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출처: 치료적 맞춤운동, 비타미네 연구소 원문보기 글쓴이: 이영호
Muscle | Origin on scapula | Attachment on humerus | Function | Innervation |
Supraspinatus muscle | supraspinous fossa | superior and middle facet of the greater tubercle | abducts thehumerus | Suprascapular nerve (C5) |
Infraspinatus muscle | infraspinous fossa | posterior facet of the greater tubercle | externally rotatesthe humerus | Suprascapular nerve (C5-C6) |
Teres minor muscle | middle half oflateral border | inferior facet of the greater tubercle | externally rotates the humerus | Axillary nerve (C5) |
Subscapularis muscle | subscapular fossa | lesser tubercle (60%) orhumeral neck (40%) | internally rotatesthe humerus | Upper and Lower subscapular nerve (C5-C6) |
라. Teres major muscle
Teres major muscle
Details
Latin
Musculus teres major
Origin
Posterior aspect of the inferior angleof the scapula
Insertion
Medial lip of the intertubercular sulcus of the humerus
Subscapular and circumflex scapular arteries
Lower subscapular nerve(segmental levels C5 and C6)
Actions
adduct the humerus,Internal rotation(medial rotation) of the humerus, extend the humerus from flexed position, Protracts scapula, Depress shoulder
마. Rhomboid muscle
Rhomboid muscles.
Rhomboid muscle
Details
Latin
musculi rhomboidei
Origin
nuchal ligaments, spinous processes of the C7 to T5 vertebrae
Insertion
medial border of the scapula
dorsal scapular artery
dorsal scapular nerve
Actions
Pulls scapulae medially, rotates scapulae, Holds scapluae intothorax wall
사. Levator scapulae muscle
Levator scapulae muscle
Details
Latin
musculus levator scapulae
Origin
Posterior tubercles of transverse processes of C1 - C4 vertebrae
Insertion
Superior part of medial border of scapula
dorsal scapular artery
cervical nerve (C3, C4) and dorsal scapular nerve (C5)
Actions
Elevates scapula and tilts itsglenoid cavity inferiorly by rotating scapula
아. Pectoralis major
Pectoralis major
Details
Latin
Musculus pectoralis major
Origin
Clavicular head: anterior border of the medial half of the clavicle.
Sternocostal head: anterior surface of the sternum, the superior sixcostal cartilages, and theaponeurosis of the external oblique muscle
Insertion
Lateral lip of the bicipital groove of the humerus
(anteromedial proximal humerus)
pectoral branch of thethoracoacromial trunk
lateral pectoral nerve and medial pectoral nerve
Clavicular head: C5 and C6
Sternocostal head: C7, C8 and T1
Actions
Clavicular head: flexes the humerus
Sternocostal head: extends the humerus
As a whole, adducts and medially rotates the humerus. It also draws the scapula anteriorly and inferiorly.
자. Pectoralis minor
Pectoralis minor
Details
Latin
Musculus pectoralis minor
Origin
Third to fifth ribs, near their costal cartilages
Insertion
Medial border and superior surface of the coracoid process of thescapula
Pectoral branch of thethoracoacromial trunk
Medial pectoral nerve (C8, T1)
Actions
Stabilizes the scapula by drawing it inferiorly and anteriorly against thethoracic wall, raises ribs in inspiration
차. Subclavius muscle
Subclavius muscle
Details
Latin
musculus subclavius
Origin
first rib and cartilage
Insertion
subclavian groove of clavicle(inferior surface of middle third of clavicle)
thoracoacromial trunk, clavicular branch
nerve to subclavius
Actions
depression of clavicle
카. Serratus anterior
Serratus anterior
Details
Latin
musculus serratus anterior, serratus lateralis
Origin
fleshy slips from the outer surface of upper 8 or 9 ribs
Insertion
costal aspect of medial margin of the scapula
lateral thoracic artery (upper part),thoracodorsal artery (lower part)
long thoracic nerve (from roots ofbrachial plexus C5, 6, 7)
Actions
protracts and stabilizes scapula, assists in upward rotation.
Antagonist
Rhomboid major, Rhomboid minor, Trapezius
4. 견관절의 흔한 질환
가. 주요 질환/ 검사 : http://cafe.daum.net/panicbird/RUll/38
나. 어깨 질환 검사법( 크레이그 리벤슨) : http://cafe.daum.net/panicbird/RUll/37
5. 근막이완
1) 롤핑
http://cafe.daum.net/panicbird/OJs0/281
2) CMP건
- http://cafe.daum.net/panicbird/Qibc/88
- http://cafe.daum.net/panicbird/Qibc/89
3) 폼롤러를 이용한 근막이완.....
