Effects of c4 and sleeper stretch manipulation on glenohumeral internal rotation déficit (GIRD) and pain in the long portion of the bíceps brachii.

In our Research project we will include: - Experimental group 1 (G1) will be made up of 25 patients (n = 25) who will undergo the manipulation technique of the 4th cervical vertebra. - Experimental group 2 (G2) will be made up of 25 patients (n = 25) who will undergo the sleeper stretch technique. - Experimental group 3 (G3) will be made up of 25 patients (n = 25) who will undergo the manipulation technique of the 4th cervical vertebra and sleeper stretch. The subjects will be in the groups at random. The randomization method that will be used in the research project is by means of a simple random sampling, for this we will use the SPSS computer program. The maneuvers to be carried out are: One of them will be the C4 manipulation technique for the subjects belonging to experimental group 1 and 3 together with the sleeper stretch technique that will be performed on experimental group 2 and 3. A structured notebook will be made to collect information of interest for the study in badminton players, which includes sociodemographic and technical data, as well as physical and ultrasound examination of the dominant shoulder. A doctor will carry out the physical and ultrasound examination of the different badminton players The doctor will carry out a new measurement of the internal rotation, as well as the external rotation of the dominant shoulder of each of the players. For this, a standard plastic goniometer will be used, with a numerical scale where the degrees are increased from 1 to 1. Pain pressure thresholds will be measured using an electronic algometer, which is used by exerting perpendicular pressure on the muscle fiber. The measurement with an algometer will be made in the anterior region of the muscle mass of the long head of the biceps brachii, just midway between the shoulder and the elbow. The total number of measurements to be carried out in each patient to see the pain pressure thresholds with an algometer in the PLB will be 3 measurements with a time of 30 seconds between each measurement, using the average of the three results as the value. The doctor will carry out two post-intervention evaluations, on the first evaluation day and 15 days later, immediately after the player has been manipulated and sleeper stretch." C4 manipulation technique: - Patient position: supine position. - Position of the therapist: Standing at the head of the patient, although a little deviated at the ipsilateral level of the vertebra to be treated, both legs parallel and semiflexed. The center of gravity must be vertical to the lesion to be treated. - Contacts: The cranial hand is placed by the radial border of the joint distal interphalangeal joint of the index finger at the articular process of C4. the other hand controls the vertebra from the other side and the patient's head. - Parameters: The cervical spine is in neutral flexoextension, ipsilateral lateroflexion and contralateral rotation. - Execution: We ask the patient to inspire, and at the end of expiration, the Therapist increases the tension in rotation with both hands and the impulse is performed to manipulate.