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Periscapular muscles are those that surround the scapula, which is a bone in the shoulder. The scapula has several roles in shoulder function, including the control of static position and motion. The shoulder complex is made up of 14 muscles, 8 of which cross the glenohumeral joint. The trapezius is the most superficial periscapular muscle and serves a primary role in scapular stabilization and motion. It is commonly regarded as having superior, middle, and lower components, with these inserting on the acromion and lateral scapular spine, superior scapular spine, and inferomedial scapular spine, respectively.
| Characteristics | Values |
|---|---|
| Definition | Periscapular muscles are those that surround the scapula (shoulder blade) and control its movement and stabilization. |
| Function | Periscapular muscles enable the scapula to rotate, tilt, and externally rotate to clear the acromion during arm movement. They also dynamically stabilize the scapula during arm use. |
| Anatomy | The trapezius is the most superficial periscapular muscle and plays a key role in scapular stabilization and motion. It has superior, middle, and lower components that insert on different parts of the scapula. |
| Clinical Relevance | Scapular dyskinesis (SD) refers to changes in the positioning or movement of the scapula, often leading to a 43% increased risk of shoulder pain. SD is associated with abnormalities in neuromuscular control and weakness or stiffness of periscapular muscles. |
| Electromyography | Electromyographic studies have analyzed the activation of periscapular muscles, such as the serratus anterior and trapezius, during exercises like push-ups on stable and unstable bases. |
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What You'll Learn
The trapezius is the most superficial periscapular muscle
The periscapular muscles are a group of muscles that surround the scapula, a bone in the shoulder. The scapula is unique in that it is a floating bone that is nearly completely stabilised by muscles. The periscapular muscles are essential for shoulder function and movement.
The trapezius has many attachment points, extending from the skull and vertebral column to the shoulder girdle. The upper trapezius fibres attach to the skull and neck, the middle trapezius fibres attach to the upper part of the spinous processes of C7-T12, and the lower trapezius fibres attach to the lower part of C7-T12. The trapezius muscle is the only muscle of the upper limb that does not receive its innervation from the brachial plexus. Instead, motor innervation is conveyed by the spinal accessory nerve (CN XI) and the anterior rami of the C3 and C4 spinal nerves.
The trapezius serves a primary role in scapular stabilisation and motion. The upper fibres of the trapezius can elevate and upwardly rotate the scapula, allowing us to raise our arm above our heads. The middle fibres adduct the scapula, drawing the two scapulae together. The lower fibres depress the scapula and aid the upper fibres in upward rotation. The trapezius works in conjunction with several other muscles to produce coordinated movements, primarily involving the scapula. Some key muscle pairings include the rhomboids, levator scapulae, serratus anterior, deltoid, and latissimus dorsi.
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Periscapular muscles and scapular dyskinesis
The scapula has several roles in shoulder function, including control of static position and control of the motions and translations. The periscapular muscles, therefore, play a critical role in scapular stabilisation and motion. The trapezius is the most superficial periscapular muscle and serves a primary role in scapular stabilisation and motion. It is commonly regarded as having superior, middle, and lower components, with these inserting on the acromion and lateral scapular spine, superior scapular spine, and inferomedial scapular spine, respectively.
Scapular dyskinesis refers to abnormal mobility or function of the scapula (shoulder blade). It is often a subtle abnormality and typically not a primary complaint by the patient. However, it can be the underlying cause of shoulder pain. The numerous muscles that attach to the scapula are responsible for its complex motions, and any deviation from the normal can lead to damage to the rotator cuff, the shoulder labrum, and cartilage. These muscles can become weak from underuse, muscle imbalance, or injury, resulting in muscle or nerve damage.
Scapular dyskinesis is commonly observed in baseball pitchers and overhead athletes with impingement symptoms. It is diagnosed through a physical examination by a surgeon or doctor, who will visually observe the affected scapula and compare it to the non-involved side. The patient may be asked to move their arms up and down with or without light weights to identify muscle weakness and abnormal motion patterns. Specific tests, such as the scapular assistance test (SAT) and the scapular retraction test (SRT), help evaluate muscle strength and scapular motion.
Treatment for scapular dyskinesis typically involves non-surgical methods, including physical therapy exercises that focus on strengthening and stretching the muscles around the shoulder. Simple home treatments, such as improving posture, balancing exercise routines, and heat therapy, can also be effective. In some cases, nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to relieve pain and swelling.
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Periscapular muscles and shoulder girdle motion
The scapula is a sturdy, flat, triangular bone that forms the posterior of the shoulder girdle. It is unique because, except for its connection to the clavicle, it is a floating bone that is almost completely stabilised by muscles. Seventeen muscles attach to the scapula, and it is involved in six types of motion that allow for full functional upper extremity movement: protraction, retraction, elevation, depression, upward rotation, and downward rotation.
The periscapular muscles are crucial for the normal scapulothoracic motion that facilitates full, pain-free motion of the shoulder complex. The trapezius is the most superficial periscapular muscle and serves a primary role in scapular stabilization and motion. It is commonly regarded as having superior, middle, and lower components, with these inserting on the acromion and lateral scapular spine, superior scapular spine, and inferomedial scapular spine, respectively. Protraction is accomplished by the actions of the serratus anterior, pectoralis major, and pectoralis minor muscles. Retraction is accomplished by the actions of the trapezius, rhomboids, and latissimus dorsi muscles. The elevation is accomplished by the trapezius, levator scapulae, and rhomboid muscles.
