The effects of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit

Objective: We aimed to investigate the effect of isolytic and static stretching exercises in modified cross-body position on pain, shoulder range of motion (ROM), posterior shoulder tightness (PST), strength, acromio-humeral distance (AHD), supraspinatus tendon thickness and tendon occupation ratio, functionality and disability level in individuals having subacromial impingement syndrome (SIS) with glenohumeral internal rotation deficit (GIRD). Methods: Sixty-three participants having SIS with GIRD were randomly divided into three groups. All groups received standard physiotherapy for four weeks. In addition to standard physiotherapy, Isolytic Stretching Group (ISG) and Static Stretching Group (SSG) received isolytic and static stretching, respectively. Pain was asssessed with (Visual Analog Scale), shoulder ROM and PST with bubble inclinometer, strength with hand-held dynamometer, AHD, tendon thickness and occupation ratio with ultrasonographic imaging, functionality and disability level with Modified Constant-Murley Scale [MCMS], Quick Disability of the Arm-Shoulder-Hand Questionnaire [Q-DASH]). Results: Pain, ROM, PST, GIRD, strength, AHD, functionality and disability level improved in all groups after treatment (p<0.05). Activity pain, ROM, PST, GIRD, AHD and tendon occupation ratio improved more in stretching groups compared to controls (CG) (p<0.05). External rotation (ER) ROM, ER strength, MCMS, and Q-DASH scores improved more in ISG compared to CG. There was no significant difference between stretching groups (p>0.05). Conclusion: Isolytic or static stretching in modified cross-body position plus standart physiotherapy is superior to standart physiotherapy to improve activity pain, ROM, PST, GIRD, subacromial space in individuals having SIS with GIRD. Effects of stretchings are similar. Isolytic stretching plus standart physiotherapy improves ER ROM and strength, functionality and diability levels more compared to standart physiotherapy. Key words: Glenohumeral internal rotation deficit, subacromial impingement syndrome, isolytic stretching.