Manual Muscle Test

GLENOHUMERAL JOINT MODULE – Full Clean Format

Supraspinatus

1. Neurological & Functional Insights

• - Initiates the first degrees of abduction and provides dynamic centering of the humeral head.
• - High mechanoreceptor density coordinating fine elevation control.
• - Prevents inferior humeral translation especially in early range.

2. Clinical Relevance

• - Common site of tendinopathy and degenerative tears.
• - Inhibition causes poor abduction and deltoid overload.
• - Key early-phase stabilizer in scapulohumeral rhythm.

3. Origin

• - Supraspinous fossa

4. Insertion

• - Superior facet of greater tubercle

5. Innervation

• - Suprascapular nerve (C5–C6)

6. Actions – Open Kinetic Chain (OKC)

• - Initiates abduction
• - Assists external rotation

7. Actions – Closed Kinetic Chain (CKC)

• - Centers humeral head
• - Provides compressive stability

8. Associated Ligaments

• - Superior GH ligament
• - Coracohumeral ligament

9. Associated Organs

Fascial:

• - Supraspinous fascia
• - Superior shoulder capsule

Viscerosomatic:

• - C5–C6

TCM:

• - Small Intestine meridian

VM:

• - Scapular fascial tension influencing supraspinatus tone

Infraspinatus

1. Neurological & Functional Insights

• - Primary external rotator of the GH joint.
• - Provides strong posterior stability against anterior translation.
• - Works synergistically with teres minor for overhead control.

2. Clinical Relevance

• - Inhibited in anterior shoulder pain and impingement.
• - Critical for deceleration phase in throwing.
• - Weakness increases anterior glide risk.

3. Origin

• - Infraspinous fossa

4. Insertion

• - Middle facet of greater tubercle

5. Innervation

• - Suprascapular nerve (C5–C6)

6. Actions – Open Kinetic Chain (OKC)

• - External rotation
• - Horizontal abduction

7. Actions – Closed Kinetic Chain (CKC)

• - Posterior humeral stabilization under load

8. Associated Ligaments

• - Posterior GH capsule

9. Associated Organs

Fascial:

• - Posterior scapular fascia

Viscerosomatic:

• - C5–C6

TCM:

• - Small Intestine meridian

VM:

• - Posterior shoulder fascial restrictions

Teres Minor

1. Neurological & Functional Insights

• - Works with infraspinatus to provide external rotation.
• - Key posterior stabilizer preventing anterior glide.
• - Important for fine-tuning humeral head centering.

2. Clinical Relevance

• - Weak in overhead athletes; often overloaded with IR dominance.
• - Supports late-cocking and deceleration phases.
• - Essential for posterior cuff balance.

3. Origin

• - Lateral border of scapula

4. Insertion

• - Inferior facet of greater tubercle

5. Innervation

• - Axillary nerve (C5–C6)

6. Actions – Open Kinetic Chain (OKC)

• - External rotation
• - Adduction support

7. Actions – Closed Kinetic Chain (CKC)

• - Posterior stabilization under load

8. Associated Ligaments

• - Posterior GH capsule

9. Associated Organs

Fascial:

• - Posterior scapular fascia

Viscerosomatic:

• - C5–C6

TCM:

• - Small Intestine meridian

VM:

• - Posterior cuff fascial tension patterns

Subscapularis

1. Neurological & Functional Insights

• - Primary internal rotator and anterior stabilizer of GH joint.
• - Resists anterior humeral translation in vulnerable positions.
• - Contributes heavily to joint compression and centering.

2. Clinical Relevance

• - Dysfunction contributes to anterior instability.
• - Large contributor to internal rotation deficits.
• - Commonly overloaded in throwers and swimmers.

3. Origin

• - Subscapular fossa

4. Insertion

• - Lesser tubercle of humerus

5. Innervation

• - Upper & lower subscapular nerves (C5–C7)

6. Actions – Open Kinetic Chain (OKC)

• - Internal rotation
• - Adduction
• - Extension in certain angles

7. Actions – Closed Kinetic Chain (CKC)

• - Anterior joint stability during loading

8. Associated Ligaments

• - Anterior GH capsule
• - Coracohumeral ligament

9. Associated Organs

Fascial:

• - Anterior shoulder capsule

Viscerosomatic:

• - C5–C7

TCM:

• - Heart / Pericardium region association

VM:

• - Anterior capsule fascial restrictions

Deltoid (Anterior / Middle / Posterior)

1. Neurological & Functional Insights

• - Primary power muscle for GH elevation.
• - Three heads allow multi‑plane movement control.
• - Works synergistically with rotator cuff to maintain humeral head centering.

