Skip to main content
PMC home page
British Journal of Sports Medicine logoLink to British Journal of Sports Medicine
. 2004 Dec;38(6):766–772. doi: 10.1136/bjsm.2003.009548

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

P Malliou 1, K Giannakopoulos 1, A Beneka 1, A Gioftsidou 1, G Godolias 1
PMCID: PMC1724971  PMID: 15562178

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.

Full Text

The Full Text of this article is available as a PDF (76.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Almåsbakk B., Hoff J. Coordination, the determinant of velocity specificity? J Appl Physiol (1985) 1996 Nov;81(5):2046–2052. doi: 10.1152/jappl.1996.81.5.2046. [DOI] [PubMed] [Google Scholar]
  2. Bassett R. W., Browne A. O., Morrey B. F., An K. N. Glenohumeral muscle force and moment mechanics in a position of shoulder instability. J Biomech. 1990;23(5):405–415. doi: 10.1016/0021-9290(90)90295-e. [DOI] [PubMed] [Google Scholar]
  3. Broström L. A., Kronberg M., Németh G., Oxelbäck U. The effect of shoulder muscle training in patients with recurrent shoulder dislocations. Scand J Rehabil Med. 1992;24(1):11–15. [PubMed] [Google Scholar]
  4. Campbell D. E., Glenn W. Rehabilitation of knee flexor and knee extensor muscle strength in patients with meniscectomies, ligamentous repairs, and chondromalacia. Phys Ther. 1982 Jan;62(1):10–15. doi: 10.1093/ptj/62.1.10. [DOI] [PubMed] [Google Scholar]
  5. Ellenbecker T. S., Davies G. J., Rowinski M. J. Concentric versus eccentric isokinetic strengthening of the rotator cuff. Objective data versus functional test. Am J Sports Med. 1988 Jan-Feb;16(1):64–69. doi: 10.1177/036354658801600112. [DOI] [PubMed] [Google Scholar]
  6. Ellenbecker T. S., Mattalino A. J. Concentric isokinetic shoulder internal and external rotation strength in professional baseball pitchers. J Orthop Sports Phys Ther. 1997 May;25(5):323–328. doi: 10.2519/jospt.1997.25.5.323. [DOI] [PubMed] [Google Scholar]
  7. Fleisig G. S., Andrews J. R., Dillman C. J., Escamilla R. F. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med. 1995 Mar-Apr;23(2):233–239. doi: 10.1177/036354659502300218. [DOI] [PubMed] [Google Scholar]
  8. Greenleaf J. E., Bernauer E. M., Ertl A. C., Trowbridge T. S., Wade C. E. Work capacity during 30 days of bed rest with isotonic and isokinetic exercise training. J Appl Physiol (1985) 1989 Nov;67(5):1820–1826. doi: 10.1152/jappl.1989.67.5.1820. [DOI] [PubMed] [Google Scholar]
  9. Hinton R. Y. Isokinetic evaluation of shoulder rotational strength in high school baseball pitchers. Am J Sports Med. 1988 May-Jun;16(3):274–279. doi: 10.1177/036354658801600314. [DOI] [PubMed] [Google Scholar]
  10. Ivey F. M., Jr, Calhoun J. H., Rusche K., Bierschenk J. Isokinetic testing of shoulder strength: normal values. Arch Phys Med Rehabil. 1985 Jun;66(6):384–386. [PubMed] [Google Scholar]
  11. Kibler W. B., Chandler T. J., Livingston B. P., Roetert E. P. Shoulder range of motion in elite tennis players. Effect of age and years of tournament play. Am J Sports Med. 1996 May-Jun;24(3):279–285. doi: 10.1177/036354659602400306. [DOI] [PubMed] [Google Scholar]
  12. Kibler W. B. Closed kinetic chain rehabilitation for sports injuries. Phys Med Rehabil Clin N Am. 2000 May;11(2):369–384. [PubMed] [Google Scholar]
  13. Kibler W. B., Livingston B. Closed-chain rehabilitation for upper and lower extremities. J Am Acad Orthop Surg. 2001 Nov-Dec;9(6):412–421. doi: 10.5435/00124635-200111000-00006. [DOI] [PubMed] [Google Scholar]
  14. McDonagh M. J., Davies C. T. Adaptive response of mammalian skeletal muscle to exercise with high loads. Eur J Appl Physiol Occup Physiol. 1984;52(2):139–155. doi: 10.1007/BF00433384. [DOI] [PubMed] [Google Scholar]
  15. Meister K. Injuries to the shoulder in the throwing athlete. Part one: Biomechanics/pathophysiology/classification of injury. Am J Sports Med. 2000 Mar-Apr;28(2):265–275. doi: 10.1177/03635465000280022301. [DOI] [PubMed] [Google Scholar]
  16. Mikesky A. E., Edwards J. E., Wigglesworth J. K., Kunkel S. Eccentric and concentric strength of the shoulder and arm musculature in collegiate baseball pitchers. Am J Sports Med. 1995 Sep-Oct;23(5):638–642. doi: 10.1177/036354659502300520. [DOI] [PubMed] [Google Scholar]
  17. Rothstein J. M., Lamb R. L., Mayhew T. P. Clinical uses of isokinetic measurements. Critical issues. Phys Ther. 1987 Dec;67(12):1840–1844. doi: 10.1093/ptj/67.12.1840. [DOI] [PubMed] [Google Scholar]
  18. Sirota S. C., Malanga G. A., Eischen J. J., Laskowski E. R. An eccentric- and concentric-strength profile of shoulder external and internal rotator muscles in professional baseball pitchers. Am J Sports Med. 1997 Jan-Feb;25(1):59–64. doi: 10.1177/036354659702500111. [DOI] [PubMed] [Google Scholar]
  19. Smith M. J., Melton P. Isokinetic versus isotonic variable-resistance training. Am J Sports Med. 1981 Jul-Aug;9(4):275–279. doi: 10.1177/036354658100900420. [DOI] [PubMed] [Google Scholar]
  20. Vandervoort A. A., Sale D. G., Moroz J. R. Strength-velocity relationship and fatiguability of unilateral versus bilateral arm extension. Eur J Appl Physiol Occup Physiol. 1987;56(2):201–205. doi: 10.1007/BF00640644. [DOI] [PubMed] [Google Scholar]
  21. Wilk K. E., Andrews J. R., Arrigo C. A. The abductor and adductor strength characteristics of professional baseball pitcherse. Am J Sports Med. 1995 May-Jun;23(3):307–311. doi: 10.1177/036354659502300309. [DOI] [PubMed] [Google Scholar]
  22. Witvrouw E., Lysens R., Bellemans J., Peers K., Vanderstraeten G. Open versus closed kinetic chain exercises for patellofemoral pain. A prospective, randomized study. Am J Sports Med. 2000 Sep-Oct;28(5):687–694. doi: 10.1177/03635465000280051201. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Sports Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES