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

NCT07229274 | Enrolling By Invitation DMC

• 1 other identifier: UBAS/ERB/FoRS/25/022
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 2

Brief Summary

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.

Conditions

Glenohumeral Internal Rotation Deficit (GIRD)

Keywords

Overhead Athletes; Internal Rotation; Kinetic Control; Sports Injury; Musculoskeletal Disorder

Outcome Measures

Primary Outcomes (3)

• Pain intensity

  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.

  baseline, 3 weeks and 6 weeks

• Shoulder Range of Motion

  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.

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

• Functional disability

  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.

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

Study Arms (2)

Movement control exercises with the concept of kinetic control and mobilization with movement

EXPERIMENTAL

Each person will follow this program three times a week. The session starts with a shoulder movement test to check how well the shoulder rotates-60 degrees inward and 45 degrees outward-without the shoulder blade or upper arm moving incorrectly. Next, movement retraining exercises are used to fix any incorrect shoulder movements. This includes helping the shoulder and shoulder blade move properly using hands-on support, along with exercises that may be supported or unsupported. Visual cues (like mirrors), touch, and manual guidance are used to teach correct movement. Lastly, Mobilization with Movement (MWM) is performed. This involves gently pushing the shoulder joint backward

Other: Kinetic control for shoulder internal rotation with mobilization with movement

Stretches, strengthening and mobilization with movement

ACTIVE COMPARATOR

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.

Other: stretches, strengthening and mobilization with movement

Interventions

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

Movement control exercises with the concept of kinetic control and mobilization with movement

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.

Stretches, strengthening and mobilization with movement

Eligibility Criteria

• Age: 18 Years - 45 Years
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences: lead

Study Sites (2)

Sehat Medical Complex

Lahore, Punjab Province, 54000, Pakistan

Location

Bata Sports Club

Lahore, Punjab Province, 54850, Pakistan

Location

MeSH Terms

Conditions

Athletic Injuries; Musculoskeletal Diseases

Interventions

Movement

Condition Hierarchy (Ancestors)

Wounds and Injuries

Intervention Hierarchy (Ancestors)

Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Hammad Haider, MS-MSK PT

  Lahore University of Biological and Applied Sciences

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr. Hammad Haider

Study Record Dates

• First Submitted: October 2, 2025
• First Posted: November 14, 2025
• Study Start: October 1, 2025
• Primary Completion: January 15, 2026
• Study Completion: February 25, 2026
• Last Updated: November 14, 2025

Record last verified: 2025-11

Locations

PA (2)