TOTAL ARC OF MOTION IN THE SIDELYING POSITION: EVIDENCE FOR A NEW METHOD TO ASSESS GLENOHUMERAL INTERNAL ROTATION DEFICIT IN OVERHEAD ATHLETES

Cort J Cieminski; Hugo Klaers; Shannon M Kelly; Michael R Stelzmiller; Tatia J Nawrocki; Alisse J Indrelie

TOTAL ARC OF MOTION IN THE SIDELYING POSITION: EVIDENCE FOR A NEW METHOD TO ASSESS GLENOHUMERAL INTERNAL ROTATION DEFICIT IN OVERHEAD ATHLETES

Int J Sports Phys Ther. 2015 Jun;10(3):319-31.

Authors

Cort J Cieminski¹, Hugo Klaers, Shannon M Kelly, Michael R Stelzmiller, Tatia J Nawrocki, Alisse J Indrelie

Affiliation

¹ Professor - St. Catherine University - Doctor of Physical Therapy Program, Minneapolis, MN, USA.

PMID: 26075147
PMCID: PMC4458919

Abstract

Background: Total arc of motion (TA) measured in a supine position has been utilized as a method to detect the presence of glenohumeral internal rotation deficit (GIRD) in overhead athletes. A component of supine TA is supine internal rotation (IR) range of motion (ROM), which has many variables including the amount and location of manual stabilization. A sidelying position for gathering IR ROM has recently been proposed and, when combined with supine external rotation (ER) ROM, constitutes a new method of quantifying TA. This new sidelying TA method, however, has no normative values for overhead athletes.

Purpose: The purposes of this study were to develop normative values for sidelying TA in overhead athletes, determine any ROM difference between supine and sidelying TA, and examine side-to-side differences within the two TA methods. A secondary purpose of the study was to examine for any effect of gender or level of competition on the two TA methods.

Study design: Cross-sectional study.

Methods: Passive supine IR ROM, supine ER ROM, and sidelying IR ROM were gathered on bilateral shoulders of 176 collegiate and recreational overhead athletes (122 male [21.4 ± 4.7 years, 71.7 ± 2.7 inches, 25.3 ± 2.7 BMI] and 54 female [21.4 ± 5.4 years, 67.6 ± 3.0 inches, 22.5 ± 2.37 BMI]).

Results: Sidelying TA mean for the dominant shoulder was 159.6 °±15.0 °; the non-dominant shoulder was 163.3 °±15.3 °. Sidelying TA for both shoulders (p < 0.0001) was 14 ° less than supine TA. Both TA methods exhibited a 4 ° dominant-shoulder deficit (p < 0.0001). For the dominant and non-dominant shoulder, respectively, there was no gender (p = 0.38, 0.54) or level of competition (p = 0.23, 0.39) effect on sidelying TA.

Conclusion: In overhead athletes, sidelying TA is a viable alternative to supine TA when examining for the presence of GIRD. Gender and level of competition does not significantly affect sidelying TA, so the mean of 160 ° on the dominant shoulder and 163 ° on the non-dominant shoulder can be used by clinicians.

Level of evidence: Level 3.

Keywords: Bubble inclinometer; range of motion; shoulder internal rotation; shoulder reliability; total arc of motion.