In patients with shoulder or neck pain, often an imbalance of the activation in the scapular upward and downward rotators is present which can cause abnormalities in coordinated scapular rotation. Shrug exercises are often recommended to activate muscles that produce upward rotation, but little information is available on the activity of the downward rotators during shrugging exercises. The position used for the shrug exercise may affect the relative participation of the medial scapular rotators.
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