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.

scholarly journals A Randomized Controlled Single-Blinded Comparison of Stretching Versus Stretching and Joint Mobilization for Posterior Shoulder Tightness Measured by Internal Rotation Motion Loss

2009 ◽  
Vol 2 (2) ◽  
pp. 94-100 ◽  
Author(s):  
Robert C. Manske ◽  
Matt Meschke ◽  
Andrew Porter ◽  
Barbara Smith ◽  
Michael Reiman
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Rehabilitation Program ◽  
Intervention Period ◽  
Joint Mobilization ◽  
Randomized Controlled ◽  
Posterior Shoulder ◽  
Rotation Motion ◽  
Posterior Shoulder Tightness

Background: Posterior shoulder tightness, as demonstrated by limited internal rotation range of motion, is a suggested factor in many shoulder pathologies. Methods to increase posterior shoulder mobility may be beneficial. Hypothesis: Shoulder internal rotation range of motion will not change with either of 2 interventions: cross-body stretch alone and cross-body stretch plus posterior capsule joint mobilization. Study Design: Randomized controlled single-blinded clinical trial. Methods: The study comprised 39 college-age asymptomatic participants (7 men, 32 women) who were randomly assigned to 1 of 2 groups: stretching only (n, 20) and stretching plus posterior joint mobilizations (n, 19). All had a between-shoulder difference of internal rotation of 10° or more. Shoulder internal and external rotation was measured before and after a 4-week intervention period and 4 weeks postintervention. Participants in the stretching-only group performed the cross-body stretch on the limited side. Those in the other group (cross-body stretch plus joint mobilization) were treated with posterior joint mobilization techniques on the limited side. Results: Overall means for internal rotation of the treated shoulders significantly increased over baseline at the end of the intervention period and at 4 weeks postintervention. External rotation in all shoulders remained unchanged. By the end of intervention, total motion increased significantly from baseline but decreased significantly from the end of intervention to 4 weeks postintervention. Although not statistically significant, the second group (cross-body stretch plus joint mobilization) had greater increases in internal rotation. At 4 weeks postintervention, the second group had maintained its internal rotation gains to a greater degree than those of the stretching-only group. Conclusion: Internal rotation increased in both groups. Inclusion of joint mobilization in a rehabilitation program created trends toward increased shoulder internal rotation mobility. Clinical Relevance: Both methods—cross-body stretch and cross-body stretch plus joint mobilization—may be beneficial for those with limited internal rotation range of motion.

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.

GIRD syndrome in male handball and volleyball players: Is the decrease of total range of motion the turning point to pathology?

2021 ◽  
pp. 1-8
Author(s):  
Jonas Schmalzl ◽  
Helen Walter ◽  
Wolfram Rothfischer ◽  
Sören Blaich ◽  
Christian Gerhardt ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Turning Point ◽  
External Rotation ◽  
Constant Score ◽  
High Rate ◽  
Overhead Athletes ◽  
Glenohumeral Internal Rotation Deficit ◽  
Total Range ◽  
Volleyball Players

BACKGROUND: Adaptations in glenohumeral range of motion may affect overhead athletes and lead to shoulder pathologies. OBJECTIVE: The purpose of this study was to evaluate glenohumeral internal rotation deficit (GIRD) and postero-superior impingement among male handball and volleyball players and the relationship between these pathologies and training level (amateur vs. professional), position (attack vs. no attack), experience (> 5 years vs. < 5 years) and sports. METHODS: Sixty-seven handball players and 67 volleyball players with a mean age of 25 [± 5] years were included. The range of motion including external and internal rotation in 90∘ abduction of the dominant and non-dominant shoulder was measured of each examined athlete. Visual analogue scale, disabilities of the shoulder and hand score, constant score and subjective shoulder value were recorded. The athletes were examined for postero-superior impingement and abduction force was measured with an isokinetic dynamometer. RESULTS: Internal rotation was significantly lower and external rotation was significantly greater in the dominant arm for both sports. 72% presented with GIRD. GIRD was more prevalent in athletes active for > 5 years (odds ratio (OR) 3), in those training > 3 times per week (OR 1.4) and in handball players (OR 2.7). 24% presented with postero-superior impingement. Players active for > 5 years (OR 1.22), professionals (OR 1.14), volleyball players (OR 1.19), offensive players (OR 2.2) and athletes with GIRD > 10∘ (OR 1.5) showed a higher prevalence of postero-superior impingement. CONCLUSION: GIRD is a common phenomenon in handball and volleyball players. Offensive players are frequently suffering from postero-superior impingement. GIRD > 10∘ leads in nearly 75% of the athletes to a decrease of total range of motion and a high rate of postero-superior impingement. Thus, a decreased range of motion seems to be the turning point from adaptation to pathology. Therefore, regular controls of range of motion and countermeasures by means of stretching the posterior shoulder joint should be integrated in the training content.

scholarly journals Acute effect of posterior deltoid static stretching on Glenohumeral Internal Rotation Deficit in elite swimmers after competition. A randomized trial

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
M Solana-Tramunt ◽  
R Lopez-Vidriero ◽  
E Lopez-Vidriero
Keyword(s):  
Internal Rotation ◽  
Repeated Measures ◽  
Sagittal Plane ◽  
External Rotation ◽  
National Level ◽  
Control Group ◽  
Overhead Athletes ◽  
Repeated Measures Design ◽  
Glenohumeral Internal Rotation Deficit ◽  
Experimental Group

Objectives: The aim of this study was to determine whether a static stretch of posterior deltoid could reduce the glenohumeral internal rotation deficit (GIRD) and the total arc of movement deficit (TAMD) in professional swimmers after competition. Methods: Participants: A total of 74 professional swimmers aged from 16-33 years volunteered to participated in the study. Their competition experience were more than 2 years at national level. All the subjects were informed in written and verbal form and signed their informed consent before being assessed. Design and procedures: A randomized repeated measures design was used to assess the glenohumeral rotation in 3 moments: prior to the race, just after finishing their trial and after performing a static passive stretch of posterior deltoid muscles of 90-sec. In randomized order the computer selected 20 subjects as a control group (CG) who didn’t perform the stretching. The experimental group (EG) included 54 swimmers. The glenohumeral internal and external rotation (IR and ER) were recorded by a video camera (IPhone 6 S, version 10.1), in sagittal plane, with the center of the screen at shoulder high. Subjects were laying on supine position over a massage table, with the glenohumeral joint at 90° of abduction, the elbow at 90° of flexion, and the researcher controlling the scapula movements by pushing the shoulder over coracoid apophasis. The App Thechnique (Ubersense ©) was used to measure the glenohumeral rotation degrees between the vertical line (controlled by a plumb) and the forearm segment. Results: The multifactorial ANOVA showed that there were significant differences on GIRD and TAMD between the experimental and the control group performing the stretching F(2,70)=49.150, P=0.000, η2p=0.992. The experimental group reduced the GIRD a16.2% and the TAMD a 6.7%. The dominant IR mean values changed significantly from 66.3±12.5 to 79.2±10.4 degrees for EG ( P=0.00) and non-significantly for CG, from 74.6±12.7 to 77.6±13.9 degrees ( P=0.11). The dominant TAM means changed significantly in EG from 173.2±16.8 to 192.0±17.0 degrees ( P=0.00) and non- significantly for CG 181.5±21.7 to 188.2±23.3 degrees ( P=0.12). Conclusion: To apply a static passive stretching on posterior deltoid during 90-sec reduced GIRD and the TAMD in professional swimmers after competition, which suggest a reduced risk of shoulder injury in these overhead athletes.

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