Gluteus

Gluteus

When you see a person walking or running, you usually observe the leg musculature, that the quadriceps are strong, that the calves have volume… In these cases, the great forgotten ones are always the gluteus muscles. They provide mobility and stability to the pelvis; in other words, without them there would be no movement.

In today’s entry, we want to make a good anatomical reminder of the three muscle bellies: major, medium and minor. And, of course, the pyramid and the deeper musculature. Also, the most frequent injuries, their kinesiology tape and some advice on how to improve them.

What are the gluteal muscles like?

The musculature of the gluteal area is very important in gait. Hence, the relevance of this detailed summary of its anatomy.

At a deeper level there is a group of muscles that are perhaps less well known. These are the inferior and superior calf, obturator externus and internus, quadratus cruris and pyramidalis. They are all primarily responsible for the external rotation of the hip, although they also interfere with other movements. In the world of sport, specifically for runners, the piriformis is well known; in the following sections we will talk about the piriformis syndrome.

Pyramidal

It has its origin in the pelvic surface of the sacrum, just in the sacral foramina 1 to 4, in the flange of the greater sciatic foramen and in the sacrotuberous ligament. Its insertion is at the upper edge of the greater trochanter. In other words, the piriformis runs from the sacrum to the hip.

Within the so-called glutei there are three: the lesser, middle and greater glutei, which will cover all those explained above.

Gluteus minimus

From the ilium (between the gluteal lines and the ridge of the greater sciatic notch) to the anterior border of the greater trochanter and the hip capsule. Its main action is abduction and internal rotation of the hip, as well as assisting in hip flexion.

Gluteus medius

From the ilium (between the gluteal lines and iliac crest) to the outer surface of the greater trochanter. Like the gluteus minimus, the main function is hip abduction. However, the anterior fibres assist in internal rotation and flexion of the hip; and the posterior fibres assist in external rotation and extension.

Gluteus maximus

From the posterolateral aspect of the sacrum and coccyx, gluteal aspect of the ilium, thoracolumbar fascia and sacrotuberous ligaments to the gluteal tuberosity of the femur (deep fibres) and iliotibial band (superficial fibres). Its action is hip extension and external rotation.

musculatura glúteos

What types of sports injuries occur in the gluteus?

Most sports injuries that are not related to a traumatic event have to do with weakness or increased tone of the musculature in question. The following section breaks down what happens to each muscle when one of these processes occurs.

  • Pyramidal
    • Weakness: modification of the gait, impairment of external rotation.
    • Contracture: PYRAMIDALIS SYNDROME. The shortening of the muscle causes compression of the sciatic nerve, triggering all its symptoms. It is one of the most frequent pathologies in sports involving prolonged walking (running, football, handball…).
  • Gluteus minimus
    • Weakness: the power of internal rotation and abduction of the hip decreases.
    • Contracture: the thigh will be found in abduction and internal rotation. When the patient is standing, the pelvis tilts laterally; it will be lower on the side that is contracted. It also causes internal rotation of the femur.
  • Gluteus medius
    • Weakness: characteristic limp (trunk shifts to the affected side when walking). Often weakness and sustained stretching of the adductors, as the leg is in abduction.
    • Contracture: deformation of abduction. In a standing position, the pelvis is tilted towards the affected side and the leg is slightly abducted.
  • Gluteus maximus
    • Weakness: When the weakness is bilateral, it is practically impossible for the patient to walk without crutches. If it only appears on one side, the patient has to use his hands to help him stand up straight.

How to perform kinesiology taping on the gluteus?

After all the analysis that has been done previously, first explaining the anatomy of each muscle and then expanding on what happens in case of weakness or contracture. Now, we are going to detail the two kinesiology tape that are most commonly used in the clinic. The first one to lower the tone of the pyramidal muscle and the second one to strengthen the gluteus medius.

Pyramidal kinesiology tape

Kinesiology tape to relax the pyramidal muscle. This muscle is overloaded in many injuries and can cause symptoms similar to sciatica. Prepare a Y-strip.

With the orientation described below, it acts on the monopodal support. If you want to influence the external rotation during walking (bipodal support), change the direction of the bandages.

How to apply the kinesiology tape for the piriformis muscle?

