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Effects of the Pullover Exercise on the Pectoralis Major and Latissimus Dorsi Muscles as Evaluated by EMG

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The aim of the current study was to investigate the EMG activity of pectoralis major and latissimus dorsi muscles during the pullover exercise. Eight healthy male volunteers took part in the study. The EMG activity of the pectoralis major and that of the latissimus dorsi of the right side were acquired simultaneously during the pullover exercise with a free-weight barbell during both the concentric and eccentric phases of the movement. After a warm-up, all the subjects were asked to perform the pullover exercise against an external load of 30% of their body weight, during 1 set × 10 repetitions. The criterion adopted to normalize the EMG data was the maximal voluntary isometric activation. The present findings demonstrated that the barbell pullover exercise emphasized the muscle action of the pectoralis major more than that of the latissimus dorsi, and the higher activation depended on the external force lever arm produced.
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380
Journal of Applied Biomechanics, 2011, 27, 380-384
© 2011 Human Kinetics, Inc.
Paulo H. Marchetti (Corresponding Author) is with Nove
de Julho University, Brazil; Faculty of Physical Education
(YMCA), Brazil; and the Department of Biological Sciences
and Health (UNIFIEO), Brazil. Marco C. Uchida is with the
Faculty of Physical Education (YMCA), Brazil.
Effects of the Pullover Exercise on the Pectoralis Major and
Latissimus Dorsi Muscles as Evaluated by EMG
Paulo H. Marchetti1,2,3 and Marco C. Uchida2
1Nove de Julho University, Brazil; 2Faculty of Physical Education (YMCA), Brazil;
3Department of Biological Sciences and Health (UNIFIEO), Brazil
The aim of the current study was to investigate the EMG activity of pectoralis major and latissimus dorsi
muscles during the pullover exercise. Eight healthy male volunteers took part in the study. The EMG activity
of the pectoralis major and that of the latissimus dorsi of the right side were acquired simultaneously during
the pullover exercise with a free-weight barbell during both the concentric and eccentric phases of the move-
ment. After a warm-up, all the subjects were asked to perform the pullover exercise against an external load
of 30% of their body weight, during 1 set × 10 repetitions. The criterion adopted to normalize the EMG data
was the maximal voluntary isometric activation. The present ndings demonstrated that the barbell pullover
exercise emphasized the muscle action of the pectoralis major more than that of the latissimus dorsi, and the
higher activation depended on the external force lever arm produced.
Keywords: electromyography, kinesiology, resistance training
Among several variables in resistance training, exer-
cise choice is one of the most important for achieving the
aims of the program (Fleck, 1999). The major goal of
the exercise denes the muscles that will be used in the
movement (Brennecke et al., 2009). Because the choice
of a specic exercise can generate mechanical and physi-
ological muscle stress, it is vital to dene the exercise
sequence during resistance training.
The supercial electromyographic (EMG) technique
is often used to identify the participation of a muscle
in different exercises (Da Silva, Brentano, Cadore, De
Almeida, & Kruel, 2008). Many studies have been con-
ducted to dene the principal muscles used in exercises,
such as the bench press (Barnett, Kippers, & Turner,
1995; Giorgio, Samozino, & Morin, 2009; Marshall &
Murphy, 2006; Santana, Vera-Garcia, & McGill, 2007;
Schick et al., 2010), the lat pull-down (Snyder & Leech,
2009; Sperandei, Barros, & Silveira-Júnior, 2009),
and other shoulder movements (Escamilla, Yamashiro,
Paulos, & Andrews, 2009; Illyés & Kiss, 2005), but
there are no specic studies about the pullover exercise
in the literature.
The pullover is a very common exercise for improv-
ing lean body mass, strength, and power in athletes and
recreational weightlifters. The prime movement of the
pullover exercise is shoulder extension (Graham, 2004).
