Scraping the surface: A systematic review of instrument-assisted soft-tissue mobilization vs passive stretching for throwers' shoulders.

OBJECTIVE

This systematic review aimed to compare the effectiveness of instrument-assisted soft-tissue mobilization (IASTM) and passive stretching in improving shoulder range of motion (ROM) in throwing athletes. The primary question addressed whether IASTM improves shoulder motion more effectively than passive stretching. Secondary questions included the effects of treatment duration and differences across throwing sports.

METHODS

A comprehensive search was conducted following PRISMA guidelines. Randomized controlled trials and comparative observational studies comparing IASTM to passive stretching in throwing athletes were included. Studies that did not measure shoulder ROM or involve throwing athletes were excluded. Data quality was assessed using the Physiotherapy Evidence Database (PEDro) scale and Cochrane Risk of Bias (RoB) tool. Reviewer agreement was excellent (κ = 0.8966).

RESULTS

Of 121 studies identified, four met the inclusion criteria. Two studies by Bailey et al. (2015 & 2017) were combined due to overlapping subjects. All studies reported significant improvements in shoulder ROM, including internal rotation, cross-body adduction, and total arc ROM, with IASTM showing superior results compared to passive stretching.

CONCLUSIONS

IASTM may be more effective than passive stretching for improving shoulder ROM deficits in throwing athletes. Further research with larger sample sizes, standardized protocols, and long-term follow-up is needed to confirm these findings.