EFFICACY OF POSTERIOR CAPSULE STRETCHING AND ECCENTRIC LOADING ON FUNCTIONAL KINEMATICS AND SERVE VELOCITY IN ADOLESCENT VOLLEYBALL ATHLETES WITH GIRD: A RANDOMIZED CONTROLLED TRIAL
DOI:
https://doi.org/10.21009/jor.v5i2.69063Keywords:
posterior capsule, eccentric load, functional kinematics, serve speed, volleyball athletes, GIRDAbstract
Background. Glenohumeral Internal Rotation Deficit (GIRD) is a significant limitation to athletic performance. Newer research findings suggest that the incidence of Glenohumeral Internal Rotation Deficit (GIRD) amongst young volleyball players stands at around 37.5% (Mine et al., 2024; Wilcox et al., 2021). Objectives. To this end, the current study investigates a novel rehabilitation protocol comprising posterior capsule stretching in association with eccentric strengthening. Method. Twenty-four adolescent athletes were randomly assigned to an experimental (EG) or a control group (CG; n = 12 per group) in a single-blind experimental design. In the experiment group, there was an 8-week targeted stretching protocol together with eccentric training for the external rotator muscles. Results. Statistical analyses indicated that the experimental group significantly outperformed control on each post-test measure (p< 0.001; 95% CI), with large effect sizes Cohen's d > 0.8). Conclusion. The experimental group experienced significant changes in internal rotation range of motion, functional strength and spike serve speed. Combining eccentric loading with targeted stretching appears effective for restoring shoulder kinematic symmetry and performance parameters in young athletes.
References
Cools, A. M., Struyf, F., Mey, K. D., Maenhout, A., Castelein, B., & Cagnie, B. (2014). Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. British Journal of Sports Medicine, 48(8), 692-697. https://doi.org/10.1136/bjsports-2013-092148
Cools, A. M., Johansson, F. R., Cagnie, B., Cambier, D., & Witvrouw, E. (2012). Stretching the posterior shoulder structures in subjects with internal rotation deficit: comparison of two stretching techniques. Shoulder & Elbow, 4(1), 56-63. https://doi.org/10.1111/j.1758-5740.2011.00159.x
Cools, A. M., et al. (2024). The challenge of the sporting shoulder: From injury prevention through sport-specific rehabilitation. International Journal of Sports Physical Therapy, 19(4), 394–409. https://doi.org/10.26603/001c.95040
Cust, E. E., et al. (2020). Validity and Reliability of Smartphone-Kinovea Method for jump and speed analysis. Journal of Biomechanics, 111333. https://doi.org/10.1016/j.jbiomech.2022.111333
Clarsen, B., Bahr, R., Andersson, S. H., et al. (2014). Reduced glenohumeral rotation, external rotation and its relation to shoulder injury in volleyball players. British Journal of Sports Medicine, 58, 204-211. https://doi.org/10.1136/bjsports-2013-092425
Ellenbecker, T. S., & Cools, A. (2010). Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review. British Journal of Sports Medicine, 44(5), 319-327. https://doi.org/10.1136/bjsm.2009.058875
Escamilla, R. F., Yamashiro, K., Paulos, L., & Andrews, J. R. (2009). Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Medicine, 39(8), 663-685. https://doi.org/10.2165/00007256-200939080-00004
Guney, H., Harput, G., Colakoglu, F., & Baltaci, G. (2016). The Effect of Glenohumeral Internal-Rotation Deficit on Functional Rotator-Strength Ratio in Adolescent Overhead Athletes. Journal of Sport Rehabilitation, 25(1), 52-57. https://doi.org/10.1123/jsr.2014-0260
Howard, K. J., Galloy, A. E., Schmitz, D. G., & Frisch, K. E. (2023). Ball-to-hand contact forces increase modeled shoulder torques during a volleyball spike. Journal of Sports Science & Medicine, 22(3), 488-495. https://doi.org/10.52082/jssm.2023.488
