Effect of Joint Mobilization and Movement Control Exercises on Shoulder Pain and Function in Fast Bowlers (RCT)

Lahore University of Biological and Applied Sciences

Status: Invitation-only

Conditions: Glenohumeral Internal Rotation Deficit (GIRD)

Treatments: Other: Kinetic control for shoulder internal rotation with mobilization with movement; Other: stretches, strengthening and mobilization with movement

Study type: Interventional

Funder types: Other

Identifiers

NCT07229274

UBAS/ERB/FoRS/25/022

Details and patient eligibility

About

The goal of this clinical trial is to determine combined effects of the Kinetic control for shoulder on pain, range, and function among fast bowlers. The main question it aims to answer is:

Does mulligan mobilization with movement along with kinetic medial rotation control work in decreasing pain, improving shoulder internal range of motion and shoulder function in fast bowlers with glenohumeral internal rotation deficit? Is the combination of Mulligan mobilization with movement along with kinetic control therapy effective in fast bowlers with glenohumeral internal rotation deficit? Treatment arm will receive movement retraining exercises to develop kinetic control with mulligan mobilization and comparison arm will receive standard physical therapy exercises with mulligan mobilization.

Treatment group will receive shoulder warm up exercises, movement retraining exercises and mulligan mobilization with movement.

Comparison group will receive shoulder warm up exercises, modified sleeper stretch, shoulder isometrics and mulligan mobilization with movement.

Enrollment: 42 estimated patients

Sex: Male

Ages: 18 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Male cricketers aged 18-45 years.
• Participants experiencing persistent mild to moderate shoulder pain during overhead movements for more than 3 months.
• Fast bowlers actively participating in regular cricket training sessions.
• Presence of Glenohumeral Internal Rotation Deficit (GIRD) greater than 10 degrees, measured with a goniometer by comparing internal rotation of the dominant and non-dominant shoulders.

Exclusion Criteria

• Cricketers who have undergone shoulder (e.g., rotator cuff repair, arthroscopic labrum repair) or elbow surgery within the past 3 months.
• Participants presenting with numbness or tingling sensations in the upper extremity.
• Individuals with comorbidities such as a history of cardiac or pulmonary diseases.
• Subjects with a history of recurrent shoulder dislocations or shoulder instability.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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42 participants in 2 patient groups

Movement control exercises with the concept of kinetic control and mobilization with movement

Experimental group

Description:

Each person will follow this program three times a week. The session starts with a shoulder movement test to check how well the shoulder rotates-60 degrees inward and 45 degrees outward-without the shoulder blade or upper arm moving incorrectly. Next, movement retraining exercises are used to fix any incorrect shoulder movements. This includes helping the shoulder and shoulder blade move properly using hands-on support, along with exercises that may be supported or unsupported. Visual cues (like mirrors), touch, and manual guidance are used to teach correct movement. Lastly, Mobilization with Movement (MWM) is performed. This involves gently pushing the shoulder joint backward

Treatment:

Other: Kinetic control for shoulder internal rotation with mobilization with movement

Stretches, strengthening and mobilization with movement

Active Comparator group

Description:

Each person in the control group will do these exercises three times a week. The session starts with shoulder warm-up exercises like arm circles, shoulder rolls, and reaching overhead. These are done in 2 sets of 10 reps. Next is the modified sleeper stretch. This is repeated 3 times, with a 30-second rest between each stretch. Then, isometric shoulder exercises are done in standing. The person pushes their arm inward against resistance without actually moving it. Finally, Mobilization with Movement (MWM) is used.

Treatment:

Other: stretches, strengthening and mobilization with movement