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Knowing internal rotator release and lengthening techniques can reduce shoulder pain, neck pain, scapulothoracic pain, etc., and improve fitness performance.

Shoulder Internal Rotator and Posterior Deltoid: Release and Lengthening 

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Brookbush Institute

I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

Totally loving the convenience and affordability of this program with my crazy lifestyle! I feel like I am getting a quality education without a massive cost! My favorite part is the videos I can watch in the courses. I learn so much better that way. Once I really spent more time on the site, I figured out how to maneuver around a lot better! I enjoy the sense of humor, as well as the easy explanation, and short tests. And if I am really tired, I can have the computer read me the lessons. 😁

Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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Human Movement Specialist

This course describes shoulder internal rotator release and lengthening (commonly referred to as shoulder mobility, shoulder mobility exercises, overhead mobility, shoulder internal rotator foam rolling, shoulder internal rotator release with ball, and/or shoulder stretching). Although terms like tight muscle, shoulder muscle tightness, rotator cuff tightness, tight lats, and tight pecs are commonly used, it may be more accurate to label these muscles as prone to over-activity (e.g. hypertonic, phasic), which may result in poor shoulder mobility. Performing shoulder internal rotator release and lengthening techniques to increase mobility prior to activation, integration, and strengthening techniques may significantly enhance rehabilitation and performance programs.

In practice, the release of the latissimus dorsi (lats), pectoralis major (pecs), subscapularis (subscap), teres major (t. major), and posterior deltoid (post delt), mobilizing the shoulder joint, and integrating a wall stretch (chest stretch), child pose stretch (lat stretch), crucifixion stretch (internal rotator stretch), and/or sleeper stretch (posterior deltoid), is likely to improve shoulder mobility and the effectiveness of exercises like shoulder external rotator activation, and exercises intended to target upper back musculature, including ITY’s, wall slides, etc.

Shoulder internal rotator over-activity and a loss of shoulder mobility have been correlated with altered upper extremity alignment, rounded shoulder posture, shoulder medial rotation syndrome, upper crossed syndrome, loss of shoulder internal rotator range of motion, loss of external rotator cuff strength and stability, shoulder injury, shoulder pain, neck pain, scapulothoracic pain, frozen shoulder, an increased risk of future injury, and a loss of sports performance. Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) should add these exercises to their repertoire to improve the outcomes of their integrated exercise programs and therapeutic (rehabilitation) interventions.

Latissimus Dorsi and Teres Major Static Release

Following release techniques, but before lengthening techniques, it may be beneficial to perform 

Self-administered Joint Mobilization Techniques: Upper Body

Latissimus Dorsi and Erector Spinae (Childs Pose) Static Stretch

Latissimus Dorsi and Erector Spinae (Childs Pose) Active Stretch

Pectoralis Major and Minor Static Stretch

Dr. Brent Brookbush demonstrating a latissimus dorsi release

Course Description: Shoulder Internal Rotator Release and Lengthening

Shoulder Internal Rotator and Posterior Deltoid: Release and Lengthening

Pectoralis Major Self-Administered Static Release

Study Guide: Shoulder Internal Rotator and Posterior Deltoid: Release and Lengthening

Introduction

The arms fall is a common sign of dysfunction during the overhead squat assessment in those with upper body dysfunction

For Upper Body Dysfunction

Dr. Brent Brookbush demonstrating an asymmetrical weight shift during an overhead squat assessment

Signs of Over-Activity and Adaptive Shortening

Optimising Motion

Optimizing Motion to Prevent Shoulder Pain

Introduction to Shoulder Internal Rotator Release & Lengthening

Research Corner

Several texts have noted the propensity of the muscles addressed in this course to become over-active and short (1-10). Further, many of these texts recommend techniques similar to those described in this course(1-6). Recently, more research has been done to investigate the relative activity of muscles as it relates to upper body movement impairment. Although there are more studies examining maladaptive changes in scapular muscle activity, there is a growing body of evidence correlating Upper Body Dysfunction (Upper Crossed Syndrome, Rounded Shoulder Posture) with increased internal rotator and posterior deltoid activity (8-10). 

For example, in a study by Scovazzo et al. (8), the 

 was more than twice as active in swimmers with shoulder pain than those without. Further in a study by Ibarra et al. (9), those with latent motor trigger points in the 

 exhibited nearly 25% more activity in the 

This may imply that despite an increase in length in those exhibiting excessive internal rotation during static and dynamic postures, this common site for trigger point development may be prone to over-activity (19).