  • 1st Position of the patient: lateral decubitus. Anchor at 0% stretch on the greater trochanter.
  • 2nd Position of the patient: lateral decubitus, flexion, adduction and internal rotation of the hip. At 10% stretch, round the muscle belly to the sacrum.
  • 3rd Position of the patient: return the hip to neutral position. Anchor at 0% stretch to the sacrum.

In addition, it is very important to combine this bandage with a good stretching routine for the gluteal and pyramidal muscles, and posterior chain in general. Results will be achieved in a shorter period of time.

Gluteus medius kinesiology tape

Kinesiology tape to tone the gluteus medius muscle. This muscle is often weak and it is very important to strengthen it. Prepare a Y-strip.

How is the kinesiology tape for the gluteus medius muscle performed?

  • 1º Patient position: lateral decubitus. Anchor at 0% stretch on the medial part of the iliac creta.
  • 2nd Patient position: lateral decubitus, leg in adduction and hip flexion. With 10% stretch, go around the muscle belly up to the edge of the greater trochanter.
  • 3rd Position of the patient: return to the initial position of the leg. Anchor at 0% stretch past the trochanter.

In this case, it is indicated to combine the bandage with a strength training routine for the gluteus medius. Performing the exercise shown in the following image routinely at home; in addition, weight weights can be added to the ankles.

This article concludes the importance of the gluteal musculature, often and unfortunately forgotten. Stability and gait will depend to a large extent on their optimal condition. If you have similar problems, try to follow the advice given above. In addition, working these muscles is very important to improve most lumbar pathologies.

 

 

Made by the Technical Department of Calvo Izquierdo S.L.

 

 

How to cite this blog:

  • Calvo Izquierdo. BLOG: buttocks [Internet]. Calvo Izquierdo SL. 2024. Available at: https://calvoizquierdo.es/blog-gluteus/

Bibliography:

  • Kase, J. Wallis, T. Kase (2003) Clinical therapeutic applications of the kinesio taping method, 2nd edition.
  • Kase, K. (2003) Illustrated Kinesio Taping, 4th edition.
  • Selva, F. (2015) Neuromuscular Taping Manual of practical applications. Physi-Rehab-Kineterapy-Eivissa. 2nd edition.
  • Sijmonsma, J. (2007) Taping Neuro Muscular. Aneid Press, 1st Spanish edition.
  • Kendall’s (2007) Musculos, pruebas funcionales postura y dolor. Marbán. 5th edition.
  • Ruiz Jl, Alfonso I, Villalón J. (2008) Síndrome del músculo piramidal. Diagnosis and treatment. Presentation of 14 cases. Spanish Journal of Orthopaedic Surgery and Traumatology. 52:359-65
The rotator cuff

The rotator cuff

One of the major joints that cause pathology and consequently pain is the shoulder. This is due to its great mobility. Today, continuing with this joint, we are going to develop on the rotator cuff. If you need a refresher on the anatomy of the shoulder, it is recommended to refer to the previous entry entitled the shoulder and its instability.

According to a 2015 article by Macias and Perez-Ramirez, rotator cuff injuries are the leading cause of shoulder pain and functional disability.

What is the rotator cuff?

The rotator cuff is composed of four scapulohumeral muscles: supraspinatus, infraspinatus, teres minor and subscapularis. They serve as dynamic stabilisers of the joint, support the capsule to prevent excessive movement, and allow the joint to move. The greater tuberosity of the humerus serves as the insertion site for three muscles: supraspinatus, infraspinatus, and teres minor. The lesser tuberosity of the humerus serves as an insertion for the subscapularis muscle.

In terms of movement, they all perform the function of external rotation with the exception of the subscapularis muscle which assists in internal rotation.

dolor de hombro

What is the incidence of rotator cuff injuries?

We mentioned earlier that it is the shoulder injury par excellence, but it is also worth noting the high incidence in the population. 28% of people over 60 years of age have a complete tear, and this percentage even reaches 65% in people over 70 years of age. There is a 50% risk of bilateral ruptures in those over 60 years of age. 50% of subjects with an asymptomatic lesion of this type will develop symptoms within 3 years and 40% may develop progression.

What types of rotator cuff injuries occur?

Having seen that the incidence of injury is very high, it is necessary to classify the types of injury that can occur. The correct classification of the injury will determine whether the treatment will be appropriately adapted and good results will be achieved.

