The Journal of Korean Physical Therapy

  • 제35권6호
  • /
  • Pages.167-176
  • /
  • 2023
  • /
  • 1229-0475(pISSN)
  • /
  • 2287-156X(eISSN)
대한물리치료학회 (The Korean Society of Physical Therapy)
권호 표지
DOI QR코드

DOI QR Code

Comparisons of Shoulder Muscle Activity and Muscle Activity Ratio during Serratus Anterior Exercise between CrossFit Practitioners with/without Shoulder Impingement Syndrome

  • Eunji Kang (Department of Physical Therapy, Graduate School, Dankook University) ;
  • Chaegil Lim (Department of Physical Therapy, Gachon University) ;
  • Hyoungwon Lim (Department of Physical Therapy, Dankook University)
  • 투고 : 2023.11.20
  • 심사 : 2023.12.26
  • 발행 : 2023.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Due to the high incidence of shoulder injuries, including shoulder impingement syndrome (SIS), among CrossFit practitioners due to frequent overhead movements, serratus anterior exercises are considered crucial for scapular stabilization in both intervention and prevention. Objective: The objective of this study is to compare the muscle activity and ratios of scapular stabilizing and shoulder girdle muscles between individuals with and without SIS during serratus punch and wall slide exercises, both targeting the serratus anterior muscle, in CrossFit training practitioners. Methods: Surface electromyography was used to compare the muscle activity and activity ratio of scapular stabilizing muscles and shoulder muscles during serratus punch and wall slide exercises in two groups of 20 CrossFit practitioners: ten with SIS and ten without symptoms. Results: The group with SIS showed higher activation of the pectoralis major, upper trapezius, and a higher pectoralis major/serratus anterior and upper trapezius/serratus anterior muscle activation ratio during the serratus punch exercise compared to the group without SIS. Similarly, during the wall slide exercise, the group with SIS exhibited higher activation of the upper trapezius and a higher upper trapezius/serratus anterior muscle activation ratio compared to the group without SIS. However, no significant difference in serratus anterior muscle activation was observed between the two groups. Conclusions: This study highlights the higher activation of the pectoralis major and upper trapezius muscles in CrossFit practitioners with SIS during the serratus anterior exercise, suggesting the importance of minimizing the overactivation of these muscles to prevent impingement syndrome in this population.

