Background: Electromyography has been used to determine the best exercise for strengthening the supraspinatus muscle, but conflicting results have been reported. Magnetic resonance imaging T2 relaxation time appears to be more accurate in determining muscle activation.
Purpose: To determine the best exercises for strengthening the supraspinatus muscle.
Study design: Criterion standard.
Methods: Six male volunteers performed three exercises: the empty can, the full can, and horizontal abduction. Immediately before and after each exercise, magnetic resonance imaging examinations were performed and changes in relaxation time for the subscapularis, supraspinatus, infraspinatus, teres minor, and deltoid muscles were recorded.
Results: The supraspinatus muscle had the greatest change among the studied muscles in relaxation time for the empty can (10.5 ms) and full can (10.5 ms) exercises. After the horizontal abduction exercise the change in relaxation time for the supraspinatus muscle (3.6 ms) was significantly smaller than that for the posterior deltoid muscle (11.5 ms) and not significantly different from that of the other muscles studied.
Conclusion: The empty can and full can exercises were most effective in activating the supraspinatus muscle.
Get full access to this article
View all access options for this article.
References
1.
Adams GR, Duvoisin MR, Dudley GA: Magnetic resonance imaging and electromyography as indexes of muscle function . J Appl Physiol73: 1578-1583,1992
2.
Adams GR, Harris RT, Woodard D., et al: Mapping of electrical stimulation using MRI. J Appl Physiol74: 532-537, 1993
3.
Akima H., Ito M., Yoshikawa H., et al: Recruitment plasticity of neuromuscular compartments in exercised tibialis anterior using echo-planar magnetic resonance imaging in humans. Neurosci Lett296: 133-136, 2000
4.
Akima H., Takahashi H., Kuno SY, et al: Early phase adaptations of muscle use and strength to isokinetic training. Med Sci Sports Exerc31: 588-594, 1999
5.
Blackburn TA , McLeod WD, White B., et al: EMG analysis of posterior rotator cuff exercises. Athl Train25: 40-45, 1990
6.
Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet1: 307-310, 1986
7.
Cahoy PM, Orwin JF, Tuite MJ: Evaluation of post-exercise magnetic resonance images of the rotator cuff . Skeletal Radiol25: 739-741, 1996
8.
Davis KE, Donatelli RA: Strengthening exercises, in Donatelli RA (ed): Physical Therapy of the Shoulder. Third edition. New York, Churchill-Livingstone, 1997, pp 365-382
9.
Disler DG, Cohen MS, Krebs DE, et al: Dynamic evaluation of exercising leg muscle in healthy subjects with echo planar MR imaging: Work rate and total work determine rate of T2 change. J Magn Reson Imaging5: 588-593, 1995
10.
Fisher MJ, Meyer RA, Adams GR, et al: Direct relationship between proton T2 and exercise intensity in skeletal muscle MR images. Invest Radiol25: 480-485, 1990
11.
Fleckenstein JL, Bertocci LA, Nunnally RL, et al: Exercise-enhanced MR imaging of variations in forearm muscle anatomy and use: Importance in MR spectroscopy. AJR Am J Roentgenol153: 693-698, 1989
12.
Fleckenstein JL, Canby RC, Parkey RW, et al: Acute effects of exercise on MR imaging of skeletal muscle in normal volunteers. AJR Am J Roentgenol151: 231-237, 1988
13.
Fleckenstein JL, Watumull LD, McIntire DD, et al: Muscle proton T2 relaxation times and work during repetitive maximal voluntary exercise. J Appl Physiol74: 2855-2859, 1993
14.
Flicker PL, Fleckenstein JL, Ferry K., et al: Lumbar muscle usage in chronic low back pain: Magnetic resonance imaging evaluation. Spine18: 582-586, 1993
15.
Giroux B., Lamontagne M.: Comparisons between surface electrodes and intramuscular wire electrodes in isometric and dynamic conditions. Electromyogr Clin Neurophysiol30: 397-405, 1990
16.
Horrigan JM , Shellock FG, Mink JH, et al: Magnetic resonance imaging evaluation of muscle usage associated with three exercises for rotator cuff rehabilitation . Med Sci Sports Exerc31: 1361-1366, 1999
17.
