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Koya Mine, Takashi Nakayama, Steve Milanese and Karen Grimmer


Posterior shoulder tightness (PST) and glenohumeral internal-rotation deficit (GIRD) can contribute to shoulder pain suffered by athletes engaged in overhead sporting activities. Stretching is a common intervention to resolve PST and GIRD, but it has weak evidence of effectiveness to date.


This systematic review aimed to collect and synthesize effectiveness data from English- and Japanese-language randomized controlled trials (RCTs) investigating stretching interventions for PST and GIRD.

Evidence Acquisition:

7 English databases and 3 Japanese databases were searched from inception until December 5, 2015. Only English- and Japanese-language RCTs were considered. Risk of bias in the included studies was assessed using the Physiotherapy Evidence Database scale. Data were synthesized qualitatively.

Evidence Synthesis:

Eight English-language and 2 Japanese-language papers of low to high quality were included. There was moderate evidence for positive immediate and short-term effects of cross-body stretch on PST and GIRD in asymptomatic young subjects. Moderate evidence was found to suggest that active sleeper stretch might not be more effective than no intervention to improve PST and GIRD in the short term.


Cross-body stretch can be effective to improve PST and GIRD in asymptomatic young subjects immediately or in the short term. Further study with methodological rigor is necessary to investigate the long-term effectiveness of stretching interventions on PST and GIRD in symptomatic patients.

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Michelle A. Sandrey

ROM and decrease posterior shoulder tightness. Two stretches that have been used in the past is the sleeper stretch and horizontal adduction stretch (also known as the cross-body stretch), with and without scapular stabilization. 1 – 3 By concentrating on a stabilization of the scapula, the posterior

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Elizabeth E. Hibberd, Sakiko Oyama, Jeffrey T. Spang, William Prentice and Joseph B. Myers


Shoulder injuries are common in swimmers because of the demands of the sport. Muscle imbalances frequently exist due to the biomechanics of the sport, which predispose swimmers to injury. To date, an effective shoulder-injury-prevention program for competitive swimmers has not been established.


To assess the effectiveness of a 6-wk strengthening and stretching intervention program on improving glenohumeral and scapular muscle strength and scapular kinematics in collegiate swimmers.


Randomized control trial.


University biomechanics research laboratory.


Forty-four Division I collegiate swimmers.


The intervention program was completed 3 times per week for 6 wk. The program included strengthening exercises completed using resistance tubing—scapular retraction (Ts), scapular retraction with upward rotation (Ys), scapular retraction with downward rotation (Ws), shoulder flexion, low rows, throwing acceleration and deceleration, scapular punches, shoulder internal rotation at 90° abduction, and external rotation at 90° abduction—and 2 stretching exercises: corner stretch and sleeper stretch.

Main Outcome Measurements:

Scapular kinematics and glenohumeral and scapular muscle strength assessed preintervention and postintervention.


There were no significant between-groups differences in strength variables at pre/post tests, although shoulder-extension and internal-rotation strength significantly increased in all subjects regardless of group assignment. Scapular kinematic data revealed increased scapular internal rotation, protraction, and elevation in all subjects at posttesting but no significant effect of group on the individual kinematic variables.


The current strengthening and stretching program was not effective in altering strength and scapular kinematic variables but may serve as a framework for future programs. Adding more stretching exercises, eliminating exercises that overlap with weight-room training and swim training, and timing of implementation may yield a more beneficial program for collegiate swimmers.

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Federico Jose Villalba and Melina Soledad Martínez

. Rev Bras Ortop . 2015 ; 50 ( 4 ): 472 – 477 . PubMed ID: 26401506 doi:10.1016/j.rbo.2014.07.013 10.1016/j.rbo.2014.07.013 25. Reuther KE , Larsen R , Kuhn PD , Kelly JD , Thomas SJ . Sleeper stretch accelerates recovery of glenohumeral internal rotation after pitching . J Shoulder

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Smokey Fermin, Lindsay Larkins, Sarah Beene and David Wetzel

3 sets of 30-second holds of a trunk twist and 3 sets of 30-second holds of an arm raise to a self-reported “good side”; compared to results measured after completing a traditional baseball-specific warm up (eg, lunges, power skips, sprints, sleeper stretch). 4 weeks of strength-training maximal

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Matthew J. Hussey, Alex E. Boron-Magulick, Tamara C. Valovich McLeod and Cailee E. Welch Bacon

stabilized by examiner, and the second examiner measured ROM with digital inclinometer. Internal rotation, external rotation, and horizontal adduction were measured passively. Patients in the self-stretch group performed the sleeper stretch and the cross-body adduction stretch. Each stretch was performed for

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Julien Le Gal, Mickael Begon, Benoit Gillet and Isabelle Rogowski

dominant glenohumeral joint. Stretching exercises are commonly recommended to restore glenohumeral mobility. 10 A recent meta-analysis, however, highlights that there is little to moderate evidence on the effectiveness of the cross-body stretch and sleeper stretch exercises, performed alone or in

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Brett S. Pexa, Eric D. Ryan, Elizabeth E. Hibberd, Elizabeth Teel, Terri Jo Rucinski and Joseph B. Myers

22179981 10.1007/s11999-011-2217-z 9. Reuther KE , Larsen R , Kuhn PD , Kelly JDT , Thomas SJ . Sleeper stretch accelerates recovery of glenohumeral internal rotation after pitching . J Shoulder Elbow Surg . 2016 ; 25 ( 12 ): 1925 – 1929 . PubMed ID: 27745803 doi:10.1016/j.jse.2016