Effectiveness of a Home-Based Eccentric-Exercise Program on the Torque-Angle Relationship of the Shoulder External Rotators: A Pilot Study

Abstract

Context: The role of the rotator cuff is to provide dynamic stability to the glenohumeral joint. Human and animal studies have identified sarcomerogenesis as an outcome of eccentric training indicated by more torque generation with the muscle in a lengthened position.

Objective: The authors hypothesized that a home-based eccentric-exercise program could increase the shoulder external rotators' eccentric strength at terminal internal rotation (IR).

Design: Prospective case series.

Setting: Clinical laboratory and home exercising.

Participants: 10 healthy subjects (age 30 ± 10 y).

Intervention: All participants performed 2 eccentric exercises targeting the posterior shoulder for 6 wk using a home-based intervention program using side-lying external rotation (ER) and horizontal abduction.

Main outcome measures: Dynamic eccentric shoulder strength measured at 60°/s through a 100° arc divided into 4 equal 25° arcs (ER 50-25°, ER 25-0°, IR 0-25°, IR 25-50°) to measure angular impulse to represent the work performed. In addition, isometric shoulder ER was measured at 5 points throughout the arc of motion (45° IR, 30° IR, 15° IR, 0°, and 15° ER). Comparison of isometric and dynamic strength from pre- to posttesting was evaluated with a repeated-measure ANOVA using time and arc or positions as within factors.

Results: The isometric force measures revealed no significant differences between the 5 positions (P = .56). Analysis of the dynamic eccentric data revealed a significant difference between arcs (P = .02). The percentage-change score of the arc of IR 25-50° was found to be significantly greater than that of the arc of IR 0-25° (P = .007).

Conclusion: After eccentric training the only arc of motion that had a positive improvement in the capacity to absorb eccentric loads was the arc of motion that represented eccentric contractions at the longest muscle length.

Keywords: exercise therapy; isokinetic dynamometer; muscle strength; sarcomerogenesis.

Figure 1

Mean eccentric angular impulse for the posterior shoulder muscles on day 1 (open diamonds) and after an eccentrically biased training program (open squares) for 4 arcs of motion. Eccentric contractions began with the posterior shoulder muscles at their shortest length (50° of external rotation), and the muscles were lengthened during contraction to their longest lengths (50° internal rotation). After eccentrically biased training, the area under the eccentric torque–angle curve (angular impulse) was significantly greater (*) for the arc of motion that represented the longest muscle lengths (25–50° internal rotation).