{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:55:58Z","timestamp":1789728958732,"version":"4.0.1"},"reference-count":35,"publisher":"National Athletic Trainers' Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011]]},"abstract":"<jats:p>\n          <jats:bold>\n            <jats:italic>Context:<\/jats:italic>\n          <\/jats:bold> Glenohumeral external rotation (GH ER) muscle fatigue might contribute to shoulder injuries in overhead athletes. Few researchers have examined the effect of such fatigue on scapular kinematics and muscle activation during a functional movement pattern.<\/jats:p>\n        <jats:p>\n          <jats:bold>\n            <jats:italic>Objective:<\/jats:italic>\n          <\/jats:bold> To examine the effects of GH ER muscle fatigue on upper trapezius, lower trapezius, serratus anterior, and infraspinatus muscle activation and to examine scapular kinematics during a diagonal movement task in overhead athletes.<\/jats:p>\n        <jats:p>\n          <jats:bold>\n            <jats:italic>Setting:<\/jats:italic>\n          <\/jats:bold> Human performance research laboratory.<\/jats:p>\n        <jats:p>\n          <jats:bold>\n            <jats:italic>Design:<\/jats:italic>\n          <\/jats:bold> Descriptive laboratory study.<\/jats:p>\n        <jats:p>\n          <jats:bold>\n            <jats:italic>Patients or Other Participants:<\/jats:italic>\n          <\/jats:bold> Our study included 25 overhead athletes (15 men, 10 women; age = 20 \u00b1 2 years, height = 180 \u00b1 11 cm, mass = 80 \u00b1 11 kg) without a history of shoulder pain on the dominant side.<\/jats:p>\n        <jats:p>\n          <jats:bold>\n            <jats:italic>Intervention(s):<\/jats:italic>\n          <\/jats:bold> We tested the healthy, dominant shoulder through a diagonal movement task before and after a fatiguing exercise involving low-resistance, high-repetition, prone GH ER from 0\u00b0 to 75\u00b0 with the shoulder in 90\u00b0 of abduction.<\/jats:p>\n        <jats:p>\n          <jats:bold>\n            <jats:italic>Main Outcome Measure(s):<\/jats:italic>\n          <\/jats:bold> Surface electromyography was used to measure muscle activity for the upper trapezius, lower trapezius, serratus anterior, and infraspinatus. An electromyographic motion analysis system was used to assess 3-dimensional scapular kinematics. Repeated-measures analyses of variance (phase \u00d7 condition) were used to test for differences.<\/jats:p>\n        <jats:p>\n          <jats:bold>\n            <jats:italic>Results:<\/jats:italic>\n          <\/jats:bold> We found a decrease in ascending-phase and descending-phase lower trapezius activity (<jats:italic>F<\/jats:italic><jats:sub>1,25<\/jats:sub> = 5.098, <jats:italic>P<\/jats:italic> = .03) and an increase in descending-phase infraspinatus activity (<jats:italic>F<\/jats:italic><jats:sub>1,25<\/jats:sub> = 5.534, <jats:italic>P<\/jats:italic> = .03) after the fatigue protocol. We also found an increase in scapular upward rotation (<jats:italic>F<\/jats:italic><jats:sub>1,24<\/jats:sub> = 3.7, <jats:italic>P<\/jats:italic> = .04) postfatigue.<\/jats:p>\n        <jats:p>\n          <jats:bold>\n            <jats:italic>Conclusions:<\/jats:italic>\n          <\/jats:bold> The GH ER muscle fatigue protocol used in this study caused decreased lower trapezius and increased infraspinatus activation concurrent with increased scapular upward rotation range of motion during the functional task. This highlights the interdependence of scapular and glenohumeral force couples. Fatigue-induced alterations in the lower trapezius might predispose the infraspinatus to injury through chronically increased activation.