{"id":12374,"date":"2022-10-26T11:47:44","date_gmt":"2022-10-26T09:47:44","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=wiki&amp;p=12374"},"modified":"2022-10-26T11:47:44","modified_gmt":"2022-10-26T09:47:44","slug":"glenohumeral-internal-rotation-deficit","status":"publish","type":"wiki","link":"https:\/\/www.physiotutors.com\/wiki\/glenohumeral-internal-rotation-deficit\/","title":{"rendered":"Glenohumeral Internal Rotation Deficit"},"featured_media":12375,"template":"","class_list":["post-12374","wiki","type-wiki","status-publish","has-post-thumbnail","hentry"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":12375,"background_image_alt_text":"Glenohumeral Internal Rotation Deficit"},"heading":"Glenohumeral Internal Rotation Deficit (GIRD) Assessment","subheading":"Shoulder Assessment","content_editor":"","button_type":"internal_link","button_label":"Check our shop","button_style":"button-five","button_internal_link":4646,"button_anchor":"","button_url":"","button_file":"","label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Learn","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Assessment E-Book","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Reviews","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":16662,"button_anchor":"","button_url":"","button_file":""},"button_description":"Find this wiki on the Physiotutors platform"},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>Learn<\/h4>"},"column_right":{"content_editor":"<h6>Glenohumeral Internal Rotation Deficit (GIRD) Assessment<\/h2>\n<span style=\"font-weight: 400;\">Glenohumeral internal rotation deficit, abbreviated as GIRD can be a cause of shoulder impingement. <\/span><span style=\"font-weight: 400;\">GIRD is a sport-specific adaptation of posterior shoulder structures due to chronic excessive overload during frequent throwing. There are 3 different theories about those adaptations:<\/span>\n<ul>\n \t<li><span style=\"font-weight: 400;\">The first assumes a contracture of the posterior capsule, which is sometimes followed by associated gains in external rotation<\/span><\/li>\n \t<li><span style=\"font-weight: 400;\">Theory two says that GIRD develops as a bony adaptation that begins in the early years of overhead throwing<\/span><\/li>\n \t<li><span style=\"font-weight: 400;\">\u00a0The third hypothesis assumes hypertrophy of the external rotators due to frequent eccentric loading<\/span><\/li>\n<\/ul>\n<div class=\"embed-container\">\n\n[embed]https:\/\/www.youtube.com\/watch?v=RtTa4dvZsYc[\/embed]\n\n<\/div>\nTo assess for GIRD, check internal rotation in the supine position with the arm at 90\u00b0 of abduction. You can use a digital inclinometer, which has been shown to be most reliable in shoulder range of motion assessment. So have the patient in supine lying position, abduct the arm to 90\u00b0and then use the thumb of one hand to palpate the coracoid process to check for scapular movement and then, grab the arm at the wrist and induce internal rotation.\n\nA loss of more than 10\u00b0 between sides is considered a positive sign for GIRD. However, it's not that simple to diagnose GIRD solely based on a more than 10\u00b0 difference between sides in internal rotation. What's more interesting is to see the total range of motion from external to internal rotation. This TROM commonly varies between 135-180\u00b0 with no more than a 10\u00b0 difference between sides.\n\nWhile you may have seen a side-to-side difference of more than 10 degrees of internal rotation, the TROM for both shoulders might be the same with the side having less internal rotation displaying an increase in external rotation.\n\nSo to diagnose GIRD, assess the total range of motion of internal and external rotation in both shoulders and see if there is a more than 10\u00b0 difference.\n\n&nbsp;\n\n[cta]\n\n&nbsp;\n\n&nbsp;\n"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>References<\/h4>"},"column_right":{"content_editor":"<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18523035\/\" target=\"_blank\" rel=\"noopener\">Cools, A. M., Cambier, D., &amp; Witvrouw, E. E. (2008). Screening the athlete\u2019s shoulder for impingement symptoms: a clinical reasoning algorithm for early detection of shoulder pathology.\u00a0<i>British journal of sports medicine<\/i>,\u00a0<i>42<\/i>(8), 628-635.<\/a>"}},{"acf_fc_layout":"cta-image-v2","layout":"","background":"transparent","heading":"","content_editor":"<p class=\"subheading\">Like what you\u2019re learning?<\/p>\n<p class=\"heading-two\">BUY THE FULL PHYSIOTUTORS <strong>ASSESSMENT BOOK<\/strong><\/p>\n\n<ul>\n \t<li>600+ Pages e-Book<\/li>\n \t<li>Interactive Content (Direct Video Demonstration, PubMed articles)<\/li>\n \t<li>Statistical Values for all Special Tests from the latest research<\/li>\n \t<li>Available in \ud83c\uddec\ud83c\udde7 \ud83c\udde9\ud83c\uddea \ud83c\uddeb\ud83c\uddf7 \ud83c\uddea\ud83c\uddf8 \ud83c\uddee\ud83c\uddf9 \ud83c\uddf5\ud83c\uddf9 \ud83c\uddf9\ud83c\uddf7<\/li>\n \t<li>And much more!<\/li>\n<\/ul>","button_type":"internal_link","button_label":"Check out our shop","button_style":"button-two","button_internal_link":4464,"button_anchor":"","button_url":"","button_file":null,"side_button":{"side_button_content_editor":""},"bottom_button":{"bottom_button_content_editor":""},"image":22705,"image_alt_text":""},{"acf_fc_layout":"review-slider","heading":"WHAT CUSTOMERS HAVE TO SAY ABOUT THE ASSESSMENT E-BOOK","image_shortcode":"","image":"","image_alt_text":"","shortcode":"[wprevpro_usetemplate tid=\"2\"]","button_type":"internal_link","button_label":"","button_style":"button-one","button_internal_link":"","button_anchor":"","button_url":"","button_file":null},{"acf_fc_layout":"cta-full-width-v2","logo":{"logo_image":22443,"logo_image_alt_text":""},"heading":"<strong>Download<\/strong> the free Physiotutors app now!","content_editor":"","download_image":{"download_image_image":22444,"download_image_image_alt_text":""},"mobile_download_image":{"mobile_download_image_image":22445,"mobile_download_image_image_alt_text":""},"download_image_link":"https:\/\/onelink.to\/6dtzk5","mockup_image":{"mockup_image_image":22447,"mockup_image_image_alt_text":""},"mobile_mockup_image":{"mobile_mockup_image_image":22446,"mobile_mockup_image_image_alt_text":""}}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Glenohumeral Internal Rotation Deficit (GIRD) Assessment<\/title>\n<meta name=\"description\" content=\"Glenohumeral internal rotation deficit, abbreviated as GIRD can be a cause of shoulder impingement. 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