This RCT compared two stretches for posterior shoulder tightness in 54 asymptomatic subjects: the cross-body stretch and the sleeper stretch. Subjects with more than 10° of side-to-side internal rotation asymmetry stretched daily for 4 weeks. The question: does scapular stabilization make the sleeper stretch superior for improving internal rotation?
When a patient has posterior shoulder tightness and lost internal rotation, this trial supports the cross-body stretch as a first-line, effective home exercise. It directly challenges the popular teaching that the sleeper stretch is superior because it stabilizes the scapula. In this study the cross-body stretch matched or beat the sleeper, and the sleeper caused more pain.
The clinical mental model to hold: the position of the arm determines which part of the posterior capsule you load. Both stretches at 90° elevation target the posterior-inferior capsule and improve IR90. To stretch the posterior-superior capsule, you need the arm at the side, as in the thumb-up-the-back position.
A key caveat: these were asymptomatic recreational athletes, not symptomatic throwers or patients with impingement. High-level throwers may have bony humeral retroversion limiting stretch response, and symptomatic patients may be pain-limited.
This RCT compared two stretches for posterior shoulder tightness in 54 asymptomatic subjects: the cross-body stretch and the sleeper stretch. Subjects with more than 10° of side-to-side internal rotation asymmetry stretched daily for 4 weeks. The question: does scapular stabilization make the sleeper stretch superior for improving internal rotation?
When a patient has posterior shoulder tightness and lost internal rotation, this trial supports the cross-body stretch as a first-line, effective home exercise. It directly challenges the popular teaching that the sleeper stretch is superior because it stabilizes the scapula. In this study the cross-body stretch matched or beat the sleeper, and the sleeper caused more pain.
The clinical mental model to hold: the position of the arm determines which part of the posterior capsule you load. Both stretches at 90° elevation target the posterior-inferior capsule and improve IR90. To stretch the posterior-superior capsule, you need the arm at the side, as in the thumb-up-the-back position.
A key caveat: these were asymptomatic recreational athletes, not symptomatic throwers or patients with impingement. High-level throwers may have bony humeral retroversion limiting stretch response, and symptomatic patients may be pain-limited.