Lack of internal range of motion or more commonly know in our industry as the “GIRD” is prevalent in sports that involve an overhead motion. Pitchers, tennis players, quarterbacks, swimmers are all susceptible to this.
The result is usually decreased range of internal motion after a hard session of throwing or serving.
Now there are many factors that can lead up to internal range of motion deficits but the most important factors to consider are Total motion of the Glenhumeral joint on both sides. Total motion= ER+IR.
In order to determine whether a client has a deficit in shoulder internal range of motion you would need to compare the measurements of both shoulders. Here’s where it gets fun. According to Myers et.al there is a range of GIRD and 19.7 degrees is the threshold you don’t want to cross. Ideally you want to be in the 12-17 degree range.
As far as total motion is concerned if there it should be similar on both sides and if there is a loss of total motion on the throwing side you are increasing the likelihood of injuring your shoulder.
Now here’s the real scary thing regarding treatment. I have had a few of my clients come in with shoulder issues who have seen a PT prior and there are PT”s out there who do not distinguish between internal and external range of motion and in my opinion do a terrible job in rehabbing the injury based on a poor diagnosis. Just doingand using electric stim will not get the job done. Make sure your therapist uses soft tissue modalities in addition to manual stretching. If he/she doesn’t the bottom line is that you need to go to a qualified PT or Sports Chiro who knows what the heck they are doing to get you better.
Enough of the ranting.
Here are my 3 favorite exercises to improve shoulder internal range of motion.
1. The cross body stretch.
I learned this from Mike Reinold from the Optimal Shoulder Performance dvd and has become my favorite internal stretch to use
Its a gentle stretch that increases internal range of motion after only 4-5 passes.
2.The sleeper stretch. For those who don’t have the luxury to have therapist or strength coach perform the cross body stretch this is the self help alternative. Some people like this stretch while others avoid it. The key is to make sure that you stabilize the shoulder-blade and be careful not to torque the shoulder. You should use 5% pressure when pulling down into the stretch. Make sure you don’t feel any pain in the anterior shoulder capsule. Below is a picture of Eric Cressey performing the sleeper stretch.
You can do the cross body version as well but again, make sure that you don’t torque your shoulder into internal rotation.
We like to use the Rotater for the sleeper stretch as it helps to keep the humerus relaxed and it works well for our third stretch.
3. The sleeper stretch may not work for everyone and some people may feel a pinch in the anterior capsule so we have this version with the arm behind the back. Again be careful you don’t torque your shoulder. I like to use the Rotater for this stretch as well.
You can also use bands to get a distraction of the humerus and turn your head to add a trap stretch as well. Often if someone has internally rotated shoulders the upper traps will be tight and over active.
Here’s the video of the internal stretch with bands.
Try these stretches out to help improve you shoulder internal range of motion and you will be on your way to preventing shoulders issues in the future.