Atypical shoulder muscle activation in multidirectional instability

Objective: Surface and intramuscular electromyography was used to investigate shoulder muscle activity in subjects with multidirectional instability (MDI). Methods: Subjects (seven MDI, 11 control) performed repetitive shoulder abduction/adduction, flexion/extension and internal/external rotation movements on an isokinetic dynamometer. The activity of the deltoid, infraspinatus, supraspinatus, latissimus dorsi, and pectoralis major muscles were recorded using double-differential surface and intramuscular fine-wire electrodes. A repeated measures analysis of variance evaluated group differences in the amplitude, onset, termination and duration of the muscle activity. Results: Significant activation parameter differences for the supraspinatus, infraspinatus, posterior deltoid and pectoralis major muscles were found in the subjects with MDI. The rotator cuff and posterior deltoid muscles demonstrated abbreviated periods of activity when performing internal/external rotation, despite activation amplitudes that were similar to the controls. In contrast, the activation of the pectoralis major differed from the control group in both the amplitude and time domains when performing shoulder extension. Conclusions: MDI is associated with atypical patterns of muscle activity that occur even when highly constrained movements are used to elicit the activity. Significance: In addition to glenohumeral hyperlaxity, the results suggest that dysfunctional neuromuscular control of the rotator cuff is also a contributing factor to the pathoetiology of MDI.