Internal Rotation Deficit Research Articles

The Effect of 8-week Online Scapular-focused Training on Scapular Kinematics, Proprioception, and Selected Muscles Strength in Female Volleyball Players With Glenohumeral Internal Rotation Deficit

Purpose: One of the most significant risk factors for throwing athletes is an internal rotation deficit of the shoulder joint. This study aims to investigate 8-week online scapular-focused training on the scapular kinematics, proprioception, and strength of particular shoulder muscles in female volleyball players with glenohumeral internal rotation deficit. Methods: The present study was conducted using a two-group with pre and post-test design. Based on the inclusion and exclusion criteria, 30 female athletes with abnormalities in the shoulder joint’s internal rotation were split into two groups, experimental (n=15) and control (n=15). In the pre-test, goniometers were used to measure shoulder range of motion, isokinetic devices were used to measure proprioception and rotator cuff muscle strength, and inclinometers were used to measure scapular kinematics. The experimental group’s participants underwent 8-week online scapular-focused training, lasting 30 minutes over three sessions each week. These exercises encompassed strength (with TheraBand) and stretching activities. Ultimately, intra-group and inter-group differences were examined using SPSS software, version 20 using paired t-tests and analysis of covariance (ANCOVA) at a significance level of 0.95. Results: The results of paired t-test revealed that only the experimental group and the pre-test and post-test had a significant difference in all study variables (P<0.05). Additionally, the results of the analysis of covariance (ANCOVA) demonstrated a significant difference between the two groups’ shoulder proprioception at 45° and 90° in the post-test (P=0.001 and P=0.01, respectively). The two groups also differed significantly in the scapular kinematics at all angles of 45°, 90°, and 135° as well as at the limit of the shoulder’s range of motion (P=0.01, P=0.04, P=0.001, and P=0.001, respectively). Additionally, significant differences were observed between the two groups in all variables of isokinetic strength of concentric internal rotation, isokinetic strength of concentric external rotation, isokinetic strength of eccentric internal rotation, and isokinetic strength of eccentric external rotation (P=0.001, P=0.02, and P=0.001, respectively). Conclusion: Based on the results, it can be concluded that 8-week online scapular-focused training improves scapular kinematics, proprioception, and shoulder internal and external rotator muscle strength in female volleyball players experiencing internal rotation deficiencies of the shoulder joint. It is advised that coaches, experts, and occupational therapists employ these workouts to enhance the aforementioned factors in female volleyball players experiencing shoulder internal rotation deficiencies.

Effectiveness of sleeper’s stretch on proprioception and range of motion in volleyball and basketball athletes with glenohumeral internal rotation deficit

Abstract Glenohumeral internal rotation deficit (GIRD) is a common impairment of neuromuscular origin that affects overhead athletes. The purpose of this study was to investigate the effect of 4-week sleeper stretch program on proprioception and range of motion (ROM) in athletes clinically diagnosed with GIRD. This study was a single group crossover study design (pre-post). The athletes underwent sleeper stretching program (5 sessions/week for 4 weeks) on the affected and non-affected sides. A total of 32 male athletes (15 basketball/17 volleyball were assessed for outcome measures of internal rotation (IR), external rotation (ER), total range of motion (TROM), and proprioception in ER, IR, and TROM (eyes open and eyes closed) at baseline and at the end of intervention. The affected side ROM significantly improved from 54.53±8.90° to 77.56±4.33° and 58.27±3.33° to 81.10±3.67° for volleyball and basketball athletes, respectively (IR ROM); from 114.56±5.88° to 95.77±6.66° and 119.44±4.67° to 104.23±5.05° for volleyball and basketball athletes, respectively (ER ROM); and from 169.90±5.78° to 173.11±5.88° and 177.28±5.88° to 186.89±3.79° for volleyball and basketball athletes, respectively (TROM), after the four-week sleeper stretch exercise. The ROM changes were non-significant on the non-affected side (P>0.05). The ANOVA reading for individual sports was found to be significant: volleyball athlete IR: [P<0.05, effect size (ES)=0.63], basketball athlete IR: [P<0.05, ES=0.74], volleyball athlete ER [P<0.05, ES=0.49), basketball athlete ER [P<0.05, ES=0.38). However, there was no significant improvement in proprioception measured with both eyes open (EO) and eyes closed (EC) for the IR, ER, and TROM. This study establishes the important role of sleeper’s stretching protocol in improvement of internal rotation, external rotation, and total rotational motion of the affected side. These findings may have important clinical implications in the management of GIRD in volleyball and basketball athletes.

