In any rehabilitation program, targeting specific muscles is key to reinforce proper movement patterns and enhance the treatment outcome. In scapular rehabilitation training in particular, humeral elevation exercises in the scapular plane are a staple of most programs. There are multiple muscles that play a key role in these movements, and it may be difficult to pick exercises that target a specific muscle, or group of muscles.

Castelein and colleagues (2016) saw the same dilemma. “A comparison of both deep and superficial muscle activity of the scapula between different types of elevation exercises is lacking and would be helpful for the clinician in choosing exercises.” These researchers set out to find some answers by evaluating scapulothoracic muscle activity during different elevation exercises in the scapular plane.

How to Target Muscles During Scapular Rehabilitation

In this study, 21 subjects underwent two types of scapulothoracic muscle activity testing:

  • Fine-wire electromyography in the levator scapulae, pectoralis minor and rhomboid major muscles
  • Surface electromyography in the upper trapezius, middle trapezius, lower trapezius and serratus anterior muscles.

The participants performed three different elevation exercises while their muscle activity was being measured:

  • Scaption

    Courtesy of: http://www.jospt.org/doi/pdf/10.2519/jospt.2016.5927

    Courtesy of: http://www.jospt.org/doi/pdf/10.2519/jospt.2016.5927

  • Towel wall slide

    Courtesy of: http://www.jospt.org/doi/pdf/10.2519/jospt.2016.5927

    Courtesy of: http://www.jospt.org/doi/pdf/10.2519/jospt.2016.5927

  • Elevation in the scapular plane with external rotationScreen Shot 2016-06-13 at 5.33.46 PM

The exercises were performed without and with additional load of a TheraBand elastic resistance band.

The answer

Exercise

Muscle Activation

Scaption Upper trapezius maximally activated
 

Towel wall slide

Highest activity of the pectoralis minor and serratus anterior. Activated the retractors to a lesser degree.
Elevation in the scapular plane with external rotation Higher middle trapezius and lower trapezius activity compared to other exercises

The authors also noted, “adding load resulted in higher muscle activity in all muscles, with some muscles showing a different activation pattern between the elevation exercises, depending on the load condition.”

Share these findings with a colleague and use this data to choose elevation exercises to facilitate specific muscle scapulothoracic activity.

 

Source:
Castelein B et al. 2016. Superficial and Deep Scapulothoracic Muscle Electromyographic Activity During Elevation Exercises in the Scapular Plane. J Orthop Sports Phys Ther. Mar;46(3):184-93.

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