Itoi E., Kido T., Sano A., et al: Which is more useful, the `full can test' or the `empty can test,' in detecting the torn supraspinatus tendon?Am J Sports Med27: 65-68, 1999
18.
Jenner G., Foley JM, Cooper TG, et al: Changes in magnetic resonance images of muscle depend on exercise intensity and duration, not work. J Appl Physiol76: 2119-2124, 1994
19.
Jobe FW, Moynes DR: Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries. Am J Sports Med10: 336-339, 1982
20.
Kadaba MP, Cole A., Wootten ME, et al: Intramuscular wire electromyography of the subscapularis. J Orthop Res10: 394-397, 1992
21.
Kadaba MP, Wootten ME, Gainey J., et al: Repeatability of phasic muscle activity: Performance of surface and intramuscular wire electrodes in gait analysis. J Orthop Res3: 350-359, 1985
22.
Kelly BT, Cooper LW, Kirkendall DT, et al: Technical considerations for electromyographic research on the shoulder. Clin Orthop335: 140-151, 1997
23.
Kelly BT, Kadrmas WR, Kirkendall DT, et al: Optimal normalization tests for shoulder muscle activation: An electromyographic study. J Orthop Res14: 647-653, 1996
24.
Kelly BT, Kadrmas WR, Speer KP: The manual muscle examination for rotator cuff strength: An electromyographic investigation. Am J Sports Med24: 581-588, 1996
25.
Komi PV, Buskirk ER: Reproducibility of electromyographic measurements with inserted wire electrodes and surface electodes. Electromyography10: 357-367, 1970
26.
Le Rumeur E. , de Certaines J., Toulouse P., et al: Water phases in rat striated muscles as determined by T2 proton NMR relaxation times. Magn Reson Imaging5: 267-272, 1987
27.
Malanga GA, Jenp Y.-N, Growney ES, et al: EMG analysis of shoulder positioning in testing and strengthening the supraspinatus. Med Sci Sports Exerc28: 661-664, 1996
28.
Matsen FA III, Arntz CT, Lippitt SB: Rotator cuff, in Rockwood CA Jr, Matsen FA III (eds): The Shoulder. Second edition. Philadelphia , W. B. Saunders Co, 1998, pp 755-839
29.
Morris AD, Kemp GJ, Lees A., et al: A study of the reproducibility of three different normalisation methods in intramuscular dual fine wire electromyography of the shoulder. J Electromyogr Kinesiol8: 317-322, 1998
30.
Otis JC, Jiang C.-C, Wickiewicz TL, et al: Changes in the moment arms of the rotator cuff and deltoid muscles with abduction and rotation. J Bone Joint Surg76A: 667-676, 1994
31.
Ploutz LL, Tesch PA, Biro RL, et al: Effect of resistance training on muscle use during exercise . J Appl Physiol76: 1675-1681, 1994
32.
Price TB, McCauley TR, Duleba AJ, et al: Changes in magnetic resonance transverse relaxation times of two muscles following standardized exercise. Med Sci Sports Exerc27: 1421-1429, 1995
33.
Shellock FG , Fukunaga T., Mink JH, et al: Exertional muscle injury: Evaluation of concentric versus eccentric actions with serial MR imaging. Radiology179: 659-664, 1991
34.
Shellock FG , Fukunaga T., Mink JH, et al: Acute effects of exercise on MR imaging of skeletal muscle: Concentric vs eccentric actions. AJR Am J Roentgenol156: 765-768, 1991
35.
Sjogaard G. , Saltin B.: Extra- and intracellular water spaces in muscles of man at rest and with dynamic exercise. Am J Physiol243: R271-R280, 1982
36.
Townsend H. , Jobe FW, Pink M., et al: Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. Am J Sports Med19: 264-272, 1991
37.
Worrell TW, Corey BJ, York SL, et al: An analysis of supraspinatus EMG activity and shoulder isometric force development. Med Sci Sports Exerc24: 744-748, 1992
38.
Yue G., Alexander AL, Laidlaw DH, et al: Sensitivity of muscle proton spin-spin relaxation time as an index of muscle activation. J Appl Physiol77: 84-92, 1994