COMPARATIVE STUDY ON THE EFFECTIVENESS OF MUSCLE ENERGY TECHNIQUE AND ACTIVE RELEASE TECHNIQUE ON THE GLENOHUMERAL INTERNAL ROTATION DEFICIT (GIRD) IN YOUNG THROWING ATHLETES

<p><strong>Background: </strong>Glenohumeral internal rotation deficit (GIRD) is one of the most common causes of impairments in overhead throwing athletes due to high intense and repeated throwing activities. The purpose of this study is to compare the effects of Muscle energy technique and Active release technique in overhead throwing athletes with Glenohumeral internal rotation deficits. <strong>Materials and Methods:</strong> A total of 42 athletes with age group 18-25 were selected for the study and a simple random lottery method was used to divide the sample into three groups; Group A (n=14) received muscle energy technique and conventional therapy, Group B (n=14) received active release technique and conventional therapy, Group C (n=14) received only conventional therapy. Measurements of shoulder internal rotation ROM (by Goniometer) and SPADI (shoulder pain and disability index) were assessed pre- and post-treatment after 4 weeks. <strong>Results:</strong> The results showed that Group A shows a significant difference in shoulder internal rotation ROM with a p-value <0.05 than Group B and C, but there was no significant difference was found between all the groups in the SPADI score with p-value >0.600. <strong>Conclusion:</strong> The study concluded that the muscle energy technique is more effective than the active release technique in improving shoulder internal rotation ROM, but both techniques have equally effective in improving shoulder function among athletes with GIRD.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0009/a.php" alt="Hit counter" /></p>

Shoulder muscle imbalance as a risk factor for shoulder injury in elite badminton players: A prospective study

ObjectivesTo assess the impact of preseason shoulder testing on the risk of significant shoulder injury (SSI) in elite badminton players. DesignProspective cohort study. SettingSecondary care, academic medical center. ParticipantsNineteen elite badminton players (19.37 ± 4.79 years, n = 13 males). Main outcome measuresAt preseason, they had shoulder examination tests including the table-to-acromion distance and the glenohumeral rotation range of motion. The glenohumeral internal rotation deficit (GIRD) was calculated. Isokinetic internal and external rotator shoulder muscle strength was tested at 60°/s (concentric and eccentric modes) and 240°/s (concentric mode). Bilateral strength ratio (non-dominant:dominant) and unilateral agonist:antagonist conventional and functional ratios (FR: eccentric-to-concentric) were calculated. ResultsDuring the follow-up time of 38 weeks, SSIs were assessed by an experienced sport physician and 42% of the participants sustained at least one SSI at their dominant side. The preseason GIRD and FR at 240°/s (FR240) were independently associated with SSIs (G2 = 6.28, p = .012 and G2 = 6.23, p = .013, respectively). FR240 < 0.69 (odds ratio = 28.0) and GIRD> 14° (odds ratio = 36.14) were predictors for SSIs. ConclusionsLower functional deceleration ratio and greater GIRD are associated with a higher risk of SSI at the dominant side in elite badminton players.

Comparative Effects of Novel Modified Sleeper and Cross-body Stretching on Scapular Anterior Tilting and Shoulder Internal Rotation in Subjects With Anterior Tilted Scapular and Shoulder Internal Rotation Deficits

Comparative Effects of Novel Modified Sleeper and Cross-body Stretching on Scapular Anterior Tilting and Shoulder Internal Rotation in Subjects With Anterior Tilted Scapular and Shoulder Internal Rotation Deficits

Risk Factors for Glenohumeral Internal Rotation Deficit in Adolescent Athletes: A Comparison of Overhead Sports and Non-overhead Sports.