<\/jats:p>","DOI":"10.4085\/1062-6050-46.4.349","type":"journal-article","created":{"date-parts":[[2017,3,2]],"date-time":"2017-03-02T15:20:48Z","timestamp":1488468048000},"page":"349-357","source":"Crossref","is-referenced-by-count":45,"title":["Shoulder External Rotation Fatigue and Scapular Muscle Activation and Kinematics in Overhead Athletes"],"prefix":"10.4085","volume":"46","author":[{"given":"Mithun","family":"Joshi","sequence":"first","affiliation":[{"name":"\u2020University of Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A.","family":"Thigpen","sequence":"additional","affiliation":[{"name":"*Proaxis Therapy, Greenville, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Bunn","sequence":"additional","affiliation":[{"name":"\u2021University of North Carolina, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spero G.","family":"Karas","sequence":"additional","affiliation":[{"name":"\u00a7Emory University, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darin A.","family":"Padua","sequence":"additional","affiliation":[{"name":"\u00b6Department of Exercise & Sport Science, University of North Carolina, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"3","key":"i1062-6050-46-4-349-b1","series-title":"Br J Sports Med.","first-page":"173","article-title":"Epidemiology of shoulder impingement in upper arm sports events","volume":"24","year":"1990","unstructured":"Lo\n              YPC\n            , HsuYCS, ChanKM.\n          Epidemiology of shoulder impingement in upper arm sports events. Br J Sports Med.1990;24 (3):173\u2013177."},{"issue":"5","key":"i1062-6050-46-4-349-b2","series-title":"J Orthop Sports Phys Ther.","first-page":"221","article-title":"Scapular muscle recruitment pattern: electromyographic response of the trapezius muscle to sudden shoulder movement before and after a fatiguing exercise","volume":"32","year":"2002","unstructured":"Cools\n              AM\n            , WitvrouwEE, De ClercqGA, \n          et al. Scapular muscle recruitment pattern: electromyographic response of the trapezius muscle to sudden shoulder movement before and after a fatiguing exercise. J Orthop Sports Phys Ther.2002;32 (5):221\u2013229."},{"issue":"8","key":"i1062-6050-46-4-349-b3","series-title":"J Orthop Sports Phys Ther.","first-page":"557","article-title":"Scapulothoracic and glenohumeral kinematics following an external rotation fatigue protocol","volume":"36","year":"2006","unstructured":"Ebaugh\n              DD\n            , McClurePW, KardunaAR.\n          Scapulothoracic and glenohumeral kinematics following an external rotation fatigue protocol. J Orthop Sports Phys Ther.2006;36 (8):557\u2013571."},{"issue":"2","key":"i1062-6050-46-4-349-b4","series-title":"J Orthop Sports Phys Ther.","first-page":"74","article-title":"Scapulothoracic muscle fatigue associated with alterations in scapulohumeral rhythm kinematics during maximum resistive shoulder elevation","volume":"28","year":"1998","unstructured":"McQuade\n              KJ\n            , DawsonJ, SmidtGL.\n          Scapulothoracic muscle fatigue associated with alterations in scapulohumeral rhythm kinematics during maximum resistive shoulder elevation. J Orthop Sports Phys Ther.1998;28 (2):74\u201380."},{"issue":"3","key":"i1062-6050-46-4-349-b5","series-title":"Clin Biomech (Bristol, Avon)","first-page":"144","article-title":"Effects of local muscle fatigue on three-dimensional scapulohumeral rhythm","volume":"10","year":"1995","unstructured":"McQuade\n              K\n            , Hwa WeiS, SmidtGL.\n          Effects of local muscle fatigue on three-dimensional scapulohumeral rhythm. Clin Biomech (Bristol, Avon). 1995; 10(3):144\u2013148."},{"issue":"7","key":"i1062-6050-46-4-349-b6","series-title":"Arch Phys Med Rehabil.","first-page":"1000","article-title":"Effects of muscle fatigue on 3- dimensional scapular kinematics","volume":"84","year":"2003","unstructured":"Tsai\n              NT\n            , McClurePW, KardunaAR.\n          Effects of muscle fatigue on 3- dimensional scapular kinematics. Arch Phys Med Rehabil.2003;84 (7): 1000\u20131005."},{"issue":"4","key":"i1062-6050-46-4-349-b7","series-title":"Am J Sports Med.","first-page":"542","article-title":"Scapular muscle recruitment patterns: trapezius muscle latency with and without impingement symptoms","volume":"31","year":"2003","unstructured":"Cools\n              AM\n            , WitvrouwEE, DeclercqGA, DanneelsLA, CambierDC.\n          Scapular muscle recruitment patterns: trapezius muscle latency with and without impingement symptoms. Am J Sports Med.2003;31 (4):542\u2013549."},{"issue":"1","key":"i1062-6050-46-4-349-b8","series-title":"Am J Sports Med.","first-page":"23","article-title":"Pitching biomechanics as a pitcher approaches muscular fatigue during a simulated baseball game","volume":"35","year":"2007","unstructured":"Escamilla\n              RF\n            , BarrentineSW, FleisigGS, \n          et al. Pitching biomechanics as a pitcher approaches muscular fatigue during a simulated baseball game. Am J Sports Med.2007;35 (1):23\u201333."