Stretching and strengthening exercises: Their effect on three-dimensional scapular kinematics

      This paper is only available as a PDF. To read, Please Download here.


      Objective: To quantitatively evaluate the effects of commonly used shoulder exercises on shoulder kinematics and resting posture.
      Study Design: A repeated-measures design was used with measurements performed before and after a 6-week exercise program.
      Method: Twenty asymptomatic subjects with forward shoulder posture were recruited. Stretching exercises for the pectoral muscles and resisted strengthening exercises for the scapular retractors and elevators and the glenohumeral abductors and external rotators were performed three times per week for 6 weeks. A three-dimensional electromechanical digitizer was used to measure thoracic inclination and scapular orientation and position. These measurements were taken with the arm (1) at the side, (2) abducted to 90°, and (3) at maximal abduction. The isometric force of glenohumeral external and internal rotation and horizontal abduction and adduction were measured with a hand-held dynamometer. All subjects were tested before and after the 6-week exercise program. Hotelling's T2 and paired t tests were used for data analysis.
      Results: The strength of horizontal abduction and internal and external rotation increased after exercise (p < .01). The anterior inclination of the thoracic spine decreased, and the glenohumeral contribution to arm elevation increased (p < .01). Resting scapular posture did not change. As the arm was abducted to 90°, the scapula showed less upward rotation and less superior translation after the exercise program (p < .01).
      Conclusion: The exercise program improved muscle strength, produced a more erect upper trunk posture, increased scapular stability, and altered scapulohumeral rhythm.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Culham E
        • Peat M
        Functional anatomy of the shoulder complex.
        J Orthop Sports Phys Ther. 1993; 18: 342-350
        • Inman VT
        • Saunders M
        • Abbott LC
        Observations on the function of the shoulder joint.
        J Bone Joint Surg Am. 1944; 26: 1-30
        • Paine RM
        • Voight M
        The role of the scapula.
        J Orthop Sports Phys Ther. 1993; 18: 386-391
        • Kelley MJ
        • Clark WA
        Orthopedic therapy of the shoulder.
        J. B. Lippincott, Philadelphia (PA)1995
        • Kendall FP
        • McCreary EK
        Muscle testing and function.
        3rd ed. Williams & Wilkins, Baltimore (MD)1983
        • Diveta J
        • Walker ML
        • Skibinski B
        Relationship between performance of selected scapular muscles and scapular abduction in standing subjects.
        Phys Ther. 1990; 70: 476-479
        • Greenfield B
        • Catlin PA
        • Coats PW
        • Green E
        • McDonald JJ
        • North C
        Posture in patients with shoulder overuse injuries and healthy individuals.
        J Orthop Sports Phys Ther. 1995; 21: 287-295
        • Allegrucci M
        • Whitney SL
        • Irrgang JJ
        Clinical implications of secondary impingement of the shoulder in freestyle swimmers.
        J Orthop Sports Phys Ther. 1994; 20: 307-318
        • Jobe FW
        • Moynes DR
        Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries.
        Am J Sports Med. 1982; 10: 336-339
        • Kvitne RS
        • Jobe FW
        The diagnosis and treatment of anterior instability in the throwing athlete.
        Clin Orthop. 1993; 291: 107-123
        • Baker-Sawyer K
        • McClure P
        • Fitzgerald K
        The effect of a scapular retraction exercise program on scapular position and scapular muscle force [abstract].
        J Orthop Sports Phys Ther. 1996; 23: 75-76
        • Moseley JB
        • Jobe FW
        • Pink M
        • Perry J
        • Tibone J
        EMG analysis of the scapular muscles during a shoulder rehabilitation program.
        Am J Sports Med. 1992; 20: 128-134
        • McCann PD
        • Wootten ME
        • Kadaba MP
        • Bigliani LU
        A kinematic and electromyographic study of shoulder rehabilitation exercises.
        Clin Orthop. 1993; 288: 179-188
        • Rozier CK
        • Schafer DS
        Isokinetic strength training: comparison of daily and three times weekly patterns.
        Int J Rehabil Res. 1981; 4: 345-351
        • Zmierski T
        • Kegerreis S
        • Scarpaci J
        Scapular muscle strengthening.
        J Sports Rehabil. 1995; : 244-252
        • Freedman L
        • Munro RR
        Abduction of the arm in the scapular plane: scapular and glenohumeral movements.
        in: A roentgenographic study. 5th ed. J Bone Joint Surg. 48. 1966: 1503-1510
        • Cole A
        • McClure P
        • Pratt N
        Scapular kinematics during arm elevation in healthy subjects and patients with shoulder impingement syndrome [abstract].
        J Orthop Sports Phys Ther. 1996; 23: 68
        • Babyar S
        Excessive scapular motion in individuals recovering from painful and stiff shoulders: causes and treatment strategies.
        Phys Ther. 1996; 76: 226-238
        • Waner JP
        • Micheli L
        • Arstania L
        • Kennedy J
        • Kennedy R
        Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome.
        Clin Orthop. 1992; 285: 191-199
        • Kaebaetse M
        • McClure PW
        • Pratt N
        The effect of thoracic posture on scapular position, shoulder elevation muscle force and shoulder elevation range of motion [abstract].
        J Orthop Sport Phys Ther. 1997; 25: 68