Background A glenohumeral internal rotation deficit (GIRD) occurs in baseball players due to the repetitive pitching motion. However, few reports have addressed associations between GIRD and sports other than baseball. In this study, we investigated whether GIRD occurs in adolescent athletes playing overhead sports other than baseball, and also, the risk factors that cause GIRD in these sports were examined. Methods A total of 214 junior high school athletes who had undergone medical checks were evaluated. Seventy-five athletes playing sports requiring overhead motions were classified into the overhead sports group (39 tennis, 18 handball, 12 badminton, and 6 softball players). Eighty athletes participating in sports requiring the use of the upper limbs but not requiring frequent overhead motions were classified into the non-overhead sports group (31 kendo, 20 fencing, 19 basketball, and 10 table tennis players); 59 athletes who mainly did not use an upper limb were classified into the contact sports group (22 judo, 15 wrestling, 13 soccer, and 9 rugby football players). The range of shoulder motion (internal rotation, external rotation, and total arc), background factors, general laxity, and flexibility of the lower body were compared among the three groups. Results Thirty-four (16%) of 214 players were classified as having GIRD (internal rotation deficit >15°). Significantly more athletes had GIRD in the overhead sports group than in the other groups (p=0.007). The internal rotation deficit was significantly worse in the overhead sports group than in the other groups (p=0.006, p=0.02, respectively). Background factors, general laxity, and lower body flexibility did not differ significantly among the groups. Conclusion The sole risk factor for GIRD was participating in any sport that required overhead movements. Thus, not only baseball players, but also other athletes who participate in sports requiring overhead movements should receive correct information to prevent GIRD.

Professional tennis players suffer high prevalence of shoulder alterations during the season: a possible tennis shoulder syndrome.

To analyze the shoulder alterations of professional tennis players during the competition season and to compare the differences between their dominant vs. non-dominant shoulders, as well as gender and age differences. Two-hundred and seventy shoulders of (78 men and 57 women) professional active tennis players were assessed during 3 ATP and WTA tournaments. long head of biceps (LHB) tenderness and synovitis; glenohumeral internal rotation deficit (GIRD), total range of motion (TRM), external rotation (ER) and scapular dyskinesis (DK). Secondary variables: shoulder dominance, gender, age, training hours, ranking, type of backhand. LHB tenderness and synovitis were assessed by clinical and ultrasound examination, TRM with goniometer and DK by dynamic observation. LHB tenderness of the dominant shoulder was present in 35% of all players, being more prevalent in women (47.4%) than men (26.9%) p = 0.023. LHB synovitis of the dominant shoulder was present in 20.2% of all players without difference between genders (n.s). High prevalence of GIRD was found in both dominant (87.4%) and non-dominant (56.3%) shoulders, being more prevalent in the dominant shoulder p = 0.00005. TRM was decreased in both dominant (144.5° ± 20.2°) and non-dominant shoulders (161.2° ± 18.9°) p = 0.00005. ER was normal in dominant (93.8° + /9.3°) and non-dominant shoulders (93.4° + /8.4°) (n.s). DK was present in 57.7% of dominant and 45.9% of non-dominant shoulders (n.s). The combination of LHB alterations, GIRD and DK in the dominant shoulder was present in 13.3% of the participants. There were no significant differences between younger (< 22years) vs older players (≥ 22years). Professional tennis players actively playing suffer a high prevalence of LHB inflammation, GIRD, scapular dyskinesis and decreased TRM in their dominant and non-dominant shoulders. The LHB is a significant cause for anterior shoulder pain in this population. Women suffer more LHB tenderness than men. Young players are as affected as older players. Level IV.

Correlation of Glenohumeral Internal Rotation Deficit With Shoulder Pain in Elite Table Tennis Players.

The aims of the study were (1) to investigate glenohumeral internal rotation deficit (a difference in internal rotation of 15.6 degrees or more between dominant and nondominant shoulders) and its correlation with self-reported shoulder pain in table tennis players and (2) to find the optimal cutoff point for the difference in the internal rotation range of motion between dominant and nondominant shoulders of self-reported shoulder pain. The internal rotation range of motion of both shoulders of 46 table tennis players was measured in the supine and side-lying positions, and the external rotation range of motion was measured in the supine position. Significant differences existed in internal rotation range of motion between the two sides in the supine ( z = 6.53, P < 0.001) and side-lying positions ( z = 5.67, P < 0.001). Self-reported shoulder pain was associated with glenohumeral internal rotation deficit (odds ratio = 6.86, 95% confidence interval = 1.752-26.832, P = 0.006). The cutoff points for the difference in internal rotation range of motion between the sides of self-reported shoulder pain were 17.9 degrees in the supine position and 11.1 degrees in the side-lying position. Table tennis players exhibited glenohumeral internal rotation deficit. There was a correlation between glenohumeral internal rotation deficit and self-reported shoulder pain in the past year; therefore, glenohumeral internal rotation deficit may be a risk factor for shoulder pain in table tennis players.

