Immediate effect of combining glenohumeral and scapulothoracic mobilization with stretching on improving shoulder internal rotation in overhead throwing athletes with glenohumeral internal rotation deficit: A randomized clinical trial study

BACKGROUND: Posterior shoulder tightness as demonstrated by glenohumeral internal rotation deficit (GIRD) is a common contributor to many shoulder pathologies in overhead throwing athletes. PURPOSE: This study aimed to assess immediate effect of combining glenohumeral and scapulothoracic mobilization with stretching on improving internal rotation range of motion (ROM) in overhead athletes with GIRD METHODS: This study was a single-blind randomized controlled trial with parallel groups. The participants were 30 asymptomatic male volleyball players who had a loss of shoulder internal rotation ROM of 15 degrees or more on their dominant compared to their nondominant side. They were randomly assigned to 1 of 2 groups: stretching only (n = 15) or stretching plus joint mobilization (n = 15). Participants in the stretching group performed cross-body stretches, and those in stretching plus mobilization group were treated with both cross-body stretching and mobilization techniques for the glenohumeral and scapulothoracic joints. Both groups received the intervention every other day for 1 week. Shoulder internal and external ROM were measured before and after the intervention. RESULTS: Before the intervention, dominant-side deficits in internal rotation ROM compared to the nondominant side were 20.11±5.27 degrees in the stretching group and 21.87±8.06 degrees in the stretching plus mobilization group. After the intervention, internal rotation ROM deficit between the dominant and nondominant side decreased to 11.28±5.82 in the stretching group (P <  0.001) and 10.85±9.19 in the stretching plus mobilization group (P <  0.001). However, the between-group difference was not statistically significant (P = 0.389). External rotation ROM remained unchanged in both groups (P >  0.05). CONCLUSION: Both interventions (stretching and stretching plus mobilization) can have the same beneficial effect in decreasing GIRD in asymptomatic overhead athletes.