Modified Cross Body Stretch Verses Modified Sleeper Stretch in Basketball Players for Posterior Capsule Tightness

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.

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.

Eligibility Criteria:
Inclusion Criteria:

* Basketball Players
* Internal rotation deficit greater than 20° degrees
* BMI 18.5-24.9

Exclusion Criteria:

* Having a systemic pathology including inflammatory joint disease
* Having musculoskeletal or neurological disease
* Having taken anti-inflammatory medication