title: Scapular kinematics and shoulder elevation in a traditional push-up.
abstract: BACKGROUND
  Proper scapulothoracic motion is critical for the health and function of the shoulder and represents a principal focus in the rehabilitation setting. Variants of the traditional push-up are used frequently to help restore proper scapular kinematics. To date, substantial research has focused on muscle activation levels of rotator cuff and scapular-stabilizing musculature, whereas a dearth of literature exists regarding scapular kinematics during push-up variants.
  
  
  OBJECTIVE
  To examine the effect of shoulder position on scapular kinematics across the range of motion (ROM) of a traditional push-up.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  University laboratory.
  
  
  METHODS
  Sixteen healthy participants without a history of upper extremity or spine injury requiring rehabilitation or surgery.
  
  
  METHODS
  Participants performed a traditional push-up while kinematic measurements were acquired from multiple upper extremity segments. The 3 shoulder position conditions were (1) self-selected position, (2) shoulder adducted upon ascent (at side), and (3) shoulder elevated to approximately 90°.
  
  
  METHODS
  Scapular posterior tilt, upward rotation, and external rotation were examined across elbow-extension ROM and compared across conditions.
  
  
  RESULTS
  Posterior tilt was greater in the self-selected and at-side conditions than in the elevated condition and increased linearly with elbow extension. External rotation was greater in the self-selected and at-side conditions compared with that in the elevated condition. In the at-side condition, upward rotation began lower than in the other conditions at the start of the concentric phase but increased above the others soon after the elbow started to extend.
  
  
  CONCLUSIONS
  Performing a traditional push-up with the shoulders elevated may place the scapula in a position of impingement. Clinicians should be cognizant of shoulder elevation when prescribing and monitoring exercise progression. The results of this study will provide further direction for clinicians in prescribing rehabilitation exercises for the upper extremity, especially closed chain exercises for shoulder conditions.
authors: Western Washington University, Bellingham.
authors: David N
authors: DN
authors: Suprak
authors: Jennifer
authors: J
authors: Bohannon
authors: Gabriel
authors: G
authors: Morales
authors: Joseph
authors: J
authors: Stroschein
authors: Jun G
authors: JG
authors: San Juan
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology*; D003430:Cross-Sectional Studies; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal; D005082:Physical Exertion / Q000502:physiology; D016059:Range of Motion, Articular; D012399:Rotation; D017006:Rotator Cuff / Q000503:physiopathology; D012540:Scapula / Q000502:physiology*; D012782:Shoulder / Q000502:physiology*; D019534:Shoulder Impingement Syndrome / Q000517:prevention & control / Q000534:rehabilitation; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000502:physiology* / Q000503:physiopathology; D055815:Young Adult
references: J Biomech. 2005 May;38(5):981-992
references: 15844264
references: Clin Biomech (Bristol, Avon). 2001 Jun;16(5):408-14
references: 11390048
references: J Am Acad Orthop Surg. 2003 Mar-Apr;11(2):142-51
references: 12670140
references: J Appl Biomech. 2008 May;24(2):130-9
references: 18579905
references: Int J Shoulder Surg. 2008 Apr;2(2):30-5
references: 20300308
references: J Orthop Sports Phys Ther. 1998 Sep;28(3):146-57
references: 9742471
references: J Strength Cond Res. 2011 Feb;25(2):497-503
references: 20179649
references: J Strength Cond Res. 2005 Feb;19(1):146-51
references: 15705025
references: J Biomech Eng. 2001 Apr;123(2):184-90
references: 11340880
references: Am J Sports Med. 2004 Mar;32(2):484-93
references: 14977678
references: J Orthop Res. 2006 Mar;24(3):559-68
references: 16463364
references: J Orthop Sports Phys Ther. 2003 Mar;33(3):109-17
references: 12683686
references: J Bone Joint Surg Am. 1992 Jan;74(1):53-66
references: 1734014
references: J Biomech. 2000 Sep;33(9):1063-8
references: 10854878
references: J Biomech. 1993 Jun;26(6):625-32
references: 8514808
references: Am J Sports Med. 2003 Jan-Feb;31(1):126-34
references: 12531769
references: Clin Biomech (Bristol, Avon). 2002 Nov-Dec;17(9-10):650-9
references: 12446161
references: Am J Sports Med. 1999 Nov-Dec;27(6):784-91
references: 10569366
references: J Orthop Sports Phys Ther. 1996 Aug;24(2):57-65
references: 8832468
references: Phys Ther. 2000 Mar;80(3):276-91
references: 10696154
references: J Shoulder Elbow Surg. 2010 Mar;19(2):216-23
references: 19733487
references: Br J Sports Med. 2010 Nov;44(14):1010-5
references: 19752153
references: J Orthop Sports Phys Ther. 2005 Apr;35(4):227-38
references: 15901124
references: Dyn Med. 2006 Jun 09;5:7
references: 16762080
references: J Electromyogr Kinesiol. 2011 Oct;21(5):861-7
references: 21807535
references: Orthopedics. 2002 Jan;25(1):75-8
references: 11811247
references: Clin Biomech (Bristol, Avon). 2003 Jun;18(5):369-79
references: 12763431
references: J Strength Cond Res. 2005 Aug;19(3):628-33
references: 16095413