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Focused Clinical Question: Does a passive stretching protocol, whether immediate or long-term, improve range of motion and decrease posterior shoulder tightness in overhead athletes? Clinical Bottom Line: There is moderate level 2 evidence to support the incorporation of passive stretching for overhead athletes to increase range of motion or decrease posterior shoulder tightness.

Abstract: Postural distortions in the upper limb are prevalent and change the anatomical alignment, which alters force couples and the biomechanics of the body. Forward head posture (FHP) and rounded shoulder posture (RSP) are the two that are most prevalent. Measurement techniques using the craniovertebral angle for FHP and forward shoulder angle for RSP have been used both clinically and in the literature. However, what is not known is what specific criteria can be consistently used to define FHP and RSP as reference angles lack vigorous validity and there is a shortage of quantity, quality, and consistency of the evidence. Thus, there is much to be learned about postural classifications and the effect on the kinetic chain, supporting the need for further research in this area. As it is important to classify those who may need exercise and therapeutic intervention, following evidence-informed practice to inform decision-making clinicians should continue to evaluate posture, as well as examine scapular kinematics and muscle activity and the effects of interventions to improve posture. Therefore, determining whether FHP and RSP are present is paramount for the treatment to be successful.

Introduction/Clinical Scenario : As many hamstring injuries occur when the hamstrings are in a lengthened state during the deceleration phase of running when the muscle is eccentrically contracting to slow the body down this functional aspect needs to be addressed. Thus, a rehabilitation program with a focus on progressive targeted eccentric hamstring exercises by gradually placing and exposing the muscle to eccentric force in a lengthened state supplemented with progressive running drills should be evaluated. Focused Clinical Question : Does the inclusion of a complementary running progression program for the rehabilitation of an acute hamstring injury reduce the time to safe return to sport with less hamstring reinjury occurrence for an athletic population? Summary of Key Findings: Three studies assessed the inclusion of a progressive running program with several types of running progression parameters addressed. Progressive running drills will load the hamstring in a functional manner, with a gradual increase in velocity of movement and lengthening of the muscle. Clinical Bottom Line : It appears that a complementary progressive running program within an acute hamstring rehabilitation program should be included as it caused no further harm and does not tend to increase hamstring reinjury occurrence. Strength of Recommendation : There is grade B evidence to include a complementary running progression program within an acute hamstring rehabilitation program.