Effectiveness of Modified Sleeper Stretch Combined with Modified Cross-Body Adduction in Alleviating Shoulder Stiffness Among Overhead Throwing Athletes: A Retrospective Cohort Study

Castagna, Alessandro; Amouzadeh Omrani, Farzad; Afzal, Sina; Baroutkoub, Mojtaba; Hajikarimloo, Bardia; Azadnajafabad, Sina; Mohammad Sharifi, Ghasem; Kokly, Saeed

doi:10.30491/tm.2024.466150.1747

Effectiveness of Modified Sleeper Stretch Combined with Modified Cross-Body Adduction in Alleviating Shoulder Stiffness Among Overhead Throwing Athletes: A Retrospective Cohort Study

Document Type : Original Article

Authors

Alessandro Castagna ¹

Farzad Amouzadeh Omrani ²

Sina Afzal ²

Mojtaba Baroutkoub ²

Bardia Hajikarimloo ³

Sina Azadnajafabad ⁴

Ghasem Mohammad Sharifi ⁵

Saeed Kokly ⁶

¹ Humanitas Clinical and Research Center, Milan, Italy

² Shahid Beheshti University of Medical Sciences, Tehran, Iran

³ Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

⁴ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK

⁵ Department of Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran

⁶ Joint, Bone, Connective Tissue and Rheumatology Research Center (JBCRC), Golestan University of Medical Sciences, Gorgan, Iran

10.30491/tm.2024.466150.1747

Abstract

Introduction: Overhead-throwing athletes frequently experience shoulder joint issues, specifically reduced internal rotation and posterior capsule tightness. This study aimed to compare the effects of two interventions on shoulder internal rotation, pain, and joint function: one involving a combination of modified sleeper stretch and cross-body adduction and the other, conventional physiotherapy.
Methods: This retrospective cohort study compared two groups of overhead-throwing athletes: one undergoing conventional physiotherapy from 2016 to 2019 and another receiving a combination of modified sleeper stretch and cross-body adduction exercises from 2020 to 2021. The conventional physiotherapy cohort focused on Codman’s exercises, while the later cohort received modified sleeper stretch combined with cross-body adduction exercise. Outcome measures included pain intensity (visual analog scale), glen humeral internal rotation (GHIR), and shoulder function (Constant Score).
Results: The study enrolled 160 patients, equally divided into two cohorts. Both cohorts showed similar baseline characteristics regarding age, sex, VAS score, GHIR degree, and Constant Score, with no statistically significant differences. Post-treatment, the second cohort (sleeper stretch and cross-body adduction) exhibited more significant improvements: GHIR increased from 49.0 ± 6.4 to 71.0 ± 5.8 degrees compared to 48.0 ± 5.2 to 59.2 ± 5.4 degrees in the first cohort. VAS scores decreased more significantly in the second cohort, from 4.5 ± 1.2 to 0.9 ± 0.8, compared to 4.8 ± 1.0 to 2.6 ± 0.8 in the first cohort. Similarly, Constant Scores improved more in the second cohort, from 49.0 ± 6.4 to 88.0 ± 4.0, in contrast to 48.0 ± 5.2 to 79.2 ± 3.8 in the first cohort.
Conclusion: These findings indicate the superior effectiveness of posterior shoulder stretching exercises in enhancing shoulder function and reducing pain among overhead-throwing athletes compared to conventional physiotherapy.

Keywords

Shoulder rehabilitation

stretching techniques

Overhead-throwing athletes

Sports injuries

Shoulder stiffness

Subjects