Kirsch, J. M., Kay, J., Bakshi, N., et al. (2020). Clinical Outcomes and Quality of Literature Addressing Glenohumeral Internal Rotation Deficit. Clinics in Shoulder and Elbow, 27(4), 505-513. https://doi.org/10.5397/cise.2023.00885
Laudner, K. G., Sipes, R. C., & Wilson, J. T. (2008). The acute effects of sleeper stretch on shoulder range of motion. Journal of Athletic Training, 43(4), 359-363. https://doi.org/10.4085/1062-6050-43.4.359
Kruse, A., Schranz, C., Tilp, M., & Svehlik, M. (2023). Prediction of Rotator Cuff Muscle Fibre Orientations Using Magnetic Resonance Images. Scandinavian Journal of Medicine & Science in Sports, 30, 2205–2214. https://doi.org/10.1111/sms.13780
Manske, R. C., Wilk, K. E., Davies, G., Ellenbecker, T., & Reinold, M. (2013). Glenohumeral motion deficits: friend or foe?. International Journal of Sports Physical Therapy, 8(5), 537-553. PMC3811728
Mine, K., Nakayama, T., Milanese, S., & Grimmer, K. (2024). Efficacy of Stretching Interventions for Overhead Athletes. Applied Sciences, 14(16), 7166. https://doi.org/10.3390/app14167166
Mohsin, S. J. (2024). The Impact of a Rehabilitation Program Using Mental Training on the Recovery of Partial Tear Ligament Injuries of the Shoulder Joint in Wrestlers. Journal of Studies and Researches of Sport Education, 34(4), 101-114. https://doi.org/10.55998/jsrse.v34i4.760
Navarro-Ledesma, S., Fernandez-Sanchez, M., Struyf, F., & Luque-Suarez, A. (2023). Efficacy of Conservative Therapy in Overhead Athletes with Glenohumeral Internal Rotation Deficit: A Systematic Review. Journal of Clinical Medicine, 12(1), 4. https://doi.org/10.3390/jcm12010004
Reinold, M. M., Escamilla, R. F., & Wilk, K. E. (2009). Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. Journal of Orthopaedic & Sports Physical Therapy, 39(2), 105-117. https://doi.org/10.2519/jospt.2009.2835
Türksan, H. E., & Yesilyaprak, S. S. (2023). Effectiveness of Modified Posterior Shoulder Stretching Exercises in Posterior Shoulder Tightness and GIRD. Türk Fizyoterapi Ve Rehabilitasyon Dergisi, 34(2), 256-272. https://doi.org/10.21653/tjpr.1009683
Vicente-Pina, A., et al. (2025). Concurrent Validity and Reliability of 2D Kinovea System for Kinematics Assessment. Sensors, 25(1), 250. https://doi.org/10.3390/s25010250
Wang, Y., et al. (2025). Comparative analysis of anatomical and pathological glenohumeral internal rotation deficit among volleyball players: a cross-sectional study. BMC Musculoskeletal Disorders, 26, 112. https://doi.org/10.1016/j.jse.2014.01.006
Manske, R. C., & Prohaska, D. (2021). Rehabilitation following medial patellofemoral ligament reconstruction and shoulder tracking. Current Reviews in Musculoskeletal Medicine, 14(6), 321-327. https://doi.org/10.1007/s12178-021-09719-2
Watson, L., Hoy, G., Wood, T., et al. (2023). Posterior Shoulder Instability in Tennis and Overhead Players: Aetiology, Classification, Assessment and Management. International Journal of Sports Physical Therapy, 18(3), 769-788. https://doi.org/10.26603/001c.75371
Wilcox, C. L., Plummer, H. A., & Ostrander, R. V. (2021). Comparison of Glenohumeral Range of Motion Deficits in Youth, Collegiate, and Professional Baseball Players. International Journal of Sports Physical Therapy, 16(6), 1485-1491. https://doi.org/10.26603/001c.29683
Wilk, K. E., Arrigo, C. G., & Andrews, J. R. (2002). Current concepts in the rehabilitation of the overhead throwing athlete. The American Journal of Sports Medicine, 30(1), 136-151. https://doi.org/10.1177/03635465020300011201
Wu, D., Wen, Z., Ke, H., et al. (2025). Specific modes of exercise to improve rotator cuff-related shoulder pain: systematic review and meta-analysis. Frontiers in Bioengineering and Biotechnology, 13, 1560597. https://doi.org/10.3389/fbioe.2025.1560597
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Samer Jaafar Mohsin, Ali Hussien Mnade
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
