Effects of acute static stretching and dynamic warm-up protocols on shoulder function in male athletes with shoulder impingement syndrome: A randomized controlled crossover trial
Authors
Mohammad Alghosi 1,2, Maryam Abduljabbar Khudhair 3, Mohammed Sadique K 4,5, Fereshteh Ejlali 6, Mojtaba Iranmanesh 7, Mohammad Alimoradi 7,8, Nicola Relph 9, Ali Shamsi Majelan 2.
1 Department of Physical Education, Technical and Vocational University (TVU), Tehran, Iran.
2 Department of Sports Injury and Corrective Exercise, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran.
3 College of Physical Education and Sports Sciences for Girls, University of Baghdad, Baghdad, Iraq.
4 Department of Physical Education and Sports, Pondicherry University, Puducherry, India.
5 Department of Physical Education, Muhammed Abdurahiman Memorial Orphanage College, Mukkam, Kerala, India.
6 Department of Physical Education and Exercise Science, Islamic Azad University, Central Tehran Branch (Velayat Campus), Tehran, Iran.
7 Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University of Kerman, Kerman, Iran.
8 HERC – Health, Exercise & Research Center, Mina Rashid, Dubai Maritime City, Dubai, United Arab Emirates.
9 Faculty of Health, Social Work and Medicine, Edge Hill University, Ormskirk, Lancashire, UK.
Phase
The Project
Abstract
Background:
Shoulder impingement syndrome (SIS) is common among overhead athletes. Static stretching (SS) and dynamic warm-up (DW) are widely used, but their acute effects on comprehensive shoulder function in athletes with SIS are not fully understood. This study compared the acute effects of SS, DW, and a combined protocol (SS+DW) on range of motion (ROM), stability, proprioception, and strength in male athletes with SIS and healthy controls.
Methods:
In this randomized controlled crossover trial, 25 male athletes with SIS and 25 healthy controls performed SS, DW, and SS+DW protocols in a randomized order. Outcomes included shoulder internal rotation (IR) and external rotation (ER) ROM, Y-Balance Test (YBT) performance, joint position sense (JPS) accuracy, and isokinetic strength, measured at baseline, immediately post-intervention, and at 15-minute follow-up. Data were analyzed using mixed-design ANOVA.
Results:
All protocols improved internal (IR) and external (ER) rotation range of motion (ROM), with SS providing the greatest gains for the SIS group (IR +4.4°, d=1.25; ER +3.4°, d=1.02). For the SIS group, DW produced the largest improvements in Y-Balance Test performance (+7.4 cm, d=1.09) and enhanced joint position sense accuracy (reducing error by –3.8°, d=6.66). In contrast, SS increased proprioceptive error in SIS athletes (+1.2°, d=2.91). Isokinetic strength assessment for the SIS group revealed that SS reduced eccentric IR strength at 60°/s (–2.5 Nm, d=0.69) and concentric ER strength at 120°/s (–0.7 Nm, d=0.14), while DW improved eccentric IR strength at 60°/s (+0.9 Nm, d=0.21), concentric IR at 120°/s (+0.7 Nm, d=0.14), and concentric ER at 120°/s (+0.9 Nm, d=0.33). The combined protocol generally yielded intermediate results with minimal effect sizes (d=0.02-0.17).
Conclusions:
The findings indicate that while all warm-ups improve ROM and stability, DW offers the most comprehensive benefits for athletes with SIS by enhancing proprioception and strength without the performance inhibition associated with SS. Dynamic warm-up is recommended for pre-activity routines when neuromuscular readiness is critical.