None listed
Conditions
Brief summary
Shoulder impingement syndrome (SIS) represents the most common diagnosis for patients experiencing shoulder pain and is a prevalent condition in overhead athletes. Optimal performance of overhead sporting activities requires overheads athletes to have unrestricted, pain free arm range of motion (ROM). On examination, overhead throwers typically present with an increase in external rotation ROM accompanied by a concomitant decrease in internal rotation ROM. This asymmetrical ROM finding is well documented in the literature. It is postulated that posterior capsule tightness (PST) causes de-centering of the humeral head within the glenohumeral joint with compression of tissues in that joint space and consequent pain and restriction of movement. Clinically, a variety of techniques are implemented to address PST. These include stretching, joint mobilisations and strengthening exercises with varying degrees of success. Outcomes of treatment are commonly measured using pain, disability questionnaires or changes in ROM in order to determine the effectiveness of the treatment program. However, despite studies showing the effects of PST on acromio-humeral distance (AHD) and anterior translation of the humeral head, few studies have focussed on whether or not there is a normalisation of humeral head position, with resolution of PST and reduction in pain with movement following treatment. Therefore this research project will aim to investigate whether a modified sleeper stretch or cross body stretch is most effective at addressing PST, AHD and anterior humeral translation in overhead athletes using diagnostic ultrasound to measure the changes in the subacromial space and humeral head position.
Interventions
This particular study will require the participants to perform one of two stretches on the dominant side over a 3 weeks period . Participants will be taught the correct technique for performing the stretches by the investigator carrying out the measures. They will be instructed to hold the stretch for 30 seconds for 5 repetitions each session. Following this the therapist will inspect the performance of the stretch and ensure a correct technique .The stretch will be able to be performed on the
This particular study will require the participants to perform one of two stretches on the dominant side over a 3 weeks period . Participants will be taught the correct technique for performing the stretches by the investigator carrying out the measures. They will be instructed to hold the stretch for 30 seconds for 5 repetitions each session. Following this the therapist will inspect the performance of the stretch and ensure a correct technique .The stretch will be able to be performed on the floor,yoga mat or carpet /rug. Participants will be given an information sheet with instructions and pictures of the stretch and told to contact the researcher if they have any questions about the stretch during the study. Stretching is to be performed twice a day and it is recommended that this occur once in the morning and once in the evening before bed. Participants in both groups will be instructed to perform their respective stretches both morning and night, 7 days a week for 3 weeks. Before starting the stretch it is recommended to do some gentle warm up movements of the shoulder such as large slow circles of the arms. The participant should perform 5 repetitions of the stretch in the morning and 5 repetitions in the afternoon. 1. Modified sleeper stretch - the participant should be lying on a firm surface (floor with yoga mat, carpet) on their dominant side, With their trunk rotated slightly backwards. Using the non-dominant arm, the participant gently should pull the forearm down to the floor until they feel the stretch at the back of their shoulder. The participant should not feel any pain with the stretch. 2. The participant positions him/her self in sitting with feet flat on the floor. He/she raises the dominant arm to 90 degrees of forward flexion. Using the non-dominant arm the participant pulls the throwing arm across the body towards the opposite shoulder as shown in the photo in the Instruction sheet. The stretch should be felt across the back of the shoulder. Participants will be required to fill in a diary recording completion of the stretching program in the morning and at night. It will be made clear to the participants that accurate recollection is essential to the study and there will be no consequences for a lack of adherence to the stretching program.
Sponsors
Australian Catholic University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 35 Years
Healthy volunteers
Yes
Inclusion criteria
- Sex: males and females - Ages: 18-35 - Population: overhead throwing athletes: cricketers, baseballers, tennis players, volleyballers - Minimum 2 hours overhead throwing per week - Posterior shoulder tightness identified through: - Greater than 10 degrees asymmetry between the dominant arm and non- dominant arm in shoulder internal rotation
Exclusion criteria
- Undergoing current treatment for shoulder pain - Intending to seek treatment for shoulder pain in the next 3 weeks - Previous shoulder injury in the last 3 months - Shoulder surgery in the last 6 months - Shoulder dislocation/ recurrent dislocation - Cervical spine pain or disorders - Previous recent history of fracture to the humerus
Outcome results
None listed