# Muscle Recruitment and Asymmetry in Bilateral Shoulder Injury Prevention Exercises: A Cross-Sectional Comparison Between Tennis Players and Non-Tennis Players

## TL;DR

Tennis players show different muscle activation patterns in shoulder exercises compared to non-tennis athletes, which may increase injury risk due to muscle imbalances.

## Contribution

The study reveals angle-specific adaptations in trapezius activation and symmetry in tennis players during bilateral shoulder exercises.

## Key findings

- Tennis players had significantly lower trapezius activation during prone retraction at 90°.
- Muscle symmetry was higher in tennis players at 90° but worse at 45°, indicating angle-specific adaptations.
- Bilateral exercises may help reduce injury risk by improving scapular muscle function in overhead athletes.

## Abstract

Background/Objectives: Shoulder injuries are common in overhead sports like tennis due to repetitive unilateral movements that can lead to muscle imbalances. This study aimed to compare muscle recruitment and asymmetry during bilateral shoulder injury prevention exercises (performed with both arms simultaneously) in tennis players versus non-tennis athletes. Methods: Thirty-nine athletes (sixteen tennis players, twenty-three non-tennis athletes) performed two bilateral scapular retraction exercises at 45° and 90° shoulder abduction. Surface electromyography (sEMG) recorded the activation of the middle and lower trapezius. Root Mean Square (RMS), peak RMS and muscle symmetry indices were analyzed. Results: Tennis players showed significantly lower trapezius activation, especially during prone retraction at 90°. Muscle symmetry was slightly higher in tennis players at 90°, but asymmetry increased at 45°, suggesting angle-specific adaptations. Conclusions: Repetitive asymmetric loading in tennis may reduce the activation of scapular stabilizers and contribute to muscular imbalances. Including targeted bilateral exercises in training may help improve scapular muscle function and reduce injury risk in overhead athletes.