Various muscles and ligaments attach on scapula that are used to stabilize and move the bone. Movement of scapula helps in movements of shoulder joint.
Muscles
- The subscapularis arises from the medial two thirds of the subscapular fossa.
- The serratus anterior is inserted along the medial border of the costal surface-one digitations to the superior angle, two digitations to the medial border, and five digitations to the inferior angle.
- The supraspinatus arises from the medial two thirds of the supraspinous fossa (including the upper surface of the spine).
- The infraspinatus arises from the medial two thirds of the infraspinous fossa (including the lower surface of the spine).
- The deltoid arises from the lower border of the crest of the spine and from the lateral border of the acromion.
- The trapezius is inserted into the upper border of the crest of the spine and into the medial border of the acromion.
- The long head of the biceps arises from the supraglenoid tubercle; and the short head from the lateral part of the tip of the coracoid process.
- The coracobrachialis arises from the medial part of the tip of the coracoid process.
- The pectoralis minor is inserted into the medial border and superior surface of the coracoid process.
- The long head of the triceps arises from the infraglenoid tubercle.
- The teres minor arises from the upper two thirds of the rough strip on the dorsal surface along the lateral border.
- The teres major arises from the lower one third of the rough strip on the lateral aspect of the lateral border.
- The levator scapulae is inserted along the dorsal aspect of the media border, from the superior angle up to the root of the spine.
- The rhomboideus minor is inserted into the medial border (dorsal aspect) opposite the root of the spine.
- The rhomboideus major is inserted into the medial border (dorsal aspect) between the root of the spine and the inferior angle.
- The inferior belly of the omohyoid arises from the upper border near the suprascapular notch.
Ligaments
- The margin of the glenoid cavity gives attachment to the capsule of the shoulder joint and to the glenoid labrum.
- The margin of the facet on the medial aspect of the acromion gives attachment to the capsule of the acromioclavicular joint.
- The coracoacromial ligament is attached
- To the lateral border of the coracoid process, and
- To the medial side of the tip of the acromion process.
- The coracohumeral ligament is attached to the root of the coracoid process.
- The coracoclavicular ligament is attached to the coracoid process: the trapezoid part on the superior aspect, and the conoid part near the root.
- The suprascapular ligament bridges across the suprascapular notch and converts it into a foramen which transmits the suprascapular nerve. The suprascapular vessels lie above the ligament.
- The spinoglenoid ligament bridges the spino-glenoid notch. The suprascapular vessels and nerve pass deep to it.
Clinical Features
- Paralysis of the serratus anterior cause ‘winging’ of the scapula. The medial border of the bone becomes unduly prominent, and the arm cannot be abducted.
- In a developmental anomaly called scaphoid scapula, the medial border is concave.
Text adapted from: Human Anatomy by BD Chaurasia
Image Credit: Wikipedia
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I thought of that. However, this sound is “loud” to me, but I’m not sure that it is loud enough to be heard by the doctor. Besides that I’m not sure it could be reproduced as it doesn’t happen each time I move my arm. Could this be arthritis, or might it be something else?
Thank you.
Dr Arun Pal Singh Reply:
February 24th, 2010 at 9:50 am
@Janq,
If it is so infrequent, stays like this and does not worsen over the time, I think it should not be cause for concern.
Hi Dr Singh,
I tore all three ligaments off my left collar bone about 2 yrs ago. I go rock climbing regularly now and my chest is building non symetrically. On the left side where I did the damage my chest is larger than on the right. Can u recommend what exercises I need to do to even out. Thanks
Dr Arun Pal Singh Reply:
February 24th, 2010 at 9:58 am
@eric,
Did you see a doctor and got checked for ligamentous insufficiency?
Get examined to know if surgery would help you or exercises would surfice!
my thoracic spine was locked up for several years causing me severe chronic pain in the mid right back. A therapist finally suggested using a thoracic wedge to loosen in up. This did start to give me some relief but it never stayed mobilized for more than a couple of days. He finally determined and upon evaluation found my entire right shoulder to be out of wack. After attempting PT my entire shoulder MOSTLY the shoulder blade responded in severe pain especially the top and inside alongside spine.Any Idea what could be wrong with my shoulder blade that would cause so much pain?
Dr Arun Pal Singh Reply:
March 8th, 2010 at 12:36 pm
@Mike,
Did you visit a qualified doctor. What you tell me does not translate into any meaningful conclusion.
