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 shoulder assessment infographic series

Click here to access the free shoulder infographic series and learn how to easily assess shoulder pain patients with this simple 6-step shoulder assessment from Jo Gibson

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

CLICK HERE to get access to Sherlock Holmes and the sign of the four hypotheses with Nick Kendrick

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
• Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson
• Download and subscribe to the podcast on iTunes
• Download the podcast now using the best podcast app currently in existence - Overcast
• Listen to the podcast on Spotify
• Improve your confidence and clinical reasoning with a free trial Clinical Edge membership
• Let David know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Jo Gibson on Twitter

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.