If injuries are classified according to the mechanism that causes them, they can be defined as follows:

  • Primary compression: Combined effect of extrinsic compression of the coracoacromial arch and tendon degeneration due to ageing. It is more frequent in people over 40 years of age.
  • Secondary compression: Secondary to anterior glenohumeral instability; occurs in young people.
  • Strain: Due to repeated microtrauma during the deceleration phase, which produces an eccentric overload on the cuff. Tears appear on the underside of the cuff and injuries to the biceps insertion-circumduct complex. It can occur in people who play sports or work with overhead arm movement.
  • Acute trauma: Following high-energy trauma or contact sports. The most common mechanism is forced adduction and active abduction against resistance.

Once the origin of the injury is known, it is important to know the type; there are various rotator cuff injuries, the main ones being partial and complete tears. Different differential diagnoses should always be considered, from tears to tendinopathies, bursitis, osteoarthrosis, adhesive capsulitis, among others.

How to diagnose rotator cuff injuries?

As with most injuries, diagnosis begins with a good anamnesis, physical examination and specific tests. In physiotherapy, the most frequently used tests are:

  • Upper Apley manoeuvre: assesses the entire rotator cuff.
  • Job’s manoeuvre: assesses the supraspinatus muscle.
  • Posterior elbow flexion test: assesses the subscapularis muscle.
  • Impingement test: assesses an impingement of the subscapularis tendon.

Subsequent medical tests are performed to confirm clinical suspicion. The most common tests include X-ray (to check the bony arrangement of the joint), ultrasound and MRI (to obtain soft tissue information).

What is the treatment for rotator cuff syndrome?

The treatment chosen depends on several factors such as the mechanism, type of injury and the involvement of other structures. As with most pathologies, there are two main types: surgical and conservative; both of which may or may not be accompanied by pharmacological support.

However, a conservative approach is recommended as the initial treatment modality for rotator cuff injuries. Physiotherapy is less prone to complications and less expensive than surgery, and one type has not been scientifically proven to have better results than the other. Therefore, the process will be started in most mild to medium cases with conservative treatment and, if unsuccessful, surgery.

  • Surgical treatment

Indicated when the soft tissue injury is massive and involves a complete tear of the muscle or tendon or is associated with a process in which the circulation adjacent to the shoulder is affected.

  • Conservative treatment

Processes with little soft tissue injury such as shoulder impingement or instability, or in chronic non-traumatic tears or where there is a contraindication to surgical treatment.
It is initially based on rest, modification of physical activity and work, avoiding shoulder flexion of more than 90 degrees, and then rehabilitation to recover and increase movement. Then a programme of rotator cuff strengthening and scapular stability should be initiated. Simultaneous to this, passive stretcher work to reduce symptomatology and support with kinesiology taping.

How to perform rotator cuff taping?

Supraspinatus kinesiology tape:

If we take into account the 4 muscles that form the cuff, the supraspinatus is the one that will be most affected. For this reason, a kinesiology tape application is described for it. In this case with a Y-technique around the muscle belly, but it can also be done with an I-technique at the same time.

Functional taping for shoulder tendinopathy:

Functional bandage for general musculotendinous problems of the shoulder, for clinical or sporting purposes. Adhesive elastic bandage is used for the proximal anchorage and the rest of the tape. It is interesting to use it in combination with kinesiology anterior application.

Kinesiology tape for a painful shoulder:

Kinesiology tape for a painful shoulder. It is a general application, it can be used for a frozen shoulder as well as for a global cuff injury. The important thing is to adapt it to the symptomatology and origin of the patient’s injury. In this example we are going to use a toning technique for the deltoid muscle (I+Y straps), together with a scapular support technique (Y-strap).

The importance and incidence of shoulder injuries leads to the conclusion that it is very difficult to escape from such an injury. As a patient, it is a priority to use the guidelines to avoid aggravating the injury and to go to the healthcare professionals for optimal treatment. As a health professional, it is essential to know the injury, its types and origin, to work in a multidisciplinary way and to achieve the patient’s improvement in the shortest possible time.

 

Made by the Technical Department of Calvo Izquierdo S.L.

