A Systematic Literature Review of the Resistance Exercises That Promote Maximal Muscle Activity of the Rotator Cuff in Normal Shoulders

Abstract

Background There are numerous resistance exercises that can be used to activate the rotator cuff. However, the optimal exercises to achieve maximal muscle activation in supraspinatus, infraspinatus, subscapularis and teres minor remain unclear. Thus, the aim of this systematic review is to identify the optimal resistance exercises for producing maximal muscle activation of the rotator cuff in normal shoulders. Methods A literature search was completed using six key databases - MEDLINE, EMBASE, CINAHL, PEDro, SPORTdiscus and Cochrane Library (from inception to January 2012). The search yielded 452 records using terms relating to rotator cuff, exercise, and electromyography. Eighteen papers remained after duplicates were removed and selection criteria applied. Quality assessment, data extraction and data synthesis of included papers was undertaken. Results Prone horizontal abduction at 90–100° with external rotation, push-up-plus, empty can and full can produced greatest activity in supraspinatus; prone horizontal abduction at 90–100° with full external rotation, standing external rotation at 0° abduction and the push-up-plus exercise produced greatest activity in infraspinatus and push-up-plus and shoulder flexion exercise in subscapularis. There was limited data for teres minor. Discussion Exercises to elicit maximal activity of supraspinatus, infraspinatus and subscapularis in normal shoulders were identified.