Sleeper Stretch for posterior capsular tightness

by | May 10, 2011 | All Blogs | 4 comments

Entry By: Eric Folmar, MPT, OCS, PT

Just looking for some feedback on the commonly used sleeper stretch for posterior capsular tightness.  As I have played with this stretch over the years I find that patients have a tendency to move away from the ideal stretch position.  I have begun to have patients actually 1/4 turn top prone, basically placing their face onto the upper arm.  I find it seems to free the scap from the table yet seems to hold it to allow for a nice stretch.  Let me know you thoughts.  Below is the traditional version.



Love to hear your thoughts.

Thanks

Eric Folmar, MPT, OCS

4 Comments

  1. Eric Folmar, MPT, OCS, PT on May 12, 2011 at 7:38 pm

    Robin – feel free to use the picture. I found it off google images. No copyrights attached. I was concerned about the increased impingement as well at first. However, I myself have had many bouts of tendonitis/impingement, partial cuff repair and SLAP repair. As I have found with with most pts. (including myself), this position seemed to move beyond impingement and actually was a very tolerable stretch. Just my experience!

    Mike – Thanks for the compliments. I agree with you on this stretch. I have the patient lay the chin right on the bicep. I myself find this a better position as well.

    Lisa – yes this is one of my favorite stretches. I use it often. Great stretch for throwing athletes. As far as sleeping on their side, I try to encourage patients to stay off their side if possible, as I believe side-sleeping is the cause of a lot of the RC issues we see.

    Eric

  2. Robin on May 12, 2011 at 11:03 am

    Eric,

    The modified position seems to place the anterior shoulder into more compression, therefore a potential increased impingement of the supraspinatus tendon and other anterior structures, which typically causes increased pain. But if you have used that position successfully, then that would be indication to use it. The traditional position seems to stabilize the scapula well, thus getting better isolated GH internal rotation.

    Would it be ok for me to copy this exercise and use it in our clinic for our patients?

    Thanks for sharing your thoughts on this particular stretch!

    Have a great day!
    Robin Braden, PT

  3. Michael Cudahy on May 12, 2011 at 9:48 am

    Hi Eric,
    Enjoyed your foot and ankle course in Albany recently. Rolling foward definitely helps. I cue them to bring their chin right close to their bicep. Great stretch if they take their time and be consistent with proper form.
    Thanks
    Mike

    • Lisa Cordova on May 12, 2011 at 10:30 am

      Hi Eric,

      I’m so glad to hear that other therapists are using this stretch. I though that I had invented it, since I had shoulder stiffness and supraspinatus tendinitis once, and I was able to treat the tightness and pain by using this stretch. I find the goal needs to be where the patient can tolerate a 3/4 prone lying postion with the arm elevated under the pillow so that the elbow is (ER’d) up toward 1:00 o’clock. I never let shoulder patients sleep with their arm under them with the elbow facing down (IR’d)toward 7:00 o’clock.