As an Orthopedist specializing in shoulder injuries, I see many patients with sports-related injuries. I would like to talk about a very common condition seen in overhead athletes. This condition is frequently seen in baseball pitchers, but is also common in athletes who participate in volleyball, softball, tennis and swimming.

Glenohumeral internal rotation deficit, commonly referred to as GIRD, is due to adaptations in both bony and dynamic restraints of the shoulder from repetitive stress. These adaptations lead to an increase in external rotation and a decrease in internal rotation of the shoulder. Although these changes are preventable and treatable, if left unattended, GIRD may contribute to more serious shoulder injuries such as labral tears and partial thickness rotator cuff tears, and elbow injuries such as ulnar collateral ligament tears.

GIRD is evaluated by assessing range of motion deficits when compared bilaterally. A positive assessment of GIRD is present if an athlete has less than 25º of internal rotation or if there is a 25º difference in total rotational arc when compared bilaterally.

Fortunately, GIRD is easily addressed by adding a few simple stretches to your daily warm-up and cool-down routines. The Sleeper Stretch and horizontal adduction stretch are designed to improve the flexibility of the muscles and joint capsule in the posterior shoulder.

The Sleeper stretch is performed side laying with your arm extended in front of you at 90º, bend your knees and keep your shoulders, hips and ankles in line with your spine, and don't lean back. It is important to squeeze your shoulder blades together to maintain proper position throughout the stretch. Lastly, with your elbow at 90º, gently push the palm of your hand towards the floor. Hold the stretch for 20 - 30 seconds and repeat 5 - 10 times.

The horizontal adduction stretch is performed standing with the posterior shoulder stabilized against the wall. With the shoulder at 90º, gently stretch your arm across your body with your opposite hand. Hold the stretch for 20 - 30 seconds and repeat 5 - 10 times.

If you continue to have shoulder symptoms, please schedule an appointment to be evaluated.