Various techniques for stretching the posterior shoulder capsule have been incorporated into rehabilitation and injury prevention programs for overhead athletes. The Cross-body Stretch and Sleeper Stretch techniques are discussed in literature with the aim of relieving pain and increasing internal rotation (IR) range of motion. However, there are still no studies comparing the effects of these stretches on overhead athletes with pain and glenohumeral movement limitations.

To compare two techniques for stretching the posterior capsule in terms of pain relief and glenohumeral range of motion in overhead athletes.

This is a randomized, controlled clinical trial with two parallel arms. The sample consisted of competitive-level overhead athletes who exhibited a minimum difference of 20° in IR limitation compared to the non-dominant side and reported pain during daily or sports activities of at least 2/10 on the Numeric Visual Scale (NVS). Participants underwent the following steps: (a) eligibility screening; (b) outcome assessment (pain, IR range of motion) by blind evaluators; and (c) intervention. All participants were evaluated twice during the study (baseline and after four weeks). After evaluation and randomization (1:1), participants were allocated to either the Cross-body Stretch group (GCB) or the Sleeper Stretch group (GSS). The exercises were performed three times a week, in 5 sets of 30 seconds each, with a 30-second rest between sets, for 4 weeks. The first session was conducted in person, with a demonstration of the technique and provision of an illustrated guide. Subsequent sessions were self-administered and remotely supervised.

Thirty-five participants were included in the study (GSS = 18; GCB = 17). After 4 weeks of intervention, both stretches promoted pain reduction (GSS: MD = -2.17 points; 95% CI = -3.13 to -1.21; GCB: MD = -1.54 points; 95% CI = -2.53 to -0.55), but there was no difference between the groups (MD = 0.14; 95% CI = -1.21 to 1.48). The IR deficit was reduced in both groups. The GSS showed a reduction of -14.69° (95% CI = -19.48 to -9.89), and the GCB showed a reduction of -14.77° (95% CI = -19.70 to -9.84). There was no significant difference between the groups (MD = 3.08°; 95% CI = -1.74 to 7.89).

For competitive-level overhead athletes with IR deficit and shoulder pain, both the sleeper stretch and the cross-body stretch are effective in improving pain and mobility after four weeks of intervention, with no superiority between the techniques.

In addition to improving the established outcomes, no athlete experienced adverse effects from the techniques throughout the protocols. Therefore, both can be appropriate strategies for reducing pain and improving glenohumeral mobility in overhead athletes.