EFFECT OF HAND POSITION ON EMG ACTIVITY OF

THE POSTERIOR SHOULDER MUSCULATURE DURING

A HORIZONTAL ABDUCTION EXERCISE
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BRAD SCHOENFELD,1 R. GUL TIRYAKI SONMEZ,1 MOREY J. KOLBER,2 BRET CONTRERAS,3

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ROBERT HARRIS,1 AND SERIFE OZEN4

1
Lehman College, Bronx, New York; 2Nova Southeastern University, Ft. Lauderdale, Florida; 3AUT University, Aukland,
New Zealand; and 4Abant Izzet Baysal University, Bolu, Turkey

ABSTRACT isometric contraction). The results of this study show that per-
Schoenfeld, B, Sonmez, RGT, Kolber, MJ, Contreras, B, Harris, R, forming exercise on the reverse fly machine with a neutral hand
and Ozen, S. Effect of hand position on EMG activity of the position significantly increases activity of the posterior deltoid and
posterior shoulder musculature during a horizontal abduction infraspinatus muscles compared with a PRO hand position.
exercise. J Strength Cond Res 27(10): 2644–2649, 2013—The KEY WORDS reverse fly machine, internal rotation, external
reverse fly machine is a popular exercise for strengthening the rotation, neutral grip, pronated grip, glenohumeral muscles,
horizontal shoulder abductors including the posterior deltoid. infraspinatus, middle deltoid, rear deltoid
There seems to be little consensus as to which hand position
most effectively targets the posterior deltoid despite this option INTRODUCTION