},{"issue":"1","key":"i1062-6050-46-4-349-b9","series-title":"Am J Sports Med.","first-page":"108","article-title":"Upper and lower extremity muscle fatigue after a baseball pitching performance","volume":"33","year":"2005","unstructured":"Mullaney\n              MJ\n            , McHughMP, DonofrioTM, NicholasSJ.\n          Upper and lower extremity muscle fatigue after a baseball pitching performance. Am J Sports Med.2005;33 (1):108\u2013113."},{"issue":"2","key":"i1062-6050-46-4-349-b10","series-title":"Am J Sports Med.","first-page":"137","article-title":"The effects of extended play on professional baseball pitchers","volume":"29","year":"2001","unstructured":"Murray\n              TA\n            , CookTD, WernerSL, SchlegelTF, HawkinsRJ.\n          The effects of extended play on professional baseball pitchers. Am J Sports Med.2001;29 (2):137\u2013142."},{"issue":"3","key":"i1062-6050-46-4-349-b11","series-title":"Am J Sports Med.","first-page":"523","article-title":"Changes in shoulder and elbow passive range of motion after pitching in professional baseball players","volume":"36","year":"2008","unstructured":"Reinold\n              MM\n            , WilkKE, MacrinaLC, \n          et al. Changes in shoulder and elbow passive range of motion after pitching in professional baseball players. Am J Sports Med.2008;36 (3):523\u2013527."},{"issue":"4","key":"i1062-6050-46-4-349-b12","series-title":"J Athl Train.","first-page":"316","article-title":"Functional fatigue decreases 3-dimensional multijoint position reproduction acuity in the overhead-throwing athlete","volume":"39","year":"2004","unstructured":"Tripp\n              BL\n            , BoswellL, GansnederBM, ShultzSJ.\n          Functional fatigue decreases 3-dimensional multijoint position reproduction acuity in the overhead-throwing athlete. J Athl Train.2004;39 (4):316\u2013320."},{"issue":"1","key":"i1062-6050-46-4-349-b13","series-title":"J Athl Train.","first-page":"90","article-title":"Functional fatigue and upper extremity sensorimotor system acuity in baseball athletes","volume":"42","year":"2007","unstructured":"Tripp\n              BL\n            , YochemEM, UhlTL.\n          Functional fatigue and upper extremity sensorimotor system acuity in baseball athletes. J Athl Train.2007;42 (1):90\u201398."},{"key":"i1062-6050-46-4-349-b14","article-title":"A standardized protocol for motion recordings of the shoulder","unstructured":"van der Helm\n              FCT.\n            \n          \n          A standardized protocol for motion recordings of the shoulder. Paper presented at: Fourth Conference of the International Shoulder Group; June 17\u2013 18, 2002; Cleveland, OH."},{"key":"i1062-6050-46-4-349-b15","series-title":"Muscles Alive: Their Functions Revealed by Electromyography","year":"1985","unstructured":"Basmajian\n              JV\n            , DeLucaCJ.\n          Muscles Alive: Their Functions Revealed by Electromyography. 5th ed. Baltimore, MD: Williams & Wilkins; 1985."},{"key":"i1062-6050-46-4-349-b16","series-title":"Anatomic Guide for the Electromyographer: The Limbs","year":"1980","unstructured":"Delagi\n              EF\n            , PerottoA.\n          Anatomic Guide for the Electromyographer: The Limbs. 2nd ed. Springfield, IL: Charles C. Thomas; 1980."},{"issue":"4","key":"i1062-6050-46-4-349-b17","series-title":"J Electromyogr Kinesiol.","first-page":"418","article-title":"Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis","volume":"15","year":"2005","unstructured":"Ekstrom\n              RA\n            , SoderbergGL, DonatelliRA.\n          Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis. J Electromyogr Kinesiol.2005;15 (4):418\u2013428."},{"issue":"1","key":"i1062-6050-46-4-349-b18","series-title":"Athl Train J Natl Athl Train Assoc.","first-page":"40","article-title":"EMG analysis of posterior rotator cuff exercises","volume":"25","year":"1990","unstructured":"Blackburn\n              TA\n            , McLeodWD, WhiteB, WoffordL.\n          EMG analysis of posterior rotator cuff exercises. Athl Train J Natl Athl Train Assoc.1990;25 (1):40\u201345."