Shoulder GIRD
Shoulder - Mobility
Glenohumeral internal rotation deficit (GIRD) is a loss of internal rotation commonly seen in overhead athletes.
Biomechanical Mechanism
Posterior capsule tightness, rotator cuff stiffness, and bony adaptation can reduce IR and increase impingement or labral stress.
Clinical Rationale
GIRD increases risk of labral injury and impingement. Addressing posterior capsule and cuff stiffness improves mechanics.
Practical Solution
Restore IR and total arc while maintaining scapular control. Use caution with aggressive stretching in acute pain.
Common Compensations
- Scapular dyskinesis
- Excess external rotation
- Altered throwing mechanics
Progression
- Level 1: Low-load IR mobility
- Level 2: Posterior capsule soft tissue
- Level 3: Rotator cuff strengthening
- Level 4: Throwing integration
Regression
- Reduce ROM
- Avoid painful end ranges
- Use gentle mobilizations
Red Flags
- Severe pain
- Instability
- Acute trauma
Differential Diagnosis
- SLAP lesion
- Posterior capsule contracture
- Impingement
Related Patterns
Related Exercises
- sleeper stretch
- posterior shoulder ball
- thoracic extension foam roller
- doorway pec stretch
- shoulder ir 90 stretch
- cross body stretch
Related Assessments
- shoulder ir 90 assessment
- sleeper stretch test assessment
Evidence
Level: moderate
Stretching interventions can improve shoulder ROM in overhead athletes with GIRD; evidence supports ROM gains but varies by protocol.
Sources:
- systematic review/meta-analysis: Role of stretching interventions in enhancing the shoulder range of motion in overhead athletes with glenohumeral internal rotation deficit: A systematic review and meta-analysis. (link)
- systematic review: Glenohumeral Internal Rotation Deficit and Risk of Upper Extremity Injury in Overhead Athletes: Systematic Review. (link)