 

 

 

How to cite this blog:

  • Calvo Izquierdo. BLOG: the rotator cuff [Internet]. Calvo Izquierdo SL. 2024. Available at: https://calvoizquierdo.es/blog-the-rotator-cuff/

Bibliography:

  • Jain N, Wilcox III R, Katz J, Higgins L. Clinical Examination of the Rotator Cuff. American Academy of Physical Medicine and Rehabilitation, Jan 2013; Vol. 5: p.45-56.
  • López Espinosa O, Pérez Solares A, Mejía Rohenes LC. Description of the most frequent type of rotator cuff injuries at the Hospital Regional General Ignacio Zaragoza. Revista de Especialidades Médico- Quirúrgicas 2008; 13(4): p.173-176.
  • Sánchez Sánchez F, Llinares Clausi, B. Cruz Gisbert J. Rotator cuff pathology in the work environment. University of Barcelona, Master’s Degree in Evaluative Medicine. Ed. 2006- 2007, p. 1-21.
  • Sánchez, Alepuz, Calero Ferrándiz, Carratalá Baixauli (2008). Updates in arthroscopic treatment of the rotator cuff. Servicio de Cirugía Ortopédica de Unión de Mutuas Unidad de Artroscopia Clínica Sanchez Alepuz. Valencia, Spain: CSA
  • Macías, SI. Pérez-Ramirez, LE. (2015) Eccentric strengthening in rotator cuff tendinopathies associated with subacromial impingement. Current evidence. Surgery and Surgeons. Vol 83; p. 74-80.
  • Kase, J. Wallis, T. Kase (2003) Clinical therapeutic applications of the kinesio taping method, 2nd edition.
  • Kase, K. (2003) Illustrated Kinesio Taping, 4th edition.
  • Selva, F. (2015) Neuromuscular Taping Manual of practical applications. Physi-Rehab-Kineterapy-Eivissa. 2nd edition.
  • Castillo, J. (2020) Bases y aplicaciones del vendaje neuromuscular. Formación Alcalá. 2nd edition.
  • Aguirre, T. Agirre, J. (2018) Vendaje neuromuscular kinesiotape en fisioterapia. Biocorp Europa. 1st edition.
  • Sijmonsma, J. (2007) Taping Neuro Muscular. Aneid Press, 1st Spanish edition.
  • Kendall’s (2007) Musculos, pruebas funcionales postura y dolor. Marbán. 5th edition.
  • Martínez, JL. Martínez, J. Fuster, I. (2006) Lesiones en el hombro y fisioterapia. Aran. 1st edition.
  • Oliveira, C. Navarro, R. Navarro, R. Ruiz, JA. Jimenez, JT. Brito, E. (2007) Biomechanics of the shoulder and its injuries. Canarias médica y quirúrgica. January-April 2007.
The large muscles of the arm

The large muscles of the arm

When talking about arm muscles, most people are familiar with the biceps and triceps. In this post we want to provide more information about the large muscles of the arm. Their anatomy, the functions they perform, exercises to improve them and kinesiology tape for their recovery.

What is the upper arm like?

The upper extremity consists of 5 regions: shoulder, arm, elbow, forearm and hand. Previous posts have dealt with injuries to the shoulder, elbow, forearm, hand and fingers. Today is the first time that the arm as such, i.e. the area extending from the elbow to the shoulder, is discussed.

It is very difficult, if not impossible, to separate the area of the arm from that of the shoulder, but we will try to do so. If more information is needed on the upper joint, it is recommended to refer to the shoulder joint and on the lower part to the elbow joint.

To describe the large muscles of the arm in a general way, it is simplified in that the bone that gives support is the humerus, as for the musculature there is the anterior or flexor compartment (biceps, coracobrachial and brachial) and the posterior or extensor compartment that only contains the triceps. At the nervous level, the brachial plexus remains responsible. As for the vascular bundle, branches of the axillary artery (humeral artery), deep brachial veins, basilic and cephalic vein.

ejercicio biceps

What is the biceps and what is its function?

It is a muscle that divides into two heads to fuse into a common central part. The long portion originates from the supraglenohyoid tubercle of the scapula, and the short portion from the apex of the coracoid process, both portions insert into the tuberosity of the radius and deep fascia of the forearm.

This muscle, the biceps can influence the movement of two joints, the elbow joint and the shoulder joint. The main function is elbow flexion, although it also participates in supination of the forearm; weak flexion of the shoulder, but the long portion also contributes to shoulder abduction and the short portion to adduction. Innervated by the musculocutaneous (C5-C6) and supplied by branches of the brachial artery.

How do you increase the muscle tone of the biceps?

