Bulk effect of the deltoid muscle on the glenohumeral joint

Abstract

Background: There remains controversy on the role of the deltoid on glenohumeral translations during basic and pitching motions. We thus studied the passive effect of the deltoid on the deltoid glenohumeral joint center (GHJC). Methods: Six shoulders were tested using an automated mechanical system. A baseline motion pattern of the intact specimen was contrasted with glenohumeral translation after removal of the deltoid. Each condition was evaluated in abduction (ABD) and an abbreviated throwing motion (ATM) using retro-reflective, bone-embedded markers. The absolute trajectory and the area under the curve (AUC) for each motion were calculated and glenohumeral kinematics with respect to the GH translation were compared. Results: The removal of the deltoid resulted in significant changes of the GH translation. During 30-60° of ABD, it resulted in a superior and more anterior GH translation, while in the 60-90° segment in a more inferior and medial GH translation. During 90-120°, the GH translation was medialized. In the pitching motion from maximum external rotation to 90° of external rotation (ER), the removal of the deltoid resulted in a more superior, anterior and lateral GH translation. Thus limits anterior translation in the abduction-external rotation position. In the remaining segments (90-80° and 80-45° of ER), it resulted in a lateralization of the GH translation. Conclusions: Modelling the throwing shoulder, the deltoid has a significant influence on glenohumeral motion. Athletes with deltoid dysfunction and limited range of motion are at risk for injury due to the resulting change in their throwing mechanics.