Shoulder Anatomy

Introduction

Physiotherapy in Calgary for Shoulder

 


Welcome to Momentum Health's patient resource about Shoulder problems.

The shoulder is an elegant piece of machinery. It has the greatest range of motion of any joint in the body. However, this large range of motion can lead to joint problems.

Understanding how the different layers of the shoulder are built and connected can help you understand how the shoulder works, how it can be injured, and how challenging recovery can be when the shoulder is injured. The deepest layer of the shoulder includes the bones and the joints. The next layer is made up of the ligaments of the joint capsule. The tendons and the muscles come next.

This article will help you understand:

  • what parts make up the shoulder
  • how these parts work together

Hear from some of our patients who we treated for Shoulder Pain
I’ve had several massages with Amber and I honestly can’t rave enough about her. She diagnosed a chronic shoulder injury that I have seen multiple practitioners for over the course of the past 10...
 I’ve had several massages with Amber and I honestly can’t rave enough about her. She diagnosed a chronic shoulder injury that I have seen multiple practitioners for over the course of the past 10 years and has given me treatment that far surpasses anything I’ve received before. I can’t recommend her enough! 
Shaun R
Calgary, AB
I can't sing Momentum Health (Seton) enough praises. From the moment I arrive there are smiles at the front desk, both Anthony and Sara are so welcoming and pleasant. Anthony especially has a level of...
 I can't sing Momentum Health (Seton) enough praises. From the moment I arrive there are smiles at the front desk, both Anthony and Sara are so welcoming and pleasant. Anthony especially has a level of professionalism and a proactive attitude that is all too rare these days. He remembers every patient (somehow, that man has one heck of a memory!), knows their schedules and goes above and beyond in every sense of the word. From booking in at arrival, to scheduling future appointments he's remarkably efficient and just "gets it". When it comes to my physio treatment, Eli has saved my shoulder and taught me a great deal along the way. He's patient and will explain any concern or query you have with knowledge and a gentle nature. Furthermore, he's effective. My range of mobility and pain has improved significantly, from their practices and the exercises advised for at-home care. Even being stuck with the needles isn't so bad! I'm on the mend now and it's genuinely a sadness that I won't see them so often. Unless I tear another shoulder! 
Hannah C
Calgary, AB
I have been to many other Physio clinics for injuries, this one is the best one by far and unrivaled. The staff are all very professional and polite. I came to this clinic for a shoulder injury from...
 I have been to many other Physio clinics for injuries, this one is the best one by far and unrivaled. The staff are all very professional and polite. I came to this clinic for a shoulder injury from an MVA, Moustafa was my physio and he was exceptional! He not only helped me to get me back into the condition I was before the car crash, but also taught me a lot about my body and exercises to improve my issues. 100% would recommend Moustafa and any of their professionals on staff for any injuries! 
Ethan C
Calgary, AB
I had a stubborn shoulder impingement that had been bothering me for nearly 2 years and completely derailed my fitness aspirations. It was an issue that seemingly would not go away no matter what...
 I had a stubborn shoulder impingement that had been bothering me for nearly 2 years and completely derailed my fitness aspirations. It was an issue that seemingly would not go away no matter what remedy I tried. Moustafa is extremely knowledgeable and within a month of working with him and Noni, my shoulder was feeling better than it ever had in the last 2 years. I am now back in the gym feeling better each and every week. I am super grateful to the Momentum Health staff who create a very warm and welcoming atmosphere, and are fantastic at what they do. I would recommend anyone to try this place out. 
Safwan H
Calgary, AB
Marjo is a gem. I have a desk job, so the knots in my shoulders and hips are epic - but she manages to work them out every time. If you want a deep massage that has great results, she is the right...
 Marjo is a gem. I have a desk job, so the knots in my shoulders and hips are epic - but she manages to work them out every time. If you want a deep massage that has great results, she is the right person to see. 
Mare B
Calgary, AB
Great experience with Momentum Health in Seton. I had a shoulder issue that was going on for 2 years and tried many things but the only thing that helped was my visits here!
 Great experience with Momentum Health in Seton. I had a shoulder issue that was going on for 2 years and tried many things but the only thing that helped was my visits here! 
Ashley K
Calgary, AB
In January and December of this past year I experienced two separate musculoskeletal injuries at a fast paced, physical labour intensive work environment. WCB Alberta approved treatment for the work...
 In January and December of this past year I experienced two separate musculoskeletal injuries at a fast paced, physical labour intensive work environment. WCB Alberta approved treatment for the work related injuries and I was able to find a physiotherapist and chiropractor at Momentum Health Deerfoot City. I was initially naive as to the work necessary to recover from a shoulder strain, and reluctant to put in the physio / chiro "homework" outside of the clinic - but Dr. Carpino and Mark carefully and competently provided immediate symptom treatment and small steps of training to ensure medium to long term recovery. I am now able to independently train a physical regime that is appropriate for the continued demands of a full time manual labour occupation, and am in better physical health than before the workplace injuries occurred. I actually feel lucky that I was needing and able to find treatment with the team at Momentum Health, due to a once difficult circumstance. I look forward to returning to the clinic this summer for more athletically developed personal training sessions with Dr. Carpino, Mark and Safia, and likewise want to thank receptionists Megan and Emily for their accommodations, professionalism and overall amazing support. Thank you, guys! 
