Effect of a Novel Stretching Technique on Shoulder Range of Motion in Overhead Athletes with Glenohumeral Internal Rotation Deficits: A Randomized Controlled Trial

Abstract

Background The cross-body and the modified sleeper stretch have been used to improve posterior shoulder soft tissue flexibility and to increase glenohumeral joint internal rotation (GHJ IR) in overhead athletes. However, due to the inability to stabilize patient’s scapula and control GHJ rotation with the cross-body stretch and the potential for subacromial impingement or symptoms’ aggravation with the modified sleeper stretch, a new stretching technique was developed as an alternative to these commonly used stretches that may allow for greater stability of the scapula without reproducing symptoms, as well as providing an inhibition component to the posterior shoulder girdle muscles. Thus, the current study aimed to examine and compare a novel stretching technique to the traditional modified sleeper stretch to determine the effect on glenohumeral IR range of motion (ROM), self-reported pain, and subject satisfaction in overhead athletes with glenohumeral internal rotation deficits (GIRD).Methods Forty-two overhead athletes with GIRD [mean age 25.9 ± 2.6 years] participated in this study. Participants were randomly assigned into either novel stretching group or modified sleeper stretching group. IR ROM was measured with a digital inclinometer, pain was measured with Numeric Pain Rating Scale, and subject satisfaction level was measured by a 6-item questionnaire developed and validated by the study’s authors. Outcomes were measured before, immediately, and at week 4 post intervention.Results There was no significant group by time interaction effect for IR ROM (p=0.27); however, there was a significant change over time (p<0.001). Both groups demonstrated a significant increase in IR from baseline to immediate and week 4, and from immediate to week 4 (p<0.001). There was also a significant reduction in pain intensity over time for the novel group (p=0.016) compared to the traditional group (p=0.080). For the satisfaction level, only the easiness of performance was significantly different and in favor of the traditional group (p=0.020) following the 4 weeks of the stretching protocols.Conclusion Both stretches appear to be effective at improving IR ROM in overhead athletes with GIRD. However, the novel stretching is more effective at reducing shoulder pain and thus might be more appropriate for symptomatic patients.

Effectiveness of Mobility and Stability Exercises in Resistance-Trained Males with Shoulder Immobility in Different Age Groups

“…However, more differences were observed in the range of motion in the young adult group. Gharisia et al concluded that stretching exercises increase joint range of motion in athletes with internal deficits in the glenohumeral joint (Gharisia et al, 2021). Goto et al examined the effects of range of motion exercises performed at different angles in their study on young trained men.…”

Comparative Effects of Novel Modified Sleeper and Cross-body Stretching on Scapular Anterior Tilting and Shoulder Internal Rotation in Subjects With Anterior Tilted Scapular and Shoulder Internal Rotation Deficits

“…This decreased IR creates a significantly greater scapular anterior tilt, especially towards the end of IR, at 90° shoulder flexion or abduction position [3,5,11]. This kinematic alteration is associated with Yeonghun Han, et al anterior to posterior lesions [5,[11][12][13].…”

“…Several studies have investigated the effectiveness of posterior shoulder stretching exercises in restoring lost shoulder range of motion (ROM) [12][13][14][16][17][18][19][20][21][22][23], improving pain [12,13,21], shoulder dysfunction [12], muscle strength [20], and muscle stiffness [18], and decreasing the shear elastic modulus [24]. Different methods, such as joint mobilization [16,22,23] and scapular stabilization [17,20,24] have been combined with posterior stretching.…”