Effectiveness of Theraband-Based Throwing Exercise in Volleyball Players with Symptomatic Glenohumeral Internal Rotation Deficit: A Randomized Control Trial

Abstract Background: Glenohumeral internal rotation deficit (GIRD) is prevalent in overhead athletes, particularly volleyball players, contributing to shoulder pain and functional limitation during throwing activities. Theraband-based throwing exercises have demonstrated potential for rotator cuff retraining, yet their efficacy in symptomatic athletes requires rigorous evaluation. Objectives: This randomized controlled trial evaluated the effectiveness of an 8-week Theraband based throwing exercise program versus conventional active exercise on shoulder internal rotation range of motion (ROM), pain, and functional outcomes in collegiate male volleyball players with symptomatic GIRD. Methods: Fifteen symptomatic male collegiate volleyball players with GIRD (≥29° internal rotation deficit) were randomly allocated to Theraband throwing exercise group (n=8) or conventional control group (n=7). The Theraband group received supervised 8-week protocol comprising 5 sessions stretching and 3 sessions eccentric strengthening exercises weekly. Primary outcome measures included shoulder internal rotation ROM (goniometric measurement), pain (Visual Analog Scale, VAS), and functional status (Kerlan-Jobe Orthopedic Clinic Score, KJOC). Secondary measures included assessment during functional throwing tasks (spiking, serving). Assessments were conducted at baseline and post-intervention. Repeated measures ANOVA and independent t-tests were used for statistical analysis (p<0.05). Results: Theraband group demonstrated significant improvements in internal rotation ROM (23.4°±2.1° to 31.7°±1.8°, p<0.001), pain reduction (6.2±0.9 to 2.1±0.6 on VAS, p<0.001), and functional recovery (KJOC 58.3±7.2 to 82.4±6.1, p<0.001). Control group showed minimal changes (IR ROM: 24.1°±2.3 to 26.3°±2.5, p=0.089; VAS: 5.8±1.1 to 4.7±0.8, p=0.034; KJOC: 60.1±6.8 to 67.3±7.4, p=0.042). Intergroup differences were statistically significant (p<0.001 for all measures). By week 8, 7 of 8 (87.5%) Theraband participants reported return to pain-free throwing; 4 of 7 (57.1%) controls demonstrated functional improvement. Conclusion: Theraband-based throwing exercise program is highly effective for managing symptomatic GIRD in collegiate volleyball players, producing superior improvements in shoulder ROM, pain reduction, and functional restoration compared to conventional active exercise. Structured Theraband protocols warrant incorporation into volleyball player conditioning and injury prevention programs.