During this movement, the pectoralis major (sternal
portion), latissimus dorsi, and teres major are the major
acting muscles (Hall, 1999; Hamil & Knutzen, 2003;
Illyés & Kiss, 2005; Shevlin, Lehman, & Lucci, 1969;
Sperandei et al., 2009). However, there is no description
in the scientic literature about the level of action of these
different muscles, leaving a gap in the literature about
this commonly performed exercise. Therefore, the aim
of the current study was to investigate the EMG activities
of the pectoralis major and latissimus dorsi during the
pullover exercise. We hypothesize that pectoralis major
is more highly activated than the latissimus dorsi during
the pullover exercise.
Methods
Subjects
Eight healthy male volunteers took part in the study (mean
± SD: age 26 ± 8 years, height 172 ± 8 cm, and mass 71
± 9 kg). None of the volunteers reported any history of
neurological or musculoskeletal disease, and they all had
been practicing resistance training including the specic
exercise (pullover) for 2 years before this investigation.
The local ethics committee of the University of São Paulo
approved this study, and all volunteers gave their written
informed consent before participation.
Procedures
Each subject visited the laboratory twice. During the rst
visit, the subjects were familiarized with the procedures
Pullover Exercise as Evaluated by EMG 381
used in the main session. Subjects were assessed at the
same time of day (between 2:00 and 3:00 pm), and they
were instructed to refrain from any strenuous activities
in the 72 hr before the procedure. One week after the
rst visit, the subjects attended the main session, which
began with a warm-up that consisted of performing the
pullover exercise against an external load of 15% of
their body weight during 2 sets × 10 repetitions, with 1
min between sets. Next, all the subjects performed the
pullover exercise against an external load of 30% of their
body weight, during 1 set × 10 repetitions (Folland, Mc
Cauley, & Williams, 2008; Thompson et al., 2010).
The pullover exercise was executed while main-
taining contact of the head, back, and buttocks with the
bench. The arms were kept extended at the between-hands
distance equal to the shoulder joint and with the feet on
the oor (Graham, 2004). The excursion of the movement
was dened by the alignment of the barbell with the line
of the shoulder (i.e., vertical alignment, referred to as 0°)
and the maximal shoulder extension (maximal degree)
(Figures 1 and 2).
To control the cadence between subjects, a met-
ronome with 2 s for each phase was used (concentric
muscular action [CMA] and eccentric muscular action
[EMA]), and the shoulder angle was controlled by an
electrogoniometer (NorAngle, Noraxon, USA) attached
between the right arm and right side of the trunk. The
shoulder angle was offset in the alignment of the barbell
with the line of the shoulder (i.e., vertical alignment).
The EMG signals were recorded with an 8-chan-
nel telemetric EMG system (Telemyo 900, Noraxon
MyoResearch, USA) and a preamplier (gain 1,000×),
common mode rejection > 85 dB. The participants’ skin
was prepared before placement of the EMG electrodes.
Hair at the site of electrode placement was shaved and
the skin cleaned with alcohol. Bipolar passive disposable
dual Ag/AgCl snap electrodes with a 1-cm diameter for
each circular conductive area and 2-cm center-to-center
spacing were placed over the longitudinal axes of the
pectoralis major (sternal portion) and latissimus dorsi
(ascendant bers) in the direction of the muscle ber. The
positions of the electrodes were marked on the skin by
small ink tattoos, which ensured the same electrode posi-
tion in each test over the 1-week experimental protocol.
The EMG activities of the pectoralis major and latis-
simus dorsi of the right side were acquired simultaneously
during the pullover exercise with a regular barbell bar
(1.2 m). All measurements were taken on the right side
of the participants’ bodies and reference electrodes were
placed over the bone on the clavicle. The EMG signals
were acquired with a sampling rate of 1024 Hz, and data
acquisition was managed using MyoResearch software
(Noraxon MyoResearch, USA). Surface EMG was used
to measure muscle activation during both the CMA and
EMA of the movement.
The criterion adopted to normalize the EMG data
was the maximal voluntary isometric activation (MVIA).
