The Effectiveness of Shoulder Stretching and Joint Mobilizations on Posterior Shoulder Tightness

2013 ◽  
Vol 22 (4) ◽  
pp. 313-319 ◽  
Author(s):  
Nicole D. Harshbarger ◽  
Bradly L. Eppelheimer ◽  
Tamara C. Valovich McLeod ◽  
Cailee Welch McCarty
Keyword(s):  
Clinical Scenario ◽  
Clinical Question ◽  
Full Spectrum ◽  
Treatment Interventions ◽  
Physically Active ◽  
Shoulder Impingement ◽  
Overhead Athletes ◽  
Posterior Shoulder ◽  
Overhead Throwing ◽  
Posterior Shoulder Tightness

Clinical Scenario:It has been suggested that posterior shoulder tightness is a common contributor to shoulder impingement in overhead-throwing athletes. The incidence of shoulder pain in the general population has been reported to be as high as 27%, and as many as 74% of the patients who were seen for shoulder issues had signs of impingement. Particularly regarding physically active adults, shoulder impingement is frequent among overhead-throwing athletes and may lead to lost participation in sport, as well as other injuries including labral pathologies. Therefore, finding an effective mechanism to reduce posterior shoulder tightness in overhead athletes is important and may help prevent impingement-type injuries. Typically, posterior shoulder tightness is identified by measuring horizontal humeral adduction; although another clinical measure that is commonly used is the bilateral measurement of glenohumeral internal-rotation (IR) range of motion (ROM). It is important to note, however, that the measurement of glenohumeral IR ROM specifically aims to identify glenohumeral IR ROM deficits (GIRD). Although GIRD is believed to be a leading contributor to posterior shoulder tightness, this measure alone may not capture the full spectrum of posterior shoulder tightness. While treatment interventions to correct any ROM deficits typically include a stretching protocol to help increase IR, joint mobilizations have been found to produce greater mobility of soft tissue and capsular joints. However, it is unclear whether the combination of both joint mobilizations and a stretching protocol will produce even larger gains of ROM that will have greater longevity for the patient suffering from posterior shoulder tightness.Focused Clinical Question:Does the use of joint mobilizations combined with a stretching protocol more effectively increase glenohumeral IR ROM in adult physically active individuals who participate in overhead sports and are suffering from posterior shoulder tightness, compared with a stretching protocol alone?

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.

Immediate effect of combining glenohumeral and scapulothoracic mobilization with stretching on improving shoulder internal rotation in overhead throwing athletes with glenohumeral internal rotation deficit: A randomized clinical trial study

2021 ◽  
pp. 1-8
Author(s):  
Fahimeh Kamali ◽  
Narjes Ghasempour ◽  
Nasrin Salehi Dehno
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Controlled Trial ◽  
Overhead Athletes ◽  
Joint Mobilization ◽  
Glenohumeral Internal Rotation Deficit ◽  
Posterior Shoulder ◽  
Before And After ◽  
Overhead Throwing ◽  
Posterior Shoulder Tightness

BACKGROUND: Posterior shoulder tightness as demonstrated by glenohumeral internal rotation deficit (GIRD) is a common contributor to many shoulder pathologies in overhead throwing athletes. PURPOSE: This study aimed to assess immediate effect of combining glenohumeral and scapulothoracic mobilization with stretching on improving internal rotation range of motion (ROM) in overhead athletes with GIRD METHODS: This study was a single-blind randomized controlled trial with parallel groups. The participants were 30 asymptomatic male volleyball players who had a loss of shoulder internal rotation ROM of 15 degrees or more on their dominant compared to their nondominant side. They were randomly assigned to 1 of 2 groups: stretching only (n = 15) or stretching plus joint mobilization (n = 15). Participants in the stretching group performed cross-body stretches, and those in stretching plus mobilization group were treated with both cross-body stretching and mobilization techniques for the glenohumeral and scapulothoracic joints. Both groups received the intervention every other day for 1 week. Shoulder internal and external ROM were measured before and after the intervention. RESULTS: Before the intervention, dominant-side deficits in internal rotation ROM compared to the nondominant side were 20.11±5.27 degrees in the stretching group and 21.87±8.06 degrees in the stretching plus mobilization group. After the intervention, internal rotation ROM deficit between the dominant and nondominant side decreased to 11.28±5.82 in the stretching group (P <  0.001) and 10.85±9.19 in the stretching plus mobilization group (P <  0.001). However, the between-group difference was not statistically significant (P = 0.389). External rotation ROM remained unchanged in both groups (P >  0.05). CONCLUSION: Both interventions (stretching and stretching plus mobilization) can have the same beneficial effect in decreasing GIRD in asymptomatic overhead athletes.

