Maximus Gage
The shoulder is a complex joint that controls arm movements and includes many small but important muscles. The four muscles of the rotator cuff are supraspinatus, infraspinatus, teres minor, and subscapularis. The deltoid and trapezius muscles are also important for shoulder movement and stability. Other muscles that form the shoulder girdle include the pectoralis major, pectoralis minor, serratus anterior, and rhomboids. These muscles help to lift and lower the shoulder blade, providing strength, stability, and shape to the joint. Exercises such as prone I, T, Y and band pull-aparts can help strengthen the smaller stabilizing muscles in the shoulders and improve posture.
| Characteristics | Values |
|---|---|
| Muscles that hold the shoulders down | Trapezius, Deltoid, Rhomboids, Teres Minor, Supraspinatus, Infraspinatus, Pectoralis Major, Serratus Anterior, Latissimus Dorsi |
| Types of shoulder movements | Flexion, Extension, Abduction, Adduction, Internal Rotation, External Rotation |
| Exercises for rounded shoulders | Doorway stretch, Prone I, T, Y exercise, Band pull-apart exercise, Wall slide exercise |
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What You'll Learn
Deltoid
The deltoid muscle, also known as the common shoulder muscle, is the muscle forming the rounded contour of the human shoulder. It is made up of three distinct sets of muscle fibres: the anterior or clavicular part (commonly known as the front delt), the posterior or scapular part (commonly known as the rear delt), and the intermediate or acromial part (commonly known as the side delt). The deltoid muscle sits on top of the rotator cuff muscles on the front, side, and back of each shoulder. It is larger and more powerful than the rotator cuff muscles and is the shoulder's prime mover, allowing us to lift our arms.
The deltoid muscle helps us move our arms forward, backward, and to the side. It is responsible for arm abduction, which means raising the arm out to the side of the body. It also enables flexion (moving the arm forward, toward an overhead position) and extension (moving the arm backward, behind the body). The deltoid muscle is involved in stabilisation of the shoulder joint to prevent dislocations as one lifts their arm or carries weight with their arms at their sides.
The deltoid muscle is susceptible to various conditions and injuries, including tears, fatty atrophy, enthesopathy, adhesive capsulitis (frozen shoulder), axillary nerve palsy, deltoid fibrosis, rotator cuff tears, shoulder impingement syndrome, and shoulder separation. Deltoid muscle pain can affect individuals who perform repetitive overhead arm movements, such as swimmers and pitchers.
To strengthen the deltoid muscle, exercises such as standing wall pushes, suitable dumbbell weight arm raises, and resistance band exercises can be performed.
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Trapezius
The trapezius is a large, paired muscle that is triangular or trapezoid-shaped, located at the back of the shoulder. It is made up of long muscle fibres that span a large width of the upper back. Each side of the body has one trapezius muscle, which starts at the base of the neck and extends across the shoulders and down to the middle of the back. The trapezius muscle is connected to the skull, spine, ribs, and bones in the shoulders.
The trapezius muscle helps to lift and lower the shoulder. It also helps to maintain and adjust posture, allowing the spinal column to remain erect when a person is standing. The trapezius works in conjunction with several muscles to produce coordinated movements, primarily involving the scapula. For example, the trapezius works with the serratus anterior to rotate the scapula upward during arm elevation, allowing the arm to lift smoothly above shoulder height. It also works with the deltoid muscle for arm elevation, with the deltoid initiating the movement, and the trapezius stabilising and rotating the scapula to allow a full range of motion.
The trapezius muscle is commonly referred to as the 'traps' or 'trap muscles'.
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Rotator cuff
The rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the humerus (upper arm bone). The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate the arm. The four muscles that make up the rotator cuff are the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles stretch from the scapula (shoulder blade) to the humerus, with the infraspinatus and teres minor attaching beneath the supraspinatus. The rotator cuff is one of the most important parts of the shoulder, allowing us to lift our arms and reach up.
The rotator cuff tendons cover the head of the humerus, allowing us to raise and rotate our arms. A lubricating sac called a bursa sits between the rotator cuff and the acromion (the bone on top of the shoulder). This bursa allows the rotator cuff tendons to glide freely when the arm is moved.
Symptoms of a rotator cuff tear include recurring pain, especially when lifting overhead, pain that disrupts sleep, muscle weakness, limited arm mobility, and grating or cracking sounds when moving the arm. Treatment options may include rest, medication, strengthening and stretching exercises, or surgery, depending on the individual's symptoms, age, and general health.
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Rhomboids
The rhomboids are a group of muscles formed by the rhomboid major and minor. They are located deep to the trapezius, stretching from the top of the spine (at the base of the neck) to the scapula. The rhomboid minor is a cylindrical muscle that originates at the ligamentum nuchae and C7 and T1 vertebra, inserting at the scapula's medial border near the spine of the scapula. The rhomboid major is a quadrangular muscle located inferior to the rhomboid minor, originating from the spinous processes of the T2-T5 vertebra and inserting just below the rhomboid minor.
The rhomboids are important for upper limb movement and stability of the shoulder girdle and scapula. They assist in rotating the scapula and help to lift the shoulder blade. The rhomboids receive innervation from the dorsal scapular nerve and vascular supply from the dorsal scapular artery. They are vital for actions such as pulling and throwing, and their strength and health contribute to overall shoulder stability.
The motor function of the rhomboid muscles is controlled by the dorsal scapular nerve (DSN), which originates from the ventral ramus of the spinal nerve root C5. The DSN courses posteriorly and inferiorly through the middle scalene muscles and between the posterior scalene, levator scapulae, and serratus posterior superior.
Maintaining the health and strength of the rhomboids is crucial for shoulder stability and injury prevention. Weakness or loss of nerve function in the rhomboids can lead to winging of the medial border of the scapula and inferior scapular angle rotation. Exercises such as shoulder rows and external rotations using resistance bands can help strengthen the rhomboids and improve shoulder stability.
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Teres minor
The primary function of the teres minor is to modulate the action of the deltoid, preventing the humeral head from sliding upward as the arm is abducted. It also functions to rotate the humerus laterally. The teres minor is one of four muscles that make up the rotator cuff, which acts to control the movement of the humeral head and stabilise it within the glenoid cavity of the scapula. The other three muscles are the supraspinatus, infraspinatus, and subscapularis.
The teres minor is supplied by the subscapular artery and one of its branches, the circumflex scapular artery, as well as the posterior circumflex humeral artery. The circumflex scapular artery travels around the lateral border of the scapula between the subscapularis and teres minor. The subscapular artery is the largest branch off of the axillary artery. It travels caudally before dividing into two arteries: the circumflex scapular and the thoracodorsal.
Selective atrophy of the teres minor muscle has been observed in conjunction with compression of the corresponding axillary nerve branch or posterior humeral circumflex artery.
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Frequently asked questions
The trapezius, deltoid, rhomboid major, and serratus anterior muscles hold the shoulders down.
The trapezius is a large triangular muscle that extends along the back of the neck and shoulders and partway down the spine.
The trapezius muscle helps you lift and lower your shoulder.
The prone I, T, Y exercise helps strengthen the trapezius muscle. Lie on your stomach, forehead touching the ground, arms straight above your head, and hands in a thumbs-up position. Raise your arms as high as you can, pause, and then slowly lower them back down.
