Effective ways of restoring muscular imbalances of the rotator cuff muscle group: a comparative study of various training methods

Abstract

Background: Many studies have compared different training methods for improving muscular performance, but more investigations need to be directed to the restoration of muscular imbalances. Objective: To determine the most effective training for altering strength ratios in the shoulder rotator cuff. Methods: Forty eight physical education students were randomly assigned to four groups (12 per group): (a) experimental group who carried out multijoint dynamic resistance training for shoulder internal and external rotation movement (pull ups or lat pull downs, overhead press, reverse pull ups, push ups) (MJDR group); (b) experimental group who exercised the same muscle group using dumbbells weighing 2 kg (isolated group); (c) experimental group who followed an isokinetic strengthening programme for the rotator cuff muscle group (isokinetic group); (d) control group who had no strength training. Testing was performed in the supine position with the glenohumeral joint in 90˚of abduction in the coronal plane, with a range of motion of 0-90˚of external rotation and 0-65˚of internal rotation at angular velocities of 60, 120, and 180˚/s. The test procedure was performed before and after the exercise period of six weeks. Results: One way analysis of variance found no differences between the groups for the initial tests. Analysis of variance with repeated measures showed that the strength ratios in all the experimental groups had altered after the exercise period, with the isokinetic group showing the most significant improvement. Conclusions: Isokinetic strengthening is the most effective method of altering strength ratios of the rotator cuff muscle.

Avaliação muscular isocinética da articulação do ombro em atletas da Seleção Brasileira de voleibol sub-19 e sub-21 masculino

“…Assim, a força dos rotadores mediais no membro dominante é maior quando comparada com o não dominante, caracterizando o mesmo desequilíbrio muscular encontrado em jogadores de voleibol (13,20) . Esportes que requerem maior simetria entre membros, como a natação, não são caracterizados por esse desequilíbrio muscular, pois esses esportes envolvem treinamento bilateral dos membros superiores, mantendo maior simetria de forças entre membros no complexo do ombro, a qual também é encontrada na população não atleta (19,21) . Além da realização de testes concêntricos, vários estudos preconizam o uso da avaliação isocinética excêntrica em atletas, devido à especificidade desse teste em relação ao gesto esportivo, pois na fase de aceleração do braço os rotadores laterais atuam de forma excêntrica (9,10,19,22) .…”

“…Esse maior volume permite aos atletas sub-21 realizarem maior número de repetição do movimento de rotação medial em relação à categoria sub-19. Além disso, segundo Malliou et al (21) exercícios gerais de membros superiores na musculação (pulley, remada, supino) produzem aumento da força nos músculos rotadores mediais e não dos laterais. Possivelmente, esse fator contribuiu para o maior desequilíbrio na categoria sub-21, uma vez que esses atletas possuem mais tempo de prática na musculação com maior intensidade.…”

Effect of Isokinetic Versus Plyometric Training on Shoulder Proprioception and External to Internal Rotators Strength Ratio in Swimmer Children

“…A velocity spectrum rehabilitation protocol used to enhance a training response at various angular velocities. Ten repetitions at each angular velocity with 10-second rest between angular velocities were optimal to increase isokinetic peak torque across a velocity spectrum [23]. A total of 16 workout sessions were completed by every child in the allotted 8 weeks period.…”

Effect of isokinetic training on shoulder impingement

“…The emphasis is placed on the testing and training of the internal and external rotation strength of the shoulder. Davies (1984) and Malliou et al (2004) concluded that isokinetic strengthening was the most effective method of altering the strength ratios of the RTC compared with isolated isotonic training, multi-joint dynamic resistance training, and no intervention. However, a qualitative review in 2000 (Ellenbecker and Davies) concluded that isokinetic treatment techniques were only one part of the rehabilitation process, which is tremendously diverse.…”

“…This kind of imbalance can be expressed as changes in the strength ratio (peak torque ratio) of the cuff by isokinetics (Leroux et al, 1994). In addition, isokinetic training succeeded in enhancing the strength to redress the imbalance of shoulder muscle groups and the performance of normal subjects (Malliou et al, 2004). The emphasis is placed on the testing and training of the internal and external rotation strength of the shoulder.…”