To determine the clinical relevance of the effects that Massage-Therapy (MT) and Abdominal-Hypopressive-Gymnastics (AHG) and the combination of both procedures have on the disability, pain intensit...

Background: To evaluate the effectiveness of conservative therapy in range of movement (ROM), strength, pain, subacromial space and physical function, in overhead athletes with glenohumeral internal rotation deficit (GIRD). Methods: A systematic review and meta-analysis was designed, and the protocol was registered in PROSPERO (CRD42021281559). The databases searched were: PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, Web of Science and SCOPUS. Randomized controlled trials (RCTs) involving conservative therapy applied in overhead athletes with GIRD were included. Two independent assessors evaluated the quality of the studies with the PEDro scale, and with the Cochrane Risk-of-Bias tool. The overall quality of the evidence was assessed using GRADE. Data on outcomes of interest were extracted by a researcher using RevMan 5.4 software. Estimates were presented as standardized mean differences (SMD) with 95% confidence intervals (CIs). Results: A total of eleven studies involving 514 overhead athletes were included in the systematic review; of these 8 were included in the meta-analysis. The methodological quality of the included RCTs ranged from high to low. Conservative therapy showed significant improvements in internal rotation, adduction, physical function and subacromial space. Conclusions: Conservative therapy based on stretch, passive joint and muscular mobilizations can be useful to improve the internal rotation and adduction ROM, subacromial space, and physical function of the shoulder in overhead athletes with glenohumeral internal rotation deficit.

Background: The aim of this study was to determine whether the elite handball (HB) athletes with glenohumeral internal rotation deficit (GIRD) present differences in the mechanical properties in the teres major muscle, and strength and extensibility of the posterior shoulder tissues of the throwing shoulder (TS) compared to the non-throwing (non-TS) and non-HB athletes. Methods: A cross-sectional study was carried out, with sixty male participants: 30 HB athletes with GIRD and 30 age-matched healthy non-HB athletes. Mechanical properties of the teres major muscle were measured with MyotonPRO; also, extensibility of the posterior shoulder tissues and maximum isometric internal rotation (IR) and external rotation (ER) strength were recorded. Results: The teres major muscle of the TS in the HB group achieved a higher tone (Δ 0.34; 95% CI: 0.15, 0.53) and stiffness (Δ 30.86; 95% CI: 23.04,38.68), and a lower relaxation time compared to the non-TS of the same group (Δ −0.69; 95% CI: −1.15, −0.24;) and to the TS of the control group for the tone (Δ 0.36; 95% CI: 0.02, 0.70) and for the stiffness (Δ 27.03; 95% CI: 15.24, 38.83). The extensibility of the TS of the HB group presented a statistically significant decrease compared to the control group (Δ −7.83; 95% CI: −12.42, 3.23). A between-groups ER/IR ratio imbalance was found for the TS (Δ −12.18; 95% CI: −25.59, −1.23) and the non-TS (Δ −13.01; 95% CI: −25.79, −0.25). Conclusions: HB athletes with GIRD present a higher tone and stiffness of the teres major muscle and lack of extensibility of the tissues of the posterior part of the shoulder compared to the non-TS and to healthy non-HB athletes.