Biceps Disorder Rehabilitation for the Athlete: A Continuum of Moderate- to High-Load Exercises

Borms, Dorien; Ackerman, Inge; Smets, Pieter; Berge, Glen Van den; Cools, Ann

doi:10.1177/0363546516674190

Cited by 21 publications

(19 citation statements)

References 42 publications

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“…1); pectoralis minor may be inhibited by performing ER, with preference in an open kinetic chain [49]; serratus anterior is more activated during elevation exercises than isolated protraction exercises [53]; rotator cuff activity is low during low-load closed-chain exercises such as bench or wall slides [48] (Figs. 2 and 3); infra-and supraspinatus activity is high during ER exercises [48]; subscapularis activity may be increased by performing flexionextension exercises in low elevation angles [54]; biceps activity is high during plyometric elevation exercises in supination [55]; exercises with an open hand favor middle trapezius and lower trapezius activity, whereas making a fist possibly increases rotator cuff activity [52,56]; the clinician may combine the above-mentioned guidelines in the individualized exercise program, based on several treatment goals, thereby resulting in a variety of specific exercises.…”

Section: How Do We Select the Appropriate Exercises?mentioning

confidence: 99%

The challenge of the sporting shoulder: From injury prevention through sport-specific rehabilitation toward return to play

Cools¹,

Maenhout²,

Vanderstukken³

et al. 2021

Annals of Physical and Rehabilitation Medicine

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Section: How Do We Select the Appropriate Exercises?mentioning

confidence: 99%

The challenge of the sporting shoulder: From injury prevention through sport-specific rehabilitation toward return to play

Cools¹,

Maenhout²,

Vanderstukken³

et al. 2021

Annals of Physical and Rehabilitation Medicine

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“…However, the results of this exercise were obtained in only one study. 42 Therefore, this suggestion should be interpreted with caution. In addition, this review found that the UT was less active than the MT and LT during the supine pull-up with a pronated grip exercise.…”

Section: Discussionmentioning

confidence: 97%

“…Although pull-up exercises are not as common as push-ups in the clinical setting, it was found in this review that all 3 muscle ratios were excellent during half supine pull-ups with slings ( Figure 5C). 42 This exercise may be an option for the restoration of scapular muscle imbalance by selective strengthening of the MT, LT, and SA. However, the results of this exercise were obtained in only one study.…”

Section: Discussionmentioning

confidence: 99%

Muscle Activity Ratios of Scapular Stabilizers During Closed Kinetic Chain Exercises in Healthy Shoulders: A Systematic Review

Karabay¹,

Emük²,

Kaya³

2020

Journal of Sport Rehabilitation

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Context: Selective strengthening of scapular stabilizers is one of the emphases of the recent literature. Closed kinetic chain (CKC) exercises are used extensively in shoulder rehabilitation. However, a limited number of studies have reported scapular muscle ratios during CKC exercises. Objectives: To determine the CKC exercises producing the optimal ratios of the scapular stabilizer muscles in healthy shoulders. Evidence Acquisition: A systematic search within PubMed, Embase, CINAHL Plus, and SPORTDiscus with Full Text and ULAKBIM National Medical Database was performed up to January 2018. Studies were selected according to the predetermined criteria. If the pooled mean ratios (upper trapezius [UT]/middle trapezius [MT], UT/lower trapezius [LT], and UT/serratus anterior [SA]), which were calculated from the percentage of maximum voluntary contractions of muscles, were <0.60, these exercises were considered as ideal for higher activation of the MT, LT, and SA than the UT. Evidence Synthesis: The search identified 1284 studies, and 29 observational studies were included for review. Seventy-nine CKC exercises were determined. Four exercises for the MT, 9 for the LT, and 59 for the SA were identified from the articles as being optimal exercises to activate the specified muscle more than the UT. Conclusions: This review identified optimal CKC exercises that provide good ratios between the MT, LT, and SA with the UT. Most exercises have optimal UT/SA ratios, but some exercises performed on unstable surfaces may lead to excessive activation of the UT relative to the SA. For the UT/MT, the isometric low row, inferior glide, and half supine pull-up with slings are the ideal exercises. Isometric one-hand knee push-up variations seem to be the best choice for the UT/LT. The results suggest that many CKC exercises may be utilized to enhance scapular muscle balance when rehabilitating shoulder pathology.

