This EMG study measured trapezius and serratus anterior activation during 12 common scapular rehab exercises in 45 healthy subjects. The goal was to identify which exercises best activate the lower and middle trapezius while minimizing upper trapezius, using UT/LT, UT/MT, and UT/SA ratios. It is the first study to calculate intramuscular trapezius balance ratios during these exercises.
When a patient presents with scapular dyskinesis and impingement, the problem is usually imbalance, not global weakness. The upper trapezius is over-firing while the lower and middle trapezius and serratus anterior are under-recruited. Your exercise prescription should selectively wake up the weak muscles while keeping the upper trap quiet.
This paper gives you four evidence-based early-stage choices: side-lying external rotation, side-lying forward flexion, prone horizontal abduction with external rotation, and prone extension. The mental model is simple. Prone and side-lying positions remove the upper trapezius from its anti-gravity postural duty, so the lower and middle trapezius do the work.
Remember the limits: subjects were young and healthy, all top exercises are performed lying down, and no exercise isolated the serratus anterior. Use these in early rehab, then progress to functional kinetic-chain exercises. For the serratus, reach for a push-up with a plus.
This EMG study measured trapezius and serratus anterior activation during 12 common scapular rehab exercises in 45 healthy subjects. The goal was to identify which exercises best activate the lower and middle trapezius while minimizing upper trapezius, using UT/LT, UT/MT, and UT/SA ratios. It is the first study to calculate intramuscular trapezius balance ratios during these exercises.
When a patient presents with scapular dyskinesis and impingement, the problem is usually imbalance, not global weakness. The upper trapezius is over-firing while the lower and middle trapezius and serratus anterior are under-recruited. Your exercise prescription should selectively wake up the weak muscles while keeping the upper trap quiet.
This paper gives you four evidence-based early-stage choices: side-lying external rotation, side-lying forward flexion, prone horizontal abduction with external rotation, and prone extension. The mental model is simple. Prone and side-lying positions remove the upper trapezius from its anti-gravity postural duty, so the lower and middle trapezius do the work.
Remember the limits: subjects were young and healthy, all top exercises are performed lying down, and no exercise isolated the serratus anterior. Use these in early rehab, then progress to functional kinetic-chain exercises. For the serratus, reach for a push-up with a plus.