Moment Arms of the Shoulder Muscles during Axial Rotation

The objective of the present study was to determine the instantaneous moment arms of 18 major muscle sub-regions crossing the glenohumeral joint in axial rotation of the humerus during coronal-plane abduction and sagittal-plane flexion. The tendon-excursion method was used to measure instantaneous muscle moment arms in eight entire upper-extremity cadaver specimens. The results showed that the inferior subscapularis was the largest internal rotator; its rotation moment arm peaks were 24.4 and 27.0 mm during abduction and flexion, respectively. The inferior infraspinatus and teres minor were the greatest external rotators; their respective rotation moment arms peaked at 28.3 and 26.5 mm during abduction, and 23.3 and 22.1 mm during flexion. The two supraspinatus sub-regions were external rotators during abduction and internal rotators during flexion. The latissimus dorsi and pectoralis major behaved as internal rotators throughout both abduction and flexion, with the three pectoralis major sub-regions and middle and inferior latissimus dorsi displaying significantly larger internal rotation moment arms with the humerus adducted or flexed than when abducted or extended (p < 0.001). The deltoid behaved either as an internal rotator or an external rotator, depending on the degree of humeral abduction and axial rotation. Knowledge of moment arm differences between muscle sub-regions may assist in identifying the functional effects of muscle sub-region tears, assist surgeons in planning tendon transfer surgery, and aid in the development and validation of biomechanical computer models. (C) 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:658-667, 2011