James Z
Calgary, AB
I have been seeing Dr Denis Simon for treatment on my frozen shoulder. He explained everything to me during my initial assessment. Dr d is very good. Recommend him.
 I have been seeing Dr Denis Simon for treatment on my frozen shoulder. He explained everything to me during my initial assessment. Dr d is very good. Recommend him. 
Josh S
Calgary, AB
I attended Momentum Health due to issues with my right shoulder. I was very pleased with the thorough assessment completed by Mark, the physiotherapist, on my first appointment. I received some hands...
 I attended Momentum Health due to issues with my right shoulder. I was very pleased with the thorough assessment completed by Mark, the physiotherapist, on my first appointment. I received some hands on treatment and several exercises that I needed to complete daily. I did the exercises as recommended and they worked to alleviate the problem. Mark completed another assessment on my final appointment to ensure improvement in movement and determined that I did not need further appointments. I did not have to wait when I arrived for my appointments and the facilities were very clean and well organized. Overall I was very pleased with the punctual, respectful and through services that I received and would definitely recommend Mark and Momentum Health. 
Joyce B
Calgary, AB
Thanks Rebecca for providing me with help to deal with my shoulder pain. I appreciated the way in which you listened to my symptoms and created an exercise program that has worked to strengthen my...
 Thanks Rebecca for providing me with help to deal with my shoulder pain. I appreciated the way in which you listened to my symptoms and created an exercise program that has worked to strengthen my shoulder. 
Cindy B
Calgary, AB
I had a shoulder injury with chronic pain for years. After 6 weeks of physio with Moose, I’m back playing volleyball pain free. Couldn’t be happier with the results I got. Everyone there is very...
 I had a shoulder injury with chronic pain for years. After 6 weeks of physio with Moose, I’m back playing volleyball pain free. Couldn’t be happier with the results I got. Everyone there is very kind and extremely professional with the knowledge to help you with any pain you might be experiencing. 
Jillian H
Calgary, AB
I began at momentum November 14 2023 with a MVA. I was rear ended, and had major whiplash in my neck, shoulders, and back. Megan, James were both amazing with the physio therapy sessions. Not only...
 I began at momentum November 14 2023 with a MVA. I was rear ended, and had major whiplash in my neck, shoulders, and back. Megan, James were both amazing with the physio therapy sessions. Not only both knowledge but actually willing to help you. The exercises and treatments they both provided worked very well. Ali the chiropractor at this facility is fantastic. I have had really bad experiences with chiro in the past due to being miss treated. Ali is also very knowledgeable and is also quite harmless in his techniques. I never experienced any pain after these chiro appointments only the release of tightened muscles and honestly felt great each time. I 100% recommend any physio treatments from momentum health and also the chiropractic treatments. Thanks for helping me complete my journey to regain strength and recover from the whiplash I was experiencing. Today is March 15 2023 and it was my last treatment and I would like to personally thank each and everyone of you guys. So thank you. #Momentumhealthrocks Patrick r dowden 
No Face Venom
Calgary, AB
Mark Taylor and the team at Momentum provided great care after I injured my shoulder. Effective diagnosis, great step-by-step treatment to strengthen and rebuild mobility, and friendly, effective...
 Mark Taylor and the team at Momentum provided great care after I injured my shoulder. Effective diagnosis, great step-by-step treatment to strengthen and rebuild mobility, and friendly, effective administration combined to make a great experience for me. I highly recommend this physio clinic. 
Ryan H
Calgary, AB
Joel and Nik have been awesome at putting my shoulder back together after surgery.
 Joel and Nik have been awesome at putting my shoulder back together after surgery. 
Luke D
Calgary, AB
Dealt with Keri-Ann and Matt who helped me through some upper back/neck, shoulder and bicep pain. Their treatment helped and they've given me some exercise and stretching tips that have also been...
 Dealt with Keri-Ann and Matt who helped me through some upper back/neck, shoulder and bicep pain. Their treatment helped and they've given me some exercise and stretching tips that have also been beneficial. The front-end staff was great too. Billing to workplace health insurance was direct so it was a breeze to deal with. Can book and arrange everything online - super easy! I would recommend this place to others and they will be my go-to if I need more physio, chiro or massage. 
Scott S
Calgary, AB
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Important Structures

Acromioclavicular Joint

The important structures of the shoulder can be divided into several categories.

These include:

  • bones and joints
  • ligaments and tendons
  • muscles
  • nerves
  • blood vessels
  • bursae

Bones and Joints

The bones of the shoulder are the humerus (the upper arm bone), the scapula (the shoulder blade), and the clavicle (the collar bone). The roof of the shoulder is formed by a part of the scapula called the acromion.

Shoulder Bones

There are actually four joints that make up the shoulder. The main shoulder joint, called the glenohumeral joint, is formed where the ball of the humerus fits into a shallow socket on the scapula. This shallow socket is called the glenoid.

