scholarly journals The Comparison of Instrument-Assisted Soft Tissue Mobilization and Self-Stretch Measures to Increase Shoulder Range of Motion in Overhead Athletes: A Critically Appraised Topic

2018 ◽  
Vol 27 (4) ◽  
pp. 385-389 ◽  
Author(s):  
Matthew J. Hussey ◽  
Alex E. Boron-Magulick ◽  
Tamara C. Valovich McLeod ◽  
Cailee E. Welch Bacon
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Internal Rotation ◽  
Proper Function ◽  
Clinical Question ◽  
Bottom Line ◽  
Overhead Athletes ◽  
Shoulder Range Of Motion ◽  
Soft Tissue Mobilization ◽  
Shoulder Range

Clinical Scenario: Shoulder range of motion (ROM) in throwing athletes relies on a balance of mobility and stability to maintain proper function and health that, if disrupted, can lead to shoulder injury. There have been several studies that address the relationship between ROM deficits and overhead injuries; however, it may be unclear to clinicians which interventions are most effective for increasing ROM in the glenohumeral joints of overhead athletes. Clinical Question: In overhead athletes who have deficient shoulder ROM, is instrument-assisted soft tissue mobilization (IASTM) more effective at acutely increasing ROM over the course of a patient’s treatment when compared with self-stretching? Summary of Key Findings: A thorough literature review yielded 3 studies relevant to the clinical question, and all 3 studies were included. Two articles found a significant increase in acute ROM when compared with a self-stretch measure. All 3 articles showed increases in internal rotation and horizontal adduction, and 1 study reported an increase in total arc of shoulder ROM. Clinical Bottom Line: There is moderate evidence to support the use of IASTM to acutely increase ROM in the glenohumeral joint of overhead athletes. Clinicians should be aware of the variability with recommended treatment times; however, positive results have been seen with treatments lasting 5 to 6 minutes per treatment region. There is no consensus for treatment intensity, and certain IASTM tools require certification. Strength of Recommendation: Grade B evidence exists that IASTM is more effective at increasing shoulder ROM (ie, internal rotation, horizontal adduction, external rotation, total arc of motion) in overhead athletes than self-stretching measures.

Comparing the Effects of Total Motion Release® to Stretching for Increases in Internal and External Rotation at the Shoulder

2021 ◽  
pp. 1-7
Author(s):  
Nicole Sordello ◽  
Tenli Bright ◽  
Taylor Truesdell ◽  
Jace Puckett ◽  
Jayme G. Baker ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Clinical Question ◽  
Bottom Line ◽  
Warm Up ◽  
Overhead Athletes ◽  
Shoulder Range Of Motion ◽  
Shoulder Range

Focused Clinical Question: What are the effects of Total Motion Release® on shoulder range of motion compared with stretching in overhead athletes? Clinical Bottom Line: Total Motion Release® significantly improved acute dominant and nondominant shoulder ROM compared with dynamic warm-up and stretching protocols. The application of Total Motion Release® was also found to produce significantly larger increases in shoulder ROM and took substantially less time to complete when compared with dynamic warm-up protocols.

scholarly journals The Relationship Between Shoulder Range of Motion and Arm Stress in College Pitchers: A MOTUS Baseball Study

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0040
Author(s):  
Caleb Gulledge ◽  
Toufic Jildeh ◽  
Joseph Tramer ◽  
Fabien Meta ◽  
Kevin Taylor ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Internal Rotation ◽  
External Rotation ◽  
Outcome Measurement ◽  
Overhead Athletes ◽  
Shoulder Range Of Motion ◽  
Patient Reported ◽  
The Relationship ◽  
Shoulder Range

