Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials

Abstract

Context:Posterior shoulder tightness (PST) and glenohumeral internal-rotation deficit (GIRD) can contribute to shoulder pain suffered by athletes engaged in overhead sporting activities. Stretching is a common intervention to resolve PST and GIRD, but it has weak evidence of effectiveness to date.Objective:This systematic review aimed to collect and synthesize effectiveness data from English- and Japanese-language randomized controlled trials (RCTs) investigating stretching interventions for PST and GIRD.Evidence Acquisition:7 English databases and 3 Japanese databases were searched from inception until December 5, 2015. Only English- and Japanese-language RCTs were considered. Risk of bias in the included studies was assessed using the Physiotherapy Evidence Database scale. Data were synthesized qualitatively.Evidence Synthesis:Eight English-language and 2 Japanese-language papers of low to high quality were included. There was moderate evidence for positive immediate and short-term effects of cross-body stretch on PST and GIRD in asymptomatic young subjects. Moderate evidence was found to suggest that active sleeper stretch might not be more effective than no intervention to improve PST and GIRD in the short term.Conclusions:Cross-body stretch can be effective to improve PST and GIRD in asymptomatic young subjects immediately or in the short term. Further study with methodological rigor is necessary to investigate the long-term effectiveness of stretching interventions on PST and GIRD in symptomatic patients.

Does an effective shoulder injury prevention program affect risk factors in handball? A randomized controlled study

“…Most studies reporting an effect of stretching were keeping the stretching for 30 to 60 s, three to five times per day, and five to seven days per week 31,32 . In our study, the stretching was performed three times 30 s, three days per week, which is probably too low dose to achieve an effect.…”

“…Our players had normal dominant shoulder IR, with an average of 64° and a side‐to‐side difference of 8°. This might imply less room for improvement compared with studies that have demonstrated an effect of stretching in populations with GIRD ≥ 15° 31,32 …”

“…Our intervention program did not affect IR ROM at all. A recent systematic review concluded that the cross‐body stretch could be effective to improve GIRD in the immediate and short term (4 weeks), but the sleeper stretch was not effective 31 . In our program, the sleeper stretch was conducted week 1 through 6 and week 13 through 18, while the cross‐body stretch was used week 7 through 12.…”

Glenohumeral internal rotation deficit in throwing athletes: current perspectives

“… 75 Mine et al recently published a systematic review on the effectiveness of stretching (cross-body and sleeper) in asymptomatic patients with GIRD. 76 In this study, they analyzed 553 subjects in ten randomized controlled trails in the English- and Japanese-language literatures. They concluded that there was moderate evidence to support the short-term effects of stretching in patients with asymptomatic GIRD.…”

Upper Extremity Injuries in Tennis Players

“…The progression of GIRD can be reversed by stretching programs that target the posteroinferior capsule, which have proven to successfully increase internal and total rotation and reduce GIRD in high-level tennis players. 5,64 …”