The Efficacy of a Passive Stretching Intervention for Overhead Athletes: A Critically Appraised Topic

2020 ◽  
pp. 1-5
Author(s):  
Michelle A. Sandrey
Keyword(s):  
Range Of Motion ◽  
Moderate Level ◽  
Clinical Question ◽  
Bottom Line ◽  
Overhead Athletes ◽  
Passive Stretching ◽  
Posterior Shoulder ◽  
Posterior Shoulder Tightness ◽  
Level 2

Focused Clinical Question: Does a passive stretching protocol, whether immediate or long-term, improve range of motion and decrease posterior shoulder tightness in overhead athletes? Clinical Bottom Line: There is moderate level 2 evidence to support the incorporation of passive stretching for overhead athletes to increase range of motion or decrease posterior shoulder tightness.

The Effectiveness of Open Repair Versus Percutaneous Repair for an Acute Achilles Tendon Rupture

2016 ◽  
Vol 25 (4) ◽  
pp. 404-410 ◽  
Author(s):  
Heidi Krueger ◽  
Shannon David
Keyword(s):  
Achilles Tendon ◽  
Open Repair ◽  
Supporting Evidence ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Physically Active ◽  
Men And Women ◽  
Percutaneous Repair ◽  
Tendon Ruptures

Clinical Scenario:There are 2 approaches available for surgical repair of the Achilles tendon: open or percutaneous. However, there is controversy over which repair is superior.Focused Clinical Question:Which type of surgery is better in providing the best overall patient outcome, open or percutaneous repair, in physically active men and women with acute Achilles tendon ruptures?Summary of Search, “Best Evidence” Appraised, and Key Findings:The literature was searched for studies of level 3 evidence or higher that investigated the effectiveness of open repair versus percutaneous repair on acute Achilles tendon ruptures in physically active men and women. The literature search resulted in 3 studies for possible inclusion. All 3 good-quality studies were included.Clinical Bottom Line:There is supporting evidence to indicate that percutaneous repair is the best option for Achilles tendon surgery when it comes to the physically active population. Percutaneous repair has faster surgery times, less risk of complications, and faster recovery times over having an open repair, although it is acknowledged that every patient has a different situation and best individual option may vary patient to patient.

Influence of Humeral Torsion on Interpretation of Posterior Shoulder Tightness Measures in Overhead Athletes

2009 ◽  
Vol 19 (5) ◽  
pp. 366-371 ◽  
Author(s):  
Joseph B Myers ◽  
Sakiko Oyama ◽  
Benjamin M Goerger ◽  
Terri Jo Rucinski ◽  
J Troy Blackburn ◽  
...  
Keyword(s):  
Overhead Athletes ◽  
Posterior Shoulder ◽  
Humeral Torsion ◽  
Posterior Shoulder Tightness

Reliability of Clinician Scoring of the Functional Movement Screen to Assess Movement Patterns

2015 ◽  
Vol 24 (2) ◽  
pp. 219-222 ◽  
Author(s):  
Lisa M. Stobierski ◽  
Shirleeah D. Fayson ◽  
Lindsay M. Minthorn ◽  
Tamara C. Valovich McLeod ◽  
Cailee E. Welch
Keyword(s):  
Real Time ◽  
Health Care Professionals ◽  
Movement Patterns ◽  
Functional Movement Screen ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Clinical Tool ◽  
Physically Active ◽  
Functional Movement ◽  
Active Population

Clinical Scenario:Injuries are inevitable in the physically active population. As a part of preventive medicine, health care professionals often seek clinical tools that can be used in real time to identify factors that may predispose individuals to these injuries. The Functional Movement Screen (FMS), a clinical tool consisting of 7 individual tasks, has been reported as useful in identifying individuals in various populations that may be susceptible to musculoskeletal injuries. If factors that may predispose physically active individuals to injury could be identified before participation, clinicians may be able to develop a training plan based on FMS scores, which could potentially decrease the likelihood of injury and overall time missed from physical activities. However, in order for a screening tool to be used clinically, it must demonstrate acceptable reliability.Focused Clinical Question:Are clinicians reliable at scoring the FMS, in real time, to assess movement patterns of physically active individuals?

