Comparison of the Acute Effects of Different Warm-up Protocols in Overhead Athletes With Posterior Shoulder Tightness

Passive range of motion (PROM) testing includes shoulder internal rotation, external rotation, and horizontal adduction.

For shoulder internal and external rotation, the subject lies supine on a treatment table with the shoulder abducted to 90° and the elbow flexed to 90°. One examiner stabilizes the humeral head while passively moving the arm, and another examiner measures the range using a goniometer.

For shoulder horizontal adduction, the subject lies supine with the shoulder flexed to 90°, the elbow flexed to 90°, and the shoulder internally rotated. One examiner stabilizes the scapula while passively moving the arm, and another examiner measures the range using a goniometer.

(unit of measure : degree)

Active range of motion (AROM) testing includes shoulder internal rotation, external rotation, and horizontal adduction.

For shoulder internal and external rotation, the subject lies supine on a treatment table with the shoulder abducted to 90° and the elbow flexed to 90°. One examiner stabilizes the humeral head while the subject actively performs the movement, and another examiner measures the range using a goniometer.

For shoulder horizontal adduction, the subject lies supine with the shoulder flexed to 90°, the elbow flexed to 90°, and the shoulder internally rotated. One examiner stabilizes the scapula while the subject actively performs the movement, and another examiner measures the range using a goniometer.

(unit of measure : degree)

The stiffness of the posterior shoulder muscles is assessed using a myotonometer (Myoton-Pro, Myoton AS, Tallinn, Estonia) to measure the infraspinatus and posterior deltoid.

During the test, the subject exposes the shoulder area and lies in a prone position. A towel is placed under the front of the shoulder to ensure relaxation.

For the infraspinatus, the measurement is taken two finger-widths below the midpoint of the scapular spine. For the posterior deltoid, the measurement is taken two finger-widths from the inferior edge of the acromion. Each muscle is tested five times, and the average value is recorded.

(unit of measure : Newton metre)

Shoulder internal and external rotation strength is assessed with the subject lying supine on a treatment table, with the shoulder abducted to 90° and the elbow flexed to 90°.

The subject is instructed to perform a maximal isometric contraction of internal or external rotation for 3 seconds at the highest speed and force possible. One examiner stabilizes the humeral head, while a handheld dynamometer (Kinvent, Montpellier, France) attached to a handle is used for measurement.

The test is performed three times, with a 30-second rest between trials, and the average value is recorded.

(unit of measure : kilogram and Kilogram Per Second)

Before performing the Y Balance Test upper quarter (Move2Perform, Evansville, IN, USA), the subject removes shoes and socks and assumes a push-up position with feet shoulder-width apart.

The starting position is set with the dominant hand placed on the platform, aligning the adducted thumb with the red line.

The test involves reaching in three directions-lateral, diagonal-up, and diagonal-down-using the non-dominant hand while returning to the starting position after each reach. Each direction is tested three times, and the average value is recorded.

(unit of measure : centimetre)

The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) measures upper limb dynamic stability and plyometric ability.

To ensure accuracy, the distance from C7 to the tip of the middle finger is measured to determine hand placement.

During the test, the subject assumes a push-up position with feet together and alternately touches the opposite hand as many times as possible within 15 seconds. The test is performed twice, with a 45-second rest between trials, and the average value is recorded.

(unit of measure : times)

The Posterior Shoulder Endurance Test assesses the fatigue resistance of posterior shoulder muscles.

Before testing, a standardized dumbbell weight is determined as 2% of the subject's body weight, rounded to the nearest value.

The subject lies prone at the edge of a treatment table with the head turned toward the testing side and the arm hanging naturally.

Following a 60 Hz rhythm, the subject repeatedly lifts the arm sideways (shoulder external rotation, 90° horizontal abduction, and full elbow extension) until unable to continue or compensatory movements occur.

(unit of measure : times)