Effectiveness of Scapular Stabilization Versus Non-Stabilization Stretching on Shoulder Range of Motion, a Randomized Clinical Trial

BACKGROUND: Previous research has demonstrated the benefits of both stabilization and non-stabilization of the scapula during stretching in individuals with posterior shoulder tightness, but limited evidence exists in patients with shoulder pain. HYPOTHESIS/PURPOSE: The aim of this study was to determine the effect of stabilized scapular stretching on patients with shoulder pain. The primary hypothesis of this study is that stabilized scapular stretching will improve glenohumeral motion and pain compared to non-stabilized stretch program. A secondary hypothesis of this study is that stabilized scapular stretching will produce greater improvement in function compared to the non-stabilized stretching program. STUDY DESIGN: Randomized Clinical Trial METHODS: Sixteen patients with sub-acromial pain associated with tendinopathy and associated pathologies presenting to physical therapy were randomized into two groups (stabilized or non-stabilized scapular stretching). Baseline pain and range of motion were measured prior to and following each treatment session for three visits that occurred over the course five to seventeen days depending on the patients availability. The dependent measurements were stabilized horizontal adduction, stabilized internal rotation, stabilized shoulder flexion, non-stabilized shoulder flexion, and current pain level. RESULTS: Patients in the scapular stabilization stretching group increased horizontal adduction 40° (CI(95) 31, 48°) compared to the non-stabilization stretching group increase of 8° (CI(95) 0, 17°) over the course of the three treatments (p<0.001). Similarly, the stabilized stretching group increased internal rotation 48° (CI(95) 26, 69°) compared to the non-stabilized stretching group increase of 26° (CI(95) 4, 48°) (p=0.001). Pain decreased in the stabilized stretching group by 1.4 points (CI(95) -0.4, 3.2) but increased slightly in non-stabilized group by -0.5 points (CI(95) -2.3, 1.3) which was not a clinically meaningful change. (p=0.03) CONCLUSION: Stabilized scapular stretching was more effective than non-stabilized stretching at gaining shoulder mobility in patients with shoulder pain. Benefits were immediate and sustained between treatment sessions. Stretching interventions improved range of motion but had limited effect on shoulder pain. LEVEL OF EVIDENCE: 2