},{"issue":"9","key":"i1062-6050-46-4-349-b19","series-title":"Br J Phys Med.","first-page":"191","article-title":"Patterns of motion for proprioceptive neuromuscular facilitation","volume":"17","year":"1954","unstructured":"Voss\n              DE\n            , KnottM.\n          Patterns of motion for proprioceptive neuromuscular facilitation. Br J Phys Med.1954;17 (9):191\u2013198."},{"issue":"10","key":"i1062-6050-46-4-349-b20","series-title":"Phys Ther.","first-page":"668","article-title":"Electromyographic activity of selected shoulder muscles in commonly used therapeutic exercises","volume":"73","year":"1993","unstructured":"Ballantyne\n              BT\n            , O'HareSJ, PaschallJL, \n          et al. Electromyographic activity of selected shoulder muscles in commonly used therapeutic exercises. Phys Ther.1993;73 (10):668\u2013682."},{"issue":"7","key":"i1062-6050-46-4-349-b21","series-title":"Arch Phys Med Rehabil.","first-page":"923","article-title":"Electromyographic activity in the immobilized shoulder girdle musculature during scapulothoracic exercises","volume":"87","year":"2006","unstructured":"Smith\n              J\n            , DahmDL, KaufmanKR, \n          et al. Electromyographic activity in the immobilized shoulder girdle musculature during scapulothoracic exercises. Arch Phys Med Rehabil.2006;87 (7):923\u2013927."},{"issue":"10","key":"i1062-6050-46-4-349-b22","series-title":"Am J Sports Med.","first-page":"1643","article-title":"Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test","volume":"34","year":"2006","unstructured":"Kibler\n              WB\n            , SciasciaA, DomeD.\n          Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. Am J Sports Med.2006;34 (10):1643\u20131647."},{"issue":"1","key":"i1062-6050-46-4-349-b23","series-title":"J Orthop Sports Phys Ther.","first-page":"4","article-title":"Effect of the scapula reposition test on shoulder impingement symptoms and evaluation strength in overhead athletes","volume":"38","year":"2008","unstructured":"Tate\n              AR\n            , McClurePW, KarehaS, IrwinD.\n          Effect of the scapula reposition test on shoulder impingement symptoms and evaluation strength in overhead athletes. J Orthop Sports Phys Ther.2008;38 (1):4\u201311."},{"issue":"2","key":"i1062-6050-46-4-349-b24","series-title":"Am J Sports Med.","first-page":"325","article-title":"The role of the scapula in athletic shoulder function","volume":"26","year":"1998","unstructured":"Kibler\n              WB.\n            \n          \n          The role of the scapula in athletic shoulder function. Am J Sports Med.1998;26 (2):325\u2013337."},{"issue":"3","key":"i1062-6050-46-4-349-b25","series-title":"Man Ther.","first-page":"123","article-title":"Dynamic stability of the scapula","volume":"2","year":"1997","unstructured":"Mottram\n              SL.\n            \n          \n          Dynamic stability of the scapula. Man Ther.1997;2 (3):123\u2013131."},{"issue":"8","key":"i1062-6050-46-4-349-b26","series-title":"Int J Sports Med.","first-page":"618","article-title":"Recruitment patterns of the scapular rotator muscles in freestyle swimmers with subacromial impingement","volume":"18","year":"1997","unstructured":"Wadsworth\n              DJ\n            , Bullock-SaxtonJE.\n          Recruitment patterns of the scapular rotator muscles in freestyle swimmers with subacromial impingement. Int J Sports Med.1997;18 (8):618\u2013624."},{"issue":"5","key":"i1062-6050-46-4-349-b27","series-title":"J Shoulder Elbow Surg.","first-page":"756","article-title":"Analysis of the scapulohumeral rhythm and electromyography of the shoulder muscles during elevation and lowering: comparison of dominant and non-dominant shoulders","volume":"18","year":"2009","unstructured":"Yoshizaki\n              K\n            , HamadaJ, TamaiK, SaharaR, FujiwaraT, FujimotoT.\n          Analysis of the scapulohumeral rhythm and electromyography of the shoulder muscles during elevation and lowering: comparison of dominant and non-dominant shoulders. J Shoulder Elbow Surg.2009;18 (5):756\u2013763."},{"issue":"1","key":"i1062-6050-46-4-349-b28","series-title":"Acta Orthop Scand.","first-page":"57","article-title":"The subacromial space in normal shoulder radiographs","volume":"55","year":"1984","unstructured":"Petersson\n              CJ\n            , Redlund-JohnellI.\n          The subacromial space in normal shoulder radiographs. Acta Orthop Scand.1984;55 (1):57\u201358."