Important Note When Addressing Glenohumeral Internal Rotation

?Glenohumeral impingement rehabilitation of overhead athletes must consider the pathway of least resistance for the shoulder. Stretching the posterior structures to decrease the internal rotation deficit without controlling the positioning and inherent or altered motion of the humeral head often leads to further impingement of the structures that are implicated in the injury. Conscious control of the humeral head in the socket must be done by the athlete, therapist, or trainer. The research on prevalence of capsular laxity or stiffness in throwers often doesn’t consider stiffness of the capsule in all orientations and directions that can be acquired as a result of repetitive throwing. Testing the joint 3 dimensionally is the only way to assess the hyper/hypo-mobility inside the joint. It is important to ensure the humeral head is properly positioned on the glenoid fossa during shoulder stretching even in an athlete with a hypermobile joint (often seen as capsular laxity with large or moderate deficit in IR). This can be done through a presence that maintains humeral head positioning, preventing excessive translation, without applying a higher grade mobilization to the joint. ?

Checkout how we perform the sleeper stretch here:

Soft tissue mobilization in the form of active release:

?Shoulder mobilizations: