16 Sep Posterior Shoulder Mobility Drills
Got shoulder pain? A tight posterior cuff is associated with a handful of shoulder dysfunctions like subacrominal impingement syndrome, posterior impingement, anterior instability, etc. And thus, increasing posterior shoulder mobility is part of the treatment protocol for many with shoulder pain. There’s a high probability increasing your posterior shoulder mobility will help, and we’re going to show you some of our favorite posterior shoulder mobility drills that you can perform NOW to give you some relief!
The “Correct” Cross Body Stretch
The cross-body stretch is a fantastic way to target the posterior cuff (infraspinatus and teres minor) but far too often it is done incorrectly! In order to effectively stretch the posterior cuff, you need to keep your scapula stabilized ie your scapula cannot move!
If you pull your arm across your body and your scapula comes with it into horizontal adduction, the only stretch you’re getting is of your mid-scapular muscles like your rhomboids or traps. Furthermore, in this position there’s more of a distraction force on the glenohumeral joint than a true stretch of the posterior cuff – aka not as specific as it can be. They are essentially two completely separate stretches, and if the goal is to increase posterior shoulder mobility, you absolutely must keep your scapula stabilized like in the bottom video.
- First pull your shoulder blades back. This will keep your scapula in a retracted position.
- Using your other arm, pull your shoulder across. The key here is maintaining the position of your shoulder blade pulled back the entire time. This is the only way to target the posterior cuff.
Pay attention to where you feel the stretch, as you should feel a “deep stretch” in the back of your shoulder in the highlighted area on the video. If you feel a stretch or anything else not in the back of shoulder, you’re either doing the stretch incorrectly or abutting other structures in your shoulder due to pathology (ie don’t do the stretch anymore and seek out a physio if you’re in pain).
Closed Chain Posterior Shoulder Mobility
Here is a great way posterior shoulder mobility drills to hit the posterior cuff/capsule, which often get’s tight in the dominant arm of overhead athletes. Posterior shoulder mobility deficits often lead to limitations in shoulder internal rotation and horizontal adduction. With cross body stretching, people will often allow the shoulder to dump forward, defeating the intent of stretching the posterior shoulder region. This exercise is great because it will allow the head of the humerus to stay posterior, which will further increase the stretch. You are essentially giving yourself a posterior glide of the shoulder joint.
To progress the stretch, you can turn your hand inward which will now also address internal rotation and horizontal adduction limitations.
Note: Taking up the slack of these muscles initially through horizontal adduction is often more comfortable than internal rotation.
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Sleeper Stretch vs Horizontal Adduction Stretch?
There are many ways to increase posterior shoulder mobility, and two of the most popular stretches are the side-lying sleeper stretch and the side-lying horizontal adduction stretch. A previous study had shown that the horizontal adduction stretch was more beneficial in restoring internal rotation at the shoulder than the sleeper stretch. However a newer study by Yamauchi et al 2016 found that both stretches effectively increased shoulder internal rotation and horizontal adduction with no significant differences between groups!
The cool thing about this study though, is that they looked at muscle stiffness of both the infraspinatus and teres minor using ultrasound. Both of these muscles make up what is known as the “posterior cuff.” It is the posterior cuff, in addition to the posterior shoulder capsule, which contributes to deficits in posterior shoulder mobility.
➡️Interestingly enough, the study found that the sleeper stretch decreased infraspinatus muscle stiffness.
➡️Whereas the side-lying horizontal adduction stretch decreased teres minor stiffness.
Why is this relevant? For baseball pitchers, the teres minor demonstrates the highest level of EMG activity of all the shoulder muscles during the deceleration phase. Furthermore, at 90 deg of adduction (ie the position of the shoulder during throwing), the teres minor to infraspinatus muscle activity ratio is significantly higher than a 0 deg of adduction. Thus, the throwing motion requires higher intensity eccentric contraction of the teres minor than the infraspinatus, which could lead to the teres minor being more fatigued and thus more muscle stiffness after pitching.
Moral of the story, if you’re a baseball player, try the side-lying horizontal adduction instead of the sleeper stretch to stretch your posterior shoulder!
Posterior Shoulder Soft Tissue Mobility Drills
The shoulder joint is a menace for a reason, intuitively it doesn’t make sense! The posterior cuff is composed of the posterior glenohumeral joint capsule and the teres minor and infraspinatus. However, when these structures are tight, the ball of the shoulder actually moves away from the shoulder joint. The head of the humerus will actually sit anteriorly, and this disrupts normal shoulder movement ie. arthrokinematics.
What does this mean? Well the posterior cuff is a connection between the scapula and the humerus. If this is tight, whenever you reach across your body with your arm, the scapula will also be going for an early ride with the humerus. Think of a tug boat towing another boat with an extremely “tight” and short rope. This is trouble, because the scapula is connected to the clavicle, and excess scapula movement with horizontal adduction of the shoulder can stress a host of shoulder structures including the acromio-clavicular joint.
Marcondes, Freddy B., et al. “Posterior Shoulder Tightness and Rotator Cuff Strength Assessments in Painful Shoulders of Amateur Tennis Players.” Brazilian Journal of Physical Therapy, vol. 17, no. 2, 2013, pp. 185–193., doi:10.1590/s1413-35552012005000079.
Wilk, Kevin E., et al. “The Modified Sleeper Stretch and Modified Cross-Body Stretch to Increase Shoulder Internal Rotation Range of Motion in the Overhead Throwing Athlete.” Journal of Orthopaedic & Sports Physical Therapy, vol. 43, no. 12, 2013, pp. 891–894., doi:10.2519/jospt.2013.4990.
Yamauchi, Taishi, et al. “Effects of Two Stretching Methods on Shoulder Range of Motion and Muscle Stiffness in Baseball Players with Posterior Shoulder Tightness: a Randomized Controlled Trial.” Journal of Shoulder and Elbow Surgery, vol. 25, no. 9, 2016, pp. 1395–1403., doi:10.1016/j.jse.2016.04.025.