Archives of Orthopaedic and Trauma Surgery

, Volume 135, Issue 4, pp 549–563 | Cite as

Electromyographic analysis: shoulder muscle activity revisited

  • Philipp Heuberer
  • Andreas Kranzl
  • Brenda Laky
  • Werner Anderl
  • Christian Wurnig
Arthroscopy and Sports Medicine
First Online:
Received:

Abstract

Introduction

Restoring optimal strength and biomechanics of a pathologic shoulder knowledge of activity patterns of healthy glenohumeral muscles is mandatory. Yet, data on normal shoulder muscle activity are not always conclusive. The study was undertaken (a) to evaluate muscle activity patterns in the healthy shoulder using surface and fine-wire electromyography (EMG), and (b) to assess method’s suitability in the clinical setting especially regarding painfulness and practicability.

Materials and methods

Surface and fine-wire EMG was performed on 11 healthy subjects (2f/9m, Ø age 28 years) to assess 14 muscles including rotator cuff muscles during 8 planar standardised shoulder movements (abduction, forward flexion, internal and external rotation in neutral, 45° and 90° abduction). Pain was assessed using the visual analogue scale before testing, after inserting the fine-wire electrodes, after maximal voluntary contraction, before and after exercises, and after electrode removal.

Results

The most important finding regarding EMG activity patterns in the healthy shoulder was that the subscapularis activity was found to play a major role in abduction and forward flexion. Furthermore, this study was able to show that EMG measurements, especially fine-wire EMG, is prone to high failure rates (up to 32 %); however, pain was not a limiting factor.

Conclusion

The present study (1) revealed a new insight, especially finding the subscapularis activity playing a major role in abduction and forward flexion of the healthy shoulder; and (2) motion analysis system and the use of fine-wire electrodes were prone to failure; however, pain was not a limiting factor.

Level of evidence

Basic Science, Electrodiagnostic Study.

Keywords

Electromyography Shoulder muscles Rotator cuff Fine-wire electrodes Activity patterns Rehabilitation 
This is a preview of subscription content, log in to check access.

Notes

Conflict of interest

The authors certify that they have no affiliations with or financial involvement in any organisation or entity with a direct financial interest in the subject matter or materials discussed in the manuscript.

