Is there a relation between loss of shoulder external rotation and sternoclavicular joint disorders?

Main Article Content

Francesco Pisanu
Vincenzo Verderosa
Stefano Perego
Rosario Cutaia
Corrado Ciatti
Andrea Fabio Manunta
Carlo Doria


Sternoclavicular joint, shoulder instability repair, shoulder kinematics, scapulothoracic movements, scapulohumeral rhythm


Background and aim: Scapulothoracic movements are essential in shoulder kinematics and can partially compensate  stiffness and loss of motion of glenohumeral joint. The scapulothoracic movement is strictly dependent on the translation and rotation of the clavicle at the sternoclavicular joint (SCJ), this being the only true joint between the axial and the upper appendicular skeleton. 

Aim of the study is to define a possible correlation between loss of shoulder external rotation following surgery for anterior shoulder instability and long-term sternoclavicular joint disorders. Methods: A group of 20 patients and a group of 20 healthy volunteers were studied. 

Results: In the statistical analysis of the patient group and of the two groups jointly, the association between the reduction of shoulder external rotation and the onset of disorder of SCJ appeared statistically significant.

Conclusions: Our results provide support for an association between some disorders of the SCJ and the alterations of the shoulder kinematics associated with a reduction of  ROM in external rotation. Our sample is too small to allow definitive conclusions to be drawn. These results, if confirmed by larger studies, could help us further clarify the complex kinematics of the shoulder girdle.


Download data is not yet available.
Abstract 90 | PDF Downloads 58


Richard W Kang , Rachel M Frank, Shane J Nho, Neil S Ghodadra, Nikhil N Verma, Anthony A Romeo, et al. Complications associated with anterior shoulder instability repair. Arthroscopy. 2009 Aug;25(8):909-20.
Fabbriciani, M. G. Arthroscopic Versus Open Treatment of Bankart Lesion of the Shoulder: A Prospective Randomized Study. Arthroscopy: The Journal of Arthroscopic and Related Surgery , 456-462. 2004
Lefèvre-Colau MM, Nguyen C, Palazzo C, et al. Recent advances in kinematics of the shoulder complex in healthy people. Ann Phys Rehabil Med. 2018;61(1)
Roren A, Lefevre Colau MM, Poiraudeau S, Fayad F, Pasqui V, Roby-Brami A. A new description of scapulothoracic motion during arm movements in healthy subjects. Man Ther 2015; 20:46-55
Lefèvre-Colau MM, Nguyen C, Palazzo C, Srour F, Paris G, Vuillemin V, et al. Kinematic patterns in normal and degenerative shoulders. Part II: Review of 3-D scapular kinematic patterns in patients with shoulder pain, and clinical implications. Ann Phys Rehabil Med. 2018 Jan;61(1):46-53. doi: 10.1016/
Frosi, G. Reumatismo. The sterno-clavicular joint: anatomy, biomechanic, clinical features and aspect of manual therapy. 2004, pp. 82-80.
Rowe CR, Patel D, Southmayd W: The Bankart procedure. A long-term end-result study. J Bone Joint Surg 60A: 1-16, 1978
Romeo, A. A., Bach, B. R., & O’Halloran, K. L. (1996). Scoring Systems for Shoulder Conditions. The American Journal of Sports Medicine, 24(4), 472–476
Reider , Esame obiettivo in ortopedia. Spalla e braccio. Verduci editore, 2001.
Kapandji, A.I. Complesso articolare della spalla. Anatomia funzionale. s.l. : Monduzzi, 2011.
Kibler, W.B., Sciascia, A. Evaluation and Management of Scapular Dyskinesis in Overhead Athletes. Curr Rev Musculoskelet Med 12, 515–526 (2019).
Astin M., Sternoclavicular Joint Dislocations: Diagnosis and Treatment. Aliem Jul, 2014
Werner, B.C. Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application. J. Shoulder Elbow Surg. 2014.
Ludewig PM, Cook TM. The effect of head position on scapular orientation and muscle activity during shoulder elevation. J Occup Rehabil. 1996 Sep; 6(3):147-58.
Ludewig PM, Cook TM, Nawoczenski DA Three-dimensional scapular orientation and muscle activity at selected positions of humeral elevation. J Orthop Sports Phys Ther. 1996.
Meskers CG, Vermeulen HM, de Groot JH, van Der Helm FC, Rozing PM. 3D shoulder position measurements using a six-degree-of-freedom electromagnetic tracking device. Clin Biomech (Bristol, Avon). 1998 Jun;13(4-5):280-292
Meskers CG, van der Helm FC, Rozendaal LA, Rozing PM.In vivo estimation of the glenohumeral joint rotation center from scapular bony landmarks by linear regression. J Biomech. 1998 Jan;31(1):93-6.
Lawrence RL, Braman JP, Laprade RF, Ludewig PM .Comparison of 3 dimensional shoulder complex kinematics in individuals with and without shoulder pain, part 1: sternoclavicular, acromioclavicular, and scapulothoracic joints. J Orthop Sports Phys Ther. 2014 Sep;44(9):636-45,
Lawrence RL, Braman JP, Staker JL, Laprade RF, Ludewig PM. Comparison of 3 dimensional shoulder complex kinematics in individuals with and without shoulder pain, part 2: glenohumeral joint.J Orthop Sports Phys Ther. 2014 Sep;44(9):646-55.
Johnson GR, Anderson JM. Measurement of three-dimensional shoulder movement by an electromagnetic sensor. Clin Biomech (Bristol, Avon). 1990 Aug;5(3):131-6. doi: 10.1016/0268-0033(90)90015-X. PMID: 23916215.
Caggiari G, Ciurlia E, Ortu S, Sirianni R, Bonini L, Pisanu F, et al. Osteochondral avulsion fracture of the posteromedial tibial plateau. Trauma Case Rep. 2020 Jan 8;25:100281. doi: 10.1016/j.tcr.2020.100281.
Inman VT, Saunders JB, Abbott LC. Observations of the function of the shoulder joint. 1944. Clin Orthop Relat Res. 1996 Sep;(330):3-12.
Babyar SR. Excessive scapular motion in individuals recovering from painful and stiff shoulders: causes and treatment strategies. Phys Ther. 1996 Mar;76(3):226-38.
Lukasiewicz AC, McClure P, Michener L, Pratt N, Sennett B. Comparison of 3-dimensional scapular position and orientation between subjects with and without shoulder impingement. J Orthop Sports Phys Ther. 1999 Oct;29(10):574-83.
Conway AM. Movements at the sternoclavicular and acromioclavicular joints. Phys Ther Rev. 1961 Jun;41:421-32
McClure PW, Michener LA, Sennett BJ, Karduna AR Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo.J Shoulder Elbow Surg. 2001.
Van Der Helm FC, Pronk GM.Three-dimensional recording and description of motions of the shoulder mechanism. J Biomech Eng. 1995 Feb;117(1):27-40.
Ludewig PM, Behrens SA, Meyer SM, Spoden SM, Wilson LA. Three-dimensional clavicular motion during arm elevation: reliability and descriptive data. J Orthop Sports Phys Ther. 2004 Mar;34(3):140-9.
Dvir Z, Berme N. The shoulder complex in elevation of the arm: a mechanism approach. J Biomech. 1978;11(5):219-25.
Teece RM, Lunden JB, Lloyd AS, Kaiser AP, Cieminski CJ, Ludewig PM.Three-dimensional acromioclavicular joint motions during elevation of the arm. J Orthop Sports Phys Ther. 2008 Apr;38(4):181-90.

Most read articles by the same author(s)

1 2 > >>