The axillary pouch is the redundant inferior fold of the glenohumeral capsule lying between the anterior and posterior bands of the inferior glenohumeral ligament (IGHL), forming a hammock-like sling beneath the humeral head. It is slack with the arm at the side and tightens in abduction, when it becomes the primary static stabiliser. Contracture of the axillary pouch in adhesive capsulitis dramatically restricts abduction.
| Origin | Inferior glenoid labrum (4-8 o'clock) |
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| Insertion | Inferior humeral neck (medial to the surgical neck) |
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Forms an inferior sling that supports the humeral head and limits inferior translation with the arm abducted.
The axillary pouch is a key structure released in arthroscopic treatment of resistant adhesive capsulitis, since its contracture is responsible for much of the loss of abduction; releasing the inferior capsule restores abduction and rotation. The axillary nerve runs just below the inferior capsule, so inferior release is performed with care close to the glenoid. In instability surgery the redundant pouch may be plicated to reduce capsular volume.
IGHL axillary pouch fibrosis restricting abduction released by arthroscopic posterior and inferior capsular release.
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