Monday, July 23, 2012

Blue Bell, PA - Sleeper Stretch

G.I.R.D. Handout

Sleeper Stretch
Note: these stretches require repeated repetitions on a regular/daily basis to result in the desired increases in flexibility.  Also, these changes do not come about quickly.  They take time and can easily be over done to the degree that you develop pain and soreness that leads to a new problem.  Do not rush the intensity of the stretching; hold 30 seconds, 2-3 repetitions, 3-4 times a day.  If you acquire flexibility similar to the other shoulder within 4 weeks, it would be very acceptable.

To check your progress, lie on the opposite side and check how much motion you have in the other shoulder.  The shoulder you are stretching should have 80-90% of the same degree of motion.

Note: if you feel pain or stretching in the front of the shoulder the stretch is not to be used in this position.  Experiment by moving your shoulder into less flexion or more flexion until you feel the stretch in the back of the shoulder.  There should be no anterior shoulder pain with these stretches.

1. Sleeper Stretch (1) (designed to increase the degree of internal rotation (IR) in your shoulder by stretching two of the posterior rotator cuff muscles and the posterior inferior capsule/ glenohumeral ligament in the shoulder.

A.     Side Lying Stretch Position (1).  Lie on your side with your shoulder in 90 degrees of flexion and the elbow in 90 degrees of flexion.  Keep your back perpendicular to the table.  Rotate your neck so you can place your chin next to your shoulder.  Move your shoulder into internal rotation by pressing the forearm closer to the table.  Take up the slack in the motion until you feel a stretching sensation in the back of your shoulder.

SLEEPER POSITION


SLEEPER STRETCH FINISH, SHOULDER FLEXION 90 DEGREES


SHOULDER FLEXION 70 DEGREES


B. Side Lying Stretch Position (2) “roll-over”.  Assume the same position as in Side lying Stretch (1).  Move your shoulder into internal rotation and then lift your chin off your chest and roll over your shoulder creating more stretch in the back of your shoulder.


C. Wall Stretch Position (1).  Stand and place your right shoulder against the wall in the same position as you would in the Side lying Stretch (1).  Perform the same exercise in this standing position.


D. Wall Stretch Position (2) “roll-over”.  Stand and place your shoulder against the wall in the same position, as you would in the Side Lying Stretch (2) “roll-over”.  Perform the same exercise in this standing position.

No Money Exercise.  Lie on the floor or on a table, or stand with your back against the wall.  Bend your elbows and raise your hands elbow level, keep your elbows against your side.  Move into scapular retraction and rotate your shoulders so your hands move away from your stomach.  Keep your head in a good postural position.  Hold the final position for 10 seconds and then relax and return to the starting position.  Maintain good upright neck and head posture during the exercise.  Often, the best position is supine (on your back) with a pillow between your scapula to serve as a fulcrum.


Repeat 10 times with 10 seconds hold when in the final position.

Wall exercise for scapular protraction/retraction. (1)  (to strengthen scapular retractor and protractor muscles in a closed kinetic chain exercise.)  Standing with your finger tips on the wall in front of you at a comfortable height but no higher than shoulder level.  Keep your elbows straight and move both of your shoulders so your scapulae move into protraction and then move them back into retraction.  Hold the retraction position for 6 seconds.  Maintain good upright head and neck posture throughout the exercise.


Wall thumbtack exercise: Wall exercise for scapular elevation/depression and shoulder internal/external rotation.  Place your thumbs on the wall in front of you in a comfortable position with them no higher than shoulder level.  Keep your elbows straight and rotate your arms using your thumbs as pivot points (like screwing a thumbtack into the wall).  Be sure to rotate them fully in each direction to the extreme so that the shoulders raise (scapular elevation) and lower (scapular depression) with the extreme positions of rotation.  Keep your head and neck in good postural alignment.


Phillip B. Donley, PT, ATC, MS., Chris Verna, ATC, MS., Jeff Cooper, ATC, MS., and Dr. Craig Morgan, MD