The Acute Effects of Different Stretching Methods in Individuals With Subacromial Impingement Syndrome

The Acute Effects of Different Stretching Methods on Posterior Shoulder Tightness, Pain, Joint Range of Motion, Subacromial Space and Strength in Individuals Having Subacromial Impingement Syndrome With Glenohumeral Internal Rotation Deficit

The purpose of this study is to investigate and compare the acute effects of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit. Isolytic group will receive isolytic stretching in modified cross body position. Static group will receive static stretching in modified cross body position. Stretching groups will be evaluated before and just after stretching exercise. Control group will receive no stretching. Control group will be evaluated for the first time and then will be waited until the duration of the stretching exercise program. Afterwards, second evaluation will be performed

There is no information in literature about the acute effects of isolytic stretching exercise in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit. The purpose of this study is to investigate and compare the acute effects of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit.

In modified cross body position, static stretching group will perform active-assistive static stretching by the physiotherapist whereas isolytic stretching group will perform active-assistive isolytic stretching. Stretching exercises will be applied five times each for 15 seconds. After each stretching there will be a resting period for 5 seconds. Control group will receive no stretching. They will be handed a brochure about the stretching techniques and its role in injury prevention. Isolytic and static stretching groups will be evaluated before and just after stretching exercise. Control group will be evaluated for the first time and then will be passively waited until the duration of the stretching exercise program (approximately 4-5 min). Afterwards, second evaluation will be performed.

Inclusion Criteria:

• Diagnosis of subacromial impingement syndrome
• Glenohumeral internal rotation range of motion of the affected shoulder should be less than other shoulder and bilateral shoulder internal rotation range of motion difference should be ≥15 º
• Pain with resisted arm elevation or external rotation as well as a minimum of 3 of 5 positive subacromial impingement syndrome tests, painful arc, pain or weakness with resisted external rotation, Neer, Hawkins and Jobe tests .
• Ability to complete the entire study procedure

Exclusion Criteria:

• An inability to elevate the involved arm greater than 140 degree in the scapular plane
• A 50% limitation of passive shoulder range of motion in >2 planes of motion
• Pain >7/10
• A history of fracture to the shoulder girdle
• Systemic musculoskeletal disease
• History of shoulder surgery,
• Glenohumeral instability (positive apprehension, relocation or positive sulcus test) or positive findings for a full thickness rotator cuff tear (positive lag sign, positive drop arm test or marked weakness with shoulder external rotation)