Combined Upper Cervical Mobilization and Shoulder Strengthening in Overhead Athletes with Cervical Hypermobility
Cervical Exercises in Athletes with Hypermobility
Keywords:
Athletes, Pain, Range of motion, ShoulderAbstract
Background: Throwing performance among athletes is significantly affected coupled with increased risk of injury in the presence of scapular dyskinesia. The condition is prevalent among 50% of athletes involving in overhead movements. The present study is aimed to determine the effects of combined upper cervical mobilization and shoulder strengthening in overhead athletes throwing performance and scapular movement experiencing upper cervical hypermobility.
Methods: A randomized controlled trial was conducted at Aftab Physiotherapy and Medical Centre and Rawal Institute of Health Sciences, between June 2024 and August 2025. A sample size of n=24 athletes were recruited. The outcome measures were assessed at baseline, week 6 and week 12. Assessment was based on shoulder active range of motion, scapular dyskinesia test, throwing performance and disability of the arm, shoulder and hand (DASH) questionnaire.
Results: Twenty participants completed all assessments (10 per group). At 12 weeks, the experimental group demonstrated significantly greater improvements compared to the control group in shoulder flexion (178.90±4.52° vs. 172.30±5.28°, p=0.005), abduction (176.40±5.18° vs. 170.80±5.89°, p=0.028), and external rotation (94.70±4.28° vs. 89.50±4.76°, p=0.015). Normal scapular movement patterns were achieved in 60% of experimental group participants compared to only 30% in the control group (p=0.041).
Conclusion: Combining upper cervical mobilizations with shoulder strengthening exercises produced significantly superior improvements in shoulder range of motion, throwing performance, scapular movement quality, and upper extremity function compared to shoulder strengthening alone in overhead athletes with scapular dyskinesis and upper cervical hypermobility.
https://doi.org/10.59564/amrj/04.01/006
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