Shoulder Internal Rotation Exercises And Stretches - Glenohumeral Internal Rotation Deficit (GIRD)
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- čas přidán 14. 07. 2024
- In todays video we look at GIRD - Glenohumeral Internal Rotation Deficit which is a lack of internal rotation of the shoulder. We go through how to test your range of internal rotation and some of the best stretches and exercises to get you on your way to increasing your range of movement.
Why is internal rotation important?
In everyday life, the shoulder internal rotation allows you to reach behind your back. Whether it was getting something from your back pocket or reaching to scratch your back, shoulder internal rotation allows you to do that. With athletes and exercising, the shoulder internal rotation allows you to keep the bar close to the body.
For example during exercises like the clean and the snatch, the barbell should be kept close to the body. As the movement proceeds, the elbows should be kept high and outside, which puts the shoulder into an internally rotated position. Limited range of motion in shoulder internal rotation may then potentially increase the risk of injury, but also limit the performance.
What are the causes for a lack of internal shoulder rotation?
Anterior GH instability: It is hypothesized that anterior instability/laxity of the shoulder complex caused by repetitive stretching of the anterior GH capsule led to this type of impingement in throwing athletes. This laxity allows for increased anterior humeral head translation. This type of acquired instability is often referred to as acquired instability overuse syndrome (AIOS).
Tight posterior GH capsule: The posterior-inferior GH joint capsule is hypothesized to become hypertrophied in the follow-through tensile motion of throwing. The tightness of the posterior capsule and the muscle tendon unit of the posterior rotator cuff is believed to limit internal joint rotation. Posterior capsule tightness leads to GIRD (glenohumeral internal rotation deficit). It is defined GIRD as a loss of internal rotation of under 20 degrees compared with the contralateral side. When the posterior structures of the glenohumeral joint are shortened, this may compromise the hammock function of the inferior glenohumeral ligament (IGHL), and increase the risk for impingement symptoms during throwing.
Muscle imbalance and/or improper neuromuscular control of the shoulder complex: Malpositioning of the arm relative to the glenoid bone during throwing motions can also lead to impingement of the rotator cuff tendons between the glenolabral complex and the humeral head. Fatigue and/or weakness of the scapular retractors have been shown to cause a decreased force production in all four of the rotator cuff muscles, which would also lead to abnormal positioning of the GH joint. At the base of this abnormal scapular positioning lies the lack of neuromuscular control of the periscapular musculature as well as muscle imbalances between the rotator cuff and upward rotators of the scapula (serratus anterior, upper trap, lower trap).
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Exactly what I need. Well deserved thumbs up 👍. Very professional and honestly so happy I found this. As a tennis player with a weak shoulder, my shoulder and myself thank you for this 🙏
It’s been a week and the first time I tried this I couldn’t push my shoulder the opposite direction above 10% power without discomfort. Now I can!
SUCH good content, thanks! I've read some comments and I have scapula winging as well when doing the belt stretch. Looking forward to a video on that!
such a well made video. Thanks
Awesome video. Thanks so much.
Thanks , great help!!
Very good selection of exercises.
Great information, thanks
Learned many new movements to improve my mobility. Have researched many sites and this info has help me considerably.
Thanks so much for the professional analyses.
Best video I've watched in a long time. Great knowledge and teaching points. Keep up the awesome work sir.
Thanks! Really needed this help.
Thank you so much. I have been suffering with GIRD for 3-4 years and I got instant relief today. I wish I knew these stretches year’s ago. Would have saved years of pain. Once again thank you for this video and best of luck. 💪
This video revealed the reason and some solutions for my severe right shoulder mobility limitations, that I had not figured out despite years of study and research.
Thank you for the clear explanations and reasonable solutions for improved mobility and pain relief.
Great presentation!
Thank you
It works, thanks a lot
Exactly what I was looking for, perfect video. Thank you - it's appreciated!
Excellent video!!!
Thank you buddy!
Excellent content…
Отличное объяснение. Молодец! Благодарю 🙏
Spasibo!
Very good Sir
You earned a subscriber
Ahhhh the static pulse hold was genius! Already feeling less stuck in my rom
Gr8 video
I hope this is informative as you say Travis. I. Just wasted more time of listening or watching videos about the QL, but, i still not clear on what i can do to help me.
Thanks for uploading and i will be even happier if it helps my understanding what i can do for in this case my shoulders.