6. 주요 근육 스트레칭
1) 스트레칭 기본개념
*** 각 동작은 5초씩 3회가 기본(7초가 넘어가면 보상기전이 발생하므로)
*** 모든 동작은 다음 동작을 위한 예비동작 임, 건너 뛰지 말 것
http://cafe.daum.net/panicbird/QtNi/299
2) deltoid muscle
- 에반스의 삼각근 후방섬유 isolated stretching
- 에반스의 삼각근 전방섬유 isolated stretching
3) supraspinatus
에반스 스트레칭
4) inpraspinatus, teres minor
에반스의 극하근 isolated stretching
에반스의 소원근 isolated stretching
5) teres major
에반스의 isolated stretching(스트레칭)
6) pectoralis major
누워서 costal part stretching 방법
누워서 흉늑골지 스트레칭 방법
누워서 쇄골지 스트레칭 방법
7) pectoralis minor
에반스 isolated stretching
8) serrattus anterior
에반스의 전거근 isolated stretching
9) rhomboid major, minor
에반스의 능형근 isolated stretching
7. 관절가동
1) 총괄
http://cafe.daum.net/panicbird/OUdz/3
2) GH mobilization
http://cafe.daum.net/panicbird/RUll/53
3) SC and AC joint mobilizations
http://cafe.daum.net/panicbird/RUll/52
4) scapular mobilization
5) self mobilization
8. 인대 약침, 가열식 화침
http://cafe.daum.net/panicbird/RNu8/21
9. stabilizing ex.
1)견갑골 시계운동
http://tvpot.daum.net/v/v03861oPgo1fJnnoKuPTgVO
2) 브뤼거 호흡운동
http://tvpot.daum.net/v/vdd0e4XuzNu4VzL7c7iMzMX
3) Blackburn exercise(열린 사슬)
4) ball을 이용한 닫힌사슬에서의 안정화 운동
basic scapular and shoulder stabilization exercise using a small ball
http://tvpot.daum.net/v/v8917jjjpWRt66ejoepRTHa
5) 견갑골 안정화 위한 수기저항
http://cafe.daum.net/panicbird/QtNi/417
6) 견갑골 안정화 위한 전거근 운동
https://www.youtube.com/watch?v=8SBqRKZinFg&feature=player_embedded
10. 근력 불균형 검사
1)근력 검사의 고려사항
http://cafe.daum.net/panicbird/QzZ4/15
2) 외전 검사(삼각근 중부섬유, 극상근)
3) 굴곡 검사( 삼각근 전방섬유, 오훼완근)
4) 신전검사(삼각근 후방섬유, 광배근)
5) 외회전 검사(극하근, 소원근)
6) 내회전 검사(견갑하근, 대흉근)
7) winging scapular(전거근) 검사
어깨 130도 굴곡 후 저항검사
8) 견갑골 내전(능형근) 검사
11. isolation ex.
1) deltoid muscle
운동 방향에 따라 전방 중부 후방 섬유 강화
https://www.youtube.com/watch?v=iCYAqLa6t_E&feature=player_embedded
2) supraspinatus muscle
https://www.youtube.com/watch?v=gPoJlKfjUcA&feature=player_embedded
3) infraspinatus, teres minor muscle
https://www.youtube.com/watch?feature=player_embedded&v=CiN_ItUwCtQ
https://www.youtube.com/watch?v=e6batx0kxaQ&feature=player_embedded
4)subscapularis muscle
5) rhomboid muscle
https://www.youtube.com/watch?feature=player_embedded&v=bMh225Qt7vw
6) serratus anterior muscle
https://www.youtube.com/watch?v=5C1M9ms20jI&feature=player_embedded
12. functional ex.
- Self-management of shoulder disorders. part 1,2,3 크레이그 리벤슨
http://cafe.daum.net/panicbird/RUll/17
- ball을 이용한 견갑골 기능 운동
- push up
- hand walk
- pendulum 운동
- balance exercise
13. 정렬운동
여러 운동 참조......
14. 행동수정
- 바른자세 유지(목 넣고, 어깨 펴고....)
- 통증이 있는 방향으로의 운동 제한
- 충분한 휴식과 아이스팩
- .......