One of the most frequent injuries to the biceps is an increase in tone, which can be due to excessive sporting practice or without good recovery, hypertonic work in the gym, repetitive physical work with elbow flexion movements with heavy weights, etc. Activities of this type will cause a disproportionate increase in the musculature, which will be associated with certain symptoms. Symptoms may include pain, reduced agility, slowness of movement, inability to extend the elbow and decreased strength caused by fatigue. In general, impairment in activities of daily living.

If muscle injuries of this type intensify, fibre ruptures and tendon damage can occur, tendinopathy of the long portion of the biceps is very common. In more severe conditions the tendon is ruptured and the treatment becomes surgical.

How to treat a biceps with increased muscle tone?

As it is a very recurrent injury, we want to provide guidelines for the improvement or cure of the symptoms. To this end, physiotherapy work in the clinic (dry needling, manual therapy, electrotherapy and massage therapy) will be combined with guidelines at home, including the use of stretching, as shown in the image below, together with kinesiology tape.

estiramiento

The following video describes a kinesiology tape technique to decrease biceps tone after overuse; with an unequal X technique, one short end to be used as an anchor and the other long end to be used as active straps.

What is the triceps and what is its function?

It is a muscle that divides into three heads and then fuses into a common body. Like the biceps, the long head of the triceps also originates from the scapula, specifically from the infraglenohyoid tubercle, but the medial and short head from the posterior aspect of the humerus. Both insert into a joint tendon on the ulnar olecranon and forearm fascia. The function at the elbow is extension of the forearm, and at the shoulder extension and adduction of the arm. Innervated by the radial nerve (C6-C8) and supplied by the deep brachial artery and superior ulnar collateral artery.

How does triceps muscle tone weaken?

Since the biceps has been treated with an increase in muscle tone, the triceps will undergo the opposite injury, muscle atrophy. So, based on these premises, the recommendations can be extrapolated to any muscle.

Generally, muscle weakness is caused (as long as there is no neurological involvement or any other serious cause) by a lack of muscle activation, by inactivity; it consists of muscle wasting, loss or reduction. In very extreme cases, sarcopenia can occur, i.e. an extreme loss of muscle mass that leaves the person unable to perform many activities of daily living.

The most common symptoms of weakness are decreased muscle size, decreased strength, decreased mobility, difficulty in lifting and moving things and, therefore, worsening quality of life.

How to treat a triceps with weak muscle tone?

Some recommendations for improving the triceps musculature are:

  • A rich and balanced diet (with a good protein intake).
  • Electrostimulation to gain muscle.
  • Strengthening exercises
fortalecimiento tríceps
fortalecimiento tríceps
fortalecimiento tríceps
  • Regular physical activity
  • Kinesiology taping for toning

 

Below is a video of the kinesiology tape technique for toning the triceps muscle. As with the biceps, an X-technique is used with the ends of one side short and the other long.

In conclusion, it can be concluded that in cases of increased muscle tone, whether it be for the biceps, as in today’s blog, or for any other muscle, the main guidelines for action will be to work with the physiotherapist, stretching exercises at home and kinesiology tape to relax the muscles. On the other hand, in cases where muscle tone needs to be gained, it is important to follow a balanced diet, sessions with the physiotherapist to start working with electrostimulation and to create a therapeutic exercise plan to gain muscle mass, which will then be carried out at home. In addition to doing sport and helping the whole process with kinesiology tape to help the contraction of the muscle or affected area.

In both cases it is important to act early to avoid aggravation of the injury and to avoid chronification of processes that can lead to more serious injuries for which a much more aggressive intervention will be necessary. Muscle problems cause difficulties in the patient’s day-to-day life, either due to excess or lack of tone, and a healthy lifestyle must be maintained to avoid this.

 

 

Carried out by the Technical Department of Calvo Izquierdo S.L.

