Quick EMG Review: Training the rotator cuff trains the scapulothoracic muscles

I had a discussion with a Physio friend of mine about a blog he wrote championing performing scapular stability exercises before rotator cuff exercises.  Because I am bit of a picky bitch I immediately thought that while I can see the clinical rationale for it I don’t think the muscles actually do this in practice and thus we had a respectable difference of opinion.  From some old EMG reviews I knew that some of the best exercises to train the lower traps (with out upper trap activity) were actually lame old rotator cuff exercises.  A couple of  years ago I made a few graphics that illustrated this (prompted by a similar discussion on Mike Reinold’s blog).

Below you will see that shoulder External Rotation (both at 90 degrees and at 0 degrees) are great scapulothoracic exercises.  So while, Jesse might have great success with training scapula before he trains the rotator cuff the explanation for this can probably be explained million other ways then the mechanistic idea that there is some deficit in scapulothoracic function that needs correcting.

Anyways, here are the pictures.  Please feel free to download them and use them in any patient education or other blog posts as you see fit.

1-full-can-with-numbers 1-prone-ER-at-90-degrees-down-with-numbers 1-prone-horizonal-abduction-at-130-degrees-unilateral 1-prone-horizontal-abduction-unilateral-at-90-degrees 1-sidelying-shoulder-IR




  1. Tony Ingram -  February 9, 2013 - 7:52 am

    I didn’t realize how well scaption targeted the serratus ant.

    • Greg Lehman -  February 9, 2013 - 11:42 pm

      Yes. Very cool. Something has to cause the scap to rotate upwards. Certainly argues against the idea about the scapula needing to be “stable” versus “mobile”. My main point behind this is that even if we just stay in the mechanical nociceptive realm, exercises do more than we just typically think they do.

  2. Adam Meakins -  February 10, 2013 - 3:05 pm

    Hi Greg

    Great little piece again, and like the pics, what are your thoughts of the use of the contra lateral limb to get muscle activity in the other side, especially after rotator cuff surgery, I refer to Padgetts paper here http://www.jshoulderelbow.org/article/S1058-2746(04)00125-9/abstract demonstrating quiet high MVIC EMG readings in the immobilised arm when performing contra lateral arm movements.

    Do you think this has a role in early rehab???



    • Greg Lehman -  February 11, 2013 - 9:51 am

      I like it Adam. I do this at times but its nice to see newer research behind it. I think it also has a role in chronic pain. For example, if I have patient who has pain lifting their left arm and twisting it I will often have them do this movement with their right arm. Sort of an introduction to the movement.

      Thanks for the link.


  3. Random Thoughts | Bret Contreras -  February 11, 2013 - 6:58 pm

    […] HERE for some cool graphics detailing the EMG activity of various rotator cuff and scapular muscles […]

    • Greg Lehman -  February 18, 2013 - 8:14 pm

      Thanks Chris,

      Those findings are awesome. I dont think i had seen this before, great paper.



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