Treatment of glenohumeral internal rotation deficit in the general population with shoulder pain: An open single-arm clinical trial

Abstract

Background: Maladaptation can provoke important alterations in the arthrokinematics such as an internal rotation reduction in the dominant shoulder compared with the nondominant shoulder known as glenohumeral internal rotation deficit (GIRD). Though the number of studies investigating GIRD in athletic population, there are not studies reporting the efficacy of the GIRD treatment in the nonathlete population, a kind of study required to improve our understanding of patient care with this pathology. This study aimed to describe the efficacy of the GIRD treatment in nonathlete population with shoulder pain. Methods: An open single-arm trial with 35 patients was adopted for evaluating the efficacy of GIRD treatment in patients with shoulder pain. All patients with shoulder pain who attended the consultation, accepted, and agreed to participate in the study between October 2020 and March 2021 were included. A treatment sequence including joint manual therapy techniques and soft tissue release techniques was applied in the consultation. Then, patients were instructed to adapt the daily active biological stimulus at home. The IR before (IR0) and after (IR1) the treatment was considered the outcome measure. The GIRD was calculated as the difference between the IR of the non-painful shoulder and the IR of the painful shoulder before (GIRD0) and after treatment (GIRD1). A paired Student t test was used to compare the GIRD of each patient before and after the treatment. Results: Treatment of the patients significantly increased the IR of the painful shoulder in all the patients (P-value < .0001) So, the mean IR0 was 26.09 ± 14.46º (23.64–28.53), and after the treatment the mean IR1 was 67.98 ± 15.03º (65.48–70.52). The mean difference after the treatment (IR1–IR0) was 41.89 ± 14.74º (39.4–44.39). The treatment also significantly reduced GIRD (P-value < .0001). So, the mean GIRD0 was 42.95 ± 16.26º (40.2–45.7), and after the treatment the mean GIRD1 was –1.05 ± 17.18º (–3.96 to 1.85). Conclusions: The treatment administrated in this study significantly increased the internal rotation of the treated and painful shoulder and reduced the GIRD from the first consultation. Level of evidence: Level 3.