T
on most machines. This study investigated the impact of varying
he posterior deltoid is an important muscle for
one’s hand position, and consequently altering shoulder joint
maintaining dynamic stability of the shoulder joint
rotation, on muscle activity in various glenohumeral muscles dur- (2,12). It is the primary glenohumeral horizontal
ing exercise on the reverse fly machine. Nineteen resistance- abductor (10) and also serves as an external rota-
trained men (mean age = 23.2 6 4.3 years; height = 176.9 6 tor, although its moment arm for this action does not seem
7.1 centimeters; body mass = 81.3 6 10.5 kilograms; body mass to be as great as that of the infraspinatus and teres minor
index = 25.9 6 2.6) were recruited from a university population to (11). Moreover, the posterior deltoid has been shown to be
participate in the study. In a repeated measures design, subjects active in frontal plane glenohumeral adduction and abduc-
grasped the hand bars on the machine with either a pronated tion, but its role in these movements seems to be as a stabi-
(PRO) or neutral (NEU) grip and performed dynamic horizontal lizer against the tendency of the prime movers to produce
abduction repetitions to muscular failure using a load equating to unwanted internal rotation or horizontal flexion (15).
Strengthening the posterior head of the deltoid is desirous for
approximately 75% body weight. The order of performance of the
ensuring shoulder joint integrity (6) and enhancing athletic per-
hand positions was counterbalanced between participants so
formance and reducing injury potential (13). This can be
that approximately half of the subjects performed PRO first and
accomplished with a variety of modalities including free
the other half performed NEU first. Surface electromyography weights, cables, and machines. However, given the posterior
was used to record both mean and peak muscle activity of the deltoid’s limited role in the sagittal and frontal planes, traditional
posterior deltoid, middle deltoid, and infraspinatus. Results overhead pressing movements will tend to favor the anterior
showed that mean electromyography activity for the posterior and middle deltoids at the expense of the posterior head.
deltoid was significantly greater in NEU compared with PRO Hence, the posterior deltoid may become underdeveloped
(p = 0.046; 95% CI = 0.1–7.4% maximal voluntary isometric vis-a-vis the other deltoid heads unless direct transverse plane
contraction). Similarly, mean electromyography activity of the exercise such as horizontal shoulder abduction is performed.
infraspinatus also was significantly greater in NEU compared From an exercise performance standpoint, the activity of the
with PRO (p = 0.002; 95% CI = 3.7–13.6% maximal voluntary deltoid muscles are affected not only by the direction of
humeral movement in a given plane but also may be influenced
by whether the joint is placed in internal or external rotation.
Address correspondence to Brad Schoenfeld, [email protected]. Using fine wire electromyography (EMG), Reinold et al. (14)
27(10)/2644–2649 showed that the prone full can exercise, where the subject lies
Journal of Strength and Conditioning Research face down and performs horizontal abduction at approximately
Ó 2013 National Strength and Conditioning Association 1008 angle of glenohumeral abduction and full external
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rotation, produced significantly greater EMG activity in the internal rotation would produce greater muscular activity
posterior deltoid compared with the standing full can or empty compared to a performance of the movement in neutral
can exercises that elevate the arm in the scapular plane. Similar rotation. A secondary purpose of the study was to evaluate
results were found by Boettcher et al. (4), who used a combi- the effect of these exercise variations on the middle deltoid
nation of surface EMG and intramuscular fine wire electrodes and infraspinatus muscles.
to evaluate muscle activity during these same exercises. More-
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over, Anderson et al. (3) found that the reverse fly (horizontal METHODS
abduction in the transverse plane) performed with partial exter- Experimental Approach to the Problem
nal rotation produced the highest level of posterior deltoid The reverse fly machine is a popular exercise for strength-
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muscle activation when compared with the one-arm dumbbell ening the horizontal shoulder abductors, namely the poste-
row, shrug, upright row, and lateral raise. It is clear from these rior deltoid. With correct body alignment, this machine helps
studies that horizontal shoulder abduction exercise maximizes to facilitate proper form by restricting degrees of freedom so
muscle recruitment of the posterior deltoid. Unfortunately, the that movement takes place purely in the transverse plane.
impact of varying degrees of shoulder rotation during horizon- Moreover, the machine may allow for greater force devel-
tal abduction exercise has not been well studied despite the fact opment in the target shoulder musculature since the need for
that exercise equipment such as the reverse fly machine (seated core stabilization is minimized. Exercise performance can be
horizontal shoulder abduction in the transverse plane) is often carried out either with the hands in a pronated (PRO)
designed with alternate hand positioning options. position, which places the shoulder joint in internal rotation,
A number of studies have examined the effect of perform- or a neutral position, which places the shoulder joint in
ing glenohumeral elevation in external vs. internal rotation on neutral rotation. There seems to be little consensus as to
the various deltoid heads during scapular plane movement. which hand position most effectively targets the posterior
Reinold et al. (14) found significantly greater muscle activity deltoid despite this option on most machines. This study was
in the middle and posterior heads in the empty can exercise designed to investigate whether significant differences in
(shoulder abduction 308 angle anterior to the frontal plane muscle activity are seen in the posterior deltoid when
with internal rotation) compared with the full can exercise performing the reverse fly with either a neutral grip (NEU)
(shoulder abduction 308 angle anterior to the frontal plane or a PRO grip as determined by surface EMG. A repeated
with external rotation). Similarly, Boettcher et al. (4) dis- measures counterbalanced design was used to answer the
played that the empty can exercise produced greater EMG question: During horizontal abduction of the glenohumeral
activation of all 3 deltoid muscles compared with the full can joint (reverse fly), will varying hand position significantly
exercise, but results did not reach statistical significance. affect muscle activation of the posterior deltoid?
A search of the PUBMED-MEDLINE and EBSCO data-
Subjects
bases revealed only one study that examined the effects of
Nineteen men (mean age = 23.2 6 4.3 years; height = 176.9 6
using internal vs. external rotation during horizontal abduc-
7.1 centimeters; body mass = 81.3 6 10.5 kilograms; body
tion. In this study (16), 15 male subjects performed 17 different
mass index = 25.9 6 2.6) were recruited from a university
dumbbell exercises for the glenohumeral joint, including hor-
population to participate in this study. All subjects were expe-
izontal shoulder abduction carried out in both internal and
rienced with resistance training, defined as lifting weights for
external rotation. Fine wire EMG was used to assess peak
a minimum of 2 days a week (mean = 4.1 6 1.3 days/week)
activity in the glenohumeral muscles. Results in the aforemen-
for 1 year or more (mean = 5.2 6 2.7 years).
tioned study showed that shoulder rotation had a minimal
Inclusion criteria required subjects to read and speak
effect on muscle activation of the posterior deltoid. Statistical
English and pass a physical activity readiness questionnaire.
significance between exercises was not reported, however, so
Those receiving care for any shoulder or neck pathology at
results can only be interpreted on an absolute basis.
the time of the study or those with an amputation of an upper
In summary, there is a paucity of evidence-based research
extremity limb were excluded from participation. A post hoc
that has investigated the effect of shoulder rotation during
power analysis showed that this sample size was sufficient to
horizontal abduction on muscle activation of the posterior
detect an absolute mean difference in EMG activity of 10%—
deltoids. Moreover, no research that we are aware of has
normalized to the maximal voluntary isometric contraction
investigated the effect of shoulder internal rotation vs.
(MVIC)—between conditions with a statistical power of 0.80
neutral rotation on posterior deltoid activation when using
at a = 0.05. Each subject gave written informed consent
the reverse fly machine. Thus, the purpose of this study was
before participation. The research protocol was approved by
to assess the impact of varying one’s hand position, and
the institutional review board at Lehman College, Bronx, NY.
consequently altering shoulder joint rotation, on muscle
activity in the posterior deltoid during exercise on the Procedure
reverse fly machine. Given that internally rotating the shoul- After consent, subjects were prepared for testing by wiping
der increases stiffness of the posterior deltoid (8), it was the skin in the desired areas of electrode attachment with an
hypothesized that horizontal abduction combined with alcohol swab to ensure stable electrode contact and low skin

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 Effect of Hand Position

TABLE 1. Manual muscle tests employed to determine MVIC.

Muscle Testing protocol

Posterior From a seated position, the shoulder was flexed to 908 angle with hands in neutral position. Resistance
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deltoid was applied just proximal to the elbow in a medial direction although subject attempts to horizontally
abduct the shoulder.
Middle From a seated position, the arm was held at the side with hands in neutral position. Resistance was
deltoid applied just proximal to the elbow in an inferior direction although subject attempts to abduct the
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shoulder.
Infraspinatus From a seated position, the arm was held at the side with elbows flexed to 908 angle and hands
pronated. Resistance was applied just proximal to the wrist in a medial direction although subject
attempts to externally rotate the shoulder.

MVIC, maximal voluntary isometric contraction.

impedence. After preparation, self-adhesive disposable silver/ initial warm-up consisting of 5 minutes of light cardiovascular
silver chloride–pregelled snap surface bipolar electrodes (Nor- exercise and slow dynamic stretching in all 3 cardinal planes,
axon Product #272, Noraxon USA Inc, Scottsdale, AZ) with subjects were asked to slowly increase the force of the contrac-
a diameter of 1 cm and an interelectrode distance of 2 cm were tion so as to reach a maximum effort after approximately 3
attached parallel to the fiber direction of the posterior deltoid, seconds. Subjects then held the maximal contraction for 3 sec-
middle deltoid, and infraspinatus muscles. All subjects had onds before slowly reducing force over a final period of 3
very little if any body hair in the shoulder region, thus render- seconds. This procedure was repeated once for each muscle
ing it unnecessary to shave the area. Electrode placement was after a 60 second rest interval and the highest MVIC value was
made on the right side of each subject to minimize potential used for comparison.
ECG artifact. The posterior deltoid electrode was centered
approximately 2 fingerbreaths behind the angle of the acro-
mion. The middle deltoid electrode was placed along the line
from the acromion to the lateral epicondyle of the elbow,
corresponding to the greatest bulge of the muscle. The infra-
spinatus electrode was placed parallel to and approximately 4
cm below the spine of the scapula, on the lateral aspect, over
the infraspinous fossa. A neutral reference electrode was
placed over the bony process at the base of the neck. These
methods are consistent with the recommendations of Criswell
(5) and the Surface EMG for Non Invasive Assessment of
Muscles project (1). After all electrodes were secured, a quality
check was performed to ensure EMG signal validity.
Instrumentation
Raw EMG signals were collected at 2000 Hz by a Myotrace
400 EMG unit (Noraxon USA Inc, Scottsdale, AZ, USA) and
filtered by an eighth order Butterworth bandpass filter with
cutoffs of 20–500 Hz. Data were sent in real time to a com-
puter via Bluetooth and recorded and analyzed by MyoRe-
search XP Clinical Applications software (Noraxon USA,
Inc.). Signals were rectified (by root mean square algorithm)
and smoothed in real time.
Maximal Voluntary Isometric Contraction
Maximal voluntary isometric contraction data were obtained
for each muscle tested by performing a series of resisted
isometric contractions as outlined by Hislop and Montgom-
ery (7). Table 1 describes the specific manual muscle testing Figure 1. Pronated hand position (PRO).
exercises employed. Tests were carried out as follows: After an
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palm down, Figure 1) or NEU (performed with thumb up;

Figure 2) grip. The order of performance of the hand posi-
tions was counterbalanced between participants so that
approximately half of the subjects performed PRO first and
the other half performed NEU first. The starting position of
the exercise was at 908 angle of humeral elevation in the
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sagittal plane and the finish position was when subjects

reached the point where the humerus was parallel to the
torso. Subjects completed as many repetitions as possible
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to muscular fatigue for each hand position with a resistance

corresponding to ;75% of body mass, which ultimately cor-
responded to an intersubject variance of 4–12 total repeti-
tions. From a within-subject standpoint, there was virtually
no difference in the number of repetitions between varia-
tions. The vast majority of subjects performed equal number
of repetitions for each of the hand positions, and no subject
had a variance of more than 1 repetition between hand
positions, therefore indicating that fatigue was not a con-
founding issue in results. Concentric actions were performed
as forcefully as possible (velocity of ;1 second), and eccen-
tric actions were performed at a 2 count (velocity of ;2
seconds). Technique instruction and verbal inducements
were given to each subject before and during performance
by the primary investigator who is a certified trainer to
ensure that exercise was carried out in the prescribed man-
Figure 2. Neutral hand position (NEU).
ner. The exercise bout was stopped when the subject could
no longer perform a concentric repetition in proper form
Exercise Description throughout a complete range of motion.
Five minutes after MVIC testing, subjects were positioned to
sit face forward in a reverse fly machine (Model #MD 504, Statistical Analysis
Body Masters Corporation, Rayne, LA, USA) so that the Statistical analysis was carried out using SPSS statistical
chest was flush against the restraint pad. Seat height was software (version 20.0; IBM Corporation, New York, NY,
adjusted so that the hand grips of the unit were aligned with USA). The normalized EMG differences between the 2 trials
the shoulder joint axes of rotation. Subjects grasped the hand for each of the muscles studied were tested for statistical
bars on the machine with either a PRO (performed with significance using a paired t-test. The entire set of repetitions
was analyzed for each variation
in every subject. Both mean (the
average amplitude across each
set) and peak (the highest
value found in each set) EMG
values were assessed. Effect
size (d) was calculated using for-
mula M1-M2/SD, whereas means
from each group (hand position)
were subtracted and divided by
the SD. Statistical significance
was considered at a # 0.05.
Power analysis was performed
a priori to determine the number
of subjects required to produce
a power of 0.80 at an a level of
0.05. It was assumed that 10%
Figure 3. Descriptive data from electromyographic testing. MVIC = maximum voluntary isometric contraction;
PD = posterior deltoid; MD = middle deltoid; IF = infraspinatus; Int.Rot = internally rotated shoulder position. difference between hand posi-
Lines represent SD. tions in posterior deltoid muscle
activity would be clinically

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 Effect of Hand Position

TABLE 2. Influence of shoulder position on mean and peak electromyography of tested musculature.

95% confidence interval of the difference

Mean SD Lower Upper p* Effect size d

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Mean PD: I 2 E 23.737 7.615 27.407 20.067 0.046† 0.19

Mean MD: I 2 E 24.053 9.755 28.754 0.649 0.087 0.12
Mean IF: I 2 E 28.632 10.232 213.563 23.700 0.002† 0.5
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Peak PD: I 2 E 5.474 32.341 210.114 21.061 0.470 0.09

Peak MD: I 2 E 23.211 20.239 212.965 6.544 0.498 0.07
Peak IF: I 2 E 215.579 36.121 232.989 1.831 0.076 0.3

*Paired t-test.
†Statistically significant.
PD = posterior deltoid; MD = middle deltoid; IF = infraspinatus; I 2 E = EMG activity of internal rotation position minus (2) neutral
shoulder rotation.

relevant. A sample of at least 18 subjects was determined to be function of external rotation. Furthermore, the internally
a reasonable number to achieve adequate statistical power. rotated and horizontally adducted start position of this exer-
cise has the potential to place a considerable stretch on the
RESULTS posterior deltoid (8, 9) thus this position may prevent the
Results showed that mean normalized EMG activity for the musculature from developing adequate force due to the
posterior deltoid was significantly greater in NEU com- length tension relationship of the actinomyosin complex.
pared with PRO (p = 0.046; 95% CI = 0.1–7.4% MVIC). These hypotheses require further study.
Similarly, mean normalized EMG activity of the infraspi- When comparing our findings to that of Townsend et al.
natus also was significantly greater in NEU compared with (16), it is important to point out several important differences
PRO (p = 0.002; 95% CI = 3.7–13.6% MVIC). There was between the two studies. First, the Townsend et al. (16)
a trend for greater mean normalized EMG activity in the study was designed to determine muscle recruitment during
middle deltoid during NEU compared with PRO (p = a shoulder rehabilitation program, and thus exercises were
0.087), but this did not reach statistical significance. No signif- performed slowly with very light weights. Conversely, our
icant differences were seen in peak normalized EMG activity study sought to evaluate horizontal abduction exercise per-
between hand positions in any of the muscles studied, formed in a manner that is more common to strength and
although there was a trend for greater peak activity in the conditioning, where intensity is relatively high and there is
infraspinatus during NEU compared with PRO (p = 0.076). intent to move the weight quickly on concentric actions.
Effect sizes for differences between shoulder positioning were Furthermore, subjects in the Townsend et al. (16) study used
small for both mean and peak EMG for all muscles (d , 0.3) dumbbells whereas exercise in our study was carried out on
with the exception of mean infraspinatus activity where a mod- a reverse fly machine. Finally, the hand position for internal
erate effect was identified (d = 0.5). Figure 3 and Table 2 rotation in Townsend et al. (16) was consistent with the
provide descriptive data and paired sample test results, respec- NEU position in our study, while full external rotation in
tively, for all of the muscles studied. Townsend et al. (16) was performed with hands in a supi-
nated position. Considering these differences, it is difficult to
DISCUSSION make a comparison between studies.
This was the first study to investigate the effects of shoulder Another intriguing finding was that the infraspinatus
joint rotation on various glenohumeral muscles during showed a clear advantage to using a neutral vs. a PRO grip
performance exercise on the reverse fly machine. The study with respect to mean normalized EMG activity (70.4 6
produced several interesting findings. First, contrary to our 19.9 vs. 61.7 6 13.7% MVIC, respectively) and a strong trend
original hypothesis, mean normalized EMG activity of the for significance in peak normalized EMG activity (158.7 6
posterior deltoid was significantly greater with a neutral hand 63.1 vs. 143.1 6 46.5% MVIC, respectively). Similar to the
position compared with a PRO hand position (90.3 6 28.3 posterior deltoid, plausible explanations for these results lie
vs. 86.5 6 31.4% MVIC, respectively), although the magni- in both the action of the infraspinatus and the length tension
tude of this difference was small (d ; 0.2). While it is uncer- relationship of the muscle. Given the infraspinatus is an exter-
tain as to the exact mechanism for this finding one might nal rotator, the neutral position more closely represents the
postulate that maintaining the internally rotated position muscles action and thus it would not be unreasonable to
prevents the posterior deltoid from achieving its secondary assume it would be advantageous from a muscle activity
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perspective. Additionally, the internally rotated and horizon- a neutral hand position. On the other hand, the magnitude of
tally abducted start position has the potential to place a con- the effect for normalized mean EMG activity for the infra-
siderable stretch on the posterior deltoid (8,9) thus this spinatus was moderately greater for NEU compared with
position may prevent the musculature from developing ade- PRO (d = 0.05), which would conceivably translate into
quate force due to the length tension relationship of the acti- meaningful differences in muscle recruitment. Hence, if the
nomyosin complex. training objective is to target the infraspinatus, a neutral hand
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It is also interesting to note the large interindividual position seems to be the preferred choice in this exercise
variability between subjects with respect to muscle activation irrespective of competitive status.
patterns at the glenohumeral joint. Despite the relative
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homogeneity in subject age and training status, subjects

nevertheless showed substantial variation in both normalized REFERENCES
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self-select hand position based on whichever position feels Arch Phys Med Rehabil 50: 264–270, 1969.
most comfortable. Among the athletic or competitive pop-
16. Townsend, H, Jobe, FW, Pink, M, and Perry, J. Electromyographic
ulation, however, this small difference may in fact be of value analysis of the glenohumeral muscles during a baseball rehabilitation
and these individuals therefore may be best served by using program. Am J Sports Med 19: 264–272, 1991.

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