Who is writting??

Shun.M / Personal trainer 

Academic Background

Master degree of physical education (sports medicine)
Bachelor Degree of Biomedical Engineering

Experiences

Over 10 years in fitness industry
Over 6 years of sports coach
Over 5 years of personal training
Over 2 years of research and teaching assistant

Sternoclavicular (SC) Joint 

Elevation of the clavicle

Agonist muscle: Sternocleidomastoid and upper trapezius

Limited by: Pectoralis major, subclavius and costoclavicular ligament

Optimal Range of Motion (ROM): up to 48°

Depression of the clavicle

Agonist muscle: Pectoralis major and subclavius

Limited by: Sternocleidomastoid, upper trapezius, anterior & posterior capsular ligaments (superior portions) and interclavicular ligament

Optimal ROM: 10°-15° 

Protraction of the clavicle

Agonist muscle: Serratus anterior, pectoralis minor 

Limited by: Costoclavicular ligament (posterior portion), posterior capsular ligament and retractors(rhomboids, middle trapezius, levator scapula)

Optimal ROM: 15°-30° (1, 3)

Retraction of the clavicle

Agonist muscle: Rhomboids, middle trapezius, levator scapula

Limited by: Costoclavicular ligament (anterior portion), anterior capsular ligament and protractors (serratus anterior, pectoralis minor)

Optimal ROM: 15°-30° 

*The muscles that contribute to clavicle prostration do no attach to the clavicle. It is through motion of the scapula being imparted on the clavicle via the AC joint that motion occurs

Posterior Rotation (inferior surface of the clavicle to face anterior)

Agonist muscle: Clavicular fibers of upper trapezius

Limited by: Pectoralis major, subclavius, pectoral fascia and clavipectoral fascia

Optimal ROM: 20°-50° 

Anterior Rotation (clavicle return to neutral from posterior rotation)

Agonist muscle: Pectoralis major

Limited by: Sternocleidomastoid, platysma, investing layer of deep cervical fascia

Optimal ROM: <10° (return to resting position from posterior rotation) 

 

Scapulothoracic (ST) 

Elevation

Agonist muscle: Upper trapezius,  levator scapulae, rhomboids

Limited by: Lower trapezius, latissimus dorsi,  pectoralis minor

Optimal ROM: not typically measured

Contributing from SC joint: clavicular elevation

Contributing from AC joint: slight downward rotation, slight anterior/posterior tilt, int/ext rotation

Depression

Agonist muscle: Lower trapezius, latissimus dorsi, pectoralis minor

Limited by: Upper trapezius, levator scapulae, and rhomboids

Optimal ROM: not typically measured

Contributing from SC joint: clavicular depression

Contributing from AC joint: slight upward rotation, slight anterior/posterior tilt and internal/external rotation

Upward Rotation

Agonist muscle: Serratus anterior, upper and lower trapezius

Limited by: Rhomboids, pectoralis minor, levator scapulae, coracoclavicular ligament

Optimal ROM: up to 50-60°

Contributing from SC joint: clavicular elevation and posterior rotation

Contributing from AC joint: scapula upward rotation, posterior tilt 

int/ext rotation

Downward Rotation

Agonist muscle: Rhomboids, pectoralis minor, levator scapulae

Limited by: Serratus anterior, upper and lower trapezius

Optimal ROM: return to resting position from upward rotation

Contributing from SC joint: clavicular depression and anterior rotation

Contributing from AC joint: scapula downward rotation, anterior tilt,  int/ext rotation

Protraction

Agonist muscle: Serratus anterior, pectoralis minor

Limited by: Middle trapezius, rhomboids, lower trapezius and levator scapulae

Contributing from SC joint: clavicular protraction

Contributing from AC joint: scapula int rotation

Retraction

Agonist muscle: Middle trapezius, rhomboids, lower trapezius, levator scapulae

Limited by: Serratus anterior, pectoralis minor

Contributing from SC joint: clavicular retraction

Contributing from AC joint: scapula ext rotation

Acromioclavicular (AC)

Upward Rotation 

(upward and outward motion of the inferior angle of the scapula)

Agonist muscle: Serratus anterior, upper and lower trapezius

Limited by: Rhomboids, pectoralis minor, levator scapulae and coracoclavicular ligament

Optimal ROM: 30°

Downward Rotation

Agonist muscle: Rhomboids, pectoralis minor, and levator scapulae

Limited by: Serratus anterior, upper and lower trapezius

Optimal ROM: 17° 

Occurs actively in conjunction with shoulder extension or adduction (return to neutral); cannot occur as an isolated movement.

Internal Rotation 

(glenoid fossa faces anteromedially)

Agonist muscle: Pectoralis minor

Limited by: Serratus anterior, middle trapezius and rhomboids

Optimal ROM: 20°-35° 

*depending on accompanying upper extremity movement 

External Rotation (glenoid fossa faces posterolaterally)

Agonist muscle: Serratus anterior, middle trapezius, and rhomboids

Limited by: Pectoralis minor

Optimal ROM: 20° – 35° 

*depending on accompanying upper extremity movement 

Anterior Tilt

Agonist muscle: Upper trapezius, levator scapulae and pectoralis minor

Limited by: Serratus anterior and lower trapezius

Optimal ROM: 20° – 40° 

*depending on accompanying upper extremity movement

Posterior Tilt

Agonist muscle: Serratus anterior and lower trapezius

Limited by: Upper trapezius, levator scapulae and pectoralis minor

Optimal ROM: 20° – 40° 

*depending on accompanying upper extremity movement