Three MVIAs were performed against a manual resis-
tance produced by a research assistant, in the following
two positions: (1) the pectoralis major—supine position
with the right shoulder horizontally abducted at 90° and
(2) the latissimus dorsi—supine position with the right
shoulder aligned with the trunk and abducted at 15°.
The subjects were asked to perform three MVIAs for 3
s, and the EMG data of both muscles were acquired. For
the data, we calculated the root mean square (RMS) (1-s
moving window) of the EMG amplitude, and the peak
of the RMS EMG value of the three MVIAs was used
for normalization.
Data Analysis
First, the shoulder angle data were low-pass ltered with
1 Hz using a fourth-order Butterworth lter. The minimal
angle was used to dene the beginning and ending of the
EMG data; we removed the rst and last repetitions from
this data to avoid body adjustments and fatigue effects.
The digitized EMG data were rst band-pass ltered
at 20–500 Hz using a fourth-order Butterworth lter with
a zero lag. The amplitude of the signals was expressed as
RMS (1-s moving window) and normalized by MVIA.
The RMS EMG then were integrated (IEMG) and nor-
malized on the temporal base (% movement cycle). All
data were analyzed using a customized program written
in Matlab (Mathworks Inc., USA). The intraclass correla-
tion coefcients were r = .83 and r = .96 for pectoralis
major and latissimus dorsi, respectively.
Statistical Analyses
The normality and homogeneity of the data variances
were conrmed by the Kolmogorov–Smirnov and the
Lilliefors tests, respectively. We performed a comparison
of the muscle activation of the pectoralis major and latis-
simus dorsi during the pullover exercise using a paired
t test. An alpha of 0.01 was used for all statistical tests
performed using the SPSS version 18.0.
Results
Figure 1 shows the phases of the pullover exercise. Figure
2 shows the RMS EMG of the pectoralis major and latis-
simus dorsi during the pullover exercise cycle. The IEMG
of the pectoralis major was signicantly larger than that
of the latissimus dorsi during the pullover exercise, t(7)
= 10.28; p < .001 (Figure 3).
Figure 1 — Phases of the pullover exercise.
382 Marchetti and Uchida
Discussion
The present study investigated the EMG activities of the
pectoralis major and latissimus dorsi during the pullover
exercise. Mechanically, the pullover exercise begins with
arms positioned perpendicular to the trunk and vertically
aligned with the shoulder joint (Graham, 2004). In this
position, the lever arm is minimal because the line of
action force (external) is aligned with both the elbow
and the shoulder joints. In addition, the muscles (internal
forces) stabilize the joints, as shown in Figures 1 and 2
(beginning of the movement cycle, 0°). The rst part of
the movement is downward (shoulder exion, EMA) until
the upper arms are parallel to the trunk. During the EMA,
the lever arm of the external force increases for both the
elbow and shoulder joints, reaching the maximal external
torque at the end of this phase at approximately 100°.
After that, the second part of the movement is upward
(shoulder extension, CMA), with the arms returning to
0°. During the CMA, the lever arm of the external force
decreases for both the elbow and shoulder joints, reach-
ing the minimal external torque at the end of this phase.
There is little scientic information concerning
the principal muscles involved in the pullover exercise.
However, muscle activity patterns and coordination have
been investigated by EMG to determine the motor control
during several exercises (Barnett et al., 1995; Da Silva
et al., 2008; Dionisio, Almeida, Duarte, & Hirata, 2008;
Earl, Schmitz, & Arnold, 2001; Escamilla et al., 2009;
Giorgio et al., 2009; Illyés & Kiss, 2005; Liebensteiner,
2008; Marshall & Murphy, 2006; Santana et al., 2007;
Schick et al., 2010; Snyder & Leech, 2009; Sperandei
et al., 2009).
Figure 2 — Mean ± SD of the RMS EMG of the pectoralis major and latissimus dorsi during the pullover cycle.
Figure 3 — Mean ± SD of the IEMG of the pectoralis major
and latissimus dorsi (*p < .001).
