title: Electromyographic Analysis of the Shoulder Girdle Musculature During External Rotation Exercises.
abstract: BACKGROUND
  Implementation of overhead activity, a key component of many professional sports, requires an effective and balanced activation of the shoulder girdle muscles, particularly during forceful external rotation (ER) motions.
  
  
  OBJECTIVE
  To identify activation strategies of 16 shoulder girdle muscles/muscle segments during common shoulder ER exercises.
  
  
  METHODS
  Descriptive laboratory study.
  
  
  METHODS
  Thirty healthy subjects were included in this study, and 16 shoulder girdle muscles/muscle segments were investigated (surface electrode: anterior, middle, and posterior deltoid; upper, middle, and lower trapezius; serratus anterior; teres major; upper and lower latissimus dorsi; and upper and lower pectoralis major; fine wire electrodes: supraspinatus, infraspinatus, subscapularis, and rhomboid major) using a telemetric electromyography (EMG) system. Five ER exercises (standing ER at 0° and 90° of abduction, with underarm towel roll, prone ER at 90° of abduction, side-lying ER with underarm towel) were studied. Exercise EMG amplitudes were normalized to EMG at maximum ER force in a standard position. Univariate analysis of variance and post hoc analysis applied on EMG activity of each muscle were used to assess the main effect of the exercise condition.
  
  
  RESULTS
  Muscular activity differed significantly among the ER exercises (P < .05 to P < .001). The greatest activation for anterior and middle deltoid, supraspinatus, upper trapezius, and serratus anterior occurred during standing ER at 90° of abduction; for posterior deltoid, middle trapezius, and rhomboid during side-lying ER with underarm towel; for lower trapezius, upper and lower latissimus dorsi, subscapularis, and teres major during prone ER at 90° of abduction; and for the clavicular and sternal part of the pectoralis major during standing ER with underarm towel.
  
  
  CONCLUSIONS
  Key glenohumeral and scapular muscles can be optimally activated during specific ER exercises, particularly in positions that stimulate athletic overhead motions.
  
  
  CONCLUSIONS
  These results enable sports medicine professionals to target specific muscles during shoulder rehabilitation protocols while minimizing the effect of others, providing a foundation for optimal evidence-based exercise prescription. They also provide information for tailored muscle training and injury prevention in overhead sports.
authors.affiliation: School of Health Sciences, Liverpool Hope University, Liverpool, UK.
authors.forename: Omid
authors.initials: O
authors.lastname: Alizadehkhaiyat
authors.affiliation: Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
authors.forename: David H
authors.initials: DH
authors.lastname: Hawkes
authors.affiliation: Department of Musculoskeletal Biology II, Institute of Ageing & Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Kemp
authors.affiliation: Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Frostick
keywords: electromyography; external rotation; overhead sports; rehabilitation; shoulder exercises