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. 2015 Nov 4;3(11):2325967115613988.
doi: 10.1177/2325967115613988. eCollection 2015 Nov.

Electromyographic Analysis of the Shoulder Girdle Musculature During External Rotation Exercises

Free PMC article

Electromyographic Analysis of the Shoulder Girdle Musculature During External Rotation Exercises

Omid Alizadehkhaiyat et al. Orthop J Sports Med. .
Free PMC article


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.

Purpose: To identify activation strategies of 16 shoulder girdle muscles/muscle segments during common shoulder ER exercises.

Study design: Descriptive laboratory study.

Method: 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.

Conclusion: Key glenohumeral and scapular muscles can be optimally activated during specific ER exercises, particularly in positions that stimulate athletic overhead motions.

Clinical relevance: 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.

Keywords: electromyography; external rotation; overhead sports; rehabilitation; shoulder exercises.

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This study was internally funded by the Musculoskeletal Science Research Group, University of Liverpool, Liverpool, UK.


Figure 1.
Figure 1.
Mean normalized electromyographic (EMG) activation of all muscles expressed as a percentage of maximum voluntary isometric contraction (MVC) (amplitude mean %) across 5 shoulder external rotation (ER) exercises. All EMG amplitudes were normalized to the reference value determined from ER MVC in a standard position. ABD, abduction; AD, anterior deltoid; ISP, infraspinatus; LLD, lower latissimus dorsi; LPM, lower pectoralis major; LT, lower trapezius; MD, middle deltoid; MT, middle trapezius; PD, posterior deltoid; RHOM, rhomboid major; SA, serratus anterior; SL, side-lying; SUBS, subscapularis; SSP, supraspinatus; TM, teres major; ULD, upper latissimus dorsi; UPM, upper pectoralis major; UT, upper trapezius.

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