Introduction

The glenohumeral ligaments (GHL) are three ligaments on the anterior side of the glenohumeral joint (ie, between the glenoid cavity of the scapula and the head of the humerus). Reinforcing the anterior glenohumeral joint capsule, the superior, middle, and inferior glenohumeral ligaments play different roles in the stability of the head of the humerus, depending on arm position and degree of rotation.


The ligaments of glenohumeral joint. The glenohumeral ligaments are labeled as the capsular ligament at the center of the illustration.

Location

The ligaments may be best seen by opening the capsule at the back of the joint and removing the head of the humerus:

  • The superior GHL at the upper part of the joint is fixed above to the apex of the glenoid cavity close to the root of the coracoid process, and passing downward along the medial edge of the tendon of the biceps brachii, is attached below to a small depression above the lesser tubercle of the humerus.
  • The middle GHL on the medial side of the joint passes from the medial edge of the glenoid cavity to the lower part of the lesser tubercle of the humerus.
  • The inferior GHL at the lower part of the joint extends from the under edge of the glenoid cavity to the under part of the anatomical neck of the humerus.

In addition to these, the capsule is strengthened in front by two bands derived from the tendons of the pectoralis major and teres major, respectively.

Function

During abduction of the arm, the middle and inferior ligaments become taut while the superior ligament relaxes. The radius of curvature of the head of the humerus is greater superiorly than inferiorly, which further stretches these ligaments so that they keep the articular surfaces of the joint in their close-packed position.

The greater tubercle of the humerus comes in contact with the upper margin of the glenoid cavity during abduction, which limits maximum abduction. By rotating the humerus laterally, this contact is delayed because the greater tubercle is pulled back so that the bicipital groove faces the coracoacromial ligament. This slightly slackens the inferior fibers of the glenohumeral ligament, allowing an abduction of 90°. Combining abduction with 30° flexion in the plane of the scapula causes a delay in the tightening of the ligament, resulting in a maximum abduction of 110°.

Lateral rotation stretches all three ligaments while medial rotation relaxes them during rotation of the arm.

Tension of ligaments

Ligament

Shoulder motions to pull the ligament taut

Humeral head motion to pull the ligament taut

Superior GHL

Full adduction

Inferior or anterior glide

Middle GHL

External rotation

Anterior glide

Inferior GHL
Anterior band
Posterior band

Abduction and external rotation
Abduction and internal rotation

Non specific

Coracohumeral ligament

Extremes of flexion, extension, or external rotation

Inferior glide

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