The scapula must be dynamically stabilised during arm use to maximise the activation of all the muscles that originate from it. In functional tasks, the scapula upwardly rotates, posteriorly tilts, and externally rotates to clear the acromion from the moving arm in forward elevation or abduction. Additionally, the scapula must synchronously internally/externally rotate and posteriorly tilt to maintain the glenoid as a congruent socket for the moving arm and maximise concavity/compression and ball and socket kinematics.
Dysfunction of scapular mechanics can lead to functional deficits in the upper extremity, such as scapular winging, a painful and debilitating condition. Therefore, the periscapular muscles are essential for maintaining normal shoulder girdle motion and preventing painful conditions associated with abnormal scapulothoracic motion.
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Periscapular muscles and shoulder impingement
The periscapular muscles are those that surround the scapula (shoulder blade). The scapula has several roles in shoulder function, including control of static position and motion. The shoulder complex is predominantly made up of 14 muscles, 8 of which cross the glenohumeral joint. The trapezius is the most superficial periscapular muscle and is responsible for scapular stabilization and motion. It is divided into superior, middle, and lower components, each inserting on a different part of the scapular spine.
Shoulder impingement syndrome is a painful condition that results from a structural narrowing of the subacromial space. It is commonly seen in individuals who participate in sports and activities requiring repetitive overhead movements, such as handball, volleyball, and swimming. The prevalence of shoulder impingement syndrome is estimated to be 7-34%, with 25% of those seeking treatment in the UK being diagnosed with this condition. It is primarily diagnosed through a patient's history and a physical examination.
The syndrome is caused by the narrowing of the subacromial space, which houses the tendons of the rotator cuff and the subacromial bursa (a fluid-filled sac for lubrication). When the shoulder is elevated or internally rotated, this space becomes narrower, causing an impingement. This can lead to pain, loss of motion, and difficulty sleeping due to nighttime pain.
Treatment of shoulder impingement syndrome typically involves physical therapy exercises to strengthen the shoulder girdle and improve scapular stabilization. A customized exercise plan can help normalize movement, with a focus on rotator cuff strengthening and scapular stabilizing muscles. Exercises performed in a prone position are often effective but may not be suitable for all patients. Other treatments include pharmacological interventions to reduce inflammation.
To summarize, periscapular muscles are crucial for shoulder function, and their strengthening is an important aspect of treating shoulder impingement syndrome. This syndrome is a common cause of shoulder pain, especially in individuals engaging in repetitive overhead activities. Treatment focuses on physical therapy and exercises to improve shoulder function and reduce pain.
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Periscapular muscles and neuromuscular control
The scapula is a floating bone that is nearly completely stabilized by muscles. The periscapular muscles are a group of muscles that surround the scapula and play a crucial role in shoulder function and stability. The trapezius is the most superficial periscapular muscle and is responsible for scapular stabilization and motion. It originates in the cervical spine and inserts on different parts of the scapula, including the acromion and lateral scapular spine.
Scapular dyskinesis (SD) refers to changes in the positioning or movement of the scapula, which can lead to a 43% increased risk of developing shoulder pain. SD is associated with abnormalities in neuromuscular control related to weakness or stiffness of the periscapular muscles. The passive stiffness and strength of these muscles can affect scapulohumeral control, especially in overhead athletes due to sport-specific training. For example, in competitive adolescent swimmers, the passive stiffness and strength of the periscapular muscles were found to be associated with muscle activity and shoulder kinematics during the elevation or lowering phase of scaption.
The coordination of scapulothoracic motion is essential for facilitating full, pain-free motion of the shoulder complex. This has led to a renewed interest in scapular-based reconstructions to improve shoulder girdle motion through muscle advancements and tendon transfers. However, many of these treatment techniques are still in their early stages and require further follow-up before universal adoption.
The activation of periscapular muscles during exercises such as push-ups has been studied using electromyographic analysis. These studies have explored the correlation between periscapular muscle activity and external oblique during push-ups, as well as the use of unstable surfaces to increase muscle activity. Understanding the role of periscapular muscles in neuromuscular control is crucial for preventing and managing shoulder injuries, especially in athletes who perform overhead movements.
In summary, the periscapular muscles play a vital role in maintaining scapular stability and controlling shoulder movements. Their neuromuscular control is essential for preventing scapular dyskinesis and associated shoulder pain, especially in athletes with specific training regimens. Further research and treatment techniques focusing on the periscapular muscles can help improve our understanding and management of complex shoulder girdle pathologies.
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Frequently asked questions
Periscapular muscles are those that surround the scapula, or shoulder blade, and facilitate its movement and stabilization. The scapula is a floating bone that is almost completely stabilized by muscles.
The trapezius is the most superficial periscapular muscle and serves a primary role in scapular stabilization and motion.
The scapula provides stable support for arm movements. Periscapular muscles, therefore, play an important role in facilitating full, pain-free motion of the shoulder complex.
