Shoulder Internal Rotation Fix: Test & Treat


Shoulder tightness is a commonly seen issue in our clinic. It can often lead to shoulder pain, but can also be a contributing cause of elbow, wrist, or even neck pain. In this installment of Test & Treat, we’ll look at internal rotation of the shoulder

Why Internal Rotation?

The shoulder joint is a ball and socket joint. The “ball” is the top part of your humerus (upper arm) and the “socket” is made by the glenoid fossa (of the scapula) which is made into a larger socket with the shoulder labrum. This joint set-up leads to a generally very mobile joint that can move in many different directions. We can test each one of these motions but there are a few that tend to lead themselves to tightness. One of these motions is internal rotation.

Shoulder Internal Rotation
Shoulder Internal Rotation

Why Is Shoulder Internal Rotation Important?

There are a few different reasons why internal rotation is important. First, we need a lot of it for self-care. Anytime you reach behind your back to put your wallet in your pocket, tuck in your shirt or clasp your bra strap, you require a significant amount of shoulder internal rotation. Being unable to perform one or more of those activities is the main reason people will present to our office if they have an issue.

A more specific task that requires loads of internal rotation is during a few weightlifting/CrossFit movements: the snatch or the clean. Both of these require the barbell to be pulled up and close to the body, which puts the shoulder in internal rotation. If that motion isn’t there, then the body has to compensate by overloading the upper back or elbows.

What Causes Shoulder Internal Rotation Tightness?

There are a few different reasons that internal rotation becomes limited in people.

Pectoral tightness: Since many of us spend too much time at a desk or hunched over our phones, our pecs (chest muscles) become tight. This pulls our shoulder forward which eliminates the need for true shoulder internal rotation. As a result, we slowly use this motion overtime.

Excessive overhead movements (throwing/swimming): Overhead athletics and overhead movements put our shoulder into external rotation. When this happens, our body compensates by moving the joint into a more externally rotated position. However, it can also restrict internal rotation during the process.

Injury/Overuse: Any time our shoulder goes through trauma, the body will lay down tissue. If we constantly beat up our shoulders without constantly checking mobility, many times this new tissue can lead to decreased mobility.

Test & Treat Your Shoulder Internal Rotation

Watch the video for instructions on how to test our your shoulder rotation. If it is tight, I also show the sleeper stretch which is a great way to increase your shoulder internal rotation.

Like I have mentioned in the previous videos, this test and the stretch should not produce any sharp pain. If it is, you may be making things worse. For instance, if you have a rotator cuff tear, overstretching it could possibly make the tear worse. So if you’re hesitant or unsure, it’s probably a good idea to just schedule an appointment.

Time to make your shoulders move! Let us know if you have any questions.

Jeff Remsburg DC MS DACRB Cert. MDT