The influence of the mobility in the cervicothoracic spine and the upper ribs (shoulder girdle) on the mobility of the scapulohumeral joint.
OBJECTIVE
To examine the influence of the cervicothoracic spine and upper ribs (shoulder girdle) on glenohumeral mobility and the development of shoulder complaints.


METHODS
Literature was collected by a search in Medline and Embase for English, German and Dutch publications, by further checking references in the articles found and by perusal of already collected literature regarding shoulder research. Articles referring directly or indirectly to a mutually influencing anatomical connection between the cervicothoracic spine, upper ribs (shoulder girdle) and scapulohumeral joint were selected during a consensus meeting of all reviewers.


RESULTS
Eight relevant articles, differing strongly in supposition and objective, were found and subsequently classified and presented according to the anatomical relations indicated in the articles. Indications were found that suggested anatomical relations between the mobility in the shoulder girdle and the scapulohumeral joint, between the mobility in the spinal column and the first rib (shoulder girdle) and between the spinal column and the scapulohumeral joint. No relevant indications regarding the development of shoulder complaints were found.


CONCLUSIONS
Although no direct evidence was found, a comparison of the results of this study with theories postulated by other researchers on this subject suggests that a certain relation does exist.
Departments of Family Medicine and Rehabilitation Medicine, Groningen State University, The Netherlands.
J S
JS
Sobel
I
I
Kremer
J C
JC
Winters
J H
JH
Arendzen
B M
BM
de Jong
D002574:Cervical Vertebrae / Q000502:physiology*; D006801:Humans; D006811:Humerus / Q000502:physiology; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D016059:Range of Motion, Articular; D012540:Scapula / Q000502:physiology*; D012785:Shoulder Joint / Q000502:physiology*; D013901:Thoracic Outlet Syndrome / Q000209:etiology / Q000503:physiopathology; D013904:Thoracic Vertebrae / Q000502:physiology*