The acromioclavicular (AC) joint is where the clavicle meets the acromion.

 

Acromioclavicular and Glenohumarel Joints

 

The sternoclavicular (SC) joint supports the connection of the arms and shoulders to the main skeleton on the front of the chest.

Sternoclavicular and Scapulothroacic Joints

A false joint is formed where the shoulder blade glides against the thorax (the rib cage). This joint, called the scapulothroacic joint, is important because it requires that the muscles surrounding the shoulder blade work together to keep the socket lined up during shoulder movements.

Articular cartilage is the material that covers the ends of the bones of any joint. Articular cartilage is about one-quarter of an inch thick in most large, weight-bearing joints. It is a bit thinner in joints such as the shoulder, which don't normally support weight. Articular cartilage is white and shiny and has a rubbery consistency. It is slippery, which allows the joint surfaces to slide against one another without causing any damage. The function of articular cartilage is to absorb shock and provide an extremely smooth surface to make motion easier. We have articular cartilage essentially everywhere that two bony surfaces move against one another, or articulate. In the shoulder, articular cartilage covers the end of the humerus and socket area of the glenoid on the scapula.

Ligaments and Tendons

There are several important ligaments in the shoulder. Ligaments are soft tissue structures that connect bones to bones. A joint capsule is a watertight sac that surrounds a joint. In the shoulder, the joint capsule is formed by a group of ligaments that connect the humerus to the glenoid. These ligaments are the main source of stability for the shoulder. They help hold the shoulder in place and keep it from dislocating.

Ligaments attach the clavicle to the acromion in the AC joint. Two ligaments connect the clavicle to the scapula by attaching to the coracoid process, a bony knob that sticks out of the scapula in the front of the shoulder.

A special type of ligament forms a unique structure inside the shoulder called the labrum. The labrum is attached almost completely around the edge of the glenoid. When viewed in cross section, the labrum is wedge-shaped. The shape and the way the labrum is attached create a deeper cup for the glenoid socket. This is important because the glenoid socket is so flat and shallow that the ball of the humerus does not fit tightly. The labrum creates a deeper cup for the ball of the humerus to fit into.

The labrum is also where the biceps tendon attaches to the glenoid. Tendons are much like ligaments, except that tendons attach muscles to bones. Muscles move the bones by pulling on the tendons. The biceps tendon runs from the biceps muscle, across the front of the shoulder, to the glenoid. At the very top of the glenoid, the biceps tendon attaches to the bone and actually becomes part of the labrum. This connection can be a source of problems when the biceps tendon is damaged and pulls away from its attachment to the glenoid.

 

Labrum

The tendons of the rotator cuff are the next layer in the shoulder joint. Four rotator cuff tendons connect the deepest layer of muscles to the humerus.

Muscles

The rotator cuff tendons attach to the deep rotator cuff muscles. This group of muscles lies just outside the shoulder joint. These muscles help raise the arm from the side and rotate the shoulder in the many directions. They are involved in many day-to-day activities. The rotator cuff muscles and tendons also help keep the shoulder joint stable by holding the humeral head in the glenoid socket.

Rotator Cuff Tendons

The large deltoid muscle is the outer layer of shoulder muscle. The deltoid is the largest, strongest muscle of the shoulder. The deltoid muscle takes over lifting the arm once the arm is away from the side.

Deltoid Muscle

Nerves

All of the nerves that travel down the arm pass through the axilla (the armpit) just under the shoulder joint. Three main nerves begin together at the shoulder: the radial nerve, the ulnar nerve, and the median nerve. These nerves carry the signals from the brain to the muscles that move the arm. The nerves also carry signals back to the brain about sensations such as touch, pain, and temperature.

Blood Vessels

Traveling along with the nerves are the large vessels that supply the arm with blood. The large axillary artery travels through the axilla. If you place your hand in your armpit, you may be able to feel the pulsing of this large artery. The axillary artery has many smaller branches that supply blood to different parts of the shoulder. The shoulder has a very rich blood supply.

Bursae

Sandwiched between the rotator cuff muscles and the outer layer of large bulky shoulder muscles are structures known as bursae. Bursae are everywhere in the body. They are found wherever two body parts move against one another and there is no joint to reduce the friction. A single bursa is simply a sac between two moving surfaces that contains a small amount of lubricating fluid.

Think of a bursa like this: If you press your hands together and slide them against one another, you produce some friction. In fact, when your hands are cold you may rub them together briskly to create heat from the friction. Now imagine that you hold in your hands a small plastic sack that contains a few drops of salad oil. This sack would let your hands glide freely against each other without a lot of friction.

 

 

Summary

As you can see, the shoulder is extremely complex, with a design that provides maximum mobility and range of motion. Besides big lifting jobs, the shoulder joint is also responsible for getting the hand in the right position for any function. When you realize all the different ways and positions we use our hands every day, it is easy to understand how hard daily life can be when the shoulder isn't working well.

Portions of this document copyright MMG, LLC.