Multidimensional Assessment of Shoulder Biomechanics: Towards an Integrated Functional Interpretation

The assessment of shoulder function remains challenging because static imaging and isolated clinical measures may not fully capture the behaviour of the shoulder complex during dynamic tasks. Instrumented biomechanical analysis provides quantitative information on shoulder kinematics, intersegmental coordination, kinetics, and neuromuscular activation; however, its clinical interpretation remains limited by task dependency, methodological variability, and the complexity of integrating multiple biomechanical outputs. This narrative review synthesizes foundational and contemporary literature on shoulder biomechanics during dynamic upper-limb tasks. Scapular-plane arm elevation is proposed as a pragmatic reference task, with shoulder motion represented through a normalized elevation cycle to provide a common temporal framework for interpretation. Biomechanical outputs are organized into complementary domains encompassing scapulothoracic and glenohumeral kinematics, intersegmental coordination, kinetics, and neuromuscular contribution. An integrated approach to the interpretation of shoulder biomechanics is presented, emphasizing the relationships among scapulothoracic and glenohumeral motion, their intersegmental coordination, and, when available, kinetic and neuromuscular information. Three recurrent functional phenotypes are described: altered scapular contribution, compensatory trunk–shoulder strategies and altered humeral axial rotation coupling. The value of shoulder biomechanical assessment lies in the integrated interpretation of movement patterns rather than in isolated variables. This multidimensional perspective provides a framework for translating biomechanical data into functionally meaningful information for clinics and research.