Effect of rotator cuff strengthening exercises along with sleeper stretch versus traditional exercises program in baseball player having Glenohumeral internal rotation deficit (gird): A comparative study

Effect of rotator cuff strengthening exercises along with sleeper stretch versus traditional exercises program in baseball player having Glenohumeral internal rotation deficit (gird): A comparative study

Identifying the underlying mechanisms responsible for glenohumeral internal rotation in professional baseball pitchers.

Glenohumeral internal rotation deficit has been identified as a significant risk factor for upper-extremity injuries in pitchers across all ages. Humeral retroversion (HR), posterior capsule thickness (PCT), and posterior rotator cuff muscle pennation angle (PA) have been independently associated with internal rotation range of motion (IR ROM); however, these anatomic structures have not been collectively measured in baseball pitchers to determine the underlying mechanisms responsible for IR ROM. Therefore, the purpose of this study was to determine the contributions of HR, PCT, and posterior rotator cuff PA on IR ROM during a preseason evaluation in healthy professional baseball pitchers. The authors hypothesized that HR, PCT, and posterior rotator cuff PA would have a significant contribution to IR ROM. This is a cross-sectional study. Healthy professional pitchers from a single organization were recruited at the beginning of the 2021 Major League Baseball Spring Training. Participants received bilateral IR ROM assessment while laying supine with the shoulder at 90 degrees of abduction and the scapula stabilized. Ultrasound imaging was also performed bilaterally to assess HR, PCT, infraspinatus (superficial+deep) PA, and teres minor (superficial+deep) PA. All ultrasound imaging processes were performed utilizing previously published, highly reliable techniques. A stepwise regression was performed, which included both arms to determine the mechanisms of IR ROM. Overall, 49 pitchers (88 shoulders) with an average age of 22.5±2.2 years were included in the final data analysis. Stepwise linear regression found that only HR and PCT were associated with the preseason IR ROM. There was a moderate relationship between HR and PCT relative to IR ROM (R=0.535, P<.001). HR and PCT were found to be the primary mechanisms responsible for the preseason glenohumeral IR ROM. The posterior rotator cuff was not found to be significantly related to IR ROM. Future research evaluating these anatomic structures longitudinally-both acutely and chronically-will help clinicians optimize ROM management throughout the season. As glenohumeral internal rotation deficit can have harmful effects in baseball pitchers, understanding which anatomic structures are most responsible for IR ROM is important for injury prevention and treatment.

Immediate Effects of Kinesio-taping and Joint Mobilisation on Shoulder in Over-head Athletes with Glenohumeral Internal Rotation Deficit

The purpose of this study was to compare efficacy of kinesio taping (K-taping) and joint mobilization as immediate interventions for treating athletes with glenohumeral internal rotation deficit (GIRD). Thirty-two asymptomatic players were recruited from basketball, volleyball and handball who had a loss of shoulder internal rotation range of motion (IR ROM) of 10 degrees or more on their dominant compared to non-dominant side. They were randomly assigned to 1 of 2 groups: K-taping (n = 16) or joint mobilization (n = 16). Participants in taping group were treated with K-tape for inhibition of external rotators of shoulder and participants in joint mobilization group were treated with grade four Maitland’s mobilization technique for increasing glenohumeral internal rotation. Shoulder internal and external ROM were measured before and after the intervention with a universal goniometer. Both the methods produced significant improvement in IR ROM. The unpaired t-test showed significant change in IR ROM within both the groups (p = 0.003). No significant change was found on comparing both the groups (p = 0.373). There were no significant differences between results of the three sports (p = 0.592). K-taping and joint mobilization both are equally effective in improving the IR ROM in over-head players with GIRD.