How to cite this blog:

  • Calvo Izquierdo. BLOG: the great muscles of the arm [Internet]. Calvo Izquierdo SL. 2024. Available at: https://calvoizquierdo.es/blog-the-large-muscles-of-the-arm/

Bibliography:

  • Kase, J. Wallis, T. Kase (2003) Clinical therapeutic applications of the kinesio taping method, 2nd edition.
  • Kase, K. (2003) Illustrated Kinesio Taping, 4th edition.
  • Selva, F. (2015) Neuromuscular Taping Manual of practical applications. Physi-Rehab-Kineterapy-Eivissa. 2nd edition.
  • Buckup, K. Buckuo, J. (2012) Clinical tests for bone, joint and muscle pathology: scans, signs and symptoms. Elsevier Masson. 5th edition.
  • Sijmonsma, J. (2007) Taping Neuro Muscular. Aneid Press, 1st Spanish edition.
  • Kendall’s (2007) Muscles, functional tests, posture and pain. Marbán. 5th edition.
The shoulder and its instability

The shoulder and its instability

To give continuity to the applications of the upper limb, today’s post will deal with one of the most complex joints of the human body, the shoulder. As you will see below, there are so many structures that form part of this joint that it is so difficult to work with. A brief but useful anatomical summary will be given, and this time not only the muscular and bony part, but also the mobility. With your assessment you will be able to adapt the necessary bandage to help with each injury.

A multitude of injuries can be found in the shoulder, from fractures, through dislocations and subluxations, tendinopathies or other types of tendon injuries, muscle strains, bursitis, more specific injuries such as frozen shoulder, compression syndrome, capsulitis, slap injury and a long etcetera. It will therefore be a frequent cause of sessions at the physiotherapist.

dolor de hombro

What bones and joints make up the shoulder?

The shoulder is made up of 3 bones: the scapula, the humerus and the clavicle.

The joints that make up the shoulder are roughly 5:

  1. Glenohumeral: formed by the head of the humerus and the cavity where it is housed (glenoid cavity). It allows movement in the three planes (flexion/extension, abduction/adduction and rotations) and provides stability.
  2. Scapulothoracic: this is not a joint as such, but is described as an area of movement between the scapula and the posterior and lateral part of the thorax. It is essential for quality and range of motion.
  3. Sternoclavicular: junction of the sternum with both clavicles. This joint is responsible for providing mobility in all shoulder movements between 0 and 90º.
  4. Acromioclavicular: where the acromion (part of the scapula located superiorly and externally) articulates with the lateral part of the scapula.
  5. Subdeltoid: false joint as such at the bony level, but biomechanically it acts by sliding between the humeral head covered by the supraspinatus and the deltoid muscle. It only acts in flexion and abduction of the shoulder.

What muscles form the shoulder?

According to the bibliography there are many ways of classifying the muscles that form part of the shoulder, whether they are superficial or deep, whether they are reinforcing or articular, located on the anterior or posterior face, whether they are palpated on the arm, on the scapula… In today’s post we have decided not to classify the muscles, we are only going to list them and then further on. Each function will then be related to the group of muscles necessary to carry it out.

Therefore, the shoulder muscles are: deltoid, teres major, teres minor, subscapularis, supraspinatus, infraspinatus, coracobrachialis, biceps, brachialis anterior, triceps, latissimus dorsi, subclavian, serratus major, trapezius, angularis, rhomboid minor and rhomboid major.

What are the movements of the shoulder?

The shoulder is the most mobile joint in our body, but this quality, which might seem positive, becomes negative because it creates instability. This instability always or almost always manifests itself in the form of pain and functional disability. To understand shoulder pathology, it is necessary to know beforehand how the shoulder moves and which muscles are involved in each movement.

The shoulder has movements in all 3 planes of space. It has flexion, extension, adduction, abduction, internal and external rotation, and circumduction. This movement combines consecutively the movements of flexion, abduction, extension and adduction.

To understand the real mobility of the shoulder, one has to think of the shoulder with the attachment of the scapula, one movement is associated with the other. A small reminder will be made in the form of a table (according to Kendall’s) of which muscles are involved in each movement.

tabla movimientos del hombro

The internal rotators are the muscles with the greatest volume and strength and are involved in most day-to-day actions. Most of them are located on the anterior aspect of the shoulder and the most relevant are the pectoralis major, anterior deltoid and subscapularis.

How do you tape for shoulder stability?

If you take into account all the previous theory that has been shown, you could choose a huge number of injuries and then make a taping from there. However, it is a good option to make a shoulder stability application and thus generally address a symptomatology.

In the following, we will describe a neuromuscular taping for shoulder instability, specifically for an anterior shoulder instability. These symptoms can appear due to several processes, some of them can be dislocation or subluxation of the humeral head to anterior, an imbalance of the musculature with predominance of the anterior, Bankart injury (tearing of the labrum and glenohumeral ligaments), laxity of the ligaments, tendon rupture, forced and extreme movements of the shoulder (throwing sports or swimming)… in conclusion, a generic bandage that could be used for many pathologies.

