Comparative electromyographic analysis of shoulder muscles during planar motions: Anterior glenohumeral instability versus normal

This study compared the electromyographic activity of rotator cuff and scapular muscles between subjects with anterior instability and subjects with normal shoulders. Thirty-eight patients were studied; 23 had anterior instability that was subsequently surgically confirmed, and 15 had normal shoulders. Fine wire electrodes were inserted into the subscapularis (upper and lower portions), supraspinatus, infraspinatus, rhomboid, serratus anterior, and trapezius (upper and lower portions) muscles. Abduction, scapular plane abduction (scaption), and forward flexion were performed over the range of motion and later divided into 30° intervals. In both abduction and scaption, the supraspinatus demonstrated significantly less electromyographic activity from 30° to 60° in shoulders with anterior instability compared with normal shoulders (p<0.05). During all three motions, shoulders with anterior instability demonstrated significantly less electromyographic activity in the serratus anterior when compared with normal shoulders (p<0.05). This occurred at 30° to 120° of abduction and at 0° to 120° of scaption and forward flexion. None of the other muscles demonstrated significant differences. These differences during planar motions were similar to those demonstrated during challenging overhead sport motions. Early rehabilitation efforts should focus both on the rotator cuff and scapular muscles to establish smooth, coordinated shoulder motion.