Shoulder kinematics during the wall push-up plus exercise.
OBJECTIVE
The push-up plus exercise is a common therapeutic exercise for improving shoulder function and treating shoulder pathology. To date, the kinematics of the push-up plus exercise have not been studied. Our hypothesis was that the wall push-up plus exercise would demonstrate increased scapular internal rotation and increased humeral anterior translation during the plus phase of the exercise, thereby potentially impacting the subacromial space.


METHODS
Bone pins were inserted in the humerus and scapula in 12 healthy volunteers with no history of shoulder pathology. In vivo motion during the wall push-up plus exercise was tracked using an electromagnetic tracking system.


RESULTS
During the wall push-up plus exercise, from a starting position to the push-up plus position, there was a significant increase in scapular downward rotation (P < .05) and internal rotation (P < .05). The pattern of glenohumeral motion was humeral elevation (P < .05) and movement anterior to the scapular plane (P < .05), with humeral external rotation remaining relatively constant.


CONCLUSIONS
We found that during a wall push-up plus exercise in healthy volunteers, the scapula was placed in a position potentially associated with shoulder impingement. Because of the shoulder kinematics of the wall push-up plus exercise, utilization of this exercise without modification early on in shoulder rehabilitation, especially in patients with subacromial impingement, should be considered cautiously.
Lunden
Jason B
JB
Minnesota Sports Medicine, University Orthopaedic Therapy Center, Minneapolis, MN 55455, USA.
Braman
Jonathan P
JP
Laprade
Robert F
RF
Ludewig
Paula M
PM
D000328:Adult; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009985:Orthopedics / Q000379:methods; D010369:Pectoralis Muscles / Q000502:physiology; D011336:Probability; D016059:Range of Motion, Articular / Q000502:physiology*; D012016:Reference Values; D012399:Rotation; D012494:Sampling Studies; D012540:Scapula / Q000502:physiology*; D012785:Shoulder Joint / Q000502:physiology*; D034941:Upper Extremity / Q000502:physiology; D055815:Young Adult