Shoulder stretching versus shoulder muscle strength training for the prevention of baseball-related arm injuries: a randomized, active-controlled, open-label, non-inferiority study

Glenohumeral internal rotation deficit (GIRD) and weakness in prone external rotation are risk factors for shoulder and elbow injuries in high school baseball pitchers. While a shoulder-stretching prevention program to improve GIRD decreases the injury rate, the effects of external rotation strength remain unclear. This non-inferiority (NI) study investigates the hypothesis that external rotation strength training is not inferior to sleeper stretching for shoulder and elbow injury prevention in high school baseball pitchers. Participants were randomly allocated to the stretching (n = 62; active control group) and muscle-training (n = 51) groups. Specific exercises were performed each night. Elbow and shoulder injuries were monitored for 150 days. Kaplan–Meier survival curves were generated, and the hazard ratios (HRs) for injury occurrence were calculated using multivariate Cox regression. The log-rank test was used to compare the injury-free time. A one-sided NI test using a fixed NI margin was performed (significance level, P = 0.025). The injury rates were 22.6% (n = 14) in the stretching group and 9.8% (n = 5) in the muscle-training group. The muscle-training group had a lower injury rate (P < 0.001) and a lower risk of injury than the stretching group (HR = 0.489). Therefore, external rotation muscle strength training is not inferior to stretching for preventing baseball-related arm injuries.

Efficacy of Conservative Therapy in Overhead Athletes with Glenohumeral Internal Rotation Deficit: A Systematic Review and Meta-Analysis

To evaluate the effectiveness of conservative therapy in range of movement (ROM), strength, pain, subacromial space and physical function, in overhead athletes with glenohumeral internal rotation deficit (GIRD). A systematic review and meta-analysis was designed, and the protocol was registered in PROSPERO (CRD42021281559). The databases searched were: PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, Web of Science and SCOPUS. Randomized controlled trials (RCTs) involving conservative therapy applied in overhead athletes with GIRD were included. Two independent assessors evaluated the quality of the studies with the PEDro scale, and with the Cochrane Risk-of-Bias tool. The overall quality of the evidence was assessed using GRADE. Data on outcomes of interest were extracted by a researcher using RevMan 5.4 software. Estimates were presented as standardized mean differences (SMD) with 95% confidence intervals (CIs). A total of eleven studies involving 514 overhead athletes were included in the systematic review; of these 8 were included in the meta-analysis. The methodological quality of the included RCTs ranged from high to low. Conservative therapy showed significant improvements in internal rotation, adduction, physical function and subacromial space. Conservative therapy based on stretch, passive joint and muscular mobilizations can be useful to improve the internal rotation and adduction ROM, subacromial space, and physical function of the shoulder in overhead athletes with glenohumeral internal rotation deficit.

The relationship between scapular position and glenohumeral rotational range of motion in high school baseball players.

Past research indicated that scapular malposition is related to the glenohumeral internal rotation deficit (GIRD). However, there is no research examining the effect of throwing-related pain on this relationship. This study investigated the relationship between scapular position and range of motion (ROM) and compared the difference in this relationship between with and without throwing-related pain. Forty male baseball players in high school were recruited for this study. The existence and degree of throwing-related pain were obtained from a questionnaire. Participants were divided into 2 groups according to the presence or absence of the pain. Glenohumeral internal and external rotation ROM (abduction internal rotation angle and abduction external rotation angle [ABER], respectively) were measured using a digital inclinometer. The pectoralis minor muscle length was measured using a vernier caliper and scapula index, which indicated the scapular position, measured using a measuring tape. All these measurements were taken on both dominant and nondominant sides. The GIRD and total motion arc (TMA) deficit were calculated from the ROM measurements. Groups were compared using a mixed-model analysis of variance. There was a significant interaction between group and ABER dominance. Other variables were not seen as the interaction effect. There was a significant positive correlation between the scapula index and TMA (r=0.47, P=.02) and a negative correlation between the scapula index and GIRD (r=-0.65, P<.01) in the dominant side of the pain group. In addition, in the nondominant side of the pain group, the scapula index and ABER were significantly correlated (r=0.43, P=.04). The results of this study indicate that the scapular position is associated with the glenohumeral ROM in high school baseball players. In addition, this study demonstrated that the scapular internally rotated position was correlated with the GIRD and TMA deficit in high school baseball players who had throwing-related pain. On the other hand, the scapular externally rotated position was correlated with increased ABER, mainly in the pain-free baseball players or on the nondominant side. These results indicated that the scapular position might affect the glenohumeral rotational ROM in high school baseball players.

