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Shoulder / Scapulohumeral Rhythm

Scapulohumeral Rhythm refers to the relationship of the humerus and scapula during upper extremity movements. The clinical relevance of this topic is to be aware that to obtain the full 180 degrees of motion, there must be a synchronized movement between the scapulothoracic and glenohumeral joint. There is a 2:1 ratio of these two joints. For every 2 degrees the humerus moves at the glenohumeral joint, the scapula moves 1 degree at the scapulothoracic joint. When the shoulder joint moves the full 180 degrees, the humerus moves 120 degrees and the scapula moves 60 degrees. Both joints contribute to the overall motion needed to complete full shoulder range of motion. The shoulder joint has the greatest mobility of any joints in the body, so the muscles and ligaments that are a part of the joint are essential for maintaining stability.
Scapulohumeral Rhythm allows for optimal length-tension relationships to prevent active insufficiency at the glenohumeral joint. The scapula is a stable base to allow the humerus to move in various directions. If the scapula is not functioning properly, there would be less control and overall function of the glenohumeral joint, leading to decreased range of motion, impingement, and pain. Additionally, if the scapula did not move during this motion, there would be increased friction of the subacromial space causing less efficient muscle movements. 
This is an important concept to understand when working in a clinical setting with patients involving shoulder injuries. By understanding Scapulohumeral Rhythm, you will be aware that the humerus, scapula, or both are contributing to the dysfunction of the joint and then be able to fully assess and address the issue. 

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Logan and I on our first day of OT school.

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