Kinesiology tape for Shoulder Stability

In the following video you can see all the steps and check the position of the patient to perform a kinesiology tape. Prior to the technique, two I-strips are measured from the pectoralis major to the scapula. The bandage is cut, the edges are rounded and the patient’s skin is prepared. The patient should be in a sitting or standing position, with the shoulder in neutral position and the elbow extended.

Functional taping for shoulder stability

In the event that the patient needs more stability because the shoulder is not yet functional, or in the event of a sports competition (in which the injury must be avoided and the joint fixed), a functional bandage will be applied. It can be performed alone as shown in the following video or combined with the one described above.

It is advisable in case of inflammation or sensitivity on the part of the patient to place a foam block over the acromioclavicular joint to protect it and provide comfort to the patient.

After collecting a lot of information about the shoulder that you want to be useful and showing some of the most commonly used bandages for instability. It is important to remember that both are standard bandages, the important thing is to know the function of the bandage and to adapt it to the patient’s injury. In this case there are many possible adaptations, such as, for example, making a kinesiology tape to some musculature and adding the functional tape on top, or combining two kinesiology tapes, one for muscular application and the other for instability, reinforcing the functional bandage with more tape or using a kinesiology star instead of foam…an endless number of combinations, the important thing is to listen to the patient, know the anatomy and physiology of their body and provide a solution to their injury.

 

 

Carried out by the Technical Department of Calvo Izquierdo S.L.

 

 

How to cite this blog:

  • Calvo Izquierdo. BLOG: The shoulder and its instability [Internet]. Calvo Izquierdo SL. 2023. Available at: https://calvoizquierdo.es/blog-the-shoulder-and-its-instability/

Bibliography:

  • Kase, J. Wallis, T. Kase (2003) Clinical therapeutic applications of the kinesio taping method, 2nd edition.
  • Bové, A. (2000) El vendaje funcional . Harcourt. 3rd edition.
  • Selva, F. (2015) Neuromuscular Taping Manual of practical applications. Physi-Rehab-Kineterapy-Eivissa. 2nd edition.
  • Castillo, J. (2020) Bases y aplicaciones del vendaje neuromuscular. Formación Alcalá. 2nd edition.
  • Aguirre, T. Agirre, J. (2018) Vendaje neuromuscular kinesiotape en fisioterapia. Biocorp Europa. 1st edition.
  • Sijmonsma, J. (2007) Taping Neuro Muscular. Aneid Press, 1st Spanish edition.
  • Kendall’s (2007) Musculos, pruebas funcionales postura y dolor. Marbán. 5th edition.
  • Martínez, JL. Martínez, J. Fuster, I. (2006) Lesiones en el hombro y fisioterapia. Aran. 1st edition.
  • Oliveira, C. Navarro, R. Navarro, R. Ruiz, JA. Jimenez, JT. Brito, E. (2007) Biomechanics of the shoulder and its injuries. Canarias médica y quirúrgica. January-April 2007.
Deltoid

Deltoid

The previous blog post recalled all the anatomy of the shoulder as a general summary, if you need to read it again before addressing today’s topic do not hesitate to go to the article “The shoulder and its instability”. Now we leave the general overview of this joint and deal with the muscular plane, specifically the superficial one, the deltoid muscle. This muscle is the cause of pain due to overuse and is involved in most sports.

What does the deltoid muscle look like?

The deltoid muscle is divided into three main groups of fibres: the anterior, middle and posterior fibres. They all insert into the deltoid tuberosity of the humerus (creating the deltoid V) and the difference is in their origin. Anterior fibres are on the anterior border, anterior surface and lateral third of the clavicle. The medial fibres on the lateral border and upper surface of the acromion. Posterior fibres are on the inferior border of the posterior border of the spine of the scapula.

The main action of this muscle is abduction of the shoulder joint, performed mainly by the medial fibres, with stabilisation of the anterior and posterior fibres. In addition, the anterior fibres flex and, in the supine position, internally rotate the shoulder. In contrast, the posterior fibres extend and, in the prone position, externally rotate.

Innervation is provided by the axillary nerve (C5-C6).

ejercicio deltoides

What injuries does the deltoid have?