Pullover Exercise as Evaluated by EMG 383
We hypothesized that the pectoralis major is more
highly activated than the latissimus dorsi during the
pullover exercise. In fact, according to our results, the
pectoralis major presented a higher activation than the
latissimus dorsi during all movement cycles, and the
IEMG of the latissimus dorsi was approximately 10% of
the IEMG of the pectoralis major (Figure 3). We observed
higher muscle activation during the concentric phase than
the eccentric phase, which was reported in other studies
(Grifn, Tooms, Vander Zwaag, Bertorini, & O’Toole,
1993; Kellis & Baltazopoulos, 1995, 1998; Pincivero,
Coelho, & Campy, 2008; Sperandei et al., 2009). In
the pullover exercise, we found that the highest level of
muscle action is related to the greatest lever arm lever
during the ascendant phase (Figure 2).
We recognize that this study has limitations, such
as small sample size and the load adjustment using a
percentage of the body weight. However, the pattern of
EMG data during all cycles was similar among the sub-
jects, who all reached a fatigue condition by the end of
the set of 10 repetitions (i.e., previously dened by the
pilot study wherein 30% body weight 10 repetitions
maximum).
In summary, the pullover is a very common exercise
for improving lean body mass, strength, and power in
athletes and recreational weightlifters, and its principal
movement is shoulder extension. The present ndings
demonstrate that the barbell pullover exercise could
emphasize the muscle action of the pectoralis major
more than the latissimus dorsi, and the higher activa-
tion depends on the external force lever arm produced.
Therefore, during resistance training programs, coaches,
athletes, and recreational weightlifters need to t the
pullover exercise into the correct training session with the
aim of developing the pectoralis major. Most exercises
for pectoralis major training are restricted to horizontal
adduction at the shoulder (CMA); examples are the bench
press, y, and crossover. Thus, an alternative movement
variation could be the pullover exercise, which is char-
acterized by shoulder extension.
Acknowledgments
The authors acknowledge Marcos Duarte, Biomedical Engi-
neering, Federal University of ABC, Brazil, and Luis Felipe
Milano Teixeira, Department of Biological Sciences and Health,
Osasco, Brazil, and Veris Faculty, Sorocaba, Brazil.
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... Thus, some studies have attempted to evaluate the electromyographic (EMG) activity in both pullover and pulldown exercises [17][18][19][20]. Marchetti and Uchida [20] evaluated the EMG activity of the pectoralis major and latissimus dorsi muscles during pullover exercises. ...
... Thus, some studies have attempted to evaluate the electromyographic (EMG) activity in both pullover and pulldown exercises [17][18][19][20]. Marchetti and Uchida [20] evaluated the EMG activity of the pectoralis major and latissimus dorsi muscles during pullover exercises. These authors reported that barbell pullover exercises produced a greater EMG activity in the pectoralis major than in the latissimus dorsi. ...
... The straight arm pulldown exercise was performed in two situations: (1) with a grip distance of 100% of the biacromial width and (2) with a grip distance of 150% of the biacromial width. Participants performed a set of 8 repetitions of each exercise against 30% of their body mass [20] at a rhythm of 2 s for the eccentric phase and 2 s for the concentric phase. A total of 4 s was used for the movement of 1 repetition [19,25]. ...
