Mechanical Properties of the Shoulder Ligaments under Dynamic Loading

Finite element study of the biomechanical effects on the rotator cuff under load

Rotator cuff injuries account for 50% of shoulder disorders that can cause shoulder pain and reduced mobility. The occurrence of rotator cuff injury is related to the variation in shoulder load, but the mechanical changes in the rotator cuff caused by load remain unclear. Therefore, the mechanical results of the rotator cuff tissue during glenohumeral abduction and adduction were analyzed based on a finite element shoulder model under non-load (0 kg) and load (7.5 kg) conditions. The results showed that the maximum von Mises stress on the supraspinatus muscle was larger than that on the subscapularis, infraspinatus, and teres minor muscles during glenohumeral abduction. Compared with the non-load condition, the maximum von Mises stress on the supraspinatus muscle increased by 75% under the load condition at 30° abduction. Under the load condition, the supraspinatus joint side exhibited an average stress that was 32% greater than that observed on the bursal side. The von Mises stress on the infraspinatus muscle was higher than that in other rotator cuff tissues during adduction. The stress on the infraspinatus muscle increased by 36% in the load condition compared to the non-load condition at 30° adduction. In summary, the increased load changed the mechanical distribution of rotator cuff tissue and increased the stress differential between the joint aspect and the bursal aspect of the supraspinatus tendon.

Shoulder function: the perfect compromise between mobility and stability

Shoulder function is a compromise between mobility and stability. Its large mobility is based on the structure of the glenohumeral joint and simultaneous motion of all segments of the shoulder girdle. This requires fine-tuned muscle coordination. Given the joint's mobility, stability is mainly based on active muscle control with only a minor role for the glenohumeral capsule, labrum and ligaments. In this review factors influencing stability and mobility and their consequences for strength are discussed, with special attention to the effects of morphology, muscle function and sensory information.

Shoulder injury and response due to lateral glenohumeral joint impact: an analysis of combined data

To date, several lateral impact studies (Bolte et al., 2000, 2003, Marth, 2002 and Compigne et al., 2004) have been performed on the shoulder to determine the response characteristics and injury threshold of the shoulder complex. Our understanding of the biomechanical response and injury tolerance of the shoulder would be improved if the results of these tests were combined. From a larger data base shoulder injury tolerance criteria can be developed as well as corridors for side impact dummies. Data from the study by Marth (2002, 12 tests) was combined with data from the previous studies. Twenty-two low speed tests (4.5 +/- 0.7 m/s) and 9 high speed tests (6.7 +/- 0.7 m/s) were selected from the combined data for developing corridors. Shoulder force, deflection and T1y acceleration corridors were developed using a minimization of cumulative variance technique. The reduction in impact speed and the addition of padding reduced the magnitude and increased the time to peak of shoulder forces and T1y accelerations. Logistic analyses were performed on the combined data sets to determine the best predictors of MAIS-2 shoulder injuries. Maximum normalized shoulder deflection and Cmax had p values of 0.0000 and were the best predictors of shoulder injuries. For the 50(th)-percentile male, a shoulder deflection of 40 mm and a Cmax of 20% corresponded to a 50 % risk of MAIS-2 shoulder injury. In linear regression analysis, maximum normalized medial scapula X acceleration and maximum normalized sternum X acceleration were best related with the shoulder deflection and confirmed the forward movement of the sternum and rearward movement of the scapula.