Comparing Two Shoulder Treatments for Athletes (PCT-KM-PPS)

Comparative Effects of Kaltenborn Joint Mobilization (Posterior Glide) Versus Pragmatic Posterior Capsular Stretch on Pain, Limited ROM and Functional Disability in Athletes With Posterior Capsule Tightness

Many athletes who play overhead sports like cricket develop tightness in the back of the shoulder. This causes pain and makes it hard to lift the arm. This study will compare two common physical therapy treatments: Kaltenborn joint mobilization (a specific manual therapy glide) versus a Pragmatic Posterior Capsular Stretch (a specific stretching technique). We want to see which one works better for pain, range of motion, and daily function. 28 athletes will be treated for 4 weeks, and we will measure their progress using a goniometer and the SPADI questionnaire.

Study Overview

• Status: Not yet recruiting
• Conditions: Joint Diseases; Joint Range of Motion; Posterior Capsule Tightness
• Intervention / Treatment: Procedure: Pragmatic Capsular Stretch; Procedure: Kaltenborn Joint Mobilization

Detailed Description

This is a single-center, randomized controlled trial. Participants aged 22-40 years with a positive GIRD test (indicating posterior capsule tightness) will be recruited from pedal courts and clinics in Faisalabad. After obtaining informed consent, participants will be randomly assigned to one of two parallel groups using a random number generator.

Group A (Experimental): Receives Pragmatic Posterior Capsular Stretch. The participant lies side-lying. The therapist stabilizes the scapula and applies medial rotation, extension, and traction for 30 seconds, repeated to achieve 15 minutes total per session.

Group B (Active Comparator): Receives Kaltenborn Joint Mobilization (Posterior Glide). The participant is positioned with the shoulder abducted and externally rotated. The therapist applies a Grade III posterior glide with lateral distraction, sustained at end-range for 15 minutes.

Both groups receive 3 sessions per week for 4 weeks (12 sessions total). Outcome measures (Pain via SPADI, ROM via Goniometer, Function via SPADI) are taken at baseline and at the end of 4 weeks. Data will be analyzed using SPSS version 20 using independent t-tests or Mann-Whitney U tests depending on normality.

• Study Type: Interventional
• Enrollment (Estimated): 34
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Dr Muhammad Ateeb, PhD Public Health; Phone Number: +923357333383; Email: mateeb.oric@tuf.edu.pk
• Study Contact Backup: Name: Dr. Muhammad Muneeb Jafar, Doctor of Physical Therapy; Phone Number: +92 300 4561972; Email: muneebjafar.DPT@tuf.edu.pk

Study Locations

• Pakistan
  • Punjab Province
    • Faisalābad, Punjab Province, Pakistan, 3800
      • The University of Faisalabad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Male and female athletes
• Positive GIRD test
• Age 22-40 years
• Overhead throwing athletes (Cricketers)
• Able to provide informed consent

Exclusion Criteria:

• Fracture
• Recent shoulder injury (last 6 months)
• History of shoulder surgery
• Osteoarthritis
• Peripheral nerve injuries

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pragmatic Posterior Capsular Stretch; Participants in this arm receive the Pragmatic Posterior Capsular Stretch. The participant is positioned in a comfortable side-lying posture on the unaffected side. To achieve targeted stretching of the posterior shoulder tissues and to prevent compensatory movements, the therapist supports the scapula in a protracted position with one hand. The therapist uses the other hand to administer a combination of medial rotation, extension, and longitudinal traction at the glenohumeral joint. The leverage required to execute the maneuver successfully is provided by the semi-flexed elbow. To improve muscular relaxation and capsular stretch, the stretch is held for 30 seconds and followed by at least three deep breaths, each held in full inspiration for 8-10 seconds. This stretch is repeated multiple times to achieve a total treatment duration of 15 minutes per session. This intervention is performed 3 sessions per week for 4 weeks (total of 12 sessions).	Procedure: Pragmatic Capsular Stretch; Side-lying stretch combining medial rotation, extension, and traction. Held for 30 seconds with deep breathing, repeated for 15 minutes total per session, 3x/week for 4 weeks.
Active Comparator: Kaltenborn Joint Mobilization (Posterior Glide); Participants in this arm receive Kaltenborn Joint Mobilization (Posterior Glide). With the shoulder at the end range of abduction and external rotation, the participant is positioned for posterior mobilization in the starting posture. While performing the posterior stretch mobilization to the end range, a lateral humeral distraction is maintained in the midrange position. The shoulder is positioned in the final range of flexion and external rotation for advancement. While the posterior stretch mobilization is performed to the end range, a lateral humeral distraction remains in its intermediate position. For a minimum of one minute, the end-range position is maintained. This stretch is repeated until a total of fifteen minutes of sustained posterior mobilization are achieved per session. This intervention is performed 3 sessions per week for 4 weeks (total of 12 sessions).	Procedure: Kaltenborn Joint Mobilization; Kaltenborn Grade III sustained posterior glide with lateral distraction. Applied to the glenohumeral joint for 15 minutes per session, 3x/week for 4 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Pain	Measured using the Shoulder Pain and Disability Index (SPADI) - Pain subscale. Score range 0-100 (higher = more pain).	Baseline and Week 4
Change in Range of Motion	Measured using a universal goniometer. Specifically Glenohumeral Internal Rotation (GIR) and Horizontal Adduction (HA) range in degrees.	Baseline and Week 4

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Functional Disability	Measured using the Shoulder Pain and Disability Index (SPADI) - Disability subscale. Score range 0-100 (higher = more disability).	Baseline and Week 4

Collaborators and Investigators

• Sponsor: University of Faisalabad

Study record dates

Study Major Dates

• Study Start (Estimated): June 15, 2026
• Primary Completion (Estimated): August 19, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: June 4, 2026
• First Submitted That Met QC Criteria: June 4, 2026
• First Posted (Actual): June 10, 2026

Study Record Updates

• Last Update Posted (Actual): June 10, 2026
• Last Update Submitted That Met QC Criteria: June 4, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Athletes; GIRD; Kaltenborn Mobilization; Posterior Capsule Tightness; Pragmatic Stretch; Glenohumeral Joint; Atheletic over head shoulder restrictions
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Joint Diseases
• Other Study ID Numbers: TUF/EIRB/ 224 /26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No