The reverse total shoulder: what muscles provide internal and external rotation?

Electromyographic and kinematic study of reverse total shoulder arthroplasty: an observational prospective cohort study

These authors sought to describe the contribution of principal muscles around the shoulder by electromyography and access the range of motion of 5 movements of patients with RTSA compared with normal shoulders.

In comparison to normal shoulders, in patients with RTSA the upper trapezius was the main activator in all directions with early and constant activity. 

The latissimus dorsi demonstrated increased muscular activity in internal rotation.

The posterior deltoid showed increased activity in external rotation.

The authors suggest that  rehabilitation protocols targeting those muscles could demonstrate better outcomes for RTSA.

Comment: It is interesting to consider whether lateralizing the humerus may increase the effectiveness of the posterior deltoid as an external rotator.

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