Do you include stretches in your treatment of shoulder pain? Have you ever identified a glenohumeral internal rotation deficit (GIRD) and used the "Sleeper stretch" to help improve internal rotation? Do stretches have any value for shoulder pain, or are there better treatment options?

In this podcast, Jo Gibson (Clinical Physiotherapy Specialist) discusses how to differentiate true capsular stiffness from muscle stiffness, what information GIRD provides, and whether sleeper stretches for shoulder pain are a useful treatment.

Jo explores the current research and clinical implications on your treatment, including:

• What is the driver of decreased range of movement (ROM)?
• If we get immediate changes in ROM with a sleeper stretch, does that mean we should use this as a treatment?
• Is stretching an effective, efficient and evidence-based treatment?
• Can we use strengthening movements to improve range and cuff recruitment?
• What exercises can you use with patients with GIRD to improve ROM and cuff recruitment?
• Humeral retroversion and how torsional load from throwing sports at a young age impact your ROM assessment.
• If you have a patient with GIRD, what does this tell you?
• In patients with true capsular stiffness, does stretching in combination with damp heat have a role?
• Does eccentric strengthening have a role in improving GIRD in patients with true capsular stiffness or fibrosis?
• How can you use GIRD to monitor your athletes fatigue and recovery?

Podcast handout

Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson

Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio)

Frozen and stiff shoulder assessment & treatment with Jo Gibson

Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

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Links associated with this episode:

• Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder
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Articles associated with this episode:

• Download the podcast handout to receive the articles associated with this podcast.

• Hall K, Borstad JD. Posterior Shoulder Tightness: To Treat or Not to Treat?. journal of orthopaedic & sports physical therapy. 2018 Mar;48(3):133-6.

• Keller RA, De Giacomo AF, Neumann JA, Limpisvasti O, Tibone JE. Glenohumeral internal rotation deficit and risk of upper extremity injury in overhead athletes: a meta-analysis and systematic review. Sports health. 2018 Mar;10(2):125-32.

• Mine K, Nakayama T, Milanese S, Grimmer K. Effectiveness of stretching on posterior shoulder tightness and glenohumeral internal-rotation deficit: a systematic review of randomized controlled trials. Journal of sport rehabilitation. 2017 Jul 1;26(4):294-305.