Sleeper Stretch

The Sleeper Stretch is a Stretching technique used to restore length and improve Flexibility in The Shoulder Girdle , in particular of the Posterior Glenohumeral Joint Capsule .

Involved Muscle

• Infraspinatus

• Teres Minor

• Posterior Deltoid

Procedure

Starting Position:

• Patient lies on their ipsilateral side with the ipsilateral arm in 90º GH Joint - Flexion and Elbow - Flexion

• The opposing arm is used to apply the stretching force at The Wrist

The patient then applies the stretch to the desired arm by increasing the amount of GH Joint - Internal Rotation , driving The Hand towards the floor.

Cluster

The following techniques share similarities to the Sleeper Stretch and may be used to more suitably address a patients pathology:

Regression

The following techniques may be used to regress the Sleeper Stretch when it exceeds the capabilities of the patient:

• Genie Stretch

Progression

The following techniques may be used as a progression to advance the patient from the Sleeper Stretch once competent:

• Sleeper Stretch MWM - self-guided Glenohumeral Joint mobilisation combined with stretch

• Dead Hangs - whole body traction for Pull and Push muscles with large overhead range

• Shoulder Dislocates - mobility exercise that emphasises the greatest circumduction range possible

• Banded Capsule Rolls - split stance biceps variation that emphasises shoulder rotation

• Bretzel 1.0 - wholebody technical stretch that incorporates anterior shoulder

• Bretzel 2.0 - variation with greater hip extension range

• Jefferson Curl - maximal stretch for posterior chain with emphasis on intersegmental movment of the Vertebral Column and capacity to add load

Pathology

This stretch may be of benefit for those with the following conditions (SOURCE-1+2):

• Posterior Glenohumeral Joint Capsule Restriction

• GH Joint - Internal Rotation Restriction

• Scapular Dyskinesis - particularly with excessive Scapulothoracic Joint - Downward Rotation

• Subacromial Impingement - posterior capsule restriction leads to anterosuperior translation of the Humeral Head during GH Joint - Flexion

• Adhesive Capsulitis - leads to global capsular restriction

• Rotator Cuff Tear / Tendinopathy - pathologic states of the rotator cuff may be related to posterior capsule restriction

• Glenoid Labrum Tear - restriction in the posterior to inferior portion of the joint capsule increase stress on the Labrum, in particular its superior portion ( SLAP Lesion )

• Glenohumeral Instability - in particular posterior instability, with chronicity may lead to adaptive changes such as capsular thickening

References

1. Paine, R., & Voight, M. L. (2013). The role of the scapula. International journal of sports physical therapy, 8(5), 617–629.

2. Woon, C., & Miller, M. (2025, April 18). Glenohumeral internal rotation deficit (GIRD). Orthobullets. Retrieved from https://www.orthobullets.com/shoulder-and-elbow/3055/glenohumeral-internal-rotation-deficit-gird?hideLeftMenu=true