Stretching program dedicated to shoulder stiffness: Functional consequences

Abstract

Overhead athletes develop a specific pattern of glenohumeral passive mobility, with external rotator gain (ERG) and internal rotation deficit (GIRD). The GIRD should correspond to tightness of the posterior structure and it seemed to be linked to various dominant shoulder pathologies. Twenty men overhead athletes were recruited from handball and volleyball clubs. To be eligible, participants had to be involved at least 6 hours in practice since at least 5 years. Ten men (22.5 ± 4 years) were asymptomatic, 10 men (24.8 ± 4 years) were symptomatic on their dominant shoulder (at least 3/10 on the VAS). They all should present, on their dominant shoulder, a GIRD based on a clinical assessment. The subjects performed daily two kinds of stretching at the dominant side for 4 weeks (5 × 30″): the sleeper stretch and the cross body arm. They sustained, before and after the stretching program, an isokinetic evaluation of the external and internal rotators and an evaluation of the scapula kinematics (3D assessment). After the stretching program, all the subjects showed a significant decrease of the shoulder stiffness. We did not observe any alteration of scapular kinematics among the asymptomatic athletes after 4 weeks of stretching. Concerning the symptomatic athletes, the stretching program modified the position at rest of the scapula, which was less anteriorly tilted after the program. During the isokinetic evaluation, only the asymptomatic population showed a low (–4%; P < 0.05) decrease of the internal rotators maximal strength at 60°/s in the concentric mode. The symptomatic overhead athletes reported a significant reduction of shoulder pain; the decrease of pain was significantly correlated with the increase of passive internal rotation of the dominant shoulder. The stretching program devoted, during 4 weeks, to the stiffness shoulder allowed an increase in passive rotation. This gain in mobility was correlated with a significant reduction of pain in symptomatic shoulder.