The injury par excellence of the deltoid muscle is due to overuse, mainly caused by sports practice but also by work that involves repeated use of the shoulder in abduction, i.e. opening the arms. Injury to the deltoid can also be caused by sudden strain following a major effort or accident. Other causes are associated with other pathologies, such as bursitis, rheumatoid arthritis, fibrillar ruptures of adjacent muscles…

When this muscle is injured, the patient usually has pain or tenderness in the anterior, middle and/or posterior part of the shoulder, especially when abducting the arm. The muscle can go from overload to fibrillar rupture and bruising will appear, so the symptoms range from mild muscle tension to intense, restrictive and limiting pain. Taking into account the intensity of the injury and the patient’s pain tolerance level, this injury sometimes makes arm mobility difficult, even decreasing the articular range of the shoulder.

How to prevent deltoid injuries?

As with all muscle injuries, it is necessary to analyse whether the movement pattern is correct. If this is the case, the intensity and duration of sports training or activities that cause pain should be reduced. If the pattern is incorrect, muscle activity should be re-educated and rebalanced to achieve optimal work.

Preventive work in sport is to respect all the stages, to carry out a good warm-up, a sporting activity that never leads to pain and a much-needed return to calm. In addition, the rest times between sessions must be controlled. This routine is indicated for sport but it is important not to forget that if a person works lifting objects in a warehouse and moving them from one place to another, their work becomes a sport as it requires a high muscular load, they should also warm up and cool down.

Tips to avoid deltoid injury

  • Stretching: bring the arm into adduction until you feel the stretch in the deltoid area, hold the position for one minute. Repeat the exercise by bringing the arm back until you feel stretching in the anterior fibres.
  • Self-massage with percussive therapy gun.
  • Pressure technique (Jones inhibition technique):
    • Locate the point of pain.
    • Press the point and increase the pressure progressively until localised pain appears and in other areas.
    • Maintaining the pressure, mobilise the joint throughout the range until the pain disappears (neurological silence).
    • In this pain-free position, maintain the pressure for 90 seconds.
    • Slowly remove the pressure and return the joint to its natural position. 
  • Apply ice after intense activity for 10 minutes (never in direct contact with the skin).

What is the treatment for deltoid pain?

Many people are in the habit of waiting too long before seeing a healthcare professional because they think that the pain will go away on its own. This is a serious mistake because many complaints can be solved in mild degrees and chronicity can be avoided.

At the deltoid level, medical treatment is protocolised as relative rest, use of ice and anti-inflammatory and muscle relaxant drugs depending on the patient’s symptoms.

Simultaneously, physiotherapy treatment based on techniques to reduce pain, restore normal muscle tone and recover function must be carried out. To achieve this, manual work on the damaged and accessory musculature, the use of electrotherapy, joint techniques to restore shoulder mobility, dry needling to eliminate trigger points, kinesiology tape to aid recovery and therapeutic exercises to restore muscle strength are used.

How to perform kinesiology tape of the deltoid?

To help the muscle to function correctly, either at the beginning of the injury to reduce the symptoms or to improve sports practice, a kinesiology tape is applied to the 3 beams.

One consideration prior to the technique would be to decide on the shape of the bandage. If the patient is large, 3 I-bands will be used, if the patient is a standard size, a Y-bandage and an I-bandage, and, finally, if the patient is very small or a child, 3 I-bands will be used, but of lesser thickness. The second option will be described here, but in the case of another type of patient, only minor adaptations will be necessary.

Shoulder pain is very common, whether it is caused by work, daily life or sporting activities, it is likely to appear at some point in a person’s life. The muscle to which we are going to refer this pain at first is the deltoid muscle because it covers the entire surface of the shoulder. As it is the outermost layer, it is the one that will have the first contact, a reflex action when something bothers to press it, in this case the deltoid will be pressed.

The content of this blog already shows some guidelines so that a poorly performed work or a slight discomfort does not develop into an injury. In addition, physiotherapy provides a very useful tool such as kinesiology tape. It is important to remember that the application must always be adapted to the symptoms and the origin of the patient’s injury.

 

 

Carried out by the Technical Department of Calvo Izquierdo S.L.

 

 

How to cite this blog:

  • Calvo Izquierdo. BLOG: deltoid [Internet]. Calvo Izquierdo SL. 2023. Available at: https://calvoizquierdo.es/blog-deltoid/

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