You must get a check up for thoraccic spine and associated region.
Hi Doc,
I have damaged my Right AC joint whilst skiing in January and am still having pain and ‘crunching’ sensations with movement. What process would be most effective for relieving the pain and stop the crunching?
Also, what is the muscle that is located under the Scapula as both my shoulder blades are winging. I am currently doing exercises for my Serratus Anterior, but are there any more for this unknown muscle?
Many thanks.
Dr Arun Pal Singh Reply:
September 14th, 2010 at 6:43 am
@Josh,
What was the damage?
Dislocation? Subluxation?
Also why do your shoulders wing? They should not unless you have weakness of your serratus anterior muscle.
if you do have SA weakness, what is the reason for that?
Hello! doctor
I am generally a healthy person but i feel weak in all my joints. i do not exercise. Would walking help? or what kind of exercise would you suggest to strengthen my joints?
Dr Arun Pal Singh Reply:
September 28th, 2010 at 6:25 am
What do you mean by feeling weak in the joints?
my mom often face unbearable pain in her muscles of chest (from back side of sholders) due to which she is finding it difficult to talk & breath. exrays of her chest doesn’t show any problem.
also at times she faces a problem of digestion. her stomach doesn’t pass stool for days sometimes even more than week. and yet she seems normal when her stomach is not passing stool.
now shes in pain in her chest from back side of sholders and in between sholders)..what should i do???
Dr Arun Pal Singh Reply:
February 22nd, 2011 at 6:45 am
@Dilawar,
This reply would be adelayed for you. How is she now?
Did you take her to doctor?
Dr Arun,
About 6 months ago I had this pain in my back “just” beneath the wing bone or scapula as I believe it is called. It is a small spot, but radiates out to about 4-5 inches. It will start real slow and then build up sudden intensify in just a few seconds. This will last a few seconds. Then after a few seconds starts again. Sometimes this will go on for a few minutes, to several minutes. If I put pressure between the rib it alleviates it for awhile or if I sit with a heating pad it helps.
It came back again a few weeks ago and when I have it it will last a couple of weeks. It went away again after a couple of weeks and now is back again.
I am not sure if I need an internist or should I see another specialist for this? I would appreciate any suggestion you have. I don’t know if I lifted anything very heavy. I am 64 yrs old and a very active person.
If I take an Alieve it doesn’t work, but the heating pad will help some while I am sitting with it on.
Thank you
@Jackie
Dr Arun Pal Singh Reply:
February 22nd, 2011 at 6:48 am
@Jackie,
What you describe seems like a Trigger spot or Fibromyalgia.
Please see your doctor. I am not sure how does your health care system work but you can begin by consulting primary health care physician.
Take care.
I have been having pain in my head face around shoulder blade and down arm all on my left side for a year now. I have had mri and ct of head mri of neck and thoracic spin…only showed minor things that the neurologist thought nothing of..my chiropractor and massage therapist both said that my left shoulder blade is out of place. It is closer to the left side of my body than it should be..(further from my spine) i can not tell a difference except for the pain that is around it and down my arm. I am wondering can it all be related..the head pain is always in same spot the face pain seems to be around the maxillary nerve in my face and the left side of my neck just has an uncomfortable feeling in it at all times and then it goes into my shoulder blade and down the arm..can the out of place shoulder blade be causing this all? I’ve been searching for help for a year and have gotten no relief! this all started after i had my son 11 months ago. During delivery my nurse kept trying to get me to make my chin touch my chest and push..i had problems doing this but they insisted that i do it! and every since i came off the pain meds from having my child i have had this pain! the head pain was so bad at first i went to the er twice! Which they did mri and ct and found nothing wrong with my head….The chiro has help some but not alot..i am wondering should i try physical therapy to get the muscle to pull the shoulder blade back into place or see another neuro and get a second opinion. the first one just kept trying meds and the last one made me sick and he insisted that i keep taking it so i just stopped going to him after the scans he just stopped trying to figure out what was wrong and just kept switching medications which were mainly antidepressants which i know are used for pain but were doing nothing for me. please give my any advice you have. Thanks, Ginalee
Dr Arun Pal Singh Reply:
March 9th, 2011 at 7:17 am
@Ginalee,
From your description it seems that the pain is coming from cervical area. Please see a spine specialist to get another opinion.
Another thing that needs to be ruled out is neuralgia which I think already must have been considered by your doctor.
Take care.