Three examples of the transition from neutral head position to forward head position (a common sign of upper body dysfunction)

To date, research on self-administered release techniques for the upper body has not been done; however, studies using these techniques on lower extremity muscles have shown promising results. This includes a perceived decrease in muscle soreness and better performance and recovery in subsequent bouts of intense exercise when foam rolling was done immediately after training (11-13), an increase in range of motion (

 and calf) without a decrease in force production (14-15), and several studies have shown release and stretching (

 and calf) is more effective for increasing ROM than either technique alone (16-18).

Research Corner: Shoulder Internal Rotator Release

Pectoralis Major (Self-Administered) Static Release

Self-administered Release: Pectoralis Major

Subscapularis (Self-Administered) Static Release

Self-administered Release: Subscapularis

Latissimus Dorsi and Teres Major SA Static Release

Latissimus Dorsi and Teres Major Dynamic Release Technique

Latissimus Dorsi (Self-Administered) Dynamic Release Technique 2

Self Administered Release: Latissimus Dorsi

Posterior Shoulder (Self-Administered) Release Technique

Sleeper's Stretch

Self-administered Release: Posterior Shoulder

Crucifixion/Cross Stretch (Brookbush Institute preferred method)

Wall Stretch (for when you do not have a 3' long foam roll handy)

Active Pectoralis Major, Pectoralis Minor, and Subscapularis Stretch

Dynamic Pectoralis Major, Pectoralis Minor, and Subscapularis Stretch

Stretching Techniques: Pectoralis Major, Pectoralis Minor and Subscapularis   

Latissimus Dorsi and Erector Spinae Static Stretch (Child's Pose)

Latissimus Dorsi Active Stretch (Child’s Pose)

Latissimus Dorsi Dynamic Stretch

Stretching Techniques: Latissimus Dorsi, Erector Spinae and Quadratus Lumborum

Important Note

Modified Sleeper's Stretch (Brookbush Institute preferred method)

Stretching Techniques: Posterior Shoulder

Manual Pectoralis Major Stretch

Manual Stretching: Pectoralis Major

Latissimus Dorsi Manual Stretch

Manual Stretching: Latissimus Dorsi

Sample Mobility Program and Progressions

Perform each technique with accuracy (ex. hold until release for static techniques, 10-15 repetitions for active techniques at a 2:2:2 count, etc.). Progress the flexibility routine as trigger points are reduced, techniques are mastered, and optimal flexibility is attained (generally over the course of weeks). This can be accomplished by adding additional release techniques, and/or replacing static stretches with active and eventually dynamic stretches.

Crucifixion Stretch (Pectoralis major and minor, and subscapularis)

Child’s Pose (Latissimus Dorsi, Teres Minor)

Activate and Integrate under-active structures specifically – 

Sample Shoulder Mobility Program and Progressions

Phillip Page, Clare Frank, Robert Lardner, 

Assessment and Treatment of Muscle Imbalance: The Janda Approach

NASM Essentials of Corrective Exercise Training

Diagnoses and Treatment of Movement Impairment Syndromes,

Scovazzo, M.L., Browne, A., Pink, M., Jobe, F.W., and Kerrigan, J. (1991). The painful shoulder during freestyle swimming: An electromyographic cinematographic analysis of twelve muscles. 

José Miota Ibarra, Hong-You Ge, Chao Wang, Vicente Martínez Vizcaíno, Thomas Graven-Nielsen, Lars Arendt-Nielsen -Latent Myofascial Trigger Points are Associated With an Increased Antagonistic Muscle Activity During Agonist Muscle Contraction– The Journal of Pain, Volume 12, Issue 12, December 2011, Pages 1282–1288

Wong CK, Coleman D, diPersia V, Song J, Wright D. (2010). The effects of manual treatment on rounded-shoulder posture, and associated muscle strength. 

Healey, K.C., Hatfield, D.L., Blanpied, P., Dorfman, L.R., and Riebe, D. (2014). The effects of myofascial release with foam rolling on performance. Journal of Strength and Conditioning Research. 28(1). 61–68

Pearcy, G.E.P., Bradbury-Squires, D.J., Kawamoto, J., Drinkwater, E.J., Behm, D.G., Button, D.C. (2015) Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. Journal of Athletic Training. 50(1): 5-13

Macdonald, G.Z., Button, D.C., Drinkwater, E.J., Behm, D.G. (2014) Foam rolling as a recovery tool after an intense bout of physical activity. 

