Effect of scapular protraction and retraction on isometric shoulder elevation strength

Smith, Jay; Kotajarvi, Brian R.; Padgett, Denny J.; Eischen, Joe J.

doi:10.1053/apmr.2002.29666

Cited by 118 publications

(90 citation statements)

References 31 publications

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“…As most of the subjects in this current study were Division I athletes competing in water polo, with minimal or no symptoms, they were well trained, and it was possible that they functioned optimally in their current shoulder posture. This seems to be consistent with the results of Smith and colleagues, 44 who found that isometric shoulder elevation strength in the sagittal plane was significantly greater when tested in the neutral resting scapular posture of healthy adults compared to a more retracted scapular position. Nine of the athletes in our study demonstrated a significant decrease in elevation torque with the SRT.…”

Section: Discussionsupporting

confidence: 92%

“…In pilot testing, we have found that passive maximal retraction of the scapula often decreased shoulder elevation force, and other investigators 44 have found decreased elevation strength with full active scapular retraction. Therefore, we modified the test position described by Kibler et al 21 by emphasizing posterior tilting and external rotation of the scapula but avoiding full retraction and named it the Scapula Reposition Test (SRT).…”

supporting

confidence: 53%

“…Most protocols demonstrating acceptable reliability using dynamometers use either the mean or maximum value from 3 trials after a submaximal effort practice. 7,17,23,44 Given these limitations, Kibler et al's 21 conclusion that strength gains were found in all symptomatic subjects should be interpreted cautiously. We feel that our use of the MDC90 to identify those with a significant change likely represents an increase in strength that a clinician could detect and use to justify an intervention strategy aimed toward strengthening of the scapular musculature.…”

Section: Discussionmentioning

confidence: 99%

“…These testing and rest intervals have been used for measurement of shoulder elevation strength with varying scapular positions in a previous study. 44 Interrater reliability between the 2 therapists performing the testing has been previously established on 13 athletically active subjects ranging in age from 22 to 28 years, each of whom performed 3 maximum isometric shoulder elevation contractions using the same test protocol. Intraclass correlation coefficients (ICC 3,3 ) of 0.982 and 0.964 were calculated for shoulder elevation strength with the scapula in its natural position and with manual repositioning using the SRT, respectively.…”

Section: Methodsmentioning

confidence: 99%

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Effect of the Scapula Reposition Test on Shoulder Impingement Symptoms and Elevation Strength in Overhead Athletes

Tate¹,

McClure²,

Kareha³

et al. 2008

J Orthop Sports Phys Ther

148

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[ research report ] t Study deSign: Two-group, repeatedmeasures design.t ObjectiveS: To determine whether manually repositioning the scapula using the Scapula Reposition Test (SRT) reduces pain and increases shoulder elevation strength in athletes with and without positive signs of shoulder impingement.t backgrOund: Symptom alteration tests may be useful in determining a subset of those with shoulder pathology who may benefit from interventions aimed at improving scapular motion abnormalities.t MethOdS and MeaSureS: One hundred forty-two college athletes underwent testing for clinical signs of shoulder impingement. Tests provoking symptoms were repeated with the scapula manually repositioned into greater retraction and posterior tilt. A numeric rating scale was used to measure symptom intensity under both conditions. Isometric shoulder elevation strength was measured using a mounted dynamometer with the scapula in its natural position and with manual repositioning. A paired t test was used to compare the strength between positions. The frequency of a significant increase in strength with scapular repositioning, defined as the minimal detectable change (90% confidence interval), was also assessed.t reSultS: Of the 98 athletes with a positive impingement test, 46 had reduced pain with scapular repositioning. Although repositioning produced an increase in strength in both the impingement (P = .001) and nonimpingement groups (P = .012), a significant increase in strength was found with repositioning in only 26% of athletes with, and 29% of athletes without, positive signs for shoulder impingement. 27,51 In addition to the variability of findings in these studies, the magnitude of differences between those with healthy shoulders and those with pathology is typically small (in the 3° to 5° range), and it is unclear whether these differences, although statistically significant, are really of clinical significance. Because of the variability of findings in symptomatic subjects and the generally small kinematic differences found compared to asymptomatic subjects, correctly identifying patients with relevant scapular dysfunction is difficult.An alternative approach in attempting to identify those with scapular motion abnormalities is the use of symptom altering tests. The premise of these tests is to assess the magnitude of symptoms during provocation tests or shoulder movements when the scapula is in its natural position and then to repeat the provocative tests and shoulder movements with the examiner manually altering scapular motion or position. Two symptom alteration tests have been reported in the literature. The Modified Scapular Assistance test involves application of both an upward rotary and retraction force to the scapula by a single examiner in an effort to reduce pain during arm elevation. Rabin et al 40 reported satisfactory interrater reliability of this test for clinical use. The Scapula Retraction Test has been described as 1 Physical Therapist, H/S Therapy Associates, Inc, Lower Gwynedd, PA; Associate Fac...

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Section: Discussionsupporting

confidence: 92%

supporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Effect of the Scapula Reposition Test on Shoulder Impingement Symptoms and Elevation Strength in Overhead Athletes

Tate¹,

McClure²,

Kareha³

et al. 2008

J Orthop Sports Phys Ther

148

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“…Rather than compressing the humeral head into the glenoid fossa, the scapula may be pulled in a lateral direction around the thoracic wall [19,36]. Additionally, the protracted scapula can increase strain on the anterior capsule and, when combined with GIRD, potentiates the risk for shoulder instability [13,16] and internal impingement [18,20] to develop by narrowing the subacromial space and allowing increased translation of the humeral head in relation to the glenoid [14,19,24,29,31,36,37]. Clinically, these results indicate baseball players with GIRD (15°or greater) have an associated increase of dominant arm scapular protraction, which may increase their risk of shoulder injuries.…”

Section: Discussionmentioning

confidence: 99%

Internal Rotation Deficits Affect Scapular Positioning in Baseball Players

Thomas

Swanik

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Anecdotal evidence suggests an association between glenohumeral internal rotation deficits (GIRD) and scapular dysfunction, an observable alteration in the normal position or motion of the scapula in relation to the thoracic cage. Questions/purposes We therefore hypothesized players with GIRD (15°or greater) will have decreased dominant arm scapular upward rotation and increased scapular protraction compared with baseball players with GIRD (14°or less). Methods We studied 43 baseball players with no current shoulder or elbow symptoms; 22 had GIRD 15°or greater and 21 had GIRD 14°or less. We measured glenohumeral internal rotation supine with the scapula stabilized. Scapular upward rotation was tested at rest; 60°, 90°, and 120°a bduction in the scapular plane; and scapular protraction at 0°, hands on hips, and 90°abduction in the scapular plane.

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