},{"issue":"2","key":"i1062-6050-46-4-349-b29","series-title":"J Bone Joint Surg Am.","first-page":"378","article-title":"Motion of the shoulder complex during multiplanar humeral elevation","volume":"91","year":"2009","unstructured":"Ludewig\n              PM\n            , PhadkeV, BramanJP, HassettDR, CieminskiCJ, LaPradeRF.\n          Motion of the shoulder complex during multiplanar humeral elevation. J Bone Joint Surg Am.2009;91 (2):378\u2013389."},{"issue":"4","key":"i1062-6050-46-4-349-b30","series-title":"J Electromyogr Kinesiol.","first-page":"701","article-title":"Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks","volume":"20","year":"2010","unstructured":"Thigpen\n              CA\n            , PaduaDA, MichenerLA, \n          et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol.2010;20 (4):701\u2013709."},{"issue":"5","key":"i1062-6050-46-4-349-b31","series-title":"J Electromyogr Kinesiol.","first-page":"458","article-title":"Altered patterns of muscle activation during performance of four functional tasks in patients with shoulder disorders: interpretation from voluntary response index","volume":"16","year":"2006","unstructured":"Lin\n              JJ\n            , LimHK, Soto-QuijanoDA, \n          et al. Altered patterns of muscle activation during performance of four functional tasks in patients with shoulder disorders: interpretation from voluntary response index. J Electromyogr Kinesiol.2006;16 (5):458\u2013468."},{"issue":"3","key":"i1062-6050-46-4-349-b32","series-title":"Phys Ther","first-page":"276","article-title":"Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement","volume":"80","year":"2000","unstructured":"Ludewig\n              PM\n            , CookTM.\n          Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80 (3):276\u2013291."},{"issue":"10","key":"i1062-6050-46-4-349-b33","series-title":"J Orthop Sports Phys Ther","first-page":"574","article-title":"Comparison of 3-dimensional scapular position and orientation between subjects with and without shoulder impingement","volume":"29","year":"1999","unstructured":"Lukasiewicz\n              AC\n            , McClureP, MichenerL, PrattN, SennettB.\n          Comparison of 3-dimensional scapular position and orientation between subjects with and without shoulder impingement. J Orthop Sports Phys Ther. 1999;29 (10):574\u2013586."},{"issue":"6","key":"i1062-6050-46-4-349-b34","series-title":"J Shoulder Elbow Surg.","first-page":"516","article-title":"Shoulder kinematics with two-plane x-ray evaluation in patients with anterior instability or rotator cuff tearing","volume":"6","year":"1997","unstructured":"Paletta\n              GA\n              Jr\n            , WarnerJJ, WarrenRF, DeutschA, AltchekDW.\n          Shoulder kinematics with two-plane x-ray evaluation in patients with anterior instability or rotator cuff tearing. J Shoulder Elbow Surg.1997;6 (6):516\u2013527."},{"key":"i1062-6050-46-4-349-b35","series-title":"Clin Orthop Relat Res.","first-page":"191","article-title":"Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome: a study using Moire topographic analysis","volume":"285","year":"1992","unstructured":"Warner\n              JJ\n            , MicheliLJ, ArslanianLE, KennedyJ, KennedyR.\n          Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome: a study using Moire topographic analysis. Clin Orthop Relat Res.1992;285:191\u2013199."}],"container-title":["Journal of Athletic Training"],"original-title":[],"link":[{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/46\/4\/article-p349.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/46\/4\/349\/1452216\/1062-6050-46_4_349.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/nata.kglmeridian.com\/downloadpdf\/journals\/attr\/46\/4\/article-p349.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/nata.kglmeridian.com\/downloadpdf\/journals\/attr\/46\/4\/article-p349.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:40:22Z","timestamp":1749688822000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/46\/4\/article-p349.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011]]},"references-count":35,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-46.4.349","relation":{},"ISSN":["1062-6050"],"issn-type":[{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2011]]}}}