Sullivan, K.M., Silvey, D.B.J., Button, D.C., Behm, D.G. (2013). Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. 

International Journal of Sports Physical Therapy

Halperin, I., Aboodarda, S.J., Button, D.C., Andersen, L.L., Behm, D.G. (2014). Roller massager improves range of motion of plantar flexor muscles without subsequent decreases in force parameters. 

The International Journal of Sports Physical Therapy. 9(1):

Mohr, A. R., Long, B. C., & Goad, C. L. (forthcoming 2014). Foam Rolling and Static Stretching on Passive Hip Flexion Range of Motion. 

Skarabot, J., Beardsley, B., Stim, I. (2015). Comparing the effects of self-myofascial release with static stretching on ankle range of motion in adolescent athletes. 

International Journal of Sports Phyiscal Therapy.

Renan-Ordine, R., Alburquerque-Sedin, F., De Souza, E.P.R., Cleland, J.A., Fernandez-De-La-Penas, C. (2011) Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: A randomized controlled trial. Journal of Orthopaedic & Sports Medicine

David G. Simons, Janet Travell, Lois S. Simons, 

Travell & Simons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition

Bibliography

Questions, comments, and criticisms are welcomed and encouraged

Shoulder Internal Rotator and Posterior Deltoid: Release and Lengthening

Related Courses:

Course Description: Shoulder Internal Rotator Release and Lengthening

Study Guide: Shoulder Internal Rotator and Posterior Deltoid: Release and Lengthening

Introduction to Shoulder Internal Rotator Release & Lengthening
3 Sub Sections

Research Corner: Shoulder Internal Rotator Release

Self-administered Release: Pectoralis Major
1 Sub Section

Self-administered Release: Subscapularis
1 Sub Section

Self Administered Release: Latissimus Dorsi
3 Sub Sections

Self-administered Release: Posterior Shoulder
2 Sub Sections

Stretching Techniques: Pectoralis Major, Pectoralis Minor and Subscapularis
4 Sub Sections

Stretching Techniques: Latissimus Dorsi, Erector Spinae and Quadratus Lumborum
3 Sub Sections

Stretching Techniques: Posterior Shoulder
3 Sub Sections

Manual Stretching: Pectoralis Major
1 Sub Section

Manual Stretching: Latissimus Dorsi
1 Sub Section

Sample Shoulder Mobility Program and Progressions

Bibliography

Related Courses:

Comments

Guest

Shoulder Internal Rotator and Posterior Deltoid: Release and Lengthening

Related Courses:

Course Description: Shoulder Internal Rotator Release and Lengthening

Study Guide: Shoulder Internal Rotator and Posterior Deltoid: Release and Lengthening

Introduction to Shoulder Internal Rotator Release & Lengthening3 Sub Sections

Research Corner: Shoulder Internal Rotator Release

Self-administered Release: Pectoralis Major1 Sub Section

Self-administered Release: Subscapularis1 Sub Section

Self Administered Release: Latissimus Dorsi3 Sub Sections

Self-administered Release: Posterior Shoulder2 Sub Sections

Stretching Techniques: Pectoralis Major, Pectoralis Minor and Subscapularis 4 Sub Sections

Stretching Techniques: Latissimus Dorsi, Erector Spinae and Quadratus Lumborum3 Sub Sections

Stretching Techniques: Posterior Shoulder3 Sub Sections

Manual Stretching: Pectoralis Major1 Sub Section

Manual Stretching: Latissimus Dorsi1 Sub Section

Sample Shoulder Mobility Program and Progressions

Bibliography

Related Courses:

Comments

Guest

Introduction to Shoulder Internal Rotator Release & Lengthening
3 Sub Sections

Self-administered Release: Pectoralis Major
1 Sub Section

Self-administered Release: Subscapularis
1 Sub Section

Self Administered Release: Latissimus Dorsi
3 Sub Sections

Self-administered Release: Posterior Shoulder
2 Sub Sections

Stretching Techniques: Pectoralis Major, Pectoralis Minor and Subscapularis
4 Sub Sections

Stretching Techniques: Latissimus Dorsi, Erector Spinae and Quadratus Lumborum
3 Sub Sections

Stretching Techniques: Posterior Shoulder
3 Sub Sections

Manual Stretching: Pectoralis Major
1 Sub Section

Manual Stretching: Latissimus Dorsi
1 Sub Section