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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