Sleeper Stretch
This stretch is performed to help address shoulder pain and symptoms that are the result of a tight posterior capsule. The medical name for this condition is GIRD or "glenohumeral internal rotation deficit." This condition is quite common in overhead athletes such as tennis players, volleyball players, and baseball pitchers.
To perform this stretch, lie on your affected side and position your shoulder and elbow at 90°, with the scapula positioned firmly against the floor or table. Next, using your other hand to accomplish the motion, passively internally rotate your forearm toward the floor or table until a posterior stretch is felt in your shoulder. Hold this position of stretch for 30 seconds and then rest for 30 seconds. Repeat twice more for a total of 3 repetitions with 3o seconds rest between repetitions. Perform this stretch twice daily (Dr. Jurek recommends doing this routine before you brush your teeth; she thinks her patients may be more likely to do this stretch if they make completion of the stretch a requirement that must be met prior to proceeding with teeth-brushing).
To make this a slightly higher-level stretch, add an isometric component to it. Do the recommended three repetitions as described above and then do a 30 second isometric hold where you keep your affected upper extremity in between the "start" and "finish" positions shown below and during this 30 seconds, push up with your affected arm and down with your other hand to achieve an isometric stretch. Then do an additional 30 second traditional sleeper stretch after the isometric hold.
To perform this stretch, lie on your affected side and position your shoulder and elbow at 90°, with the scapula positioned firmly against the floor or table. Next, using your other hand to accomplish the motion, passively internally rotate your forearm toward the floor or table until a posterior stretch is felt in your shoulder. Hold this position of stretch for 30 seconds and then rest for 30 seconds. Repeat twice more for a total of 3 repetitions with 3o seconds rest between repetitions. Perform this stretch twice daily (Dr. Jurek recommends doing this routine before you brush your teeth; she thinks her patients may be more likely to do this stretch if they make completion of the stretch a requirement that must be met prior to proceeding with teeth-brushing).
To make this a slightly higher-level stretch, add an isometric component to it. Do the recommended three repetitions as described above and then do a 30 second isometric hold where you keep your affected upper extremity in between the "start" and "finish" positions shown below and during this 30 seconds, push up with your affected arm and down with your other hand to achieve an isometric stretch. Then do an additional 30 second traditional sleeper stretch after the isometric hold.
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3 Keys to Performing the Sleeper Stretch Correctly
- Scapula position. Roll onto your side and make sure that your scapula is retracted, meaning that you want to lay mostly on your rib cage and the outside border of your scapula; you do not want to lay flat on your scapula with your shoulder rounded, The best way to accomplish this is to roll forward towards your arm to get your scapula off the ground and then roll back.
- Shoulder position. Next, make sure that your body is not straight up and down. You actually want to roll backwards so that your body is facing upward at close to a 45 degree angle. This will get your shoulder out of the sagittal plane, which places too much strain on the posterior capsule, and into the scapular plane that stretches more of the posterior musculature. Also think about keeping your head in neutral with your body position. You can use a yoga block or something similar to relax your neck and head if that makes this position more comfortable.
- Intensity. Lastly, you want to gently push down until you feel a MILD stretch and hold for 30 seconds. Avoid pushing too hard. You do not want to feel anything in the front of your shoulder. The goal is to feel a mild stretch in the back of your shoulder and to hold this position. Do this gently for a few reps and you will see improvement without cranking on the arm aggressively. The goal is to achieve some improvement in internal rotation.. It’s not a large movement and when you feel a stretch in your posterior shoulder, that is plenty. Your hand is not supposed to touch the ground, that is WAY too much motion.
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This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon.