Development of specific instrumentalist exercises to improve scapular stabilization-a proof of concept study (New exercises to strengthen musicians - Part I).

Introduction: Shoulder pain is a common problem occurring in musicians, with impairments in motor control and poor scapular stabilization considered potential causative risk factors. Despite research highlighting the importance of scapula exercises for managing shoulder pain, there are minimal guidelines for the best exercises to apply in musicians. The aim of this study is to evaluate the effect of purpose-designed musician scapula stabilization exercises on the activation patterns of shoulder muscles. Method: In this quasi-experimental pilot study, five task-specific exercises were designed based on upper string players' movements while playing to activate scapula musculature, and were compared with existing exercises, using surface electromyography on key stabilizing and on forearm flexor muscles. Results: Exercises successfully activated the selected scapula stabilizing muscles, particularly the bilateral exercises. For unilateral exercises, higher activations for middle and lower trapezius occurred during exercises involving pulling actions. However, these unilateral exercises also showed effects on the contralateral muscles, indicating bilateral potential benefits. Conclusion: The musical-instrument-specific scapula exercises were shown in this pilot study to recruit the targeted muscles, with bilateral exercises having more effect than unilateral exercises. As this was a small pilot study, the value of unilateral exercises, and their contralateral effects, may still be apparent, but larger sample size are needed. Further research should investigate effects on pain or function.