Shrug exercises combined with shoulder abduction improve scapular upward rotator activity and scapular alignment in subjects with scapular downward rotation impairment

Sequential Changes in Scapular Range of Motion After An Intervention Using the KOJI AWARENESS Original "Wall Angel Slider" Exercise

CONTEXT

We aimed to evaluate the sequential changes in the scapular range of motion (ROM) after an intervention using the KOJI AWARENESS Original Wall Angel Slider exercise in which reverse motion is applied.

DESIGN

This study used a single-group, pretest-posttest design to evaluate changes in scapular ROM following an intervention.

METHODS

Participants (n = 54) underwent a 2-week intervention in this study. Scapular mobility was screened using the KOJI AWARENESS Self-Screening Scapula Mobility test, and participants with scapular mobility restrictions were recruited (n = 48). The participants performed the Wall Angel Slider exercise involving reverse motion tasks with dynamic sliding movements against a wall. They performed 3 sets of 8 repetitions for 6 sessions in 2 weeks, and adherence to the exercise regimen was monitored using a checklist. The scapular upward rotation and glenohumeral joint external rotation ROM were measured before the intervention, immediately after the first session, and after 2 weeks of the intervention.

RESULTS

The participants exhibited significant improvements in scapular upward rotation and glenohumeral external rotation ROM after the first session of an intervention using the Wall Angel Slider exercise and after 2 weeks of the intervention.

CONCLUSION

The KOJI AWARENESS Original Wall Angel Slider exercise effectively improves scapular upward rotation and glenohumeral joint external rotation ROM over a 2-week intervention period, suggesting its potential utility in enhancing scapular mobility and function in clinical practice.

Scapular Muscle Activation at Different Shoulder Abduction Angles During Pilates Reformer Arm Work Exercise

Background and Objectives: Scapular muscles are crucial in controlling scapular movement, ensuring proper alignment, and preventing injuries during shoulder joint motion. The shoulder abduction angle is one of the most important factors when performing exercises to improve scapular movement control. The Pilates reformer arm work (AW) movement can be performed with different shoulder abduction angles. Therefore, this study analyzed the differences in scapular muscle activation depending on the shoulder abduction angle during the AW movement. Materials and Methods: Twenty-six healthy adult males performed the AW movement under four shoulder abduction angle conditions (0°, 90°, 135°, 160°). When performing the AW in the four conditions, surface electromyography analyzed the muscle activation of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), serratus anterior (SA), posterior deltoid (PD), and levator scapulae (LS), and the muscle activation ratios of the UT/LT, LS/LT, UT/SA, and LS/SA. Results: The UT, LT, and SA muscle activation increased proportionally with the increasing shoulder abduction angle (p < 0.001). The LT showed the highest muscle activity at the shoulder abduction angle of 135° (p < 0.001). The MT and PD showed the highest muscle activities at the shoulder abduction angle of 90° (p < 0.001). The muscle activity ratios of the UT/LT and LS/LT were the lowest at the shoulder abduction angles of 90° and 135° (p < 0.001). The muscle activity ratio between the UT/SA and LS/SA was the lowest at the 135° and 160° shoulder abduction angles (p < 0.001). Conclusions: Our findings highlight the impact of the shoulder abduction angle on scapular muscle activation, suggesting that different angles may be used to engage specific muscles during Pilates reformer arm work exercises selectively. This insight can guide exercise interventions for individuals aiming to improve their scapular control and stability.

Scapular muscle dynamic stiffness of asymptomatic subjects and subjects with chronic shoulder pain, at rest and isometric contraction conditions

Muscle stiffness had a crucial role in joint stability, particularly, at the shoulder complex. Although changes in upper trapezius muscle stiffness have been described for shoulder pain, contradictory findings have been obtained. Also, existing data regarding scapular muscles are, majorly, about trapezius. Myotonometry is a method used to assess stiffness; however, the reliability values of scapular muscle stiffness through this method have not been assessed in shoulder pain conditions. The present study aims to compare scapular muscles' stiffness (trapezius, serratus anterior, and levator scapulae) between subjects with and without chronic shoulder pain and to evaluate the related test-retest reliability. Twenty-two symptomatic and twenty-two asymptomatic subjects participated in a cross-sectional study. The dynamic muscular stiffness of scapular muscles, at rest and during an isometric contraction, was measured bilaterally with myotonometry, in two moments. The differences in bilateral averaged values between symptomatic and asymptomatic subjects and the effect of the group (group presenting pain in the dominant or non-dominant side, and asymptomatic group) and of the limb (unilateral painful or asymptomatic limb, and bilateral asymptomatic limbs) were investigated. Test-retest intra-rater reliability was determined. An effect of the group was observed at rest, for middle trapezius stiffness, and during contraction, for middle and lower trapezius stiffness. For middle trapezius, increased values were observed in the group presenting pain in non-dominant side comparing to both groups or to group presenting pain in dominant side. The intraclass correlation coefficient, majorly, ranged between 0.775 and 0.989. Participants with pain in the non-dominant side presented an increased middle trapezius' stiffness. Globally, high reliability was observed for scapular muscles dynamic stiffness.

Scapular Dynamic Muscular Stiffness Assessed through Myotonometry: A Narrative Review

Several tools have been used to assess muscular stiffness. Myotonometry stands out as an accessible, handheld, and easy to use tool. The purpose of this review was to summarize the psychometric properties and methodological considerations of myotonometry and its applicability in assessing scapular muscles. Myotonometry seems to be a reliable method to assess several muscles stiffness, as trapezius. This method has been demonstrated fair to moderate correlation with passive stiffness measured by shear wave elastography for several muscles, as well as with level of muscle contraction, pinch and muscle strength, Action Research Arm Test score and muscle or subcutaneous thickness. Myotonometry can detect scapular muscles stiffness differences between pre- and post-intervention in painful conditions and, sometimes, between symptomatic and asymptomatic subjects.

Focus on the Scapular Region in the Rehabilitation of Chronic Neck Pain Is Effective in Improving the Symptoms: A Randomized Controlled Trial

Chronic neck pain is a common human health problem. Changes in scapular posture and alteration of muscle activation patterns of scapulothoracic muscles are cited as potential risk factors for neck pain. The purpose of this study was to compare the effects of neck exercise training (NET) with and without scapular stabilization training (SST) on pain intensity, the scapula downward rotation index (SDRI), forward head angle (FHA) and neck range of motion (ROM) in patients with chronic neck pain and scapular dyskinesia. A total of sixty-six subjects with chronic neck pain and scapular dyskinesia were randomly divided into three groups: neck exercise training, n = 24, combined training (NET + SST), n = 24 and a control group, n = 24. Pain intensity, SDRI, FHA and ROM were measured by the numerical rating scale, caliper, photogrammetry and IMU sensor, respectively. When the combined intervention group consisting of NET and SST was compared with NET alone at six weeks, there was a statistically significant difference in pain intensity, SDRI, FHA and cervical ROM for flexion and extension (p ≤ 0.05). Adding scapular exercises to neck exercises had a more significant effect in decreasing pain intensity, SDRI, FHA and increased cervical ROM than neck exercises alone in patients with chronic neck pain. These findings indicate that focus on the scapular posture in the rehabilitation of chronic neck pain effectively improves the symptoms.

Mechanisms of Modulation of Automatic Scapulothoracic Muscle Contraction Timings

Erected posture provides humans a large shoulder mobility that requires complex automatic muscle synergies to accomplish joint stability needs. This is evident in shoulder abduction, wherein the voluntary activation of glenohumeral muscles is coupled with an automatic recruitment of scapulothoracic muscles. Here, we investigated whether volitional modification of the scapular position, and dynamic scapular elevation, modulate the contraction timing of five shoulder muscles (middle deltoid, upper, middle and lower fiber of the trapezius, serratus anterior) during shoulder abduction. The results show matched contraction timings of the deltoid and upper trapezius across the scapular positions, whereas the contraction timings of the middle and lower fibers of the trapezius change secondary to the scapular position. These results might reflect different central strategies to coordinate the automatic sequences of contraction of the scapulothoracic muscles. This suggest a flexible and adaptable predisposition of the motor control system in exploring alternative solutions to accomplish the functional movement needs, such as the fulfillment of unconstrained movements. Intriguingly, the shoulder abduction may represent a powerful, non-invasive, and straightforward tool to deepen the understanding of the neural basis underlying the voluntary motor command modulation of the out-of-volition automatic muscle contractions.