Amazing 🙏🏽👻
having this from an old injury got me really into shoulder health.. memorized all the muscles bones, tendons and ligaments in the shoulder and what they do etc. it's crazy how the body recovers from an injury but annnoying how you're often left weak/stiff after this, but really it's all to save your body from fricking itself up even more
Amen to that!
just realized I have very poor internal mobility on one side (but great external on both). I am a climber and this realization has really started to correct my form. Your video is BY FAR the best I've come across on YT. Cheers my dude thank you!
I'm a climber too and have realised the same thing. How have you been progressing and are there any other resources you recommend?
same only left side have poor internal mobility ive tried this for more than a week and theres a lot of improvement i can tip already my fingertips but cant hold them yet .
Going to give these a go - I've noticed an underlying fault with my squats causing a bar lean. Looks like my right elbow starts higher and shoots higher particularly as I squat down and it causes this uneven bar and scrunched up trap from the get go but moreso at the bottom of the squat, hoping this alleviates the issue as I've also had left knee pain as a result of probably taking too much load on my left knee in comparison to right and also a bit of back tightness to top things off with the unevenness which is great! If I do the Apley scratch test the right arm also can't get higher than the left without a lot of effort.
Wow my internal rotation is absolutely awful. Need to start doing these!
Thanks for the video. Please produce video on how to improve external rotation thanks.
Hey T Chris,
Thank you for the kind words, I will add that to my video "to do list"
Kind regards,
Travis
Thanks for this video I was looking for this as I am recovering from stroke.
Wishing you all the best in your recovery!
Kindest regards,
Travis
Many thanks for the video. I really like your manner.
As there are numerous muscle groups feeding into glenohumeral stability (chest, bicep, lat and tricep) is it also worth working on those. My Apley Scratch test has huge disparity, with right side impingement
Every one says dont train internal rotation bcs always external is the weak one. Had to learn the hard way. Both are important
Thank you for this video!! Are wall slides a good exercise to strenghten? Are you planning to make a video like this for external
rotation? Thank you so much
Hi El Levin,
There are quite a few variations of wall slides which work different muscles. An exercise like Wall angels will activate the postural muscles in your upper back that help keep your shoulders pulled back. They also work to lengthen and strengthen your chest, spinal, and trunk muscles.
Traditional serratus anterior focused wall slides can be great for those with shoulder impingement and stabilization issues.
I will at some point do a video on External rotation and how to increase it but I find working with clients that releasing the pectoral muscles often increases external ROM almost straight away.
Kind regards,
Travis
Thanks very much! Very helpful! How long it might take (min to max range) for GIRD to go away?
Hi Travis and thanks for your video. My GIRD about 70%. If I do those exercises daily, how long it would take to reach full or at least proper range of movement?
Thanks I've been having serious problems there, daily, this really feels good, do you have one for the shoulders and neck 😊. This will definitely be a daily and before bed routine. Thanks again.
Hi Jackie,
Thank you for the kind words! I am glad you have been able to get some benefit from the video!
I did do a neck stretching video some time ago czcams.com/video/MRGsnl5VOG0/video.html
Kind regards,
Travis
The video helped me so much just woahh ! Btw How to fix forward shoulders ? And get a better posture . Video on it would help many and including me
Hey Rozer,
Appreciate the kind words! I have done a video on rounded shoulders which you can see here -> czcams.com/video/cMVLmdvEqtA/video.html
Kindest regards,
Travis
💪
Hey man! I've had so much issues ever since an L5/S1 back injury a few years ago, which led to other disfunctions, including in the shoulder.
I have extremely good external rotation and extremely poor internal rotation, causing massive imbalance issues.
Thank you for a great video, very educational!
You're more than welcome nJoy, thank you for the kind words.
Wishing you all the best in fixing your imbalances and internal rotation! :)
All the best,
Travis
The belt stretch feels crazy.
Does the floor exercise target the same stretch as the behind the back one, or does each serve a different purpose?
Great Video! Do you have a similar video for external rotation ?
Hi Chris,
Not currently, but it is on my ever growing "to do" list
Kindest regards,
Travis
Thank you for this video I got diagnose with gird 5 years ago in high school as a senior playing baseball but I lost health insurance when I turned 18 so I couldn’t afford physical therapy. This video helps a lot. I miss throwing the ball but now I only hit, hopefully I can throw soon
Did it feel like your scap wa seeing stabbed when you threw?
