title: Scapular muscle activity in overhead athletes with symptoms of secondary shoulder impingement during closed chain exercises.
abstract: OBJECTIVE
  To determine the amount of muscle activation in 4 scapular muscles in overhead athletes with and without a history of secondary shoulder impingement, during 3 upper extremity closed chain exercises.
  
  
  METHODS
  One-between (group), one-within (exercise) repeated measures.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Overhead athletes (n=15; mean age +/- SD, 21.0+/-2.5 y; mean height +/- SD, 176.0+/-7.8 cm; mean weight +/- SD, 76.1+/-13.4 kg) demonstrating with symptoms of shoulder impingement and overhead athletes (n=15; mean age +/- SD, 20.4+/-3.8 y; mean height +/- SD, 174.1+/-9.7 cm; mean weight +/- SD, 73.3+/-11.7 kg) with no shoulder pathologies.
  
  
  METHODS
  Subjects completed 5 individual trials of a standard push-up, a push-up on an unstable surface, and a revolution on a shoulder rehabilitation device while electromyography (EMG) recorded muscle activity of the serratus anterior, upper trapezius, middle trapezius, and lower trapezius.
  
  
  METHODS
  The mean EMG data for the 4 muscles from the standard push-up, push-up on an unstable surface, and shoulder rehabilitation device trials were normalized as a percentage of a maximum voluntary isometric contraction for each muscle.
  
  
  RESULTS
  There was a statistically significant interaction for the middle trapezius (F(2,56)=3.856; P=.027). The shoulder impingement push-up on an unstable surface (33.76%+/-26.45%) had significantly greater activation compared with the shoulder impingement standard push-up (25.88%+/-13.76%), the shoulder impingement shoulder rehabilitation device (9.40%+/-5.86%), and the nonpathology push-up on an unstable surface (19.49%+/-7.73%). The shoulder impingement standard push-up had significantly greater activation compared with the shoulder impingement shoulder rehabilitation device and nonpathology standard push-up (17.99%+/-7.31%). The nonpathology standard push-up and nonpathology push-up on an unstable surface had significantly greater activation compared with the nonpathology shoulder rehabilitation device (7.95%+/-4.30%).
  
  
  CONCLUSIONS
  These results suggest that the muscle activation of the middle trapezius differs in overhead athletes with a history of secondary shoulder impingement compared with those who lack this history during closed chain exercise, as well as within the 3 closed chain exercises. The levels of muscle activation of the serratus anterior and upper trapezius during these closed chain exercises were similar between the 2 groups. These results support the use of closed chain exercises in the rehabilitation process of overhead athletes with secondary shoulder impingement. However, clinicians should consider the muscle(s) of interest when selecting an exercise.
authors.affiliation: Department of Kinesiology and Physical Education, University of Central Arkansas, Conway, AR 72035, USA. stucker@uca.edu
authors.forename: W Steven
authors.initials: WS
authors.lastname: Tucker
authors.forename: Charles W
authors.initials: CW
authors.lastname: Armstrong
authors.forename: Phillip A
authors.initials: PA
authors.lastname: Gribble
authors.forename: Mark K
authors.initials: MK
authors.lastname: Timmons
authors.forename: Richard A
authors.initials: RA
authors.lastname: Yeasting
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D004576:Electromyography; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D012540:Scapula / Q000503:physiopathology*; D012782:Shoulder / Q000503:physiopathology*; D019534:Shoulder Impingement Syndrome / Q000503:physiopathology / Q000534:rehabilitation*; D055815:Young Adult