References

  1. 1.
    Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K (2004) The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 86-A(2):219–224PubMedGoogle Scholar
  2. 2.
    Park JY, Siti HT, Keum JS, Moon SG, Oh KS (2010) Does an arthroscopic suture bridge technique maintain repair integrity?: a serial evaluation by ultrasonography. Clin Orthop Relat Res 468(6):1578–1587. doi: 10.1007/s11999-009-0990-8 CrossRefPubMedCentralPubMedGoogle Scholar
  3. 3.
    Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG (2005) Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am 87(6):1229–1240. doi: 10.2106/JBJS.D.02035 CrossRefPubMedGoogle Scholar
  4. 4.
    Koo SS, Burkhart SS (2010) Rehabilitation following arthroscopic rotator cuff repair. Clin Sports Med 29(2):203–211, vii. doi: 10.1016/j.csm.2009.12.001 CrossRefPubMedGoogle Scholar
  5. 5.
    Lee BG, Cho NS, Rhee YG (2012) Effect of two rehabilitation protocols on range of motion and healing rates after arthroscopic rotator cuff repair: aggressive versus limited early passive exercises. Arthroscopy 28(1):34–42. doi: 10.1016/j.arthro.2011.07.012 CrossRefPubMedGoogle Scholar
  6. 6.
    Ghodadra NS, Provencher MT, Verma NN, Wilk KE, Romeo AA (2009) Open, mini-open, and all-arthroscopic rotator cuff repair surgery: indications and implications for rehabilitation. J Orthop Sports Phys Ther 39(2):81–89. doi: 10.2519/jospt.2009.2918 CrossRefPubMedGoogle Scholar
  7. 7.
    Brislin KJ, Field LD, Savoie FH 3rd (2007) Complications after arthroscopic rotator cuff repair. Arthroscopy 23(2):124–128. doi: 10.1016/j.arthro.2006.09.001 CrossRefPubMedGoogle Scholar
  8. 8.
    Parsons BO, Gruson KI, Chen DD, Harrison AK, Gladstone J, Flatow EL (2010) Does slower rehabilitation after arthroscopic rotator cuff repair lead to long-term stiffness? J Shoulder Elbow Surg 19(7):1034–1039. doi: 10.1016/j.jse.2010.04.006 CrossRefPubMedGoogle Scholar
  9. 9.
    Inman VT, Saunders JB, Abbott LC (1996) Observations of the function of the shoulder joint. 1944. Clin Orthop Relat Res 330:3–12CrossRefPubMedGoogle Scholar
  10. 10.
    Alpert SW, Pink MM, Jobe FW, McMahon PJ, Mathiyakom W (2000) Electromyographic analysis of deltoid and rotator cuff function under varying loads and speeds. J Shoulder Elbow Surg 9(1):47–58CrossRefPubMedGoogle Scholar
  11. 11.
    David G, Magarey ME, Jones MA, Dvir Z, Turker KS, Sharpe M (2000) EMG and strength correlates of selected shoulder muscles during rotations of the glenohumeral joint. Clin Biomech (Bristol, Avon) 15(2):95–102CrossRefGoogle Scholar
  12. 12.
    Kronberg M, Nemeth G, Brostrom LA (1990) Muscle activity and coordination in the normal shoulder. An electromyographic study. Clin Orthop Relat Res 257:76–85PubMedGoogle Scholar
  13. 13.
    Wickham J, Pizzari T, Stansfeld K, Burnside A, Watson L (2010) Quantifying ‘normal’ shoulder muscle activity during abduction. J Electromyogr Kinesiol 20(2):212–222. doi: 10.1016/j.jelekin.2009.06.004 CrossRefPubMedGoogle Scholar
  14. 14.
    Hawkes DH, Alizadehkhaiyat O, Fisher AC, Kemp GJ, Roebuck MM, Frostick SP (2012) Normal shoulder muscular activation and co-ordination during a shoulder elevation task based on activities of daily living: an electromyographic study. J Orthop Res 30(1):53–60. doi: 10.1002/jor.21482 CrossRefPubMedGoogle Scholar
  15. 15.
    Townsend H, Jobe FW, Pink M, Perry J (1991) Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. Am J Sports Med 19(3):264–272CrossRefPubMedGoogle Scholar
  16. 16.
    Jobe FW, Moynes DR (1982) Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries. Am J Sports Med 10(6):336–339CrossRefPubMedGoogle Scholar
  17. 17.
    Worrell TW, Corey BJ, York SL, Santiestaban J (1992) An analysis of supraspinatus EMG activity and shoulder isometric force development. Med Sci Sports Exerc 24(7):744–748CrossRefPubMedGoogle Scholar
  18. 18.
    Malanga GA, Jenp YN, Growney ES, An KN (1996) EMG analysis of shoulder positioning in testing and strengthening the supraspinatus. Med Sci Sports Exerc 28(6):661–664CrossRefPubMedGoogle Scholar
  19. 19.
    Kelly BT, Kadrmas WR, Speer KP (1996) The manual muscle examination for rotator cuff strength. An electromyographic investigation. Am J Sports Med 24(5):581–588CrossRefPubMedGoogle Scholar
  20. 20.
    Reinold MM, Macrina LC, Wilk KE, Fleisig GS, Dun S, Barrentine SW, Ellerbusch MT, Andrews JR (2007) Electromyographic analysis of the supraspinatus and deltoid muscles during 3 common rehabilitation exercises. J Athl Train 42(4):464–469PubMedCentralPubMedGoogle Scholar
  21. 21.
    Itoi E, Morrey BF, An KN (2009) Biomechanics of the shoulder. In: Rockwood CA Jr, Matsen FA, Wirth MA, Lippitt SB (eds) The Shoulder, vol 1, 4th edn. Saunders Elsevier, Philadelphia, pp 213–265Google Scholar
  22. 22.
    Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMedGoogle Scholar
  23. 23.
    Delagi EF, Perotto A (eds) (1980) Anatomic guide for the electromyographer, 2nd edn. Charles C. Thomas, SpringfieldGoogle Scholar
  24. 24.
    Gowan ID, Jobe FW, Tibone JE, Perry J, Moynes DR (1987) A comparative electromyographic analysis of the shoulder during pitching. Professional versus amateur pitchers. Am J Sports Med 15(6):586–590CrossRefPubMedGoogle Scholar
  25. 25.
    Digiovine NM, Jobe FW, Pink M, Perry J (1992) An electromyographic analysis of the upper extremity in pitching. J Shoulder Elbow Surg 1(1):15–25. doi: 10.1016/S1058-2746(09)80011-6 CrossRefPubMedGoogle Scholar
  26. 26.
    Glousman R, Jobe F, Tibone J, Moynes D, Antonelli D, Perry J (1988) Dynamic electromyographic analysis of the throwing shoulder with glenohumeral instability. J Bone Joint Surg Am 70(2):220–226PubMedGoogle Scholar
  27. 27.
    Scovazzo ML, Browne A, Pink M, Jobe FW, Kerrigan J (1991) The painful shoulder during freestyle swimming. An electromyographic cinematographic analysis of twelve muscles. Am J Sports Med 19(6):577–582CrossRefPubMedGoogle Scholar
  28. 28.
    Wilk KE, Arrigo CA, Andrews JR (1997) Current concepts: the stabilizing structures of the glenohumeral joint. J Orthop Sports Phys Ther 25(6):364–379. doi: 10.2519/jospt.1997.25.6.364 CrossRefPubMedGoogle Scholar
  29. 29.
    Decker MJ, Tokish JM, Ellis HB, Torry MR, Hawkins RJ (2003) Subscapularis muscle activity during selected rehabilitation exercises. Am J Sports Med 31(1):126–134PubMedGoogle Scholar
  30. 30.
    Suenaga N, Minami A, Fujisawa H (2003) Electromyographic analysis of internal rotational motion of the shoulder in various arm positions. J Shoulder Elbow Surg 12(5):501–505. doi: 10.1016/S1058274603001691 CrossRefPubMedGoogle Scholar
  31. 31.
    Reinold MM, Wilk KE, Fleisig GS, Zheng N, Barrentine SW, Chmielewski T, Cody RC, Jameson GG, Andrews JR (2004) Electromyographic analysis of the rotator cuff and deltoid musculature during common shoulder external rotation exercises. J Orthop Sports Phys Ther 34(7):385–394. doi: 10.2519/jospt.2004.34.7.385 CrossRefPubMedGoogle Scholar
  32. 32.
    Murphy CA, McDermott WJ, Petersen RK, Johnson SE, Baxter SA (2013) Electromyographic analysis of the rotator cuff in postoperative shoulder patients during passive rehabilitation exercises. J Shoulder Elbow Surg 22(1):102–107. doi: 10.1016/j.jse.2012.01.021 CrossRefPubMedGoogle Scholar
  33. 33.
    Sciascia A, Kuschinsky N, Nitz AJ, Mair SD, Uhl TL (2012) Electromyographical comparison of four common shoulder exercises in unstable and stable shoulders. Rehabil Res Pract 2012:783824. doi: 10.1155/2012/783824 PubMedCentralPubMedGoogle Scholar
  34. 34.
    Illyes A, Kiss RM (2006) Kinematic and muscle activity characteristics of multidirectional shoulder joint instability during elevation. Knee Surg Sports Traumatol Arthrosc 14(7):673–685. doi: 10.1007/s00167-005-0012-7 CrossRefPubMedGoogle Scholar
  35. 35.
    Kronberg M, Brostrom LA, Nemeth G (1991) Differences in shoulder muscle activity between patients with generalized joint laxity and normal controls. Clin Orthop Relat Res 269:181–192PubMedGoogle Scholar
  36. 36.
    Morris AD, Kemp GJ, Lees A, Frostick SP (1998) A study of the reproducibility of three different normalisation methods in intramuscular dual fine wire electromyography of the shoulder. J Electromyogr Kinesiol 8(5):317–322CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Philipp Heuberer
    • 1
  • Andreas Kranzl
    • 2
  • Brenda Laky
    • 1
  • Werner Anderl
    • 1
  • Christian Wurnig
    • 2
  1. 1.Department of OrthopaedicsSt. Vincent Hospital ViennaViennaAustria
  2. 2.Orthopaedic Hospital SpeisingViennaAustria

Personalised recommendations