Stretching the Posterior Capsule of the Shoulder in the Stability and the Throwing Performance in Handball Players
Condition: Shoulder Injuries and Disorders
MeSH terms: Shoulder Injuries
Study type: Interventional

Summary: 
      Introduction: Handball is a sport with a high prevalence of shoulder injuries due to the
      overuse that causes a glenohumeral internal rotation deficit, and excess of external rotation
      and scapular dyskinesia. Stretching is essential to restore physiological movement and
      improve strength.

      Aim: To evaluate the efficacy of a posterior capsule stretching and strengthening of the
      shoulder and scapular program in handball players from 18 to 37 years old.

      Study design: randomized clinical trial, multicenter, single-blind with follow-up period.

      Methods: 60 handball players will be randomly assigned to the two study groups (experimental
      and control). The intervention will last 4 weeks, with 3 weekly sessions with a duration of
      21 and 12 minutes each. The study variables will be: range of motion in internal and external
      rotation (goniometer), throwing speed (Ball Throwing Speed Test), functionality (DASH
      questionnaire), perceived exertion (Borg scale), glenohumeral stability (CKCUEST y YBT-UQ
      Test) and the throwing force (Overhead Medicine Ball Throw). The intervention will consist in
      the application of stretching of the posterior shoulder capsule with an exercise protocol. A
      Kolmogorov-Smirnov analysis will calculate the normality of the distribution. In case of
      homogeneity of the groups, with the t-student test of repeated measurements and an ANOVA of
      repeated averages, the difference between the different evaluations and the intra- and
      inter-subject effect will be calculated.

      Expected results: Improved range of motion of the shoulder, strength and throwing speed after
      the intervention.
    


Intervention name(s): Experimental; Control
Intervention type(s): Other; Other
Intervention description(s): Two exercises will be done to strengthen the external rotation (using elastic bands): standing with 90 degrees of shoulder abduction and elbow flexion and also in standing with the shoulder in neutral position and the elbow flexed to 90 degrees. Subjects will perform 3 sets of 10 repetitions with the band slightly stretched, at a distance of 0.70 m from the wall. Dumbbell exercises will be performed through 4 exercises: flexion in the horizontal plane of 135º, external rotation in lateral decubitus, horizontal abduction with external rotation, and extension in prone position. There will be 5 repetitions each exercise of 3 seconds each, with 2 minutes of rest between exercises.; Two exercises will be done to strengthen the external rotation, using elastic bands. The first, standing, with 90 degrees of shoulder abduction and elbow flexion. The second, also in standing, with the shoulder in neutral position and the elbow flexed to 90 degrees. Subjects will perform 3 sets of 10 repetitions with the band slightly stretched, at a distance of 0.70 m from the wall. The band will be subject to a surface, at an equal distance from the subject's elbow to the ground. The repetitions will last one second in concentric external rotation and two seconds in eccentric external rotation, with a rest of 30 seconds between series.
Other intervention name(s): Strengthening exercises and capsular stretches; Strengthening exercises
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Handball; Physiotherapy; Shoulder instability; Scapular dyskinesia; Female