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Glenohumeral internal rotation deficit in throwing athletes: current perspectives

Authors Rose MB, Noonan T

Received 16 October 2017

Accepted for publication 16 January 2018

Published 19 March 2018 Volume 2018:9 Pages 69—78

DOI https://doi.org/10.2147/OAJSM.S138975

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Andreas Imhoff


Michael B Rose, Thomas Noonan

Steadman Hawkins Clinic, University of Colorado School of Medicine, Denver, CO, USA

Abstract: Glenohumeral internal rotation deficit (GIRD) is an adaptive process in which the throwing shoulder experiences a loss of internal rotation (IR). GIRD has most commonly been defined by a loss of >20° of IR compared to the contralateral shoulder. Total rotational motion of the shoulder is the sum of internal and external rotation and may be more important than the absolute value of IR loss. Pathologic GIRD has been defined as a loss of IR combined with a loss of total rotational motion. The leading pathologic process in GIRD is posterior capsular and rotator-cuff tightness, due to the repetitive cocking that occurs with the overhead throwing motion. GIRD has been associated with numerous pathologic conditions, including posterior superior labral tears, partial articular-sided rotator-cuff tears, and superior labral anterior-to-posterior tears. The mainstay of treatment for patients with GIRD is posterior capsular stretching and strengthening to improve scapular mechanics. In patients who fail nonoperative therapy, shoulder arthroscopy can be performed. Arthroscopic surgery in the high-level throwing athlete should be to restore them to their functional baseline with the minimum amount of intervention possible.

Keywords: GIRD, throwing athlete, internal impingement, shoulder

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