Everything You Need to Know About Glenohumeral Internal Rotation Deficit (GIRD) and How to Find Relief

Glenohumeral Internal Rotation Deficit (GIRD) might sound like a complicated term, but it’s essentially a condition where your shoulder loses its ability to rotate inward properly. This is often due to the repetitive stress from activities that require overhead movements, like throwing a baseball or swimming.

The issue usually arises when the tissue in the back of the shoulder becomes tight or scarred. Over time, this tightness leads to limited internal rotation of the shoulder, making it harder to move your arm in certain directions. For athletes, especially those who throw frequently, this can result in discomfort and a decrease in performance, often described as a “dead arm.”

What Are the Symptoms?

If you have GIRD, you might feel stiffness in your shoulder, especially before you start moving it a lot. This is why athletes often report the need for a prolonged warm-up. You may also notice a decrease in throwing speed or power, which can affect your game. When throwing or reaching overhead, pain may arise, particularly in the back of the shoulder.

What makes GIRD different from other shoulder injuries is that the pain is often localized to the back of the shoulder, and you might not feel it in other parts of the arm. If you’re dealing with a lot of discomfort in the back of your shoulder when performing overhead activities, GIRD could be the culprit.

How to Diagnose GIRD

Diagnosing GIRD isn’t too difficult. Your doctor or physical therapist will test your shoulder’s range of motion. If your internal rotation is at least 20 degrees less on your dominant side compared to your non-dominant side, this is a key sign of GIRD. The condition can also be assessed through a simple physical exam, but in some cases, doctors may recommend imaging tests like an MRI to rule out other potential issues.

Treatment: How to Get Back to Feeling Your Best

The good news is that GIRD can often be managed effectively with the right approach. Here’s how to treat it:

Stretching for Relief
Stretching is the cornerstone of GIRD treatment. The main goal is to loosen up the tight areas around the shoulder joint, particularly the muscles and ligaments that contribute to the loss of internal rotation. Stretching the posterior shoulder, chest, and rotator cuff muscles can help restore normal range of motion. Specific stretches include crossbody shoulder stretches and others aimed at the internal rotators, such as the infraspinatus and subscapularis muscles.
Strengthening Exercises
While stretching addresses tightness, strengthening helps support the shoulder and prevent further injury. Strengthening the muscles that stabilize the shoulder joint, including the rotator cuff and scapular stabilizers, is essential for improving mobility and avoiding compensations that could make the condition worse. Strengthening exercises should be introduced once the pain has reduced and the range of motion improves.
Manual Therapy
Your physical therapist or chiropractor may use manual therapy to mobilize the shoulder joint, particularly focusing on the internal rotation. These gentle techniques can help restore motion and reduce stiffness.
Pain Management
If you’re in pain, you may find relief from over-the-counter pain medications like acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). These can help reduce inflammation and ease discomfort, especially when starting with exercises. In more severe cases, a corticosteroid injection may be recommended.
Additional Therapies
If conservative treatments aren’t enough, your provider might consider therapies like dry needling or even advanced options like Normatec Compression Therapy to reduce muscle tightness and improve circulation around the shoulder joint. Each case is different, so a tailored approach works best.
Lifestyle Changes and Prevention
Managing GIRD is not just about treating it in the moment; it’s about keeping it from coming back. Incorporating microbreak exercises during long periods of sitting or desk job tension can help maintain shoulder mobility. Additionally, if you’re an athlete, make sure to incorporate rest periods into your training routine, avoiding overuse injuries and allowing your shoulder to recover.

Managing GIRD as Part of Your Overall Health Journey

If you’re dealing with GIRD, it’s important to approach your recovery holistically. Beyond shoulder-specific treatments, ensuring your overall mobility and maintaining healthy aging through regular exercise can go a long way. Exercise for aging bodies is vital to maintain flexibility, strength, and prevent further joint problems. Addressing lifestyle habits and balancing activities that stress the shoulder will help you stay active while avoiding injury.

For athletes, GIRD can often be managed well if you get help early. In fact, the sooner you address the imbalance in your shoulder, the better your long-term results will be. Whether you’re recovering from an injury or simply want to avoid one, being proactive is key to better mobility and pain-free movement.

Glenohumeral Internal Rotation Deficit (GIRD) is a common condition among overhead athletes, but it doesn’t have to sideline you for long. With the right combination of stretching, strengthening, and manual therapy, you can restore full shoulder function and prevent future problems. Don’t let GIRD hold you back—talk to your healthcare provider today to find a treatment plan that works for you!

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2845 Summer Oaks Dr., Memphis, TN 38134
(901) 377-2340

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