Scapulothoracic and Scapulohumeral Exercises: A Narrative Review of Electromyographic Studies

Study Design: Narrative review. Introduction: A well-constructed rehabilitation program of the shoulder complex is critical to stabilizing the scapulothoracic and scapulohumeral joints while encouraging normal scapulohumeral rhythm. Review of the literature demonstrates a variety of scapulothoracic and glenohumeral conditioning exercises. Purpose: To assist the occupational and physical therapist in prioritizing exercises for a shoulder conditioning program based on a narrative review of electromyographic (EMG) studies of the shoulder. Methods: The authors performed a comprehensive literature search of approximately 250 articles describing shoulder (EMG) testing of the rotator cuff and periscapular musculature. Twenty-two articles were selected based on the author's inclusion criteria. The authors developed a flow sheet outlining each exercise, starting and ending positions, principle muscle(s), and description of exercise. Exercises were assigned to two different muscle groups: rotator cuff or periscapular depending on the principle muscles activated. Results: The 22 included articles provided an evidenced-based list of exercises aimed to efficiently and maximally recruit specific rotator cuff and periscapular musculature. Based on these 22 articles, the authors were able to establish a useful series of exercises to promote glenohumeral stability and foster normal scapulohumeral rhythm. Those exercises that elicited the highest maximum voluntary isometric contraction recruitment and were cited to be critical for stability and scapulohumeral rhythm were selected for the exercise flow sheet. Conclusions: This review provides a useful evidence-based tool to establish a practical shoulder exercise program. Level of Evidence: Level 5. J HAND THER. 2011;24:322-34.