Modified wall-stretching exercises: A practical strategy to promote an immediate effect of shoulder flexibility

Main Article Content

Gresilia Tambing
Sugalya Amatachaya
Arpassanan Wiyanad
Thiwabhorn Thaweewannakij
Nuttaset Manimmanakorn
Wilairat Namwong

Abstract

Background: The decreased flexibility could attribute numerous adverse impacts to daily functions and risk of joint injury, especially in the joint with a large range of motion (ROM), such as that of the shoulder. Current management to increase shoulder flexibility mostly face the problems of regular adherence due to the need for expert guidance and the requirement of specific and numerous poses that are difficult to remember and time-consuming.


Objective: To investigate the immediate effects of the modified wall-stretching exercise on shoulder flexibility using a quasi-experimental design. Moreover, the study explored the proportion of arms (dominant and non-dominant) with limited shoulder flexibility.


Materials and methods: Fifty-six participants (38 females, 68%) with limited shoulder flexibility as determined using the back scratch test performed a modified wall-stretching exercise. The method required the participants to place their hands against the wall at the shoulder levels with elbow and wrist extensions while the hands were in three positions: upward, sideward, and downward. Participants moved the upper trunk downward and held at the maximal stretch position for 15 seconds in each hand position. After a sufficient rest period, participants were re-assessed for their shoulder flexibility using the back scratch test. The paired samples t-tests were used to analyze the study findings.


Results: Most participants had limited shoulder flexibility in both arms (N=35, 63%), especially in the non-dominant arm (60%). Immediately after 45 seconds of a modified wall-stretching exercise, participants significantly improved their shoulder flexibility by approximately 3 cm (p<0.001).


Conclusion: The limited shoulder flexibility, particularly on the non-dominant arm, suggests that a sedentary lifestyle, characterized by spending the most time in a flexed posture using social media, may have contributed to reduced muscle strength, particularly in the non-dominant arm when performing overhead activities. The present findings suggest using a modified wall-stretching exercise as an alternative practical, self-administering, and effective method to promote shoulder flexibility that can be applied easily in various settings.

Article Details

How to Cite
Tambing, G., Amatachaya, S., Wiyanad, A., Thaweewannakij, T., Manimmanakorn, N., & Namwong, W. (2025). Modified wall-stretching exercises: A practical strategy to promote an immediate effect of shoulder flexibility. Journal of Associated Medical Sciences, 58(2), 179–185. retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/270308
Section
Research Articles

References

Pate R, Oria M, Pillsbury L, Fitness measures and health outcomes in youth [e-book]. Washington (DC): National Academies Press (US); 2012 [cited 2024 Mar 12]. Available from://www.nap.edu/catalog/13483/. doi: 10.17226/13483.

Bouguezzi R, Sammoud S, Markov A, Negra Y, Chaabene H. Why Flexibility Deserves to Be Further Considered as a Standard Component of Physical Fitness: A Narrative Review of Existing Insights from Static Stretching Study Interventions. Youth. 2023; 3(1): 146-56. doi: 10.3390/youth3010010.

Hopper D, Deacon S, Das S, Jain A, Riddell D, Hall T, et al. Dynamic soft tissue mobilisation increases hamstring flexibility in healthy male subjects. Br J Sports Med. 2005; 39(9): 594-8. doi: 10.1136/ bjsm.2004.011981.

Gasibat Q, Bin Simbak N, Abd Aziz A. Stretching Exercises to Prevent Work-related Musculoskeletal Disorders – A Review Article. Am J Sport Sci Med. 2017; 5(2): 27-37. doi: 10.12691/ajssm-5-2-3.

Nuzzo JL. The Case for Retiring Flexibility as a Major Component of Physical Fitness. Sport Med. 2020; 50(5): 853-70. doi: 10.1007/s40279-019-01248-w.

Lugo R, Kung P, Ma CB. Shoulder biomechanics. Eur J Radiol. 2008; 68(1): 16-24. doi: 10.1016/j.ejrad. 2008.02.051.

