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Articles by M. P. McHugh
Total Records ( 2 ) for M. P. McHugh
  J Tallent , B Greene , C. D Johnson and M. P. McHugh

The aim of the study was to examine whether increased neural tension during passive hamstring stretching contributes to stretch-induced strength loss. Eleven healthy subjects performed maximal isometric knee flexion contractions (100°, 80°, 60° and 20°) before and after a series of hamstring stretches (six 1-min stretches), performed in either a spinal neutral position or a neural tension position. Effect of stretch technique (neutral or neural tension) on passive resistance to stretch, strength-induced strength loss and electromyography activity during strength tests was assessed with repeated measures analysis of variance. Passive resistance to stretch was reduced by 19% after the series of stretches (p=0.001) with no difference between neutral or neural tension stretches (p=0.41). Stretch-induced strength loss was greater (p=0.043) after the neural tension stretches (13%) vs the neutral stretches (5%). There was an apparent rightward shift in the length tension curve after neutral stretches with a 15% strength loss at muscle lengths shorter than optimum, and a 10% gain in strength at muscle lengths longer than optimum (p<0.001). This effect was not apparent after neural tension stretches where strength loss was 21% at muscle lengths shorter than optimum and 9% at muscle lengths longer than optimum. The addition of neural tension to hamstring stretching increased stretch-induced strength loss but this was not associated with observable neural inhibition. The absence of a rightward shift in the length-tension curve after neural tension stretching indicates that muscle fibre shortening during isometric contractions was unaffected, presumably because tendon-aponeurosis compliance was not increased.

  T. F Tyler , S. J Nicholas , S. J Lee , M Mullaney and M. P. McHugh

Glenohumeral internal rotation deficit (GIRD) and posterior shoulder tightness have been linked to internal impingement.


To determine if improvements in GIRD and/or decreased posterior shoulder tightness are associated with a resolution of symptoms.

Study Design

Cohort study; Level of evidence, 3.


Passive internal rotation and external rotation (ER) range of motion (ROM) at 90° of shoulder abduction and posterior shoulder tightness (cross-chest adduction in side lying) were assessed in 22 patients with internal impingement (11 men, 11 women; age 41 ± 13 years). Treatment involved stretching and mobilization of the posterior shoulder. The Simple Shoulder Test (SST) was administered on initial evaluation and discharge. Changes in GIRD, ER ROM, and posterior shoulder tightness were compared between patients with complete resolution of symptoms versus patients with residual symptoms using independent t tests.


Patients had significant GIRD (35°), loss of ER ROM (23°), and posterior shoulder tightness (35°) on initial evaluation (all P < .01). Physical therapy (7 ± 2 weeks; range, 3–12 weeks) improved GIRD (26° ± 14°; P < .01), ER ROM loss (14° ± 20°), and posterior shoulder tightness (27° ±19°). The SST improved from 5 ± 3 to 11 ± 1 (P < .01). A greater improvement in posterior shoulder tightness was seen in patients with complete resolution of symptoms (n = 12) compared with patients with residual symptoms (35° vs 18°; P < .05). Improvements in GIRD and ER ROM loss were not different between groups (GIRD, 25° vs 28°, P = .57; ER ROM, 14° vs 15°, P = .84).


Resolution of symptoms after physical therapy treatment for internal impingement was related to correction of posterior shoulder tightness but not correction of GIRD.

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