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Pullover and straight arm pulldown exercises are commonly used in resistance exercise programs to improve sports performance or in physical activity health programs. This study aimed to evaluate the individual electromyographic (EMG) activity of the pectoralis major (clavicular, sternal, and costal portions), latissimus dorsi, anterior deltoid, triceps brachii, and rectus abdominis muscles in a barbell pullover exercise at a 100% biacromial width and a straight arm pulldown exercise at a 100% and 150% biacromial width and to compare the EMG activity in these selected muscles and exercises. Twenty healthy and physically active adults performed a set of eight repetitions of each exercise against 30% of their body mass. The barbell pullover exercise presented a higher EMG activity (p ≤ 0.01) than the straight arm pulldown exercise in both biacromial widths in all evaluated muscles except for the latissimus dorsi and the triceps brachii. These muscles showed the highest EMG activity in the straight arm pulldown exercise at both biacromial widths. In all of the exercises and muscles evaluated, the concentric phase showed a greater EMG activity than the eccentric phase. In conclusion, the barbell pullover exercise can highlight muscle activity in the pectoralis major (mainly in the sternal and lower portions), triceps brachii, and rectus abdominis muscles. However, the straight arm pulldown exercise at 100% and 150% biacromial widths could be a better exercise to stimulate the latissimus dorsi and triceps brachii muscles. Moreover, all exercises showed significantly greater EMG activity (p < 0.001) in the concentric phase than in the eccentric phase for all the evaluated muscles.
... Several studies have reported greater myoelectric activation of the PM when compared to the LD for the PO exercise [with dumbbell (2,3), straight bar (3,12,13), and W bar (1)] in dynamic contractions. On the other hand, no study was found comparing PM and LD for PW exercise. ...
... It is possible to assume that the myoelectric activation is angle-dependent and pennate muscles like PM and LD have an oblique disposition of their fibers in relation to the tendon (7). In this way, the myoelectric activation and the capacity to produce force can be affected by the disposition of the muscle fibers, as well as by the joint position throughout the movement cycle (12,13). However, to the best of the authors' knowledge, there is no study comparing force production and myoelectric activation between both exercises in similar mechanical conditions. ...
... Therefore, the aim of the present study was to compare the myoelectric activation and peak force between PO and PW exercises in different shoulder joint positions during maximal isometric contractions. The main hypothesis considers that, due to the functional and morphological characteristics of different muscle groups around the shoulder joint, the interaction among these muscles will change based on the shoulder joint position and will produce a different peak force and maximal myoelectric activation (7,13). The secondary hypothesis considers that the RPE will remain constant for both exercises and shoulder joint positions. ...
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International Journal of Exercise Science 15(4): 797-807, 2022 The aim of the present study was to compare the myoelectric activation and peak force (PF) between pullover (PO) and pulldown (PW) exercises in different shoulder joint positions during maximal isometric contractions (0º, 45º, 90º, 135º, and 180°). Fifteen young, healthy, resistance-trained men were recruited. The participants performed three maximal voluntary isometric contractions for each exercise at five shoulder joint positions. The myoelectric activation (iEMG) from pectoralis major (PM); latissimus dorsi (LD); posterior deltoid (PD), and PF were measured. For PF, there were significant main effects for exercise and joint positions (p < 0.001). For iEMG PM, there was significant a main effect for joint positions (p < 0.001). There was a significant interaction between exercises and joint positions (p < 0.001). For iEMG LD, there was a significant main effect for joint positions (p < 0.001). There was no significant interaction between exercises and joint positions. For iEMG PD, there was a significant main effect for joint positions (p < 0.001). There was no significant interaction between exercises and joint positions. For RPE, there were no significant differences between exercises and joint positions. The study concludes that specific shoulder joint positions affect PF production and iEMG during both exercises. RPE was not affected.
... The pullover exercise is characterized by flexion and extension of the glenohumeral joint (5,6,15,18), and can be prescribed as a complementary exercise for the development of the muscles of the anterior trunk (5). In this context, Marchetti and Uchida (18) and Borges et al. (4) found a greater muscle activation of the pectoralis major (PM) when compared to the latissimus dorsi. ...
... The pullover exercise is characterized by flexion and extension of the glenohumeral joint (5,6,15,18), and can be prescribed as a complementary exercise for the development of the muscles of the anterior trunk (5). In this context, Marchetti and Uchida (18) and Borges et al. (4) found a greater muscle activation of the pectoralis major (PM) when compared to the latissimus dorsi. Yet, interestingly, Campos et al. (6) found no differences in the muscle activity of the sternal fibers of the PM (PMS), the clavicular fibers of the PM (PMC), the long head of the triceps (TB), the anterior and posterior fibers of the deltoid, the latissimus dorsi, and the serratus anterior. ...
