Immediate Effects of Postero-lateral Glide V/S Static Stretching on Shoulder Dysfunction in Badminton Players – A Randomized Controlled Trial

INTRODUCTION-

The Maitland concept is a method for examining, diagnosing, and treating neuromusculoskeletal disorders with manipulative physical therapy. [1] The cyclical alterations will be made in the joint’s modest spinning, gliding, and other supplementary motions between joints, such as rolling or distracting movements. In order to move around normally, surfaces are necessary. [2] In contrast to grade 3 and4, grade 1 and 2 of Maitland mobilization techniques are generally utilized to treat joints that are painfully constrained stretching technique.

Static Stretching is a commonly used method of stretching in which soft tissues are elongated just beyond the point of tissue resistance and then held in the lengthened position with a sustained stretch over a period of time. The duration of static stretch can be predetermined prior to stretching or be based on the patient’s tolerance and response during stretch. [3]

 Badminton is a sport that requires a lot of over-shoulder motion, with the shoulder in abduction, internal and external rotation. [4]. Due to extreme ranges of motion and high arm velocities occurring during overhead shots, the glenohumeral joint is subjected to various amounts of force. Repetitions of these activities leads to structural adaptations which can lead to decrease in ROM and pain.

 Kinematic analysis of badminton power strokes was the major focus, and results contradicted that found in the badminton literature, including manuals of sports governing bodies. An estimation of the joint contributions made to the velocity of the shuttle in the badminton smash attributed 53% of the final output to shoulder rotation and radio-ulnar pronation. [5]

 Several studies have aimed to quantify the contributions of specific joint movements and rotations to a badminton smash. The majority of the findings indicate that shoulder internal rotation makes the largest contribution (up to 66%) to shuttlecock velocity or racquet head speed in a badminton smash. [6]

This study aims to find the effects of using Maitland mobilization in the form of Postero-lateral glide to increase the ROM of the glenohumeral joint.

NEED FOR STUDY-

 The glenohumeral joint is considered as one of the most mobile joints in human body and due to its high mobility, the chances of impingements, subluxations, dislocations also increase. Especially if the muscles surrounding the shoulder joint are overused and extensively stretched regularly. This may start with decrease in ROM but can lead to impingement of valuable structures.

 Researchers have implicated posterior shoulder tightness (PST) as a potential cause of muscular dysfunction, superior labral anterior to posterior lesions, subacromial impingement, and pathological internal impingement. [7]  However, to know whether impingement led to loss of ROM or loss of ROM led to impingement is difficult to determine.

 The purpose of this study is to find the effects of using Maitland mobilization in form of Postero-lateral glide for shoulder abductors, external and internal rotators on Range of Motion.

AIM-

 Â·       To compare the effects of Postero-lateral glide and Static Stretching on ROM of Shoulder joint in Badminton players.

 OBJECTIVE-

 Â·       To find the prevalence of Shoulder tightness in badminton players.

·       To find the effects of Postero-lateral glide on ROM of Shoulder joint in Badminton players.

·       To find effect of Static Stretching on ROM of Shoulder joint in Badminton players.

 RESEARCH QUESTION-

 Is there any difference in effects of Posterolateral glide and Static Stretching on Shoulder tightness in Badminton players?

HYPOTHESIS-

 Â·       Null Hypothesis [H0]-

 There is no difference in effects of Postero-lateral glide and Static Stretching on Shoulder tightness in Badminton players.

 Â·       Alternate Hypothesis [H1]-

 There is difference in effects of Postero-lateral glide and Static Stretching on Shoulder tightness in Badminton players.

    REVIEW OF LITERATURE-

 1. A study conducted by Mouleeswari.B, and Kumar.S, Senthil and Kameswaran; Comparison of Effectiveness of Maitland Mobilization and Muscle Energy Technique in Patients with Periarthritis Shoulder Using SPADI and NPRS;2024. This study resulted in significant improvement from pre-treatment levels in pain and ROM in Maitland mobilization group compared to muscle energy group. Hence the study concludes that there is a more significant increase in ROM and SPADI score, and a significant decrease in pain on NPRS by Maitland mobilization as compared with Muscle energy technique. [8]

2. The study conducted by Antonio Cejudo; Risk Factors for, and Prediction of, Shoulder Pain in Young Badminton Players: A Prospective Cohort Study; 2022.  This study has shown that based on the fact that Shoulder pain is multifactorial, several modifiable risk factors have been proposed in addition to limited rotation ROM, such as asymmetric ROM, rotational strength imbalance, weakness of the external rotators, altered scapular kinematics or load changes depending on the technical gesture.                                                                           Also, the young badminton players who had a shoulder internal rotation ROM of 55° or less have a higher risk of Shoulder pain one year later.  [9]

3. Another study
conducted by **Pardiwala,
D. N., Subbiah, K., Rao, N., & Modi, R.; Badminton Injuries in Elite
Athletes: A Review of Epidemiology and Biomechanics; 2020**. This showed that skilled players reached significantly higher angular
velocities of glenohumeral external rotation, forearm supination and wrist
extension in the backhand stroke, compared to less-skilled players, but there
was no such difference in the forehand stroke. [10]

