In the prone position, which muscle groups are commonly at risk for contractures?

• A. Neck rotators
• B. Shoulder extensors, adductors, external rotators, and internal rotators
• C. Ankle plantar flexors
• D. Neck extensors

Answer: (B)

When a patient is immobilized in the prone position, the shoulder is often held in a posture that places the muscles responsible for extending and pulling the arm toward the body in a shortened length. The shoulder extensors and adductors are the primary groups that become chronically shortened in this position, and depending on how the arm is supported, the rotator cuff muscles can also be held in a shortened state—both the external rotators and the internal rotators. This combination makes these shoulder muscle groups the ones most at risk for developing contractures with prolonged prone immobilization. In contrast, the ankle plantar flexors and neck muscles aren’t typically maintained in a shortened position in this setup, so they’re less likely to form contractures in this specific posture.