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... Comparing electromyographic (EMG) activity between RT exercises is a common way to compare exercises' efficiency (Andersen, Fimland, Wiik, Skoglund, & Saeterbakken, 2014;Brennecke et al., 2009;Calatayud et al., 2014;Campos & Da Silva, 2014; Chris Barnett, 1995;Marchetti & Uchida, 2011;Schick et al., 2010;Soncin et al., 2014;Youdas et al., 2010). It was found that LPD produced higher latissimus dorsi (LD) activity followed by pectoralis major (PM) and long head of the triceps brachii (TBl) activity Signorile, Zink, & Szwed, 2002) and that bench press (BP) shows higher PM and TBl activity (Stastny et al., 2017). ...
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... Different experimental designs and EMG normalization procedures restrains a comparison between them. Marchetti and Uchida (Marchetti & Uchida, 2011) used 30 % of body mass as the experimental condition while Campos and Da Silva (Campos & Da Silva, 2014) ...
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We aimed to compare electromyographic activity of the external portion of the pectoralis major, latissimus dorsi and triceps brachii long head in an acute resistance training session between bench press (BP), lat pull down, pullover and triceps lying exercises. Concentric and eccentric phases electromyographic activity were compared. pectoralis major showed significantly higher activity in bench press (67.9 %) than in pullover (50.8 %), triceps lying (35.9 %) and lat pull down (14.1 %) in the concentric and eccentric phase (43.4 %, 27.5 %, 24.5 % and 7%, respectively). Latissimus dorsi showed significantly higher activity in lat pull down (59.5 %) than in pullover (22.7 %), triceps lying (10.7 %) and bench press (6.6 %) in the concentric and eccentric phase (37.4 %, 8.4 %, 7.6 % and 4.4 %, respectively). Triceps brachii long head showed significantly higher activity in triceps lying (67.7 %) than in bench press (49.2 %), pullover (34.3 %) and lat pull down (12.4 %) in the concentric and eccentric phase (37.6 %, 23.8 %, 20.5 % and 9.7 %, respectively). We found that bench press, lat pull down and triceps lying exercises are more effective to activate pectoralis major, latissimus dorsi and brachii long head muscles, respectively. Pullover exercise is more effective to activate pectoralis major (50.8 %) rather that latissimus dorsi (22.7 %). One should take into account such results while preparing a strength training periodization routine in order to avoid overtraining.
... In particular, the latissimus dorsi and teres major had large shoulder adductor and extensor moment arms, while the pectoralis major was a prominent adductor. The inferiorly directed lines of action of these muscles, together with their insertions far from the glenohumeral joint centre of rotation (on the proximal humeral shaft), give these muscles exceptional depressor function and significant mechanical advantage during tasks requiring both humeral depression and internal rotation, such as climbing and swimming (Marchetti & Uchida, 2011). In particular, the teres major, which is a frequently neglected muscle, has been shown from electromyographic data to play a significant role in shoulder function by being active as an antagonist and agonist during shoulder elevation and depression movements, respectively (Steenbrink et al. 2010;Marchetti & Uchida, 2011). ...
... The inferiorly directed lines of action of these muscles, together with their insertions far from the glenohumeral joint centre of rotation (on the proximal humeral shaft), give these muscles exceptional depressor function and significant mechanical advantage during tasks requiring both humeral depression and internal rotation, such as climbing and swimming (Marchetti & Uchida, 2011). In particular, the teres major, which is a frequently neglected muscle, has been shown from electromyographic data to play a significant role in shoulder function by being active as an antagonist and agonist during shoulder elevation and depression movements, respectively (Steenbrink et al. 2010;Marchetti & Uchida, 2011). The results suggest that both the latissimus dorsi and teres major have the greatest mechanical Axial rotation data are provided for humerus in its neutral position. ...