Shoulder Dysfunction in High School Tennis Players - an exploratory study

Previous studies have investigated sports activity related shoulder dysfunction, such as scapular dyskinesis and glenohumeral internal rotation deficit (GIRD), mainly in high-level tennis players. The prevalence of these dysfunctions in comparatively low to moderate level tennis players, such as those at the high school level is poorly understood. The purpose of this study was to explore the prevalence of scapular dyskinesis and GIRD at the high school level and identify some of the factors that makes a high school tennis player more susceptible to developing shoulder dysfunction. A survey related to sports-related shoulder dysfunction was developed in collaboration with physical therapists and was completed by twenty-seven high school level tennis players. The results show that players who have more years of experience, played tennis more often on a weekly basis, and were on the varsity team are more likely to develop shoulder pain and dysfunction. The average number of symptoms increased with years of playing experience and a higher frequency of playing tennis every week, with more than 40% of players on the varsity team reporting a decrease in the velocity, control, and arm motion during their serve. While male players reported more symptoms related to pain, decreased performance and strength, female players reported almost three times more occurrence of lower shoulders compared to male players. Players who consistently did workouts for shoulder and back muscles were less likely to develop shoulder pain and dysfunction, regardless of their level of experience and gender.

Prevalence of Glenohumeral Internal Rotation Deficit and Sex Differences in Range of Motion of Adolescent Volleyball Players: A Case-Control Study.

Shoulder range of motion (ROM) adaptation is common observed among volleyball players, but studies on the shoulder joint function of adolescent athletes are lacking. This study aimed to clarify the prevalence of glenohumeral internal rotation deficit (GIRD) among adolescent players and differences in ROM based on sex. A questionnaire survey and ROM measurements of the shoulder joint and trunk using a plastic goniometer were conducted on 123 volleyball players (63 males and 60 females; mean age, 15.8 years). The prevalence of GIRD was investigated for internal rotation differences of &gt;10° and total rotation motion of &lt;5°. Questionnaire items and ROM were compared between GIRD and non-GIRD patients, and sex differences in ROM were also presented. Of the participants, 38.2% (n = 47/123) had GIRD. The GIRD group showed a decrease in external rotation on the dominant side (p = 0.003, 1 - beta = 0.84), but this was not associated with a history of shoulder injury. Sex differences in shoulder ROM showed hypomobility in males and hypermobility in females. However, there was no association between shoulder injury and GIRD among adolescent players. There are sex differences in ROM, which should be considered in future studies.

Shoulder Rotational Strength and Range of Motion in Unilateral and Bilateral Overhead Elite Athletes.

Overhead athletes place tremendous demands on the shoulder complex, which result in adaptive kinematics but potential susceptibility to injury. This study aimed to compare shoulder glenohumeral range of motion (ROM) and rotator muscles strength in bilateral and unilateral overhead sports. Cross-sectional study; secondary care. Forty-two elite athletes (17.7 [4.5]y; 42.9% female), including 18 swimmers and 24 badminton players, were included. Preseason glenohumeral rotation ROM and isokinetic shoulder internal and external rotator muscles strength was tested (60°·s-1). Bilateral (nondominant:dominant) and agonist:antagonist (external rotator:internal rotator) conventional and functional deceleration ratios (eccentric to concentric) were calculated. The impact of sport and number of competitive years on shoulder ROM and strength was tested. Badminton players had greater glenohumeral internal rotation deficit, total ROM deficit, and lower bilateral strength ratio than swimmers (P < .050). Rotational strength was positively associated with the competitive years, but greater in swimmers (P < .050) and on the internal rotator (P < .001). The functional deceleration ratio was negatively associated with the competitive years on the dominant side in swimmers and for both sides in badminton. Unilateral overhead athletes had greater ROM and rotational strength asymmetries than bilateral athletes. Interestingly, the functional deceleration ratio was lower over time on the dominant shoulder for both sports, but, surprisingly, also on the nondominant shoulder in badminton, potentially creating a greater risk for shoulder injuries.

Immediate effect of MET of shoulder horizontal abductors and active sleeper stretch on glenohumeral internal rotation deficit in Indian lawn tennis players

