Objectives: To evaluate the muscle latency times of the 3 portions of the trapezius muscle to a sudden arm movement in normal shoulders and to determine if this recruitment pattern is altered as a result of fatigue.

Background: It has been suggested that shoulder impingement may be related to altered muscle activity and muscle fatigue in the scapular stabilizers. Fatigue-induced changes in latency times of the trapezius might influence scapular stability.

Methods and Measures: Muscle latency times were investigated in 30 healthy shoulders with surface electromyography. Muscle activity was measured in all 3 sections of the trapezius and the middle deltoid muscle during a sudden downward falling movement of the arm. Subsequently the shoulder was fatigued on an isokinetic dynamometer, after which muscle latency time measurement was repeated.

Results: ANOVA for repeated measures revealed significant differences in latency times (P < 0.05) among the 4 muscles of interest. Although there were no significant differences among the 3 sections of the trapezius muscle, they all were recruited after the initialization of the deltoid muscle. The recruitment order of the shoulder muscles did not change with muscle fatigue. However, after fatigue, muscle responses were significantly slower in all muscles except for the lower trapezius (P < 0.05).

Conclusions: There is a specific recruitment sequence in the shoulder muscles in response to a sudden arm movement characterized by initial activation of the middle deltoid muscle and followed by simultaneous contraction of all 3 sections of the trapezius. This muscle activation pattern is delayed but not altered with fatigue.

J Orthop Sports Phys Ther. 2002; 32(5):221–229.

Key Words: muscle latency times, muscular balance, neuromuscular properties, scapular stabilizers

Various authors have indicated that imbalance of the vastus medialis/vastus lateralis muscles might lead to patellofemoral pain syndrome. However, few reports have been published to substantiate such a hypothesis. The purpose of this study was to attempt to set a scale for the normal reflex response times of the vastus medialis oblique and vastus lateralis muscles after a patellar tendon tap and to determine if patellofemoral pain syndrome patients have an alteration in this firing sequence. A control group of 80 healthy adults was compared with a group of 19 patellofemoral pain syndrome patients. Results indicated that the reflex response time of the vastus medialis oblique was significantly shorter than the reflex response time of the vastus lateralis in the normal subjects (p = .01). When comparing these data in the patellofemoral pain syndrome group, a significant earlier firing was obtained from the vastus lateralis in comparison with the vastus medialis oblique (p = .01). These findings suggest that a reversal has occurred in the firing pattern of the vastus medialis oblique and vastus lateralis muscles in patellofemoral pain syndrome patients. The results indicate an alteration in the neuromuscular answer of the vastus medialis oblique and vastus lateralis muscles during a patellar tendon tap.

J Orthop Sports Phys Ther. 1996;24(3):160-165.

Key Words: patellofemoral pain syndrome, reflex response, electromyography, patellofemoral, pain