Was being*
@@austinshows30yess
So I'm lacking in both internal and external rotation (internal is about 30 degrees and external is about 70 degrees) and the infraspinatus/teres minor area of my shoulder feels really tender and hurts to touch. Do you have any idea on where should I start?
Does this help with GIRD? And what is the recovery time for GIRD?
Thank you so much sir, you are the God for my shoulder.
At 8:10 in starting point of this position my right shoulder become rounded with pain and in this position my scapula wing comes out & I am not able to bring them back like you said.
In the other hand with left shoulder everything is fine I can grab both hands.
Thank you for the kind words, really appreciate it!
It sounds like you have scapula winging on one side. I will do a in depth video on Scapula winging in the future but as a starting point keep doing all of the stretches and exercises in this video but also start strengthening up your mid/lower trapezius muscles and serratus anterior.
Kind regards,
Travis
@@UKFH 🙏💐
Can I also do these excercies when I have bursitis, and tendinitis in the long bicep tendon? I have pain when i rotate my hands internally, as soon as i started these excercices I felt much better. I just want to be sure though :) Thank you :D
Hi Mod,
Should be okay, if you do start to get sharp pain however that would be when you would stop!
Kindest regards,
Travis
I'm shocked that my internal rotation mobility is so terrible, 45° from vertical. I've been working on my middle splits, fronts splits and pancake for months. I can't believe I neglected my shoulder mobility. I've been doing olympic lifts for years so I thought I was in great shape but that trains your external rotation. It wasn't until I added a shoulder moblity routine to my calisthenics program that I realized bridge, crab and wheel pose are really hard.
Few months ago pain started in left arm internal rotation only, my range of movement is very little, if I try bend my army I get s sharp pain. Can I do this exercise only in one side? My right side is fine. Could it be inflammation? It difficult to sleep in that hurt site.😒
How many times a week do you recommend doing these ?
Hey mate
Really useful. How long does it take for the stretches to fix the tightly adapted tissues to normal so you don't have to stretch every day
Hi Asif,
Studies on mechanical elongation of muscle tissue vary however if someone was to stretch every day for 21 days they would start to see permanent changes.
Kind regards,
Travis
I have shoulder mobility issue from past 8 years and i keep leaving sports activities like cricket and badminton because i cant move my right hand back enough to generate the power it just twists my shoulder,
but after watching your video i can say i have a huge mobility issue..
Wishing you al the best ahmad! :)
thanks bless u Jesus name Halleluyah
Man can less shoulder internal rotation on one side leads to kind of rolling of shoulder in forward direction like if I’m normally sitting or standing my shoulder with less rotation is rolled forward seems like it dropped. Can this less rotation be the reason plzzzz reply it would be really helpful been with this problem for 2 months and my doctor or Physio kind of not really helpful 😢(GIRD)should I do these exercise while in this condition??
are these the best beginning exercises for the last description you listed; the muscle imbalance; neuromuscular control? I have been having aching discomfort all around my shoulder joint and nerve impingement near my armpit for almost 4 years and I cant figure out how to help it. I'm not an athlete but I do have limited internal rotation and I garden and do massage therapy. Could you link me to any other helpful exercises for this problem?
Hey Kacie!
Scapula depression and serratus anterior exercises would be a good starter point for you!
Kindest regards,
Travis
@@UKFH only a start ing after doing this fire 21 days.
Should this be done daily?
Great exercises but where do you put the cushion you suggest in the video: under your elbow resting on the ground or under your armpit/body lying on the ground?
Hi Ftdec,
Thanks for the question! When doing the side lying shoulder internal rotation stretch I would recommend putting a pillow/cushion underneath the head to avoid any neck straining and to make the stretch as comfortable as possible.
Kind regards,
Travis
@@UKFH Travis , many thanks and can I take this opportunity to say that these stretches are brilliant: they're helping me fix massive shoulder pain that I've had for a year now so many thanks.
Could you potentially use a light weight with this exercises to gain IR strength
Hi Christopher,
You can indeed! Most Physiotherapists tend to advise strengthening up internal rotation by using resistance bands but it can be done with dumbells also!
Regards,
Travis
I assume it would make sense to do the exercises before a workout to warm up?
Hi Stephan,
This can absolutely be done as a warm up prior to exercise. Thanks for the question.
Kind regards,
Travis
Why so painful😢😢😢😢am using belt to pull up my hand. Is it normal?