Prall J, Ross M. The management of work-related musculoskeletal injuries in an occupational health setting: The role of the physical therapist. J Exerc Rehabil. 2019; 15(2): 193-9. doi: 10.12965/jer.18366 36.318.

De Oliveira Medeiros HB, De Araújo DSMS, De Araújo CGS. Age-related mobility loss is joint-specific: An analysis from 6,000 Flexitest results. Age (Omaha). 2013; 35(6): 2399-407.

Weerapong P, Hume PA, Kolt GS. Stretching: Mechanisms and Benefits for Sport Performance and Injury Prevention. Phys Ther Rev. 2004; 9(4): 189-206. doi: 10.1179/108331904225007078.

Afonso J, Moscão J, Rocha T, Zacca R, Martins A, Milheiro A, et al. Strength training is as effective as stretching or improving range of motion: A systematic review and meta-analysis. Healthcare (Basel). 2021; 9(4): 427. doi:10.3390/healthcare9040427.

Kang MH, Oh JS. Effects of self-stretching with mobilization on shoulder range of motion in individuals with glenohumeral internal rotation deficits: a randomized controlled trial. J Shoulder Elb Surg. 2020; 29(1): 36-43. doi: 10.1016/j.jse.2019.08.007.

Bryant J, Cooper DJ, Peters DM, Cook MD. The Effects of Static Stretching Intensity on Range of Motion and Strength: A Systematic Review. J Funct Morphol Kinesiol. 2023; 8(2): 1-16. doi: 10.3390/jfmk8020037.

Turgut E, Duzgun I, Baltaci G. Stretching exercises for subacromial impingement syndrome: Effects of 6-Week program on shoulder tightness, pain, and disability status. J Sport Rehabil. 2018; 27(2): 132-7. doi: 10.1123/jsr.2016-0182.

Gharisia O, Lohman E, Daher N, Eldridge A, Shallan A, Jaber H. Effect of a novel stretching technique on shoulder range of motion in overhead athletes with glenohumeral internal rotation deficits: a randomized controlled trial. BMC Musculoskelet Disord. 2021; 22(1): 1-10. doi: 10.1186/s12891-021-04292-8.

Konrad A, Stafilidis S, Tilp M. Effects of acute static, ballistic, and PNF stretching exercise on the muscle and tendon tissue properties. Scand J Med Sci Sport. 2017; 27(10): 1070-80. doi: 10.1111/sms.12725.

Behm DG, Chaouachi A. A review of the acute effects of static and dynamic stretching on performance. Eur J Appl Physiol. 2011; 111(11): 2633-51. doi: 10.1007/ s00421-011-1879-2.

Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: A systematic review. Appl Physiol Nutr Metab. 2015; 41(1): 1-11. doi: 10.1139/apnm-2015-0235.

Behm DG, Alizadeh S, Daneshjoo A, Anvar SH, Graham A, Zahiri A, et al. Acute effects of various stretching techniques on range of motion: A systematic review with meta-analysis. Sport Med - Open [Internet]. 2023; 9(1): 107 doi.org/10.1186/s40798-023-00652-x.

Busch AM, Browstein J, Ulm R. Comparison of the effects of static-stretching and tubing exercises on acute shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther. 2021; 16(1): 207-15. doi: 10.26603/001c.18862.

Knudson D. The biomechanics of stretching the biomechanics of stretching. J Exerc Sci Physiother [Internet]. 2006; 2: 3-12.

Vetter S, Schleichardt A, Köhler HP, Witt M. The effects of eccentric strength training on flexibility and strength in healthy samples and laboratory settings: A systematic review. Front Physiol. 2022; 13: 1-13. doi: 10.3389/fphys.2022.873370.

Stecco C, Pirri C, Fede C, Yucesoy CA, De Caro R, Stecco A. Fascial or muscle stretching? A narrative review. Appl Sci. 2021; 11(1): 1-11. doi: 10.3390/ app11010307.

Olenich S, Waterworth G, Badger GJ, Levy B, Israel E, Langevin HM. Flexibility and strength training in asthma: A pilot study. J Asthma. 2018; 55(12): 1376- 83. doi: 10.1080/02770903.2017.1414236.

