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# IGHL

The inferior glenohumeral ligament is the band under the shoulder joint that stops the ball slipping out the front with the arm raised, as in throwing.

Official name: Inferior glenohumeral ligament

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## What it is

A hammock-like thickening of the lower shoulder capsule, from the labrum to the humeral neck.

## What it does

The main restraint that stops the ball slipping out the front when the arm is raised and turned back (throwing position).

## Key points

- Three parts (anterior band, axillary pouch, posterior band): in abduction with external rotation the anterior band swings under the head like a sling; with internal rotation the posterior band does
- Fails in an anterior dislocation at the glenoid (Bankart lesion, the most common), within its substance, or at the humerus (HAGL lesion)
- Tightness of the posterior band and posteroinferior capsule in throwers causes glenohumeral internal rotation deficit (GIRD)
- The axillary nerve runs just below the axillary pouch, so it is at risk in dislocations and in inferior capsular surgery

## Key facts

**Attaches**
Anteroinferior glenoid labrum and rim to the anatomical neck of the humerus (anterior band, axillary pouch, posterior band)

**Function**
Main restraint to anterior-inferior dislocation

**Tight in**
Abduction + external rotation (90/90 position)

## Relations

**Medial**
[Glenoid labrum](https://durgical.com/en/anatomy/glenoid-labrum/) and rim of the lower half of the glenoid

**Lateral**
Anatomical neck of the [humerus](https://durgical.com/en/anatomy/humerus/), just below the articular margin of the head

**Below**
[Axillary nerve](https://durgical.com/en/anatomy/axillary-nerve/) and posterior circumflex humeral artery heading for the quadrangular space; the axillary pouch is the lowest part of the [shoulder capsule](https://durgical.com/en/anatomy/shoulder-joint-capsule/)

**In front**
Lower [subscapularis](https://durgical.com/en/anatomy/subscapularis/) muscle and tendon; the [middle glenohumeral ligament](https://durgical.com/en/anatomy/middle-glenohumeral-ligament/) (MGHL) just above the anterior band

**Behind**
[Teres minor tendon](https://durgical.com/en/anatomy/teres-minor-tendon/) and lower [infraspinatus tendon](https://durgical.com/en/anatomy/infraspinatus-tendon/) over the posterior band

## How to find it

Not palpable. From the posterior arthroscopic portal the anterior band appears as a thick fold running from the anteroinferior labrum to the humeral neck; the axillary pouch lies under the head and is inspected while the arm is rotated.

## Examination

- Apprehension test (arm at 90° abduction and external rotation): apprehension means the anterior band and labrum no longer hold the head
- Relocation (Jobe) test: a backward push on the head removes the apprehension, confirming anterior instability; releasing it suddenly brings it back (release or surprise test)
- Load and shift test: grades anterior and posterior translation of the head (to the rim, over the rim and reducing, or locking out)
- Gagey hyperabduction test: passive abduction clearly greater than the other side (over about 105°) with the [scapula](https://durgical.com/en/anatomy/scapula/) held down suggests a lax IGHL

## On imaging

MR arthrography distends the axillary pouch: on coronal images a normal pouch is U-shaped; in a HAGL lesion it becomes J-shaped as the humeral end drops away (J sign), with contrast leaking down the humeral neck. The ABER view stretches the anterior band and shows labroligamentous tears.

## Common problems

- Stretched or torn from the labrum or the humerus when the shoulder dislocates forward.
- A loose ligament lets the shoulder slip out again (recurrent instability).

## How it is diagnosed

Apprehension test with the arm raised and turned back. MRI or MR arthrogram shows the ligament and labrum.

## Treatment

- Strengthening program after a first dislocation in some patients.
- Arthroscopic repair that re-attaches and re-tensions the labrum and this ligament.

## Clinical notes

- Bankart repair reattaches the labrum with the IGHL to the glenoid rim; a capsular shift tightens a stretched axillary pouch in multidirectional instability
- HAGL lesions are missed if the humeral side is not checked at arthroscopy; left untreated they cause recurrent instability after a Bankart repair
- GIRD and posterior band tightness are linked to internal impingement and SLAP tears in overhead athletes; posterior capsule stretching is the usual first step

## Related conditions

- [Shoulder dislocation](https://durgical.com/en/conditions/shoulder-dislocation/)
- [Frozen shoulder (adhesive capsulitis)](https://durgical.com/en/conditions/frozen-shoulder/)

## Test yourself

Think of the answer, then tap the question to see it.

## What are the three parts of the inferior glenohumeral ligament?

The anterior band, the axillary pouch and the posterior band.

## In which arm position is the inferior glenohumeral ligament the main restraint to dislocation?

Abduction with external rotation (90/90), when the anterior band swings under the head like a sling.

## What is a HAGL lesion?

Humeral avulsion of the inferior glenohumeral ligament; on MR arthrography the axillary pouch becomes J-shaped.

## Which nerve runs just below the axillary pouch of the inferior glenohumeral ligament?

The axillary nerve, at risk in dislocations and inferior capsular surgery.

## What causes glenohumeral internal rotation deficit (GIRD) in throwers?

Tightness of the posterior band of the inferior glenohumeral ligament and the posteroinferior capsule.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
ligamentum glenohumerale inferius TA2 1769

**Official Spanish (DeCS)**
Ligamento glenohumeral inferior

**English (TA2)**
Inferior glenohumeral ligament

**Also called**
inferior glenohumeral band

## Related

- [Labrum](https://durgical.com/en/anatomy/glenoid-labrum/)
- [Shoulder capsule](https://durgical.com/en/anatomy/shoulder-joint-capsule/)
- [Humerus](https://durgical.com/en/anatomy/humerus/)
- [Scapula](https://durgical.com/en/anatomy/scapula/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Glenohumeral Joint](https://www.ncbi.nlm.nih.gov/books/NBK537018/); [Anatomy, Shoulder and Upper Limb, Shoulder](https://www.ncbi.nlm.nih.gov/books/NBK536933/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/inferior-glenohumeral-ligament/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/inferior-glenohumeral-ligament/