Background Although conservative treatment is often recommended in biceps related pathology and SLAP lesions in overhead athletes, a progressive exercise protocol with controlled low to moderate load on the biceps has not been described yet.

Objective To describe a continuum of exercises with progressive low to moderate load on the biceps, based on EMG analysis.

Design Descriptive laboratory study.

Participants Non-injured participants, age 22.3 yrs (±1.3 yrs).

Risk factor assessment Electromyographic (EMG) activity of 8 muscles (upper (UT), middle (MT), lower (LT) trapezius, serratus anterior (SA), anterior (DA) and posterior (DP) portions of the deltoid, biceps (BB) and triceps (TB) brachii) was measured in 32 healthy subjects performing 16 commonly described shoulder rehabilitation exercises, using surface electromyography.

Main outcome measurements EMG activity, normalized to MIVC.

Results Out of the 16 exercises, 13 show low (<20% MIVC) and 3 moderate (20-50% MIVC) EMG activity in the BB. Based on the results, a ranking is presented of the exercises with EMG levels between 2.2±1.24 (during internal rotation against resistance in 90° of shoulder abduction) and 35.9±18.82 (during forward flexion in external rotation and supination) % MIVC.

Conclusion A continuum of exercises may be used in the rehabilitation of biceps pathology and SLAP lesions, based on the EMG activity of the BB, varying from very low to moderate load. The results may assist the clinician in the appropriate choice of exercises in a graded rehabilitation program of biceps related pathology.