2. Clinical Relevance

• - Overactivity without cuff balance increases superior humeral migration.
• - Important in restoring functional overhead mechanics.
• - Posterior fibers crucial for deceleration and posture.

3. Origin

• - Lateral clavicle
• - Acromion
• - Spine of scapula

4. Insertion

• - Deltoid tuberosity

5. Innervation

• - Axillary nerve (C5–C6)

6. Actions – Open Kinetic Chain (OKC)

• - Anterior: flexion, IR, horizontal adduction
• - Middle: abduction
• - Posterior: extension, ER, horizontal abduction

7. Actions – Closed Kinetic Chain (CKC)

• - Stabilizes humerus against trunk during pushing or pulling

8. Associated Ligaments

• - Acromioclavicular capsule
• - Coracoacromial arch

9. Associated Organs

Fascial:

• - Deltoid fascia
• - Brachial fascia

Viscerosomatic:

• - C5–C6

TCM:

• - Large Intestine meridian pathway region

VM:

• - Shoulder girdle fascial tension affecting deltoid recruitment

Pectoralis Major

1. Neurological & Functional Insights

• - Powerful adductor and internal rotator contributing to anterior shoulder stability.
• - Strong influence on thoracic posture and rib mechanics.
• - Provides dynamic control during pushing and horizontal actions.

2. Clinical Relevance

• - Shortening contributes to rounded shoulders and anterior humeral glide.
• - Overactivation common in pushing-dominant athletes.
• - Important for restoring scapulohumeral balance.

3. Origin

• - Clavicular head: medial clavicle
• - Sternal head: sternum & costal cartilages 1–6

4. Insertion

• - Lateral lip of bicipital groove

5. Innervation

• - Medial & lateral pectoral nerves (C5–T1)

6. Actions – Open Kinetic Chain (OKC)

• - Adduction
• - Horizontal adduction
• - Internal rotation
• - Flexion (clavicular fibers)
• - Extension from flexed position (sternal fibers)

7. Actions – Closed Kinetic Chain (CKC)

• - Assists rib elevation in forced breathing
• - Stabilizes anterior thorax during pushing

8. Associated Ligaments

• - Anterior GH capsule
• - Sternocostal attachments

9. Associated Organs

Fascial:

• - Pectoral fascia
• - Anterior thoracic fascia

Viscerosomatic:

• - T1–T4

TCM:

• - Heart / Lung meridian region

VM:

• - Anterior chest wall tension altering GH mechanics

Latissimus Dorsi

1. Neurological & Functional Insights

• - Large posterior chain driver integrating spine, pelvis, and arm.
• - Contributes to humeral extension, adduction, and internal rotation.
• - Key link in cross-body myofascial slings.

2. Clinical Relevance

• - Tightness restricts overhead elevation.
• - Common contributor to anterior pelvic tilt and rib flare.
• - Important for high-force pulling and trunk-shoulder coupling.

3. Origin

• - Spinous processes T7–L5
• - Thoracolumbar fascia
• - Iliac crest
• - Inferior ribs

4. Insertion

• - Floor of bicipital groove

5. Innervation

• - Thoracodorsal nerve (C6–C8)

6. Actions – Open Kinetic Chain (OKC)

• - Extension
• - Adduction
• - Internal rotation

7. Actions – Closed Kinetic Chain (CKC)

• - Trunk elevation (crutch gait, transfers)
• - Posterior chain stabilization

8. Associated Ligaments

• - Thoracolumbar fascia connections

9. Associated Organs

Fascial:

• - Posterior thoracolumbar fascia

Viscerosomatic:

• - T6–T9

TCM:

• - Bladder meridian region

VM:

• - Diaphragmatic and visceral drag altering lat recruitment

Teres Major

1. Neurological & Functional Insights

• - Acts as ‘lat’s little helper’ in IR, adduction, and extension.
• - Important for humeral control in midrange pulling.
• - Resists anterior humeral translation.

2. Clinical Relevance

• - Overactivity seen in IR-dominant patterns.
• - Important for strengthening in posterior chain deficits.
• - Can restrict overhead ROM when shortened.