Comparison of the effects of sensorimotor training programs on pain, electromyography and kinematics in patients with scapular downward rotation syndrome

OBJECTIVES

Comparison of the effects of six weeks sensorimotor and sensorimotor with passive interventions programs on pain, electromyography (EMG) and kinematics in patients with scapular downward rotation syndrome (SDRS).

DESIGN

Randomized Controlled Trial.

SETTING

Institutional practice.

PARTICIPANTS

140 active subjects with unilateral SDRS were randomized to three groups. Group one received sensorimotor (n = 46), group two received sensorimotor with passive interventions (n = 48), and group three received active self-exercise as a control group (n = 46). Pain, EMG of the levator scapula (LS), upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA), as well as kinematics were measured at the baseline and after the interventions.

MAIN OUTCOME MEASURES

Primary outcome: Pain - Secondary outcomes: EMG and kinematics.

RESULTS

There were significant between-group differences between intervention groups one and two in pain, LS and SA onset activation favoring group two and LS muscle activity favoring group one. There were significant within-group changes in almost all dependent variables except LT muscle onset activation in both groups one and two.

CONCLUSIONS

The addition of passive interventions on the scapula and neck may be superior to conservative training alone on the scapula and neck for improving neck pain, EMG and kinematics in participants with SDRS.

Stretching position can affect levator scapular muscle activity, length, and cervical range of motion in people with a shortened levator scapulae

OBJECTIVES

Levator scapulae (LS) muscle stretching exercises are a common method of lengthening a shortened muscle; however, the appropriate stretching position for lengthening the LS in people with a shortened LS remains unclear. The purpose of this study was to compare the effects of different stretching exercise positions on the LS and introduce effective stretching exercise methods to clinicians.

PARTICIPANTS

Twenty-four university students (12 men, 12 women) with a shortened LS were recruited.

METHODS

LS muscle activity, LS index (LSI), and cervical range of motion (ROM) were measured pre (baseline) and post three different stretching exercise positions (sitting, quadruped, and prone).

RESULTS

The LSI and cervical ROM exceeded the minimal detectable change and had significant changes. The LSI was greater in the sitting position than at the baseline (p = 0.01), quadruped position (p < 0.01); the LSI in the prone position presented a higher increase than the quadruped position (p = 0.01). The cervical ROM increased in the sitting position when compared to the baseline (p < 0.01) and quadruped position (p < 0.01).

CONCLUSIONS

Stretching the LS in the sitting position was the most effective exercise for improving LS muscle length and cervical ROM.

The effects of wall slide and sling slide exercises on scapular alignment and pain in subjects with scapular downward rotation

[Purpose] The present study was performed to evaluate the changes in the scapular alignment, pressure pain threshold and pain in subjects with scapular downward rotation after 4 weeks of wall slide exercise or sling slide exercise. [Subjects and Methods] Twenty-two subjects with scapular downward rotation participated in this study. The alignment of the scapula was measured using radiographic analysis (X-ray). Pain and pressure pain threshold were assessed using visual analogue scale and digital algometer. Patients were assessed before and after a 4 weeks of exercise. [Results] In the within-group comparison, the wall slide exercise group showed significant differences in the resting scapular alignment, pressure pain threshold, and pain after four weeks. The between-group comparison showed that there were significant differences between the wall slide group and the sling slide group after four weeks. [Conclusion] The results of this study found that the wall slide exercise may be effective at reducing pain and improving scapular alignment in subjects with scapular downward rotation.