Whenever i try to get into internal roation with my right arm at some extend my shoulder starts to tip forward and a deep pinching pain occurs inside the shoulder (more on the front side). Is this just because the lack of internal roation causes some tendons to get pinched or is this an underlying problem in addition to the lack of internal rotation?
Hi Phil,
Without seeing you and examining you I unfortunately can not diagnose however it sounds to be like impingement of the anterior shoulder onto your coracoid process. It might be worth seeing if shoulder impingement stretches are better suited to you :)
Kind regards,
Travis
My scapula wings when I reach behind my back. Do I need to correct that with other exercises, or is it a lack of internal rotation?
Hi Dylan,
It is a lack of range of motion and thus the scapula is compensating. You can always improve this with shoulder stabilization exercises alongside stretching and shoulder mobility work :)
Kindest regards,
Travis
His accent reminds me of Charles berthoud the bass player.
Hi, do these exercises have to be done every day?
Hi Med,
Every other day would be fine or 3x per week.
Kind regards,
Travis
Greetings, i also noticed that in the shoulder that i lack internal rotation i also don't have winged shoulder. So my shoulder won't pop up and allow me to reach way on the back, as on the other shoulder i can reach higher on the back, but also get that winged scapula.
Hi AL!
Might be worth putting some serratus anterior exercises into your workouts as it is a key scapular stabilizer, keeping the shoulder blades against the ribcage when at rest and during movement.
Kind regards,
Travis
@@UKFH Appreciate that, thank you!
I have question I got gird from baseball. Im trying to throw again, I got diagnosed with gird 5 years ago. How many times a week should I do these work outs? Men’s league started in 3 months. Should I do these everyday?
Hi Adrian,
I wouldn't do these every day however I would do a shoulder prehab warm up before going into baseball sessions, whether that be training or an actual game.
I did a video on shoulder prehab here: czcams.com/video/NDy2lxLMntk/video.html
In answer to your question, up to 4 times a week at max with a days rest in-between.
Kindest regards,
Travis
Does lacking internal rotation causes limited shoulder extension, weak shoulder and bicep muscles ? Because I have same symptoms
Hi Kaustubh!
The main muscle that controls internal rotation of the shoulder is the subscapularis, It is one of the four rotator cuff muscles. If there is a weakness or dysfunction in the muscle it can cause a lack of shoulder stability. It doesn't tend to cause weakness in the bicep unless it is torn or injured.
All the best in your recovery!
Travis
@@UKFH could a tight/short infraspinatus cause limited internal rotation?
Hi where are you located in the UK?
Hi Raj,
In Kent :)
Kind regards,
Travis
Sir I have less internal rotation in my right arm compared to my left arm which lead to less development in my right arm in terms of width like lateral head of tricep and Lateral head ( side delt ) of shoulder in my right arm which leads me to another problem... My left arm and right arm have almost same external rotation ROM but I don't know why my right arm tricep long head got developed so much and my left arm's tricep long head is very small compared to my right arm, but in terms of size my right arm dominates my left arm because of long head development in my right arm and also my left arm looks circular from front coz of that lateral head development of tricep compared to my right arm... Any solutions or suggestions sir Please... I trust you coz following one of your videos helped me to cure my tricep Tendonitis ( elbow pain )..... So please any suggestions for both my left and right arm situations sir please...? Also if there is any solution warmups or exercises for both issues can you please say the timing when I have to do them...
Hi Nag,
Firstly thank you for your questions.
The best way to get body symmetry is to do unilateral exercises. A unilateral exercise movement is when each limb works independently of the other to create the desired movement, these types of movements make the body work evenly rather than on most fixed track machines where a movement can be dominated by the stronger side which further facilitates muscular imbalances.
When you do tricep exercises isolate one side at a time (so doing skullcrushers with dumbells rather than a bar for example) make each tricep work independently. I would also try to add in more sets (just on your smaller tricep long head) so it catches up.
As for warm ups when I am dealing with bodybuilding clients they will grab a 2-16kg resistance band and loop it over the top of a fixed object such as a power rack and grab one side of the band with each hand for sets of 25-50 for 2-3 sets to get the tendons as warm as possible before heavy pressing movements. This is to reduce the chance of injury, promote bloodflow and get the elbow joint ready for loading.