 4. Another study conducted by Agus Rusdiana, Herman Subarjah ; Effect of Fatigue on Biomechanical Variable Changes in Overhead Badminton Jump Smash ; 2020 showed that several factors lead to a decrease in shuttlecock speed during jump smash with a reduction in body segment rotation. These include the shoulder internal angular velocity, elbow extension, forearm supination, and wrist dorsiflexion at the instant of maximal shoulder external rotation phase. The series of movement patterns associated with the overhead jump smash requires both linear and angular velocity and acceleration of the body movement, shuttlecock, and racket swing. A few studies explain the mechanism of action related to the forehand overhead stroke technique, especially in the jumping smash. [11]While analyzing the contribution of the upper body joints’ angular velocity in a tennis serve, stated that a maximum shoulder external rotation is a first moment used to produce a higher speed of its internal rotation. Therefore, this enables the acquisition of a higher ball velocity. [12] Same way in badminton to achieve greater force maximum amount of external rotation is needed for greater internal rotation of shoulder for jump smash.

MATERIALS & METHODOLOGY-

 1. Sample Size- This study will enroll a total of 30 participants.

 2. Participants- The participants will be selected from Mumbai and Loni.

 3. Sampling Method- Random Sampling

 4. Study Design- Comparative

 5. Selection Criteria-

 5.1. Inclusion Criteria-

 (1) Participants who regularly play badminton for minimum 1 month.

(2) Participants with shoulder abductor, internal and external rotator tightness.

(3) Participants willing to participate in this study.

(4) Participants within age group of 18-35.

 5.1. Exclusion Criteria-

 (1) Participants with fractures to upper extremity or ribs.

(2) Participants with known ligament laxity.

(3) Participants with any recent spinal trauma or surgery.

(4) Participants under steroid therapy.

  6. Outcome Measures-

6.1. SPADI

6.2. NPRS

6.3. Goniometer.

  7. Procedure-

 The participants will be divided into two groups, of 15 participants each according to random sampling method.

 Group A (n=15) will receive Poster-lateral glide for shoulder abductors, external and internal rotators and Group B (n=15) will receive static stretching protocol for the same muscle group as warm up exercise.

 Both Pre and Post intervention Range of Motion will be measured and then compared.

References

[1]

D. J. Y. F. K. S. C. Kazmi SA, "mparative study on the efficacy of Maitland technique (GradeIV) and mulligan technique, in the treatment of frozen shoulder.," Pakistan Journal of Rehabilitation, vol. 2(1), no. 10-4, 2013.

|[2]

N. GG., "The effects of passive joint mobilizationon pain and hypomobility associated with adhesivecapsulitis of the shoulder.," Journal of Orthopaedic &Sports Physical Therapy. , vol. 6, no. 4, pp. 238-46, 1985;Feb.

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L. A. C. J. B. Carolyn Kisner, Therapeutic Exercise- Foundations and Techniques, Jaypee.

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M. Y. J. S. A. H. &. S. K. Fahlström, "“Shoulder pain -- a common problem in world-class badminton players.”," Candinavian journal of medicine & science in sports, vol. 16, 2006.

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D. B. W. a. B. A. Gowitzke, "BIOMECHANICAL PRINCIPLES APPLIED TO BADMINTON POWER STROKES," International Symposium on Biomechanics in Sports, vol. 18, 2000.

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R. F. P. M.-N. S. T. H. &. K. M. Miller, "Optimum performance in the badminton jump smash," 2020.

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M. L. B. R. L. &. L. K. G. Reed, "ACUTE EFFECTS OF MUSCLE ENERGY TECHNIQUE AND JOINT MOBILIZATION ON SHOULDER TIGHTNESS IN YOUTH THROWING ATHLETES: A RANDOMIZED CONTROLLED TRIAL," International journal of sports physical therapy, vol. 13, pp. 1024-1031, 2018.

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a. K. S. a. K. R. a. S. P. a. A. J. Mouleeswari.B, "Comparison of Effectiveness of Maitland Mobilization and Muscle Energy Technique in Patients with Periarthritis Shoulder Using SPADI and NPRS," Indian Journal of Physiotherapy and Occupational therapy- an International Journal, vol. 18, pp. 629-634, 2024.

|[9]

A. Cejudo, "Risk Factors for, and Prediction of, Shoulder Pain in Young Badminton Players: A Prospective Cohort Study," International journal of environmental research and public health, 2022.

|[10]

D. N. S. K. R. N. &. M. R. Pardiwala, "Badminton Injuries in Elite Athletes: A Review of Epidemiology and Biomechanics," A Review of Epidemiology and Biomechanics. Indian journal of orthopaedics, pp. 237-245, 2020.

|[11]

H. S. I. Y. K. M. S. T. K. A. Rusdiana, "Effect of Fatigue on Biomechanical Variable Changes in Overhead Badminton Jump Smash," Annals of Applied Sport Sciences, 2020.

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B. C. S. M. G. W, "A competition analysis of the single and double disciplines in world-class badminton," International Journal of Performance Analysis in Sports, Vols. 15,no.3, pp. 997-1006, 2017.