Jeevannavar JS, Jalamsingh PS, Misalankar N, Rajesh KP. Variability in flexibility of dominant and nondominant shoulder joints among healthy young adults. Indian J Physiother Occup Ther - An Int J. 2022; 16(4): 112-6. doi: 10.37506/ijpot.v16i4.18716.

Bhattacharya PK, Deka K, Roy A. Assessment of interrater variability of the Senior Fitness Test in the geriatric population: A community based study. Int J Biomed Adv Res. 2016; 7(5): 208-12. doi: 10.7439/ijbar.

Rikli RE, Jones CJ. Development and validation of a functional fitness test for community-residing older adults. J Aging Phys Act. 1999; 7(2): 129-61. doi: 10.1123/ japa.7.2.129.

Cote JN, Hoeger Bement MK. Update on the relation between pain and movement: Consequences for clinical practice. Clin J Pain. 2010; 26(9): 754-62.

Valencia Mora M, Ibán MÁR, Heredia JD, GutiérrezGómez JC, Diaz RR, Aramberri M, et al. Physical Exam and Evaluation of the Unstable Shoulder. Open Orthop J. 2017; 11(1): 946-56. doi: 10.2174/187 4325001711010946.

MF, Fodale M, Capasso L, Cazzato G, Milano G. Generalized joint laxity and multidirectional instability of the shoulder. Joints. 2013; 1(4): 171-9. doi: 10.11138/ jts/2013.1.4.171.

Ozaras N, Cidem M, Demir S, Suyabatmaz O, Solak O, Esenyel M. Shoulder pain and functional consequences: Does it differ when it is at dominant side or not? J Back Musculoskelet Rehabil. 2009; 22(4): 223-5. doi: 10.3233/BMR-2009-0240.

Oldfield RC. The assessment and analysis of handedness. Neuropsychologia. 1971; 9(1): 97-113. doi: 10.1016/0028-3932(71)90067-4.

Veale JF. Edinburgh Handedness Inventory - Short Form: A revised version based on confirmatory factor analysis. Laterality Asymmetries Body, Brain Cogn. 2014; 19(2): 164-77. doi: 10.1080/1357650X. 2013.783045.

Thomas E, Bianco A, Paoli A, Palma A. The relation between stretching typology and stretching duration: The effects on range of motion. Int J Sports Med. 2018; 39(4): 243-54. doi: 10.1055/s-0044-101146.

Kokkonen J, Nelson AG, Eldredge C, Winchester JB. Chronic static stretching improves exercise performance. Med Sci Sports Exerc. 2007; 39(10): 1825-31. doi: 10.1249/mss.0b013e3181238a2b.

Kang F-J, Lin K-Y. Observing the effect of physical activity on forward head posture and rounded shoulder posture in young healthy adults. J Phys Ther Sci. 2023; 35(8): 564-7. doi: 10.1589/jpts.35.564.

Ranjani M, Muthukumaran J, Suganya P. Prevalence of flexibility among college students. Int J Creat Res Thoughts. 2018; 6(2): 439-46

Bryant J, Cooper DJ, Peters DM, Cook MD. The effects of static stretching intensity on range of motion and strength: A systematic review. J Funct Morphol Kinesiol. 2023; 8(2). 2-16

Page P. Current concepts in muscle stretching for exercise and rehabilitation. Int J Sports Phys Ther. 2012; 7(1): 109-19.

Stanziano DC, Roos BA, Perry AC, Lai S, Signorile JF. The effects of an active-assisted stretching program on functional performance in elderly persons: A pilot study. Clin Interv Aging. 2015; 4(1): 115-20. doi: 10.2147/cia.s4152.

Choi M-J, Sohng K-Y. The Effects of floor-seated exercise program on physical fitness, depression, and sleep in older adults: A cluster randomized controlled trial. Int J Gerontol. 2018; 12(2): 116-21. doi: 10.1016/j. ijge.2017.06.003.