Effect of Joint Mobilization and Movement Control Exercises on Shoulder Pain and Function in Fast Bowlers (RCT)

The goal of this clinical trial is to determine combined effects of the Kinetic control for shoulder on pain, range, and function among fast bowlers. The main question it aims to answer is:

Does mulligan mobilization with movement along with kinetic medial rotation control work in decreasing pain, improving shoulder internal range of motion and shoulder function in fast bowlers with glenohumeral internal rotation deficit? Is the combination of Mulligan mobilization with movement along with kinetic control therapy effective in fast bowlers with glenohumeral internal rotation deficit? Treatment arm will receive movement retraining exercises to develop kinetic control with mulligan mobilization and comparison arm will receive standard physical therapy exercises with mulligan mobilization.

Treatment group will receive shoulder warm up exercises, movement retraining exercises and mulligan mobilization with movement.

Comparison group will receive shoulder warm up exercises, modified sleeper stretch, shoulder isometrics and mulligan mobilization with movement.

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Key information

Conditions

Glenohumeral Internal Rotation Deficit (GIRD) Athletic Injuries Musculoskeletal Diseases Wounds and Injuries

Age range

18 year–45 year

Sex eligibility

Male

Study type

Interventional

Phase

Not applicable

Primary location

Bata Sports Club, Lahore, Punjab Province, Pakistan

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Male cricketers aged 18-45 years.
Participants experiencing persistent mild to moderate shoulder pain during overhead movements for more than 3 months.
Fast bowlers actively participating in regular cricket training sessions.
Presence of Glenohumeral Internal Rotation Deficit (GIRD) greater than 10 degrees, measured with a goniometer by comparing internal rotation of the dominant and non-dominant shoulders.

Exclusion criteria

Cricketers who have undergone shoulder (e.g., rotator cuff repair, arthroscopic labrum repair) or elbow surgery within the past 3 months.
Participants presenting with numbness or tingling sensations in the upper extremity.
Individuals with comorbidities such as a history of cardiac or pulmonary diseases.
Subjects with a history of recurrent shoulder dislocations or shoulder instability.

Treatment and study plan

Kinetic control for shoulder internal rotation with mobilization with movement

Other

stretches and strengthening along with mobilization with movement is given to participants. stretches include sleeper stretch and isometrics in strengthening

stretches, strengthening and mobilization with movement

Other

Each person in the control group will do these exercises three times a week. The session starts with shoulder warm-up exercises like arm circles, shoulder rolls, and reaching overhead. These are done in 2 sets of 10 reps. Next is the modified sleeper stretch. This is repeated 3 times, with a 30-second rest between each stretch. Then, isometric shoulder exercises are done in standing. The person pushes their arm inward against resistance without actually moving it. Finally, Mobilization with Movement (MWM) is used.

Primary outcomes

Pain intensity

Time frame: baseline, 3 weeks and 6 weeks

Pain intensity will be evaluated using the Numeric Pain Rating Scale (NPRS) ranging from 0 to 10, where 0 indicates no pain, 1-3 represents mild pain, 4-6 indicates moderate pain, and 7-10 reflects severe pain.
Shoulder Range of Motion

Time frame: All outcomes will be recorded at baseline, after 3 weeks, and after 6 weeks of intervention.

Shoulder range of motion will be measured in all planes of movement using a universal goniometer. The movements will include:

Flexion (0-180°) Extension (0-60°) Abduction (0-180°) Adduction (0-40°) Internal Rotation (0-70°) External Rotation (0-90°) All measurements will be recorded in degrees to assess improvement in joint mobility across these planes.
Functional disability

Time frame: All outcomes will be recorded at baseline, after 3 weeks, and after 6 weeks of intervention.

Functional disability will be assessed using the Shoulder Pain and Disability Index (SPADI), which provides a percentage score ranging from 0 to 100%. A low score (0-29%) represents minimal disability, a moderate score (30-59%) indicates moderate disability, and a high score (60-100%) signifies severe functional limitation.

Sponsors and collaborators

Lead sponsor

Lahore University of Biological and Applied Sciences

Other

Registry information

Official study title

Combined Effects of Mulligan Mobilization With Movement and Kinetic Medial Rotation Control for Shoulder on Pain, Range of Motion, and Function Among Fast Bowlers

Acronym: RCT

Important dates

Study start: 2025
Primary completion: 2026
Study completion: 2026
First posted: Nov 14, 2025
Registry last updated: Nov 14, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed