Another Guest Post today by Dr. Zach Long, just in time for the release of Bulletproof Mobility!
Shoulder Internal Rotation’s Impact on the Athlete and Fitness
Shoulder internal rotation (IR) mobility is one of the most commonly restricted motions I see in fitness athletes. It is also one of the least self-treated areas by athletes.
For the weightlifting/CrossFit populations, limited shoulder IR not only puts the shoulder at a potentially increased risk of injury, but it also limits performance.
During the clean and the snatch, two common weightlifting exercises, the athlete should keep the barbell as close to their body as possible. As the barbell passes the hips, the athlete should keep their elbows high and outside, putting their shoulder into an internally rotated position.
If shoulder IR is restricted either the barbell drifts slightly away from the body, or the shoulder blade will anteriorly tilt to allow the barbell to stay close to the body. Either way, total force output will decrease and unnecessary stress may be placed on multiple shoulder structures. This means they will potentially lift less weight or fatigue quicker during workouts.
To assess shoulder internal rotation, I have the athlete lie on their back with elbow slightly elevated and shoulder in 90 degrees of abduction. I place my hand on the front of their shoulder to prevent it from rising off the ground to compensate. Next, their shoulder is internally rotated. The shoulder should have the ability to internally rotate far enough that their hand reaches the height of their stomach (around 70 degrees). This shows me that they have the mobility necessary to keep the barbell close to the body as it is lifted.
My favorite treatments for restoring shoulder internal rotation includes posterior mobilizations of the shoulder joint and IASTM to the muscles of the posterior shoulder. But, these should only be performed by trained medical professionals. If your shoulder internal rotation is lacking, try these self-treatment options first.
1. Repeated shoulder motions
My go-to exercises for initially improving shoulder internal rotation are repeated functional IR and extensions. I use a stretch strap and repeatedly take the shoulder into functional internal rotation. An alternative involves repeatedly taking the shoulder into extension. Both of these moves will frequently restore shoulder internal rotation quickly.
2. Posterior shoulder soft tissue mobilization
Using a tennis ball or lacrosse ball for some gentle soft tissue mobilization to the shoulder will often decrease muscle tone enough to improve shoulder internal rotation. I have athletes spend ~1 minute rolling.
3. Posterior shoulder stretch
While pinning the lateral border of the shoulder blade against a wall, pull the arm across your body. A gentle stretch should be felt in the posterior shoulder. To increase the effectiveness of the stretch, perform contract-relax techniques. Take the shoulder to end range and then gently push into the opposite hand for 5 seconds. Repeat the contract-relax process several times to decrease muscle tone and improve range of motion.
4. Sleeper Stretch
The sleeper stretch is a very often-prescribed stretch for improving rotation. While it can be a great stretch, it is often not appropriate. During execution, a stretch should be felt in the posterior shoulder not pain in the front side of the shoulder. If anterior pain is felt, this exercise should not be used.
To perform, the athlete lies on their side with the lateral border of the shoulder blade pinned against the ground. The elbow is raised to the height of the shoulder and the opposite arm is internally rotated.
5. Half Turkish Get Ups with Rotations
After performing the previous mobilizations I like to have athletes perform some stability work to help “lock-in” the mobility we’ve gained. One of my favorites to follow up shoulder internal rotation stretching with is Half Turkish Get Ups with Rotations.
Thanks again to Dr. Zach Long of The Barbell Physio for guest posting last Friday and today. Be sure to check out Bulletproof Mobility, Zach's new product that has a systematic way for you to self assess and correct many common mobility deficits. For this week only, get 20% off as an introductory price. Be sure and support this site by using this link to purchase Bulletproof Mobility now!
Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!
Keeping it Eclectic...