Kind regards,
Travis
@@UKFH Yeah sir I was doing only unilateral exercises by focusing on on arm at a time without doing that movement with dumbell, like I was doing tricep push downs with one arm at a time to come up with my lagging Lateral head of tricep but I got to understand that less internal rotation of shoulder is the main reason for the wider look .... But I don't know why I wasn't able to improve my long head of left arm tricep even when I am doing unilateral exercises with only one arm at a time by touching the working arm with non working arm for more mind muscle connection.... But still even after doing that for 2months my left arm tricep long head is lagging so much and I am not getting what to do.... For 2 months I did only unilateral exercises without doing that exercise with both hands at a time even with dumbell any suggestion for that sir?
I've found that when I put put right hand behind the back, to some degree, my right should start to round forward and my right scapula starts to stick out. Can I benefit from those exercise u mentioned in this video for my specific problem?
Same problem with me bro :(
I am not sure about this trick but first I pull and hold my shoulder back and then in this position by using wall support ( wall pillar corner something like that) so when I try to put my hand behind the back shoulder is not get forward or rounded due to wall corner support. sorry for my bad English.
Hi Jackco,
Like the previous commenter it sounds like you have whats called scapula winging when you come into internal rotation. I will do an in depth video on Scapula winging in the future but as a starting point keep doing all of the stretches and exercises in this video but also start strengthening up your mid/lower trapezius muscles and serratus anterior. Over time you should find that internal rotation becomes easier as the serratus and mid/lower traps function better.
Kind regards,
Travis
What if your shoulder doesn’t even touch the ground to begin with, while lying down in this position ? (Ie. In Hyperkyphosis)
Hi Goodness unite,
I would then modify the technique to standing by using a broomstick to get the individual into internal and external ranges of motion or the third technique in this video with the belt.
This is the broomstick variation: czcams.com/video/6GqVLvhWU20/video.html&ab_channel=COREChiropractic
Kind regards,
Travis
4:50
it looks like you are demonstrating the sleeper stretch which lot of PT seems to dislike and discourage people from doing
Hi Fit,
I definitely can't speak for other PT's that's for sure, what I can say is in my own experience I've been using the sleeper stretch on clients for around 12 years now and not had any negatives other than stiffness and soreness when it is first introduced. There are other options in this video if you are not keen on the sleeper stretch! I don't use it on every case of GIRD rehab with clients.
Thank you for the comment!
Travis
Why focus isn't put in strengthening in addition of range of motion?
Hi Jack,
Its definately important to gain muscular strength in all ranges of motion. I would often in this case do that with simple isometrics in severe cases.
Kind Regards,
Travis
I just ask a friend to twist me arm behind me back , thanks mate.
I have come across the information that the sleeper stretch can be an aggressive exercise, especially if it's done incorrectly, and better to be avoided particularly for people over 50 years old. Any comments?
Hi Gabri,
I think anything done too aggressively can cause further injury. You could have someone take any stretch too far and cause either a muscular or capsular problem.
With those suffering with GIRD its vital to get the shoulder moving and gradually increasing range of movement to try combat the adhesive nature of the soft tissues and how they have adapted overtime.
You're quite right however, any stretch taken too aggressively could cause negative effects. With those in the 50+ age range tissues tensile strength and elasticity is lower hence the change of injury goes up, this is why it is so important to stick within safe ranges of perceived stretch.
Great comment, thank you!
Kind regards,
Travis
My shoulder loses contact with floor while doing internal rotation
Hi Sylvanus,
Only go as far as the shoulder is comfortable initially, this would be at the point just before the shoulder loses contact with the floor. Each time you do the stretch try to see if you can improve this, even if it is half a CM at a time.
Kind regards,
Travis
@@UKFH with the standing internal rotation stretches i get scapular winging with rounding of the shoulders
@@bernardb.brownsr5918 Start combining these stretches with serratus anterior exercises 😊
i get pins and needles every time i use this little used muscles
Ohhhh...he said UK. fitness hub. I heard gay fitness hub. 😆
I'll leave that type of content for other websites 🤣
There is litterature suggesting that the cross body stretch might be more effective in improving internal shoulder mobility.
pubmed.ncbi.nlm.nih.gov/17416125/
Hey Jump,
It would be interesting to see that study done with symptomatic patients! I would need to see a far bigger control group in both senses. It also looks like the sleeper stretch was done static and not PNF. It would be quite challenging to do a "across body stretch" in PNF stretch format, would be interesting to see sleeper PNF vs across body static. Thank you for sharing :)
Kind regards,
Travis