External handheld loads affect scapular elevation and upward rotation during shoulder elevation tasks.

Altered scapular kinematics is associated with shoulder pain. Resistance exercise is a common treatment; however, the effects of lifting an external load on scapular kinematics is limited. Understanding whether an external handheld load affects scapular kinematics in a healthy population can provide normal values utilized for comparison to individuals with shoulder pain. Currently, no studies have examined the effect of incrementally increased handheld loads. We defined the effects of varying external handheld loads on scapular kinematics during a shoulder elevation task. Healthy participants (n = 50) elevated their shoulder in the scapular plane over 4 trials. One trial of no loading (control) and 3 trials with incrementally increased external handheld loads. Scapular kinematic rotations and translations were measured during ascent and descent phases using 3D motion capture. Compared to no load, the highest external load during ascent increased scapular elevation [mean difference = 3.2 degrees (95%CI: 0.9, 5.4), p = 0.006], and during descent increased scapular elevation [mean difference = 3.9 degrees (95%CI: 2.8, 5.1), p < 0.001] and increased scapular upward rotation [mean difference = 4.5 degrees (95%CI: 2.4, 6.6), p < 0.001]. External handheld loads result in small increases in scapular elevation and scapular upward rotation. These results should be utilized as normal values to compare to individuals with shoulder pain.

Effect of a novel stretching technique on shoulder range of motion in overhead athletes with glenohumeral internal rotation deficits: a randomized controlled trial.

BACKGROUND: The cross-body and the modified sleeper stretch have been used to improve posterior shoulder soft tissue flexibility and to increase glenohumeral joint internal rotation (GHJ IR) in overhead athletes. However, due to the inability to stabilize patient's scapula and control GHJ rotation with the cross-body stretch and the potential for subacromial impingement or symptoms' aggravation with the modified sleeper stretch, a new stretching technique (Passive Glenohumeral Internal Rotation with Clam Shell Bridging) was developed as an alternative to these commonly used stretches that may allow for greater stability of the scapula without reproducing symptoms. Thus, the current study aimed to examine and compare a novel stretching technique to the traditional modified sleeper stretch to determine the effect on glenohumeral IR range of motion (ROM) and self-reported pain in overhead athletes with glenohumeral internal rotation deficits (GIRD). METHODS: Forty-two overhead athletes with GIRD [mean age 25.9 ± 2.6 years, 20 males and 22 females] participated in this study. Participants were randomly assigned into either novel stretching group or modified sleeper stretching group. IR ROM was measured with a digital inclinometer before, immediately, and at week 4 post intervention, while pain was measured with Numeric Pain Rating Scale before and at week 4 post intervention. RESULTS: There was no significant group by time interaction effect for IR ROM (p = 0.27); however, there was a significant change over time (p < 0.001, η2 = 0.77). Both groups demonstrated a significant increase in IR from baseline to immediate and week 4, and from immediate to week 4 (p < 0.001). There was a significant group by time interaction for pain intensity (p < 0.001, η2 = 0.72). Results showed a significant reduction in pain intensity over time in the novel group (p = 0.001, d = 2.18), but not in the traditional group (p = 0.231, d = 0.46). CONCLUSION: Both stretches appear to be effective at improving IR ROM in overhead athletes with GIRD. However, the novel stretching might be more effective at reducing shoulder pain and thus may be more appropriate for symptomatic patients. TRIAL REGISTRATION: Prospectively registered in February 6, 2017 under Clinical Trial Registry # NCT03044236 .