Objectives: Overuse injuries in overhead athletes are becoming more prevalent, with an unclear relationship between shoulder biomechanics and medial elbow symptoms and injury. The purpose of this study was to investigate the relationship of shoulder range of motion to torque across the medial elbow in college pitchers using a validated MOTUS sensor baseball sleeve. Methods: Pitchers were recruited from three local university baseball teams. Exclusion criteria included injury or restricted activity due to pain. They were evaluated in the preseason, within two weeks before their first game of the season. Pitchers completed workload questionnaires and patient reported outcome measurement information system (PROMIS) pain interference (PI), physical function (PF), and upper extremity (UE) surveys. Shoulder range of motion and upper extremity lengths were measured bilaterally. After adequate warm-up, pitchers were fitted with a MOTUS sensor baseball sleeve (Motus Global, Massapequa, NY) and instructed to throw 5 fastballs in a standardized manner off the mound at game-speed effort. The sensor placed at the medial elbow reported elbow torque, arm speed, arm slot, and shoulder rotation for each pitch, while a radar gun measured peak ball velocity. The primary outcome was to evaluate the relationship between shoulder range of motion and increased stress across the medial elbow. Additional outcomes evaluated pitcher characteristics, demographics, and outcome scores. Outcomes were assessed via a multivariable model, which controlled for possible covariates. Results: Twenty-eight pitchers were included in the preseason analysis with an average (SD) age of 20.1 (1.3) years and playing experience of 15.3 (1.8) years, 2.5 (1.2) of those years at collegiate level. The dominant shoulder demonstrated decreased internal rotation (54.5+/-10.6 vs 65.8+/-9.1) and increased external rotation (ER, 94.1+/-10.4 vs 88.4+/-9.2) relative to the non-dominant side (p < 0.001), while total rotational range of motion (TRROM) was significantly decreased in the dominant arm (148.6+/-12.4 vs 154.1+/-10.6, p < 0.001). The average glenohumeral internal rotation deficiency (GIRD) was 11.3 (9.87) and average external rotation gain (ERG) was 5.71 (8.8). External rotation was found to be a predictor of arm stress, with an increase in 0.35 Nm of elbow torque for every degree increase in ER (beta = 0.35+/-0.06, p = 0.003); there was moderate correlation between ER and arm stress (r = .45, P<.001). Pitchers demonstrated significantly greater arm stress with the following shoulder ROM measurements: GIRD < 20 as compared to greater than 20 degrees (46.6 +/- 0.5 versus 43.5 +/- 1.1, P=.011), ERG greater than 5 as compared to < 5 degrees (47.4 +/- 0.7 versus 45.1 +/- 0.6, P=.014), and loss of total rotational ROM less than 5 as compared to > 5 degrees (46.6 +/- 0.5 versus 43.6 +/- 1.1, P=.013). Multivariate analysis demonstrated significant predictors of PROMIS PF and UE scores were arm stress, ERG, and GIRD (p<0.05), while increased PROMIS PI scores were predicted by increased ERG and GIRD (p<0.05). Conclusion: We found medial elbow stress, arm speed, arm slot, and shoulder rotation as measured by the MOTUS baseball sensor sleeve were influenced by rotational adaptations of the pitching shoulder in collegiate throwing athletes prior to their season. Likewise, arm stress and shoulder rotational adaptations were reflected as predictors of PROMIS PF, UE, and PI scores.

The Effectiveness of Posterior Shoulder Stretching on Reducing Posterior Shoulder Tightness in Overhead Athletes: A Critically Appraised Topic

2016 ◽  
Vol 21 (5) ◽  
pp. 8-13
Author(s):  
Megan Pathoomvanh ◽  
Chase Feldbrugge ◽  
Lauren Welsch ◽  
Bonnie Van Lunen
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Clinical Question ◽  
Bottom Line ◽  
High Quality ◽  
Overhead Athletes ◽  
High Quality Evidence ◽  
Posterior Shoulder ◽  
Posterior Shoulder Tightness ◽  
Quality Evidence

Clinical Question:Are posterior shoulder stretching programs effective in reducing posterior shoulder tightness, or tightness to the soft tissue of the shoulder, in overhead athletes? Clinical Bottom Line:In overhead athletes, there is high quality evidence to support the use of posterior shoulder stretching to reduce a commonly used measure of posterior shoulder tightness. All three studies1–3 reported an increase in shoulder internal rotation range of motion following implementation of posterior shoulder stretching.

Instrument-Assisted Soft Tissue Mobilization for Improving Ankle Dorsiflexion Range of Motion in Healthy Patients: A Critically Appraised Topic

2020 ◽  
Vol 25 (4) ◽  
pp. 170-175
Author(s):  
Alison M. Gardiner-Shires ◽  
Cristina B. Seffrin
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Ankle Dorsiflexion ◽  
Therapeutic Interventions ◽  
Healthy Population ◽  
Clinical Question ◽  
Short Term ◽  
Bottom Line ◽  
Soft Tissue Mobilization ◽  
Quality Evidence

Clinical Question: In a healthy population, is instrument-assisted soft tissue mobilization beneficial in improving ankle dorsiflexion range of motion as compared to other therapeutic interventions? Clinical Bottom Line: For healthy patients, there is moderate-quality evidence to support the short-term use of instrument-assisted soft tissue mobilization for improving ankle dorsiflexion range of motion.

Shoulder Range of Motion Deficits in Baseball Players With an Ulnar Collateral Ligament Tear

2012 ◽  
Vol 40 (11) ◽  
pp. 2597-2603 ◽  
Author(s):  
J. Craig Garrison ◽  
Mollie A. Cole ◽  
John E. Conway ◽  
Michael J. Macko ◽  
Charles Thigpen ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Ulnar Collateral Ligament ◽  
Control Group ◽  
Elbow Extension ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Elbow Injury ◽  
Shoulder Range Of Motion ◽  
Shoulder Range

