Veeger & van der Helm (2007) review the biomechanical basis of shoulder function, asking how the joint achieves the largest ROM of any human articulation while maintaining functional stability. The paper examines the contributions of joint morphology, muscle architecture, ligamentous restraints, and proprioceptive feedback across the SC, AC, and GH joints.
When a patient presents with shoulder instability or post-operative stiffness after capsulorrhaphy, remember that passive restraints (capsule, labrum, ligaments) stabilize only at end-range — midrange stability is entirely muscle-dependent.
This means rehabilitation must prioritize rotator cuff neuromuscular re-education, and over-tightening the capsule to gain stability will predictably sacrifice rotation and abduction (Gerber et al. Showed ~30° ER loss and ~20° abduction loss with just 1 cm of anterosuperior plication).
Veeger & van der Helm (2007) review the biomechanical basis of shoulder function, asking how the joint achieves the largest ROM of any human articulation while maintaining functional stability. The paper examines the contributions of joint morphology, muscle architecture, ligamentous restraints, and proprioceptive feedback across the SC, AC, and GH joints.
When a patient presents with shoulder instability or post-operative stiffness after capsulorrhaphy, remember that passive restraints (capsule, labrum, ligaments) stabilize only at end-range — midrange stability is entirely muscle-dependent.
This means rehabilitation must prioritize rotator cuff neuromuscular re-education, and over-tightening the capsule to gain stability will predictably sacrifice rotation and abduction (Gerber et al. Showed ~30° ER loss and ~20° abduction loss with just 1 cm of anterosuperior plication).