Joint Diseases, Joint Range of Motion, Posterior Capsule Tightness
Conditions
Keywords
Posterior Capsule Tightness, GIRD, Kaltenborn Mobilization, Pragmatic Stretch, Glenohumeral Joint, Athletes, Atheletic over head shoulder restrictions
Brief summary
Many athletes who play overhead sports like cricket develop tightness in the back of the shoulder. This causes pain and makes it hard to lift the arm. This study will compare two common physical therapy treatments: Kaltenborn joint mobilization (a specific manual therapy glide) versus a Pragmatic Posterior Capsular Stretch (a specific stretching technique). We want to see which one works better for pain, range of motion, and daily function. 28 athletes will be treated for 4 weeks, and we will measure their progress using a goniometer and the SPADI questionnaire.
Detailed description
This is a single-center, randomized controlled trial. Participants aged 22-40 years with a positive GIRD test (indicating posterior capsule tightness) will be recruited from pedal courts and clinics in Faisalabad. After obtaining informed consent, participants will be randomly assigned to one of two parallel groups using a random number generator. Group A (Experimental): Receives Pragmatic Posterior Capsular Stretch. The participant lies side-lying. The therapist stabilizes the scapula and applies medial rotation, extension, and traction for 30 seconds, repeated to achieve 15 minutes total per session. Group B (Active Comparator): Receives Kaltenborn Joint Mobilization (Posterior Glide). The participant is positioned with the shoulder abducted and externally rotated. The therapist applies a Grade III posterior glide with lateral distraction, sustained at end-range for 15 minutes. Both groups receive 3 sessions per week for 4 weeks (12 sessions total). Outcome measures (Pain via SPADI, ROM via Goniometer, Function via SPADI) are taken at baseline and at the end of 4 weeks. Data will be analyzed using SPSS version 20 using independent t-tests or Mann-Whitney U tests depending on normality.
Interventions
PROCEDUREKaltenborn Joint Mobilization
Kaltenborn Grade III sustained posterior glide with lateral distraction. Applied to the glenohumeral joint for 15 minutes per session, 3x/week for 4 weeks.
PROCEDUREPragmatic Capsular Stretch
Side-lying stretch combining medial rotation, extension, and traction. Held for 30 seconds with deep breathing, repeated for 15 minutes total per session, 3x/week for 4 weeks.
Sponsors
University of Faisalabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
22 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Male and female athletes * Positive GIRD test * Age 22-40 years * Overhead throwing athletes (Cricketers) * Able to provide informed consent
Exclusion criteria
* Fracture * Recent shoulder injury (last 6 months) * History of shoulder surgery * Osteoarthritis * Peripheral nerve injuries
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pain | Baseline and Week 4 | Measured using the Shoulder Pain and Disability Index (SPADI) - Pain subscale. Score range 0-100 (higher = more pain). |
| Change in Range of Motion | Baseline and Week 4 | Measured using a universal goniometer. Specifically Glenohumeral Internal Rotation (GIR) and Horizontal Adduction (HA) range in degrees. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Functional Disability | Baseline and Week 4 | Measured using the Shoulder Pain and Disability Index (SPADI) - Disability subscale. Score range 0-100 (higher = more disability). |
Countries
Pakistan
Contacts
CONTACTDr. Muhammad Muneeb Jafar, Doctor of Physical Therapy
CONTACTDr Muhammad Ateeb, PhD Public Health
Outcome results
None listed