Modified Cross Body Stretch Verses Modified Sleeper Stretch in Basketball Players for Posterior Capsule Tightness
Condition: Shoulder Capsulitis
MeSH terms: Bursitis
Study type: Interventional

Summary: 
      The aim of this research is to compare the effect of modified cross body stretch and modified
      sleeper stretch on pain, range of motion, disability and throwing ability in athletes with
      posterior capsule tightness. Randomized controlled trials done at International Islamic
      University. The sample size was 32. The subjects were divided in two groups, 16 subjects in
      modified cross body stretch group and 16 in modified sleeper stretch group. Study duration
      was of 6 months. Sampling technique applied was non probability connivance sampling
      technique. Tools used in the study are PENN shoulder score, gonoiometer, thumb up back(TUB)
      and seated basketball throw test(SBBT). Data was be analyzed through SPSS 21.
    

Detailed description: 
      Basketball is considered as the highly demanding sports due to high demand and complexity of
      the game. The overhead throwing activities makes it more vulnerable to the injuries. In
      repetitive throwing there are different type of violet forces placed on shoulder joint It
      causes adaptation in soft tissue anatomically which in turn limits ROM of shoulder joint and
      Posterior shoulder tightness.

      Posterior capsule tightness can result due to abnormal humeral head motion which decreases
      subacromial space during overhead activities leading to compression of tissues causing
      limited shoulder flexion, internal rotation and horizontal adduction. Posterior capsule
      tightening occurs when the capsular tissue and musculature of the shoulder tighten, usually
      due to "repeated overload in the eccentric portion of arm deceleration. This loss of internal
      rotation results from contracture and tightening of the posterior inferior portion of the
      glenohumeral joint capsule, which occurs from the repetitive microtrauma imparted during the
      deceleration phase of the throwing motion. Repetitive throwing motion creates adaptive
      increased external rotation and decreased internal rotation in the dominant shoulder joint
      which is termed as GIRD (Glenohumeral internal rotation deficit).Posterior capsule tightness
      is often treated without surgery. It can be treated by strengthening, stretching,
      neuromuscular control exercises. Strengthening protocol can perform specifically on Weak
      muscles by using resistance and weight. The neuromuscular training helps the body to act and
      react on different pattern of stress demand on it through neural pathways. The mainstay of
      the posterior capsule tightness treatment for athlete is the stretching of the posterior
      capsule. One author proposed the modified forms, the modified sleeper stretch and the
      modified cross body stretch. And found these modified stretching more effective and
      beneficial than the sleeper and cross body stretch Literature review: Kevin et al
      investigated the acute effects of sleeper stretch on posterior shoulder tightness and
      internal rotation of shoulder. There was significant improvement in results.

      A study conducted in 2018 to determine whether posterior shoulder stretch was effective in
      increasing internal rotation and horizontal adduction ROM in volleyball and tennis players
      with internal rotation deficit >¬¬15 degrees. The intervention group performs the sleeper
      stretch daily for 8 weeks. Results showed significant improvement in internal rotation and
      horizontal adduction.

      Another article was published in 2014, with the aim to compare the effects of horizontal
      adduction stretch with scapular stabilization versus horizontal adduction stretch without
      scapular stabilization on posterior shoulder tightness and passive internal rotation. Results
      showed significant improvement among the scapular stabilization group.

      A RCT conducted in which each subject completed stretching interventions for two days.
      Purpose of the study was to investigate acute effects of modified sleeper stretch and
      modified cross body stretch on posterior shoulder tightness and glenohumral internal rotation
      deficit with more than 10-degree loss.
    

Intervention name(s): Modified cross body stretch; Modified sleeper stretch
Intervention type(s): Other; Other
Intervention description(s): Athlete was in side lying positioned. trunk was moved posteriorly 200 to 300 and shoulder is raised to 900 and semi flex both knees. Athlete was ask to passively pull the humerus across the body into horizontal adduction with the opposite hand.
5 reps once daily 3 sets for 4 weeks was given; Athlete was in side lying positioned on the involved side, trunk was rolled posteriorly 200 to 300 and shoulder is raised to 900 and elbow is flexed to 900 and semiflex both knees. athlete was ask to perform internal rotation passively by using the opposite arm.
5 reps once daily 3 sets for 4 weeks was given
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Modified cross body stretch; Modified sleeper stretch; Posterior capsule tightness; Range of motion; Seated basketball throw; Thumb up back