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The moment arm of a muscle represents its leverage or torque‐producing capacity, and is indicative of the role of the muscle in joint actuation. The objective of this study was to undertake a systematic review of the moment arms of the major muscles spanning the glenohumeral joint during abduction, flexion and axial rotation. Moment arm data for the deltoid, pectoralis major, latissimus dorsi, teres major, supraspinatus, infraspinatus, subscapularis and teres minor were reported when measured using the geometric and tendon excursion methods. The anterior and middle sub‐regions of the deltoid had the largest humeral elevator moment arm values of all muscles during coronal‐ and scapular‐plane abduction, as well as during flexion. The pectoralis major, latissimus dorsi and teres major had the largest depressor moment arms, with each of these muscles exhibiting prominent leverage in shoulder adduction, and the latissimus dorsi and teres major also in extension. The rotator cuff muscles had the largest axial rotation moment arms regardless of the axial position of the humerus. The supraspinatus had the most prominent elevator moment arms during early abduction in both the coronal and scapular planes as well as in flexion. This systematic review shows that the rotator cuff muscles function as humeral rotators and weak humeral depressors or elevators, while the three sub‐regions of the deltoid behave as substantial humeral elevators throughout the range of humeral motion. The pectoralis major, latissimus dorsi and teres major are significant shoulder depressors, particularly during abduction. This study provides muscle moment arm data on functionally relevant shoulder movements that are involved in tasks of daily living, including lifting and pushing. The results may be useful in quantifying shoulder muscle function during specific planes of movement, in designing and validating computational models of the shoulder, and in planning surgical procedures such as tendon transfer surgery.
... Allen et al. [16] suggested that there occur significant changes in the neural activation of the prime mover muscles such as PM and deltoid when push-ups are performed with wide base hand position on perfect push-up. Biomechanical theory also supports the findings of the present study since the moment arm of the PM muscle increases as the hands move far apart [25] which may lead to increased force production in WSW hand position during the push-up exercise. It was previously postulated that the amount of force production is related to the global activity of the underlying muscle fibers, and surface EMG provides information about the electrical activity picked up from the motor units of the individual muscle fibres located in the region [26]. ...
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A middle-aged female veteran artistic gymnast sustained an avulsion-injury of the latissimus dorsi and teres major. The case reveals unclarity in the current classification system and illustrates how a non-operative approach, in opposition to interpretation of recommended guidelines, was adequate for an excellent clinical outcome.
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It has been observed anecdotally that while performing the multijoint lat pull-down exercise, novice strength trainers often rely on the elbow flexors to complete the movement rather than fully utilizing the relevant back muscles such as the latissimus dorsi (LD) and teres major (TM). The primary aim of the study was to determine whether specific technique instruction could result in a voluntary increase in LD and TM electromyographic (EMG) activity with a concurrent decrease in the activity of the biceps brachii (BB) during the front wide-grip lat pull-down exercise. Eight women with little or no background in strength training were asked to perform lat pull-down exercise with only basic instruction, performing 2 sets of 3 repetitions at 30% max. After a brief rest, subjects then performed the same 2 sets of 3 repetitions following verbal technique instruction on how to emphasize the latissimus while de-emphasizing the biceps. EMG activity of the LD, TM, and BB were recorded, converted to root mean square, and normalized to the maximum isometric EMG (NrmsEMG). A significant increase was seen in Nrms EMG in the LD (p = 0.005) from the average of preinstruction NrmsEMG to the average of postinstruction NrmsEMG. No significant differences were observed between pre- and postinstruction muscle activity in the BB or TM. The results show that untrained individuals can voluntarily increase the activity of a specified muscle group during the performance of a multijoint resistance exercise, but the increase probably does not represent "isolation" of the muscle group through voluntary reduction of activity in complementary agonist muscles.
