Tag Archives: internal impingement

How Effective is Internal Rotation Stretching?


I ask myself this question a lot when putting someone on a stretching program.

The most common injuries in baseball players involve the shoulder and elbow, and pitchers are more prone to these injuries than positions players (1). These injuries include SLAP tears, shoulder impingement syndrome, rotator cuff pathology, and Ulnar collateral ligament tears. Researchers that specialize in baseball injuries have found that it is common for pitchers to display a loss of internal rotation and a gain of external rotation in their dominant arm (2). This loss of internal rotation, or GIRD, has been proven to put a player at a much higher risk for injury that can sideline them and possibly require surgery (2,3). There have been several studies with both major league and collegiate players that have shown how beneficial stretching the shoulder can be in reducing the amount of shoulder internal rotation loss for a  (4, 5). However I often wonder if players can actual make changes to their range of motion that are significant and will last.

A significant study came out in 2008 that demonstrated the effects of the “sleeper stretch” immediately on shoulder mobility, however were unable to determine whether or not this would have lasting effects on injury prevention.

The Sleeper Stretch

There is much debate about what causes the change in shoulder mobility, however most people agree there is some component of soft tissue changes, and the defecit can be improved with stretching. A recent study looked at what the long term effects of stretching was on professional baseball players (5) They looked at players after 3 years of being in a stretching program and found them to have better shoulder mobility than those that had been stretching for less than 3 years. Those players were performing a few stretches DAILY for 3 years. Seems like a lot, I know. Their program was the following:1) passive internal rotation stretching 2) cross body stretch

Passive Internal Rotation Stretching

Cross Body Stretch with Scapula Stabilize


The most recent study demonstrated that the loss of internal rotation is neither permanent or necessary, and that ideally with stretching the player will maintain the gained external rotation with no loss of internal rotation. Although it may take up to years for these changes to become permanent.


Stick with the stretching boys.




  1. Wilk, KE, Meister K, Andrews JR. Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports med. 2002;30(1):136-151.
  2. Bukhart SS, Morgan CD, Kibler WB. The Disabled Throwing Shoulder: spectrum of pathology. Part 1:pathoanatomy and biomechanics. Arthroscopy. 2003; 19(4): 404-420
  3. Dines, JS, Frank JB, Akerman M, Yocum LA.. Glenohumeral Internal Rotation Deficits in Baseball Players with Ulnar Collateral Ligament Insufficiency. Am J Sports Med. 2009; 37(3): 566-570.
  4. Laudner, KG, Spines, RC, Wilson, JT.  The acute effects of sleeper stretches on shoulder ROM. Journal of Athletic Training. 2008; 43(4) 359–363.
  5. Lintner, D, Mayol, M, Obinna, U, Jones, R, Labossiere, D. Glenohumeral Internal Rotation Deficits in Professional Pitchers Enrolled in a stretching program. Am J Sports Med. 2007; 35(4): 617-62