The tester stood at the head of the examination table toward the head of the participant and positioned the test shoulder and elbow into 90° of abduction and flexion, respectively. To assess GH horizontal adduction, we placed participants in a supine position with both shoulders flush against a standard examination table. Glenohumeral Horizontal Adduction Measurement Therefore, the purpose of our study was to report the acute effects of sleeper stretches on posterior and rotational shoulder ROM. To perform the sleeper stretch, scapular movement is restricted, and then the shoulder is internally rotated to isolate the posterior soft tissue restraints.Īlthough the use of sleeper stretches is commonplace among throwing athletes, no data that detail the acute effects of this stretching technique are available. This technique is known as a “sleeper stretch” because it is applied in the side-lying position. Recently, clinicians and athletes have adopted a new stretch to isolate the soft tissue of the posterior aspect of the shoulder. Techniques typically involve both passive and ballistic stretches in several directions, such as internal and external rotation, flexion, extension, and horizontal adduction. They use these stretches to attempt to lengthen soft tissue restraints so that they can increase throwing velocity and control and can limit the incidence of injury and muscle soreness. 20, 21īecause throwing athletes often endure large forces and large numbers of repetitions, such athletes routinely participate in a variety of shoulder stretching exercises before and after a bout of throwing. 20 Accumulation of such forces may result in tightness of the posterior capsule and other dynamic restraints (posterior deltoid, infraspinatus, teres minor, and latissimus dorsi), which causes altered ROM. As the humerus internally rotates during the follow-through phase of the throwing motion, the posterior inferior capsule may be placed in a primary location to resist the deceleration forces, becoming a direct restraint against these loads. 8, 12 Furthermore, investigators 20, 21 have hypothesized that the deceleration phase of the throwing motion is a major contributor to the development of posterior shoulder soft tissue tightness, resulting in alterations of shoulder ROM similar to those of bony adaptations. This increase has been reported to decrease shoulder internal rotation 11, 12 and increase external rotation, 9 –, 12 leaving the total arc of motion (sum of total internal and external rotation) 19 relatively unchanged. 15 –, 18īony adaptations among throwing athletes often appear as increased humeral retroversion. Such alterations have been linked empirically to bony 8 –, 12 and soft tissue 13, 14 adaptations that result from the large rotational and distractive forces acting on the GH joint during the throwing motion. Researchers 1 –, 7 have extensively examined alterations in the range of motion (ROM) of the dominant shoulder of throwing athletes, such as decreased internal rotation, increased external rotation, and increased posterior shoulder tightness (limited glenohumeral horizontal adduction).
The statistically significant acute increases in shoulder range of motion may be clinically insignificant.
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