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The rotator cuff performs multiple functions during shoulder exercises, including glenohumeral abduction, external rotation (ER) and internal rotation (IR). The rotator cuff also stabilizes the glenohumeral joint and controls humeral head translations. The infraspinatus and subscapularis have significant roles in scapular plane abduction (scaption), generating forces that are two to three times greater than supraspinatus force. However, the supraspinatus still remains a more effective shoulder abductor because of its more effective moment arm. Both the deltoids and rotator cuff provide significant abduction torque, with an estimated contribution up to 35–65% by the middle deltoid, 30% by the subscapularis, 25% by the supraspinatus, 10% by the infraspinatus and 2% by the anterior deltoid. During abduction, middle deltoid force has been estimated to be 434 N, followed by 323N from the anterior deltoid, 283N from the subscapularis, 205N from the infraspinatus, and 117N from the supraspinatus. These forces are generated not only to abduct the shoulder but also to stabilize the joint and neutralize the antagonistic effects of undesirable actions. Relatively high force from the rotator cuff not only helps abduct the shoulder but also neutralizes the superior directed force generated by the deltoids at lower abduction angles. Even though anterior deltoid force is relatively high, its ability to abduct the shoulder is low due to a very small moment arm, especially at low abduction angles. The deltoids are more effective abductors at higher abduction angles while the rotator cuff muscles are more effective abductors at lower abduction angles. During maximum humeral elevation the scapula normally upwardly rotates 45–55°, posterior tilts 20–40° and externally rotates 15–35°. The scapular muscles are important during humeral elevation because they cause these motions, especially the serratus anterior, which contributes to scapular upward rotation, posterior tilt and ER. The serratus anterior also helps stabilize the medial border and inferior angle of the scapular, preventing scapular IR (winging) and anterior tilt. If normal scapular movements are disrupted by abnormal scapular muscle firing patterns, weakness, fatigue, or injury, the shoulder complex functions less efficiency and injury risk increases. Scapula position and humeral rotation can affect injury risk during humeral elevation. Compared with scapular protraction, scapular retraction has been shown to both increase subacromial space width and enhance supraspinatus force production during humeral elevation. Moreover, scapular IR and scapular anterior tilt, both of which decrease subacromial space width and increase impingement risk, are greater when performing scaption with IR (‘empty can’) compared with scaption with ER (‘full can’). There are several exercises in the literature that exhibit high to very high activity from the rotator cuff, deltoids and scapular muscles, such as prone horizontal abduction at 100° abduction with ER, flexion and abduction with ER, ‘full can’ and ‘empty can’, D1 and D2 diagonal pattern flexion and e The serratus anterior also helps stabilize the medial border and inferior angle of the scapular, preventing scapular IR (winging) and anterior tilt. If normal scapular movements are disrupted by abnormal scapular muscle firing patterns, weakness, fatigue, or injury, the shoulder complex functions less efficiency and injury risk increases. Scapula position and humeral rotation can affect injury risk during humeral elevation. Compared with scapular protraction, scapular retraction has been shown to both increase subacromial space width and enhance supraspinatus force production during humeral elevation. Moreover, scapular IR and scapular anterior tilt, both of which decrease subacromial space width and increase impingement risk, are greater when performing scaption with IR (‘empty can’) compared with scaption with ER (‘full can’). There are several exercises in the literature that exhibit high to very high activity from the rotator cuff, deltoids and scapular muscles, such as prone horizontal abduction at 100° abduction with ER, flexion and abduction with ER, ‘full can’ and ‘empty can’, D1 and D2 diagonal pattern flexion and extension, ER and IR at 0° and 90° abduction, standing extension from 90–0°, a variety of weight-bearing upper extremity exercises, such as the push-up, standing scapular dynamic hug, forward scapular punch, and rowing type exercises. Supraspinatus activity is similar between ‘empty can’ and ‘full can’ exercises, although the ‘full can’ results in less risk of subacromial impingement. Infraspinatus and subscapularis activity have generally been reported to be higher in the ‘full can’ compared with the ‘empty can’, while posterior deltoid activity has been reported to be higher in the ‘empty can’ than the ‘full can’.