Background: Shoulder range of motion (ROM) deficits are associated with elbow injury in baseball players. Purpose: To compare the ROM characteristics of baseball players with a diagnosed ulnar collateral ligament (UCL) tear with those of a group of age-, activity-, and position-matched healthy controls. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Sixty male competitive high school and collegiate baseball players participated. Thirty athletes (age [mean ± standard deviation], 18.20 ± 1.56 years) with a diagnosed UCL tear were compared with 30 (age, 18.57 ± 0.86 years) age-, activity-, and position-matched players without a UCL injury. Of the 60 participants, there were 44 pitchers, 4 catchers, 5 infielders, and 7 outfielders. Participants were measured for shoulder internal rotation (IR), external rotation (ER), and horizontal adduction (HA) at 90° of shoulder elevation. Participants were also measured for elbow extension in a seated position. Group comparisons were made between participants with and without a UCL injury using independent t tests with an α level set at P < .05. All measurements were taken bilaterally, and the differences (involved to uninvolved) were used to calculate means for all variables, including glenohumeral internal rotation deficit (GIRD), total rotational motion (TRM), HA, and elbow extension. Results: Baseball players with a UCL tear (UCLInj) exhibited significantly greater deficits in TRM compared with the control group of healthy baseball players (NUCLInj) (UCLInj = −6.67° ± 11.82°, NUCLInj = 0.93° ± 9.91°; P = .009). No group differences were present for GIRD (UCLInj = −12.53° ± 5.98°, NUCLInj = −13.63° ± 5.90°; P = .476), HA (UCLInj = −3.00° ± 5.01°, NUCLInj = −3.23° ± 5.15°; P = .860), or elbow extension (UCLInj = −2.63° ± 7.86°, NUCLInj = −1.17° ± 2.76°; P = .339). Pitchers with a UCL tear had significantly greater deficits in TRM (UCLInjPitch = −6.96° ± 11.20°, NUCLInjPitch = 1.29° ± 8.33°; P = .0087) and dominant shoulder ER (UCLInjPitch = 112.04° ± 14.35°, NUCLInjPitch = 121.85° ± 9.46°; P = .011) than pitchers without a UCL tear. Conclusion: A deficit in TRM is associated with a UCL tear in baseball players. Although GIRD may be prevalent in throwers, it may not be associated with a UCL injury. When examining ROM in baseball players, it is important to assess both TRM and GIRD.

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

2020 ◽  
Author(s):  
Omar Gharisia ◽  
Everett Lohman ◽  
Noha Daher ◽  
Alan Eldridge ◽  
Amjad Shallan ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
The Novel ◽  
Satisfaction Level ◽  
Traditional Group ◽  
Overhead Athletes ◽  
Shoulder Range Of Motion ◽  
Posterior Shoulder ◽  
The Cross ◽  
Over Time

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 (Passive Glenohumeral Internal Rotation with Clam Shell Bridging) 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, 20 males and 22 females] 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, η2=0.77). 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, r=0.6) 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, r=0.5) 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. Trial registration: Prospectively registered in February 6, 2017 under Clinical Trial Registry # NCT03044236

scholarly journals A Comparison of the Immediate Effect of Swedish Massage vs Passive Stretching on Range of Motion in Overhead Athletes

2020 ◽  
Vol 22 (3) ◽  
pp. 1-7
Author(s):  
Jim Schilling ◽  
Sujeiry Guzman ◽  
Chad Lewis ◽  
Jupil Ko
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Intervention Group ◽  
Post Treatment ◽  
Static Stretching ◽  
Post Intervention ◽  
Overhead Athletes ◽  
Passive Stretching ◽  
Shoulder Range Of Motion

OBJECTIVES To compare the clinical outcome and effectiveness of Swedish massage and a traditional passive stretching program, on the shoulder of ROM in overhead athletes.PARTICIPANTS A total of 10 overhead throwing overhead male athletes (age= 23.5 ± 1.5yrs; height= 186.69 ± 6.35 cm; mass= 91.86 ± 12.48 kg).METHODS Participants were randomly assigned to either Swedish massage or a traditional passive static stretching program for 1 session of 5 minutes. Baseline and post-intervention shoulder ROM to end range in the flexed, external rotation, internal rotation, horizontal adduction and abduction positions. The Pearson chi-square test was applied to compare the differences of shoulder ROM of both therapeutic variables. Recorded outcome measures on the participants’ shoulder ROM (flexion with scapula fixed, horizontal adduction, horizontal abduction, internal rotational & external rotation) pre- & post-interventions.RESULTS Results indicate that participants in the Swedish massage therapeutic intervention group had significant improvements in their internal rotation post-treatment (M=5.20, SD= 1.304, p=.038) and the traditional passive stretching protocol group had significant improvements in shoulder external rotation post-treatment (M=11.20, SD=2.68, p=.016).CONCLUSION Swedish massage had better effects in four out of the five shoulder motions measured compared to passive static stretching. Educating overhead athletes on the potential beneficial effects of massage therapy and its role in maintaining shoulder range of motion.

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