IntroductionThroughout the throwing motion, the glenohumeral joint (GHJ) achieves extraordinary movement speeds, forces and ranges of motion (ROMs). When the dominant arm is abducted 90°, the shoulder (GHJ) external rotation ROM is usually greater than the non-dominant arm's. Stretching, in any form, effectively increases the joint range of motion. Stretches that increase range of motion, whether active, passive, or muscle energy technique (MET), have been proven to help manage and prevent injuries related with glenohumeral internal rotation deficit (GIRD). The goal of this study was to see which protocol would be the most beneficial in terms of having an immediate effect on this condition, and if either of the stretches would produce a better result, then that could be utilised to treat athletes, the lawn tennis players in this study, to improve their posterior shoulder flexibility. Material and method30 tennis players of 16–30 years of age with GIRD were recruited for the study. The sample was taken from different lawn tennis courts in Delhi. A detailed assessment of GIRD was done. In order of recruitment for the study, each odd subject was given MET of shoulder horizontal abductors first and Active Sleeper Stretch after an interval of 24 h. The order was reversed for every even subject. Range of motion was compared with before and after the protocols readings. ResultThe result of the study says that the active sleeper stretch increases the internal rotation (IR) range of motion in 30 subjects by an average of 4.8o ± 1.95 and MET of shoulder horizontal abductor by an average of 4.73o ± 2.18. ConclusionThere are limitations of both the techniques over each other. Active sleeper stretch cannot be done by impingement syndrome athletes and MET cannot be done alone. Therefore, either of them can be used according to the convenience of the athlete.

EFFECTS OF MYOFASCIAL TRIGGER POINT RELEASE AND THERABAND STRENGTHENING AMONG THE COLLEGIATE VOLLEY BALL PLAYERS WITH GLENOHUMERAL IMPINGEMENT

Background: Volley ball is one of the common sport and most of the college students choose this as a recreational game. Almost 80% of the shoulder injuries are related to spiking movement during the game. This stress the upper arm and the shoulder leading to increased risk of injuries. The common factors that results in shoulder injuries are Glenohumeral internal rotation deficit, Glenohumeral impingement syndrome, scapular dyskinesis and altered biomechanics of ball striking movement. Aim of The Study: The present aim of the study is to identify the effectiveness of Myofascial trigger point release technique and Theraband strengthening on Glenohumeral muscles among the collegiate volley ball players with Glenohumeral impingement syndrome. Methods: There were 30 players taken for the study and pretreatment values were taken. Myofascial trigger point therapy have been applied to supraspinatus muscle. The outcome measures used for the study is Numerical pain rating scale, range of motion and shoulder pain and disability index. The post treatment values were taken. Results: The results of the present study were analyzed using pairedt test and Wilcoxon signed rank test and the test statistics shows statistically significant improvement in the posttest p value &lt; 0.05. Conclusion: The present study concluded that Myofascial trigger point release and Theraband strengthening exercises shows significant improvement in pain reduction, improves range of motion and functional ability among the collegiate volley ball players.

Bilateral glenohumeral internal rotation deficit (GIRD) in elite gymnasts

IntroductionThe “Glenohumeral Internal Rotation Deficit (GIRD)” is known as the difference in internal rotation range of motion (IRRM) between the dominant and non-dominant shoulder of overhead athletes as a result of asymmetric loading. As in contrast loading pattern in gymnastics are quite symmetric and structural changes often occur bilaterally, the question arises if GIRD might develop bilaterally in gymnasts as one source of common bilateral shoulder pathologies and to search for underlying structural adaptations.Materials and methodsA group of 35 elite gymnasts (8–24 years) were recruited from a local Olympic Training Centre and compared to a paired cohort of 28 non-overhead athletes. Clinical examinations, digital range of motion (ROM)-measurement, ultrasonographic humeral torsion measurement, and standardized MRI scans of both shoulders were obtained and examined for structural pathologies, cross-sectional areas (CSA) of the rotator cuff muscles and capsular thickness.ResultsROM-measurements showed significant decrease in IRRM in the gymnasts groups by age, with IRRM of 48.6° (SD: 8.4°, CI 95%: 43.0–54.3°) at age group 1 (8–10 years) and IRRM of 10° (SD: 11.4°; CI 95%: 0–22.0°) at age group 4 (18–26 years), that was statistically significant for the entire cohort (p = 0.017) compared to the controls. CSA were not significantly different between the cohorts, while there was a slightly increased humeral retrotorsion in the gymnasts as well as a statistically significant posterior capsular thickening.ConclusionA new bilateral form of GIRD was identified in higher age groups of youth and senior elite gymnasts enrolled in this study. Despite to former definition of GIRD there was no compensatory increase in external rotation range of motion (ERRM) but an association with posterior capsular thickening, while there was no periscapular muscle hypertrophy. Humeral retrotorsion was also slightly increased in the gymnasts group.