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“…Between MVIC measurements of different muscles, 15 seconds of rest were provided. 18 Second, participants randomly performed 5 variations of bilateral elevation with external rotation: (1) open-hand position as reference exercise, (2) closed-hand (ie, making a fist) position, (3) dynamic bipedal squat, (4) static unipedal squat on the contralateral leg, and (5) dynamic unipedal squat on the contralateral leg (see Figure A through E and Table 1 for exercise descriptions). Comparison of exercises 1 and 2 will be referred to as ''altering upper extremity position,'' while comparison of exercises 1 and 3 through 5 is described as ''incorporation of the lower extremity.''…”

Section: Methodsmentioning

confidence: 99%

“…The color of the elastic band was determined in a pilot study (n ¼ 24) and based on sex and body weight. 18,19 Participants had to rate the exercise effort between 12 and 18 on a 20-point Borg scale, which is considered necessary for training strength. 20 Based on the results of the pilot study, the same elastic bands were used for all men (red) and for all women (yellow).…”

Section: Methodsmentioning

confidence: 99%

Incorporation of the Kinetic Chain Into Shoulder-Elevation Exercises: Does It Affect Scapular Muscle Activity?

Borms

Maenhout

Cools

2020

Journal of Athletic Training

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Context Scapular rehabilitation exercises should focus on selective activation of weaker muscles and minimal activation of hyperactive muscles. For rehabilitation of overhead athletes, single-plane open chain exercises below 90° of shoulder elevation are often recommended. Moreover, incorporating the kinetic chain in shoulder rehabilitation exercises is advised and has been suggested to influence scapular muscle activity levels. Objective To study the influence of kinetic chain incorporation during 5 variations of a shoulder-elevation exercise on scapular muscle activity. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants Thirty-one asymptomatic participants (15 men, 16 women). Main Outcome Measure(s) The electromyographic activity of the upper (UT), middle (MT), and lower (LT) trapezius, and serratus anterior was determined during 5 variations of bilateral elevation with external rotation: (1) open-hand position (reference exercise), (2) closed-hand position, (3) dynamic bipedal squat, (4) static unipedal squat, and (5) dynamic unipedal squat on the contralateral leg. All data were normalized as a percentage of maximal voluntary isometric contraction (MVIC). Results A closed-hand position (exercise 2) instead of an open-hand position (exercise 1) resulted in lower MT (mean difference = 3.44% MVIC) and LT (mean difference = 7.76% MVIC) activity. Incorporating the lower limb (exercises 3–5) increased UT activity when compared with exercise 1 (mean differences = 3.67, 2.68, 5.02% MVIC, respectively), which in general resulted in increased UT : MT ratios. Additionally, LT activity decreased when a dynamic unipedal squat was added (mean difference: 4.90% MVIC). For the serratus anterior, the greatest activity occurred during elevation in a static unipedal squat position (exercise 4, 22.90% MVIC). Conclusions Incorporating the kinetic chain during shoulder-elevation exercises influenced scapular muscle activity and ratios. In particular, incorporating the lower limb resulted in more UT activity, whereas the open-hand position increased MT and LT activity.

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Biceps Disorder Rehabilitation for the Athlete: A Continuum of Moderate- to High-Load Exercises

Abstract: These findings may assist clinicians to select appropriate exercises to be used in the more advanced phases of nonoperative or postoperative rehabilitation of overhead athletes with biceps-related injuries.

Cited by 21 publications

References 42 publications

The challenge of the sporting shoulder: From injury prevention through sport-specific rehabilitation toward return to play

The challenge of the sporting shoulder: From injury prevention through sport-specific rehabilitation toward return to play

Muscle Activity Ratios of Scapular Stabilizers During Closed Kinetic Chain Exercises in Healthy Shoulders: A Systematic Review

Incorporation of the Kinetic Chain Into Shoulder-Elevation Exercises: Does It Affect Scapular Muscle Activity?

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