Role of stretching interventions in enhancing the shoulder range of motion in overhead athletes with glenohumeral internal rotation deficit: A systematic review and meta-analysis

Objective: Sleeper stretching (SS) and cross-body stretching (CS) are common nonsurgical interventions for the management of glenohumeral internal rotation deficit (GIRD) in overhead athletes such as baseball and volleyball players. However, the effectiveness of these stretching interventions in enhancing the range of motion (ROM) of shoulder internal rotation (IR) in overhead athletes with GIRD remains a subject of uncertainty. This systematic review and meta-analysis aim to critically assess the efficacy of SS and CS in the ROM of the IR among overhead athletes with GIRD, thereby providing evidence-based recommendations for their use. Literature Survey: A comprehensive search of MEDLINE, Embase, and Scopus databases up to November 2024 was conducted to identify randomized controlled trials investigating the influence of SS and CS on the ROM of shoulder IR in overhead athletes with GIRD. Methodology: Data including study characteristics and outcomes were extracted. Risk of bias assessment and random-effects model meta-analysis were performed. Synthesis: Six eligible studies involving 255 athletes with GIRD were included. The meta-analysis demonstrated statistically significant differences between stretching and control groups in terms of enhancing the ROM of IR (mean difference [MD], 7°; 95% confidence interval [CI], 1°–13°; p =.02) and horizontal adduction (HAD) ([MD], 6°; [CI], 1°–11°; p =.03). Conclusion: SS or combination of SS and CS interventions significantly enhanced the ROM of IR compared to the control group in overhead athletes diagnosed with GIRD. Furthermore, the review confirmed that SS alone also markedly enhances the ROM of HAD. These findings highlight the potential benefits of SS and CS in managing GIRD and suggest a need for further research to optimize these interventions for broader application in overhead athletes.