An Evidence-informed Rehabilitation Management Framework for Posterior Shoulder Tightness: A Scoping Review

Overview

Journal Shoulder Elbow

Date 2024 Mar 1

PMID 38425737

Authors

Yukino Fukushima

Murali Avilineni

Michelle Kao

Haider Tirmizey

Kenneth J Faber

Rochelle Furtado

Jackie Sadi

Affiliations

Soon will be listed here.

Abstract

Objective: To systematically scope the literature on posterior shoulder tightness (PST) and define a therapist-instructed and therapist-administered management framework.

Design: Scoping review.

Literature Search: We searched MEDLINE, EMBASE, CINAHL, Scopus and Google Scholar from inception to December 2021.

Study Selection Criteria: Peer-reviewed studies written in English, French, Greek, Japanese or Tamil, with extractable pre- and post-intervention data. Physiotherapy interventions amenable for posterior shoulder structural (muscle, capsule) causes of PST within an adult population.

Data Synthesis: Arksey and O'Malley's framework was implemented and the PRISMA extension for scoping reviews directed our data synthesis. The data charted from each study included authors, title, study year, location, study design; participant number, age, sex; PST intervention and parameters; patient-reported outcomes; and results. Themes were organized into therapist-instructed and therapist-administered rehabilitation strategies, as well as combined treatment methods.

Results: Of 2777 articles identified from our search strategy, 21 articles were included. Therapist-instructed interventions included cross-body stretch (CBS), sleeper stretch (SS), a combination of the two and general stretching. Therapist-administered interventions included CBS, SS, instrument-assisted soft tissue mobilization (IASTM), muscle energy techniques, dry needling and Fauls protocol (12 therapist-assisted stretches). Combined interventions of tape with self-stretching and IASTM and stretching were also identified.

Conclusion: Based on the current evidence, CBS and SS are the most researched treatments for PST and seem to be effective at improving PST. Furthermore, stabilization of the scapula while performing these stretches optimized the stretch targeted to the PST and ROM benefits for horizontal adduction.

References

Laudner K, Sipes R, Wilson J . The acute effects of sleeper stretches on shoulder range of motion. J Athl Train. 2008; 43(4):359-63. PMC: 2474815. DOI: 10.4085/1062-6050-43.4.359. View

Tahran O, Yesilyaprak S . Effects of Modified Posterior Shoulder Stretching Exercises on Shoulder Mobility, Pain, and Dysfunction in Patients With Subacromial Impingement Syndrome. Sports Health. 2020; 12(2):139-148. PMC: 7040949. DOI: 10.1177/1941738119900532. View

Passigli S, Plebani G, Poser A . ACUTE EFFECTS OF DRY NEEDLING ON POSTERIOR SHOULDER TIGHTNESS. A CASE REPORT. Int J Sports Phys Ther. 2016; 11(2):254-63. PMC: 4827368. View

Laudner K, Moline M, Meister K . The relationship between forward scapular posture and posterior shoulder tightness among baseball players. Am J Sports Med. 2010; 38(10):2106-12. DOI: 10.1177/0363546510370291. View

Mine K, Nakayama T, Milanese S, Grimmer K . Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials. J Sport Rehabil. 2016; 26(4):294-305. DOI: 10.1123/jsr.2015-0172. View

Mihata T, McGarry M, Akeda M, Peterson A, Hunter R, Nguyen L . Posterior shoulder tightness can be a risk factor of scapular malposition: a cadaveric biomechanical study. J Shoulder Elbow Surg. 2019; 29(1):175-184. DOI: 10.1016/j.jse.2019.05.040. View

Laudner K, Wong R, Latal J, Meister K . POSTERIOR SHOULDER TIGHTNESS AND SUBACROMIAL IMPINGEMENT CHARACTERISTICS IN BASEBALL PITCHERS: A BLINDED, MATCHED CONTROL STUDY. Int J Sports Phys Ther. 2020; 15(2):188-195. PMC: 7134346. View

Sauers E, August A, Snyder A . Fauls stretching routine produces acute gains in throwing shoulder mobility in collegiate baseball players. J Sport Rehabil. 2007; 16(1):28-40. DOI: 10.1123/jsr.16.1.28. View

Yang J, Chen S, Hsieh C, Lin J . Effects and predictors of shoulder muscle massage for patients with posterior shoulder tightness. BMC Musculoskelet Disord. 2012; 13:46. PMC: 3339516. DOI: 10.1186/1471-2474-13-46. View

10.

Joung H, Yi C, Jeon H, Hwang U, Kwon O . Effects of 4-week self-cross body stretching with scapular stabilization on shoulder motions and horizontal adductor strength in subjects with limited shoulder horizontal adduction: cross body stretching with stabilization. J Sports Med Phys Fitness. 2018; 59(3):456-461. DOI: 10.23736/S0022-4707.18.08454-2. View

11.

Shanley E, Rauh M, Michener L, Ellenbecker T, Garrison J, Thigpen C . Shoulder range of motion measures as risk factors for shoulder and elbow injuries in high school softball and baseball players. Am J Sports Med. 2011; 39(9):1997-2006. DOI: 10.1177/0363546511408876. View

12.

Chepeha J, Magee D, Bouliane M, Sheps D, Beaupre L . Effectiveness of a Posterior Shoulder Stretching Program on University-Level Overhead Athletes: Randomized Controlled Trial. Clin J Sport Med. 2017; 28(2):146-152. DOI: 10.1097/JSM.0000000000000434. View

13.

Burkhart S, Morgan C, Ben Kibler W . The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy. 2003; 19(4):404-20. DOI: 10.1053/jars.2003.50128. View

14.

Bailey L, Thigpen C, Hawkins R, Beattie P, Shanley E . Effectiveness of Manual Therapy and Stretching for Baseball Players With Shoulder Range of Motion Deficits. Sports Health. 2017; 9(3):230-237. PMC: 5435155. DOI: 10.1177/1941738117702835. View

15.

Almeida G, Silveira P, Rosseto N, Barbosa G, Ejnisman B, Cohen M . Glenohumeral range of motion in handball players with and without throwing-related shoulder pain. J Shoulder Elbow Surg. 2012; 22(5):602-7. DOI: 10.1016/j.jse.2012.08.027. View

16.

Cools A, Struyf F, De Mey K, Maenhout A, Castelein B, Cagnie B . Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. Br J Sports Med. 2013; 48(8):692-7. DOI: 10.1136/bjsports-2013-092148. View

17.

Hall K, Borstad J . Posterior Shoulder Tightness: To Treat or Not to Treat?. J Orthop Sports Phys Ther. 2018; 48(3):133-136. DOI: 10.2519/jospt.2018.0605. View

18.

Greenhalgh T, Howick J, Maskrey N . Evidence based medicine: a movement in crisis?. BMJ. 2014; 348:g3725. PMC: 4056639. DOI: 10.1136/bmj.g3725. View

19.

Schwartz C, Croisier J, Bruls O, Denoel V, Forthomme B . Tight shoulders: A clinical, kinematic and strength comparison of symptomatic and asymptomatic male overhead athletes before and after stretching. Eur J Sport Sci. 2020; 21(5):781-791. DOI: 10.1080/17461391.2020.1785015. View

20.

Lo C, Hsueh Y, Wang C, Chang H . Comparison of the Acute Effects of Kinesio Taping and Sleeper Stretching on the Shoulder Rotation Range of Motion, Manual Muscle Strength, and Sub-Acromial Space in Pitchers with Glenohumeral Internal Rotation Deficit. Medicina (Kaunas). 2021; 57(2). PMC: 7912309. DOI: 10.3390/medicina57020102. View