키워드

참고문헌

  1. Claudino JG, Gabbett TJ, Bourgeois F et al. Crossfit overview: systematic review and meta-analysis. Sports Med Open. 2018;4(1):11. 
  2. Meyer J, Morrison J, Zuniga J. The benefits and risks of crossFit: a systematic review. Workplace Health Saf. 2017;65(12):612-8.  https://doi.org/10.1177/2165079916685568
  3. Bolia IK, Collon K, Bogdanov J et al. Management options for shoulder impingement syndrome in athletes: insights and future directions. Open Access J Sports Med. 2021;12:43-53.  https://doi.org/10.2147/OAJSM.S281100
  4. Lewis JS, Green A, Wright C. Subacromial impingement syndrome: the role of posture and muscle imbalance. J Shoulder Elbow Surg. 2005;14(4):385-92.  https://doi.org/10.1016/j.jse.2004.08.007
  5. Carbone S, Candela V, Gumina S. High rate of return to CrossFit training after arthroscopic management of rotator cuff tear. Orthop J Sports Med. 2020;8(4):2325967120911039. 
  6. Calhoon G, Fry AC. Injury rates and profiles of elite competitive weightlifters. J Athl Train. 1999;34(3):232-8. 
  7. Diercks R, Bron C, Dorrestijn O et al. Guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopaedic Association. Acta Orthop. 2014;85(3):314-22.  https://doi.org/10.3109/17453674.2014.920991
  8. Ravichandran H, Janakiraman B, Gelaw AY et al. Effect of scapular stabilization exercise program in patients with subacromial impingement syndrome: a systematic review. J Exerc Rehabil. 2020;16(3):216-26.  https://doi.org/10.12965/jer.2040256.128
  9. Smith R Jr, Nyquist-Battie C, Clark M et al. Anatomical characteristics of the upper serratus anterior: cadaver dissection. J Orthop Sports Phys Ther. 2003;33(8):449-54.  https://doi.org/10.2519/jospt.2003.33.8.449
  10. Hardwick DH, Beebe JA, McDonnell MK et al. A comparison of serratus anterior muscle activation during a wall slide exercise and other traditional exercises. J Orthop Sports Phys Ther. 2006;36(12):903-10.  https://doi.org/10.2519/jospt.2006.2306
  11. Ludewig PM, Reynolds JF. The association of scapular kinematics and glenohumeral joint pathologies. J Orthop Sports Phys Ther. 2009;39(2):90-104.  https://doi.org/10.2519/jospt.2009.2808
  12. Lang AE, Dickerson CR, Kim SY et al. Impingement pain affects kinematics of breast cancer survivors in work-related functional tasks. Clin Biomech (Bristol, Avon). 2019;70:223-30.  https://doi.org/10.1016/j.clinbiomech.2019.10.001
  13. Escamilla RF, Yamashiro K, Paulos L et al. Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Med. 2009;39(8):663-85.  https://doi.org/10.2165/00007256-200939080-00004
  14. Castelein B, Cagnie B, Parlevliet T et al. Serratus anterior or pectoralis minor: which muscle has the upper hand during protraction exercises? Man Ther. 2016;22:158-64.  https://doi.org/10.1016/j.math.2015.12.002
  15. Michener LA, Sharma S, Cools AM et al. Relative scapular muscle activity ratios are altered in subacromial pain syndrome. J Shoulder Elbow Surg. 2016;25(11):1861-7.  https://doi.org/10.1016/j.jse.2016.04.010
  16. Cotter EJ, Hannon CP, Christian D et al. Comprehensive examination of the athlete's shoulder. Sports Health. 2018;10(4):366-75.  https://doi.org/10.1177/1941738118757197
  17. Hegedus EJ, Goode A, Campbell S et al. Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests. Br J Sports Med. 2008;42(2):80-92.  https://doi.org/10.1136/bjsm.2007.038406
  18. Alqunaee M, Galvin R, Fahey T. Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and metaanalysis. Arch Phys Med Rehabil. 2012;93(2):229-36.  https://doi.org/10.1016/j.apmr.2011.08.035
  19. Ekstrom RA, Soderberg GL, Donatelli RA. Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis. J Electromyogr Kinesiol. 2005;15(4):418-28.  https://doi.org/10.1016/j.jelekin.2004.09.006
  20. Lehman GJ, MacMillan B, MacIntyre I et al. Shoulder muscle EMG activity during push up variations on and off a Swiss ball. Dyn Med. 2006;5:7. 
  21. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80(3):276-91.  https://doi.org/10.1093/ptj/80.3.276
  22. Ludewig PM, Hoff MS, Osowski EE et al. Relative balance of serratus anterior and upper trapezius muscle activity during push-up exercises. Am J Sports Med. 2004;32(2):484-93.  https://doi.org/10.1177/0363546503258911
  23. Park KM CH, Kwon OY, Yi CH et al. Comparison of pectoralis major and serratus anterior muscle activities during different push-up plus exercises in subjects with and without scapular winging. J Strength Cond Res. 2014;28(9):2546-51.  https://doi.org/10.1519/JSC.0000000000000443
  24. Decker MJ, Hintermeister RA, Faber KJ et al. Serratus anterior muscle activity during selected rehabilitation exercises. Am J Sports Med. 1999;27(6):784-91.  https://doi.org/10.1177/03635465990270061601
  25. Robert A, Lange GW, Richard J et al. Electromyographic activity and applied load during shoulder rehabilitation exercises using elastic resistance. Am J Sports Med. 1998;26(2):210-20.  https://doi.org/10.1177/03635465980260021001
  26. Silva ER, Maffulli N, Migliorini F et al. Function, strength, and muscle activation of the shoulder complex in Crossfit practitioners with and without pain: a cross-sectional observational study. J Orthop Surg Res. 2022;17(1):24. 
  27. Lear LJ, Gross MT. An electromyographical analysis of the scapular stabilizing synergists during a push-up progression. J Orthop Sports Phys Ther. 1998;28(3):146-57.  https://doi.org/10.2519/jospt.1998.28.3.146
  28. Camargo PR, Neumann DA. Kinesiologic considerations for targeting activation of scapulothoracic muscles - part 2: trapezius. Braz J Phys Ther. 2019;23(6):467-75.  https://doi.org/10.1016/j.bjpt.2019.01.011
  29. Konrad GG, Jolly JT, Labriola JE et al. Thoracohumeral muscle activity alters glenohumeral joint biomechanics during active abduction. J Orthop Res. 2006;24(4):748-56.  https://doi.org/10.1002/jor.20062
  30. Glenn C, Terry TMC. Functional Anatomy of the Shoulder. J Athl Train. 2000;35(3):248-55. 
  31. Wilk KE, Arrigo C. Current concepts in the rehabilitation of the athletic shoulder. J Orthop Sports Phys Ther. 1993;18(1):365-78.  https://doi.org/10.2519/jospt.1993.18.1.365
  32. Hak PT, Hodzovic E, Hickey B. The nature and prevalence of injury during CrossFit training. J Strength Cond Res. 2022. 
  33. Kim JS, Ahn DH, Park DH et al. Electromyographic activity of the serratus anterior and pectoralis major during isometric scapular protraction at different resistance intensities in subjects with and without a winged scapula. Clin Biomech (Bristol, Avon). 2019;61:199-204.  https://doi.org/10.1016/j.clinbiomech.2018.12.018
  34. Hwang UJ, Kwon OY, Jeon IC et al. Effect of humeral-elevation angle on electromyographic activity in the serratus anterior during the push-up-plus exercise. J Sport Rehabil. 2017;26(1):57-64.  https://doi.org/10.1123/jsr.2015-0090
  35. da Costa TS, Louzada CTN, Miyashita GK et al. CrossFit(R): injury prevalence and main risk factors. Clinics (Sao Paulo). 2019;74:e1402.