Glenohumeral internal rotation deficit, abbreviated as GIRD can be a cause of shoulder impingement. 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:
The first assumes a contracture of the posterior capsule, which is sometimes followed by associated gains in external rotation
Theory two says that GIRD develops as a bony adaptation that begins in the early years of overhead throwing
The third hypothesis assumes hypertrophy of the external rotators due to frequent eccentric loading
To assess for GIRD, check internal rotation in the supine position with the arm at 90° 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°and 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.
A loss of more than 10° 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° 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° with no more than a 10° difference between sides.
While 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.
So 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° difference.
21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE
What customers have to say about the Assessment E-Book
The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Awesome! Also for beginners!
The Assessment E-Book It’s an amazing Compilation! Congrats to all the work you have put in there. You’ll propably find all the test’s you’ve been looking for with propper explaination and source to doublecheck for you self. definetly a must have for every student, but it will also help an experienced practioner. Im looking forward to the lifelong updates on the topics.
Great work, guys
The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. The authors conducted an extensive research on assessment tests in manual therapy. I find it very easy to read. The more I read the more I learn. Thank you!
The Assessment E-Book This book is great! It is very structured and detailed. It works extremely well on my Macbook and iPad.
The Assessment E-Book The best way to spend 80euros. Totally worth it. The amount of work you put behind this must have been absolutely huge. Every physical or physiotherapist should own it.
Congrats guys you’ve done an incredible job.
I’ve learnd a lot of new things and my approach to therapy in general have totally changed.
In one word: amazing. Keep going guys ! Best wishes from france.
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.