Reliability, Precision, Accuracy, and Validity of Posterior Shoulder Tightness Assessment in Overhead Athletes

2007 ◽  
Vol 35 (11) ◽  
pp. 1922-1930 ◽  
Author(s):  
Joseph B. Myers ◽  
Sakiko Oyama ◽  
Craig A. Wassinger ◽  
Robert D. Ricci ◽  
John P. Abt ◽  
...  
Keyword(s):  
Overhead Athletes ◽  
Posterior Shoulder ◽  
Posterior Shoulder Tightness

scholarly journals Autologous Blood and Platelet-Rich Plasma Injections in the Treatment of Achilles Tendinopathy: A Critically Appraised Topic

2017 ◽  
Vol 26 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Cori Sinnott ◽  
Hayley M. White ◽  
Jennifer W. Cuchna ◽  
Bonnie L. Van Lunen
Keyword(s):  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Achilles Tendinopathy ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Invasive Treatment ◽  
Painful Condition ◽  
Physically Active ◽  
Age Related ◽  
And Function

Clinical Scenario:Achilles tendinopathy is a painful condition commonly affecting the general and athletic population. It presents with localized pain, stiffness, and swelling in the midportion of the Achilles tendon. The physical stress placed on the tendon results in microtrauma, which leads to subsequent inflammation and degeneration. While it is not surprising that this condition affects the physically active, nearly one-third of Achilles tendinopathy cases occur in sedentary individuals. Etiology for this condition stems from a change in loading patterns and/or overuse of the tendon, resulting in microscopic tearing and degenerative changes. There are numerous causes contributing to the maladaptive response in these patients, such as mechanical, age-related, genetic, and vascular factors. The treatment for these patients is typically load management and eccentric strengthening of the gastrocnemius–soleus complex. Unfortunately, conservative treatment can lead to surgical intervention in up to 45% of cases. A relatively new phenomenon in the treatment of this condition is the use of autologous blood injections (ABI) and platelet-rich plasma injections (PRPI). This need for a less invasive treatment fostered more investigation into ABI and PRPI to treat these nonresponsive patients. However, the evidence concerning the effectiveness of these treatments in patients with Achilles tendinopathy has not been synthesized.Focused Clinical Question:In patients with Achilles tendinopathy, how do variations of ABI and PRPI compared with a placebo and/or eccentric training affect pain and function?

Effects of Rigid and Kinesio Taping on Shoulder Rotation Motions, Posterior Shoulder Tightness, and Posture in Overhead Athletes: A Randomized Controlled Trial

2019 ◽  
Vol 28 (3) ◽  
pp. 256-265 ◽  
Author(s):  
Damla Gulpinar ◽  
Sibel Tekeli Ozer ◽  
Sevgi Sevi Yesilyaprak
Keyword(s):  
Randomized Controlled Trial ◽  
Range Of Motion ◽  
Internal Rotation ◽  
Controlled Trial ◽  
Shoulder Injuries ◽  
Overhead Athletes ◽  
Randomized Controlled ◽  
Kinesio Taping ◽  
Posterior Shoulder ◽  
Posterior Shoulder Tightness

Context:Alterations in posture and motion patterns are thought to play a role in developing shoulder injuries in overhead athletes. Taping is widely used in the sporting population, but there are limited empirical data regarding its effectiveness.Objectives:To determine and compare the effects of rigid and kinesio taping on shoulder rotation motions, posterior shoulder tightness (PST), and posture in overhead athletes.Design:Randomized controlled trial.Setting:Athletic training rooms.Participants:Eighty-six asymptomatic elite overhead athletes.Interventions:Participants were randomly divided into 4 groups: rigid taping group (RTG) that underwent therapeutic rigid taping, kinesio taping group (KTG) that underwent therapeutic kinesio taping, placebo group that underwent placebo kinesio taping (shoulder and scapular region taping for taping groups), and control group (no taping).Main Outcome Measures:Shoulder rotation motions, PST, and head and shoulder posture were evaluated at baseline, immediately after application and 60 to 72 hours after application for all groups.Results:Glenohumeral internal rotation increased immediately (P < .001) and at 60 to 72 hours after application in the KTG (P = .01), whereas it decreased immediately after application in the RTG (P < .001). Immediately after application, total rotation range of motion increased in the KTG (P =.02) and decreased in the RTG (P < .001), and there was a difference between groups (P = .02). Immediately after application, PST increased in the RTG (P < .001); after 60 to 72 hours, it decreased in the KTG (P = .04) and increased in the RTG (P = .01). Posture outcomes did not change significantly (P > .05).Conclusions:Kinesio taping may improve and rigid taping may worsen glenohumeral internal rotation and PST in overhead athletes. For increasing total rotation range of motion, kinesio taping is superior to rigid taping. Taping did not affect posture. Short-term kinesio taping in overhead athletes may be useful to improve glenohumeral internal rotation, total rotation range of motion, and PST.

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