How to (Properly) Assess Shoulder Internal Rotation
In light of some recent emails I’ve received from people asking about the importance of testing shoulder internal range of motion, I thought it would be prudent (yep, I just used the word prudent) to use today’s post to give a quick little tutorial on how to do it correctly – as I feel that many people are missing the mark on how to do so.
Unfortunately, some are under the impression that you just lay someone on their back and then just crank them into IR and that’s that. Well, as with most things pertaining to the shoulder – it’s a bit more complicated than that. A lot more, in fact.
You see, while the test itself is an important tool in the toolbox, and can undoubtedly help you better ascertain any issues or underlying shoulder pathologies that may (or may not) exist, which in turn will dictate any programming considerations and/or modifications moving forward; the more important thing to consider here is execution.
Simply put, if done haphazardly, you could end up with a result that’s wrong, giving the illusion of one having more IR than (s)he actually has, hurting the client in the long run, and making you look like an asshat (which, for the record, is a step below asstard).
Alternatively, when done correctly, you won’t suck. Which is always cool.
First, though, we can’t have a discussion on testing shoulder IR without having an idea of what exactly we’re looking for:
For the normal weight training population, ideally, we’re looking for 50+ degrees of internal rotation.
For the overhead athlete (baseball, softball, tennis, volleyball – ohhhhhhh yeah, volleyball), the number gets skewed due to any number of factors – retroversion being high on the list – and a GIRD (Glenohumeral Internal Rotation Deficit) of ten degrees can and would be completely normal and an otherwise acceptable adaptation given the demands of the sport.
In a like manner, it’s important to note that internal rotation is just a small component of the overall picture. TOTAL range of motion (ER + IR) – and more specifically, total ROM between left and right sides – is the key factor here, and will definitely give you a broader scope to work from, but I’m getting a head of myself.
“Alright Tony, get with it already. What’s the proper way to test IR?”
- I don’t like that tone.
- Here’s a video to help demonstrate, with my comments to follow
The first time through, you’ll notice I don’t pin the shoulder down with my left hand, and as a result, Tyler’s shoulder goes into anterior tilt and I get a false indication of how much internal rotation he actually has. For all intents and purposes, this is how many fitness professionals are “assessing” shoulder IR, and well, it’s wrong. Tsk tsk tsk!
Conversely, on the second time through, you’ll notice I set his elbow on my thigh, use my left hand to actually “pin” the shoulder down (thumb over coracoid process, pushing scapulae into more posterior tilt), and the result is DRASTICALLY different. By preventing the shoulder from going into anterior tilt, I then get a better reading of what his “true” IR actually is.
Of course, from there, I’d test external range of motion and then compare TOTAL range of motion between left and right sides; but for today at least, my main objective was to demonstrate that one subtle correction (pinning the shoulder) can make a drastic difference in assessing shoulder IR. Well that, and Morgan Beck (see pic above) is kinda hot.