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* Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital, Ghent
private practice, Gravenwezel, Belgium
Address correspondence and reprint requests to Ann M. Cools, PT, University Hospital Ghent, Department of Rehabilitation Sciences and Physiotherapy, De Pintelaan 185, 6K3, B9000 Ghent, Belgium
Background: Altered muscle activity in the scapular muscles is commonly believed to be a factor contributing to shoulder impingement syndrome. However, one important measure of the muscular coordination in the scapular muscles, the timing of the temporal recruitment pattern, is undetermined.
Purpose: To evaluate the timing of trapezius muscle activity in response to an unexpected arm movement in athletes with impingement and in normal control subjects.
Study Design: Prospective cohort study.
Methods: Muscle latency times were measured in all three parts of the trapezius muscle and in the middle deltoid muscle of 39 "overhand athletes" with shoulder impingement and compared with that of 30 overhand athletes with no impingement during a sudden downward falling movement of the arm.
Results: There were significant differences in the relative muscle latency times between the impingement and the control group subjects. Those with impingement showed a delay in muscle activation of the middle and lower trapezius muscle.
Conclusion: The results of this study indicate that overhand athletes with impingement symptoms show abnormal muscle recruitment timing in the trapezius muscle. The findings support the theory that impingement of the shoulder may be related to delayed onset of contraction in the middle and lower parts of the trapezius muscle.
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  W. B. Kibler, A. D. Sciascia, T. L. Uhl, N. Tambay, and T. Cunningham Electromyographic Analysis of Specific Exercises for Scapular Control in Early Phases of Shoulder Rehabilitation Am. J. Sports Med., September 1, 2008; 36(9): 1789 - 1798. [Abstract] [Full Text] [PDF]
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 A M Cools, D Cambier, and E E Witvrouw Screening the athlete's shoulder for impingement symptoms: a clinical reasoning algorithm for early detection of shoulder pathology Br. J. Sports Med., August 1, 2008; 42(8): 628 - 635. [Abstract] [Full Text] [PDF]
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A M Cools, G Declercq, B Cagnie, D Cambier, and E Witvrouw Internal impingement in the tennis player: rehabilitation guidelines Br. J. Sports Med., March 1, 2008; 42(3): 165 - 171. [Abstract] [Full Text] [PDF]
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K. G. Laudner, J. M. Stanek, and K. Meister Differences in Scapular Upward Rotation Between Baseball Pitchers and Position Players Am. J. Sports Med., December 1, 2007; 35(12): 2091 - 2095. [Abstract] [Full Text] [PDF]
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A. M. Cools, V. Dewitte, F. Lanszweert, D. Notebaert, A. Roets, B. Soetens, B. Cagnie, and E. E. Witvrouw Rehabilitation of Scapular Muscle Balance: Which Exercises to Prescribe? Am. J. Sports Med., October 1, 2007; 35(10): 1744 - 1751. [Abstract] [Full Text] [PDF]
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 G. Koel, K. M Johansson, L. E Adolfsson, and M. O. Foldevi Anti-impingement Therapy? Physical Therapy, January 1, 2006; 86(1): 143 - 144. [Full Text] [PDF]
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J. A. Reo and V. S. Mercer Effects of Live, Videotaped, or Written Instruction on Learning an Upper-Extremity Exercise Program Physical Therapy, July 1, 2004; 84(7): 622 - 633. [Abstract] [Full Text] [PDF]
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A M Cools, E E Witvrouw, G A Declercq, G G Vanderstraeten, and D C Cambier Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms Br. J. Sports Med., February 1, 2004; 38(1): 64 - 68. [Abstract] [Full Text] [PDF]
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