Background: Pectoralis minor tightness is associated with reduced glenohumeral internal rotation range of motion (ROM) and scapular anterior tilt alignment. However, the synergistic effects of the pectoralis minor stretching exercise and scapular posterior tilt strategy on glenohumeral internal rotation ROM and pectoralis minor length remain unexplored. Objectives: This study examined the effects of doorway stretching with scapular posterior tilt on pectoralis minor length, scapular alignment, and glenohumeral internal rotation ROM. Design: A case series study. Methods: Fifteen adults with pectoralis minor tightness performed doorway stretching with scapular posterior tilt. Pectoralis minor length, acromion–table distance, and glenohumeral internal rotation ROM were measured before and immediately after stretching. The pectoralis minor length was calculated using the pectoralis minor index. The measured variables were analyzed using a paired t-test. Results: While the pectoralis minor index and glenohumeral internal rotation ROM significantly increased, the acromion–table distance markedly decreased after doorway stretching with scapular posterior tilt (P<.05). Conclusion: Based on the present findings, doorway stretching with scapular posterior tilt could be an effective exercise for increasing glenohumeral internal rotation ROM and pectoralis minor length.

Background: Although the scapular posterior tilt movement could facilitate the lower trapezius (LT) muscle activity, no study identified the effects of the scapular posterior tilt movement on the selective activation of the LT muscle during prone shoulder extension. Objectives: To examine the influences of additional scapular posterior tilt on electromyography (EMG) of the upper trapezius (UT) and the LT muscles during prone shoulder extension. Design: Cross-sectional study. Methods: There were 15 asymptomatic male participants in this study who performed prone shoulder extension with and without scapular posterior tilt movements. For the scapular posterior tilt movements, participants performed visual biofeedback training for scapular movement using motion sensor. During the exercises, the EMG activity of the UT and LT was recorded using surface EMG system. Results: The EMG activity of the LT significantly increased during prone shoulder extension with scapular posterior tilt compared to that of general prone shoulder extension, whereas that of the UT was not significantly different between the two exercises. Moreover, scapular posterior tilt application significantly decreased UT/LT muscle activity ratio. Conclusion: Scapular posterior tilt movement may be emphasized during exercise when facilitating LT muscle activation.

Background: Shoulder horizontal abduction in the prone position (SHAP) has been reported as an effective exercise to strengthen the lower trapezius. However, the effects of pre-emptive scapular posterior tilt on scapular muscle activity and scapulohumeral movements during SHAP have not been examined. Objectives: To examine the effect of the addition of scapular posterior tilt on muscle activity of the trapezius and posterior deltoid, and scapular posterior tilt and shoulder horizontal abduction, during SHAP. Design: Cross-sectional study. Methods: Fifteen healthy male subjects performed two types of SHAP: general and modified SHAP (SHAP combined with pre-emptive scapular posterior tilt). To perform modified SHAP, pre-emptive scapular posterior tilt training was performed prior to the modified SHAP. Muscle activity of the middle and lower trapezius and posterior deltoid, and the amount of scapular posterior tilt and shoulder horizontal abduction, were measured during two types of SHAP. Results: Muscle activity of the lower trapezius and scapular posterior tilt was significantly increased during the modified SHAP, while muscle activity of the posterior deltoid and the amount of shoulder horizontal abduction were significantly decreased. However, the middle trapezius muscle activity did not change during the modified SHAP. Conclusion: The SHAP with pre-emptive scapular posterior tilt can be useful to strengthen the lower trapezius.

Background: Scapular posterior tilt (SPT) is important in the prevention of abnormal scapular movement and pain during elevation of the arm. However, previous studies have overlooked increased upper trapezius (UT) muscle activity interrupting the normal force couple of scapular motion and compensation of levator scapulae (LS) muscle activated simultaneously with UT during SPT exercise. Objects: The purpose of this study was to compare the effects of modified SPT with depression exercise versus SPT exercise on serratus anterior (SA), lower trapezius (LT), UT, and LS muscle activities and the clavicular tilt angle, in subjects with rounded shoulder posture (RSP) and myofascial pain in the UT muscle region. Methods: Eighteen subjects with RSP were recruited and randomly allocated to 2 groups; 9 in the SPT group and 9 in the SPT with depression group. All subjects met the specific RSP criteria and had myofascial pain of UT region. Depending on the allocated group, subjects performed the assigned SPT exercise and EMG data were recorded during the each exercise. Clavicular tilt angle was defined as the angle between the line joining the medial and lateral end of the clavicle and a horizontal line. Results: The SA muscle activity was significantly greater in SPT with depression than with SPT exercise (p<.05). The UT, LS muscle activity and the clavicular tilt angle was significantly lower in SPT with depression than with SPT exercise (p<.05). Conclusion: These findings were insightful because the potential risk of pain from overactivation of the UT and LS was considered, in contrast with SPT exercise. SPT with depression exercise can be implemented as an effective method to facilitate scapular muscle activity for stability and to prevent myofascial pain in the neck and shoulder.

The purpose of this study was to investigate the effects of visual electromyography (EMG) biofeedback on the EMG activity of the lower trapezius (LT), serratus anterior (SA), and upper trapezius (UT) muscles, the LT/UT and SA/UT EMG activity ratios, and the scapular upward rotation angle during scapular posterior tilting exercise (SPTE). Twenty-four subjects with round-shoulder posture participated in this study. The EMG activities of the LT, SA, and UT were collected during SPTE both without and with visual EMG biofeedback. The scapular upward rotation angle was measured at the baseline, after SPTE without visual EMG biofeedback, and after SPTE with visual EMG biofeedback. The LT, SA, and UT EMG activities, and the LT/UT and SA/UT EMG activity ratios were analyzed by paired t-test. The scapular upward rotation angle was statistically analyzed using one-way repeated analysis of variance. If a significant difference was found, a Bonferroni correction was performed (p=.05/3=.017). The EMG activities of LT and SA significantly increased, and the EMG activity of UT significantly decreased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). In addition, the LT/UT and SA/UT EMG activity ratios significantly increased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). Significant increases were found in the scapular upward rotation angle after SPTE without and with visual EMG biofeedback compared to baseline (p<.017), and no significant differences were observed in the scapular upward rotation angle between SPTE without and with visual EMG biofeedback. In conclusion, SPTE using visual EMG biofeedback may be an effective method for increasing LT and SA activities while reducing UT activity.