Intro
Contents
1: Anatomy of the Shoulder
1.1 Glenohumeral Joint
1.1.1 Capsuloligamentous Structures
1.1.2 Glenoid
1.1.3 Glenoid Labrum
1.1.4 Humeral Head
1.2 Acromioclavicular Joint
1.3 Extraarticular/Subacromial Space
1.3.1 Acromion and Spine of the Scapula
1.3.2 Coracoacromial Ligament
1.3.3 Coracoid
1.3.4 Coracohumeral Ligament
1.3.5 Synovial Bursae
1.4 Muscles
1.4.1 Deltoid
1.4.2 Rotator Cuff
1.4.2.1 Supraspinatus
1.4.2.2 Infraspinatus
1.4.2.3 Teres Minor
1.4.2.4 Subscapularis

1.4.2.5 Rotator Cuff Innervation and Vascular Supply
1.4.3 Long Head of the Biceps
1.4.4 Latissimus Dorsi
1.5 Neurovascular Structures
1.5.1 Axillary Nerve
1.5.2 Suprascapular Nerve
1.5.3 Musculocutaneous Nerve
1.5.4 Anterior Humeral Circumflex Artery
1.5.5 Posterior Humeral Circumflex Artery
References
2: Biomechanics of the Shoulder
2.1 Kinematics of the Shoulder Complex
2.2 Kinesiology of the Shoulder Complex
2.3 Scapula
2.4 Glenohumeral Joint
2.4.1 Glenoid Labrum
2.4.2 Capsule and Ligaments

2.4.3 Dynamic Stabilizers of the Glenohumeral Joint
2.5 Acromioclavicular Joint
2.6 Sternoclavicular Joint
2.6.1 Sternoclavicular and Acromioclavicular Motion
2.7 Summary
References
3: Biology of Injury and Repair of Soft Tissues of the Shoulder
3.1 Introduction
3.2 Biology of the Intact Rotator Cuff
3.2.1 Four Zones of the Intact Tendon-Bone Interface
3.2.2 Fetal Development of the Native Tendon and the Tendon-Bone Junction
3.3 Biology of Rotator Cuff Degeneration in Adults
3.3.1 Extrinsic Causes for Rotator Cuff Degeneration

3.3.2 Intrinsic Causes for Rotator Cuff Degeneration
3.4 Biology of the Rotator Cuff Tear
3.5 Biology of Rotator Cuff Healing
3.5.1 Influence of Cells on Healing
3.5.2 Influence of Growth Factors on Healing
3.5.2.1 Transforming Growth Factor-Beta
3.5.2.2 Fibroblast Growth Factor
3.5.2.3 Bone Morphogenetic Protein
3.5.2.4 Matrix Metalloproteinases and Tissue Inhibitor Metalloproteinases
3.5.3 Influence of the Extracellular Matrix on Healing
3.5.4 Influence of Load and Mobilization on Healing
3.5.5 Influence of Muscle Changes on Rotator Cuff Healing

3.5.5.1 Retraction
3.5.5.2 Fatty Infiltration
3.5.5.3 Atrophy
3.5.6 Exogenous Factors That Affect Rotator Cuff Healing
3.5.6.1 Nonsteroidal Anti-inflammatory Drugs
3.5.6.2 MMP Inhibition with Doxycycline
3.5.6.3 Diabetes
3.5.6.4 Steroids
3.5.6.5 Nicotine
3.6 Long Head of the Biceps Tendon
3.7 Glenoid Labrum
3.8 Summary
References
4: Principles of Shoulder Arthroscopy Rehabilitation
4.1 Introduction
4.2 Rehabilitation Following Rotator Cuff Repair
4.2.1 Stages of Rehabilitation
4.2.1.1 Early Phase (0-6 Weeks)