A modified internal rotation stretching technique for overhand and throwing athletes

Strength, stretching, and rehabilitation methods for the shoulder have been previously described and have been universally applied; nevertheless, many throwing athletes continue to develop overuse injuries. The pitching process tends to increase external rotation and limit internal rotation of the shoulder joint. Our technique involves a modified stretching method of the posterior shoulder musculature. The athlete lies prone with the elbow flexed 90 degrees. With the shoulder abducted 90 degrees, in neutral flexion/extension, and 90 degrees or more of internal rotation, the scapula protrudes posteriorly. By depressing the inferior angle of the scapula toward the thoracic wall, the infraspinatus muscle and posterior joint capsule are effectively isolated and stretched. Manual stabilization of the scapula onto the chest wall transfers the internal rotation movements to the glenohumeral joint, as opposed to sharing the movement with the scapulothoracic articulation. This method improves the efficacy of the internal rotation stretching exercise for the glenohumeral joint. Such an addition to traditional stretching methods may increase the efficiency of the least effective component. We conclude that this modification to traditional programs should be an integral part of the training and rehabilitation program of any athlete requiring near maximal performance of the shoulder.