Palpation of all fascial tissues of the GH, ScC, SC, and AC joints. The foregoing was a discussion of scapulohumeral rhythm regarding humeral abduction. But scapulohumeral rhythm exists for all six cardinal-plane ranges of motion of the arm at the GH joint. Following is a brief explanation of these six scapulohumeral rhythms.* • Humeral abduction couples with scapular upward rotation. • Humeral adduction couples with scapular downward rotation. • Humeral fl exion couples with scapular upward rotation and protraction. • Humeral extension couples with scapular downward rotation and retraction. • Humeral lateral rotation couples with scapular retraction. • Humeral medial rotation couples with scapular protraction. *Scapular upward and downward rotation couple with clavicular upward and downward rotation respectively; scapular protraction and retraction couple with clavicular protraction and retraction respectively. When we appreciate the concept of scapulohumeral rhythm, our ability to appreciate larger kinematic chains of motion increases. And along with this, so does our appreciation and competency of how to counsel, assess, and treat our clients not only for shoulder problems, but for all myofascioskeletal conditions of the body. Dr. Joe Muscolino has been a manual and movement therapy educator for more than 30 years. He is the author of multiple textbooks, includingªThe Muscular System Manual: The Skeletal Muscles of the Human Body†(Elsevier, 2017);ªThe Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns, and Stretching†(Elsevier, 2016); andªKinesiology: The Skeletal System and Muscle Function†(Elsevier, 2017). He teaches continuing education workshops around the world, including a certifi cation in Clinical Orthopedic Manual Therapy (COMT), and has created LearnMuscles Continuing Education (LMCE), a video streaming subscription service for manual and movement professionals, with seven new video lessons added each and every week. And he has created Muscle Anatomy Master Class (MAMC), the most comprehensive and detailed muscle anatomy online class in the world, with each muscle taught in fi ve distinct video lessons. Visit www.learnmuscles.com for more information or reach him directly at joseph.e.muscolino@gmail.com. When we appreciate the concept of scapulohumeral rhythm, our ability to appreciate larger kinematic chains of motion increases.

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