The effects of sleeper stretch vs. crossbody stretch in overhead athletes with shoulder pain and glenohumeral internal rotation deficit: a randomized controlled trial

Glenohumeral internal rotation deficit (GIRD) has been associated to shoulder injuries in overhead athletes. The glenohumeral posterior capsule stretching techniques, such as the sleeper stretch and cross-body stretch, are used to improve range of motion (ROM) and reduce pain. However, there are no studies comparing these techniques in symptomatic overhead athletes with GIRD. This study aimed to compare the effects of sleeper stretch and cross-body stretch on shoulder pain and shoulder ROM in overhead athletes with GIRD and shoulder pain. This is a randomized, double-blind, controlled clinical trial. Overhead athletes aged 18 to 40 years who were actively engaged in their sport at a competitive level, with shoulder pain and GIRD were randomly allocated into 2 groups: the Cross-body Stretch Group (CBG), and the Sleeper Stretch Group (SSG). Both groups received interventions 3 times a week for four weeks. The primary outcomes were shoulder pain intensity and glenohumeral internal rotation range of motion. Secondary outcomes included affective response to interventions, adherence, and reported co-interventions. Thirty-five athletes participated in the study, with 17 allocated to the CBG and 18 to the SSG. No significant differences were observed between groups for shoulder pain and GIRD. SSG showed a decrease of -2.17 in pain intensity (95% CI = -3.13 to -1.21), while CBG reduced pain by -1.54 (95% CI = -2.53 to -0.55). Additionally, GIRD was attenuated in both treatment groups, with the SSG showing a reduction of -14.69 (95% CI = -19.48 to -9.89) and the CBG showing a reduction of -14.77 (95% CI = -19.70 to -9.84). The results of this study suggest that both the sleeper stretch and the cross-body stretch significantly reduced pain and improved glenohumeral internal rotation in overhead athletes with shoulder pain and GIRD after four weeks, with no significant difference between them. Affective responses, adherence, and the occurrence of co-interventions were similar, indicating good tolerance and safety of both techniques. These findings provide clinical support for the use of either strategy in the conservative management of these athletes. Future research should focus on the long-term effects and the investigation of multimodal treatment strategies. Both sleeper stretch and cross-body stretch showed similar effects in reducing pain and glenohumeral internal rotation deficit.