3. Origin

• - Inferior angle of scapula

4. Insertion

• - Medial lip of bicipital groove

5. Innervation

• - Lower subscapular nerve (C5–C6)

6. Actions – Open Kinetic Chain (OKC)

• - Internal rotation
• - Adduction
• - Extension

7. Actions – Closed Kinetic Chain (CKC)

• - Posterior humeral stability during pulling

8. Associated Ligaments

• - Posterior GH capsule

9. Associated Organs

Fascial:

• - Posterior scapular fascia

Viscerosomatic:

• - C5–C6

TCM:

• - Small Intestine meridian region

VM:

• - Posterior shoulder fascial tension interacting with teres major

Coracobrachialis

1. Neurological & Functional Insights

• - Provides anterior GH stability, especially in midrange.
• - Synergist with biceps short head for flexion and adduction.
• - Contributes to humeral head positioning during forward reach.

2. Clinical Relevance

• - Tightness can cause anterior humeral glide.
• - Underrecognized contributor to shoulder pain patterns.
• - Important stabilizer in pushing and horizontal tasks.

3. Origin

• - Coracoid process

4. Insertion

• - Medial humeral shaft

5. Innervation

• - Musculocutaneous nerve (C5–C7)

6. Actions – Open Kinetic Chain (OKC)

• - Flexion
• - Adduction

7. Actions – Closed Kinetic Chain (CKC)

• - Anterior shoulder stability during reaching

8. Associated Ligaments

• - Coracohumeral ligament

9. Associated Organs

Fascial:

• - Coracoid / clavipectoral fascia

Viscerosomatic:

• - C5–C7

TCM:

• - Lung / Heart region

VM:

• - Anterior shoulder fascial tension influencing coracoid cluster

Biceps Brachii (Long & Short Head)

1. Neurological & Functional Insights

• - Long head stabilizes humeral head superiorly.
• - Short head connects scapula to forearm, integrating elbow & shoulder.
• - Important proprioceptive contributor to anterior GH mechanics.

2. Clinical Relevance

• - Overload common in overhead athletes.
• - Long head tendinopathy contributes to anterior shoulder pain.
• - Important for stabilizing during deceleration.

3. Origin

• - Long head: supraglenoid tubercle
• - Short head: coracoid process

4. Insertion

• - Radial tuberosity
• - Bicipital aponeurosis

5. Innervation

• - Musculocutaneous nerve (C5–C6)

6. Actions – Open Kinetic Chain (OKC)

• - Flexion of shoulder
• - Elbow flexion
• - Supination

7. Actions – Closed Kinetic Chain (CKC)

• - Anterior GH stability under load

8. Associated Ligaments

• - Bicipital pulley complex

9. Associated Organs

Fascial:

• - Bicipital sheath

Viscerosomatic:

• - C5–C6

TCM:

• - Lung meridian region

VM:

• - Bicipital groove fascial drag influencing LH tension

Triceps Brachii (Long Head)

1. Neurological & Functional Insights

• - Contributes to posterior GH stability.
• - Assists in extension and adduction from hyperflexed positions.
• - Links scapula to elbow, integrating arm extension mechanics.

2. Clinical Relevance

• - Important stabilizer during closed-chain upper limb tasks.
• - Overload common in weightlifting and throwing.
• - Helps resist superior humeral translation.

3. Origin

• - Infraglenoid tubercle

4. Insertion

• - Olecranon process

5. Innervation

• - Radial nerve (C6–C8)

6. Actions – Open Kinetic Chain (OKC)

• - Shoulder extension
• - Adduction
• - Elbow extension

7. Actions – Closed Kinetic Chain (CKC)

• - Posterior humeral stability during load

8. Associated Ligaments

• - Posterior GH capsule

9. Associated Organs

Fascial:

• - Posterior shoulder fascia

Viscerosomatic:

• - C7–C8

TCM:

• - Small Intestine meridian region

VM:

• - Triceps fascial continuity affecting posterior GH control

MASTER REFERENCES – Glenohumeral Module

- Gray’s Anatomy: The Anatomical Basis of Clinical Practice, Elsevier.

- Atlas of Human Anatomy – Frank H. Netter, Elsevier.

- Kendall FP et al. Muscles: Testing and Function with Posture and Pain.

- Neumann DA. Kinesiology of the Musculoskeletal System.

- Blumenfeld H. Neuroanatomy Through Clinical Cases.

- Barral JP. Visceral Manipulation Volumes 1–2.

- Deadman P. A Manual of Acupuncture.

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