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Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
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Related Experiment Video

Updated: Oct 14, 2025

Development of a Rabbit Chronic-Like Rotator Cuff Injury Model for Study of Fibrosis and Muscular Fatty Degeneration
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Rotator cuff strength is not augmented by blood flow restriction training.

Jason Brumitt1, Marcey Keefer Hutchison1, Dan Kang1

  • 1College of Physical Therapy, George Fox University, Newberg, OR, USA, 97132.

Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine
|November 6, 2021
PubMed
Summary

Blood flow restriction (BFR) training did not enhance rotator cuff strength when combined with lower extremity (LE) exercises. This study found no significant differences in strength gains between BFR and non-BFR groups.

Keywords:
External rotatorsOcclusion trainingShoulderSupraspinatusTherapeutic exercise

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Area of Science:

  • Sports Medicine
  • Exercise Physiology
  • Rehabilitation

Background:

  • Blood flow restriction (BFR) training is a method that uses a tourniquet to occlude blood flow during exercise.
  • While BFR may enhance strength in muscles near the cuff, its effectiveness for the rotator cuff has been questioned.
  • Previous research has not shown strength augmentation in the rotator cuff with upper extremity (UE) BFR.

Purpose of the Study:

  • To investigate if performing lower extremity (LE) exercises with BFR, followed by rotator cuff exercises, improves strength and muscle size compared to standard training.
  • To evaluate the efficacy of a combined LE BFR and rotator cuff exercise protocol in untrained individuals.

Main Methods:

  • A randomized controlled trial was conducted with 35 untrained subjects.
  • Participants were assigned to either a BFR group or a non-BFR control group.
  • Muscular strength was measured using a hand-held dynamometer, and the cross-sectional area (CSA) of the rectus femoris was assessed via diagnostic ultrasound.

Main Results:

  • Both BFR and non-BFR groups showed significant improvements in both LE and rotator cuff strength.
  • The BFR group exhibited greater percentage increases in supraspinatus, shoulder external rotation, quadriceps, and hamstring strength compared to the non-BFR group.
  • No significant differences in strength gains were observed between the two groups, and neither group showed a significant increase in rectus femoris CSA.

Conclusions:

  • The specific BFR protocol involving LE exercises followed by rotator cuff exercises did not lead to augmented rotator cuff strength.
  • The findings suggest that this combined training approach may not be superior to traditional training for improving rotator cuff strength in untrained individuals.