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Manual Latissimus Dorsi and Shoulder Internal Rotator Stretch

The Manual Latissimus Dorsi and Shoulder Internal Rotator Stretch is a stretching exercise which helps to improve posture and improve shoulder and posterior upper body muscle flexibility. To perform this stretch, you should begin by standing in an upright position with your feet shoulder-width apart. Then, grab your left hand with your right and reach your left arm up and across your chest. Keeping your elbow bent, gently pull your left arm toward your right shoulder while simultaneously pushing your right shoulder in a downward

Transcript

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This is Brent, coming at you with
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videos. In this video we're going to go over both the internal rotators of the
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glenohumeral joint, as well as the latissimus dorsi. I think when I show you
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these two techniques you'll understand why I paired them both together in this
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video. I'm going to have my friend, Yvette, come out and help me demonstrate this
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exercise. Now, first things first, we talked about body position, notice here
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Yvette's right up next to my hips so that I don't have to lean over the table.
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Since I'm stretching muscles around her glenohumeral joint, I want to
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make sure that the table is stabilizing her scapula, that the glenohumeral joint
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is just slightly hanging off the table so I have free movement of that joint.
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The first manual concept, or manual technique, we're going to have to learn
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for these two stretches is how to stabilize the scapula, keep it from
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upwardly rotating. So the first thing we need to do is we need to palpate and
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find the inferior angle of the scapula. This is not too terribly difficult. We're
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then going to try to find a way to cup the inferior angle right here, and all we
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have to do is kind of hold our hand like this, slide our fingers underneath the
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patient or client, and then actually, Yvette's body weight is doing a really good
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job of holding my hand in place. I don't need to push or shove. All I need to do
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is keep my hand hooked like this, Yvette's body weight is pushing against my
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fingers, and I have her inferior angle right in the palm of my hand. I'm then
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going to go ahead and grab her arm right around her humeral condyles. That gives
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me good control of both her forearm, as well as her humerus, and then I'm going
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to pull her back into flexion and external rotation here. Now, I can feel a
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little bit of pressure up against the palm of my left hand, I can feel a good
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stretch happening here on her arm, and where do you feel this Yvette? Your armpit?
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So, this, everybody calls a lat stretch, and the truth of the matter is
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is this is not a very good lat stretch. It is a wonderful internal rotator
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stretch. Where Yvette is feeling it is in her armpit right around her
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subscapularis and teres major. So, an important stretch, but if I'm trying to
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affect the latissimus dorsi I'm going to need to start
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here, make sure that I get a good stretch out of these limiting structures, but
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then I'm actually going to need another technique for my latissimus dorsi. For
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the latissimus dorsi, what I'm going to do is, I'm going to bring Yvette into
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this hook lying position, I'm going to posteriorly tilt her pelvis, that'll help
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lengthen her lats on this side, I'm then going to take this hand and go back to
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that lumbrical grip you saw me use in the pectoralis major stretch,
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that's going to go over her humeral head, because one of the things that happens
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when we pull the arm back this way is the humeral head tends to want to pop up
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this way. I'm going to go over her humeral head, I'm going to make sure I
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have good control of her achromion shelf and the lateral third of her clavicle,
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and I'm going to keep that humeral head down, while pushing the scapula back into
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a posterior tilt, I'm going to pull her arm into flexion, a little bit of traction or
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distraction here and external rotation, and now if I take it to the first
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resistance barrier, now where do you feel this? Notice she feels it a lot lower. She
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actually feels it below her scapula. This is a lat stretch. Now, why would I want
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to stretch the lats and not the internal rotators of the shoulder? Which is
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definitely a fair question. If she had upper body dysfunction chances are I'm
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going to have to stretch both. This is part of that upper body dysfunction.
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We have both latissimus dorsi tightness, as well as subscapularis and teres
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major. So, it would probably start with the subscapularis and teres major stretch,
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get those limiting structures out of the way, and then move to the bigger
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latissimus dorsi stretch. But, if Yvette was somebody who had, let's say, an
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anterior pelvic tilt, the latissimus dorsi are contributing to
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lumbar extension, not her glenohumeral internal rotators. So even though they
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also may be tight, if my focus is here initially, I'm going to want to do this
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latissimus dorsi stretch and be very specific to a structure that is
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going to help improve the dysfunction I'm working on. So let's go over these
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two techniques one more time. The first one was
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legs in neutral position, I'm going to cup the inferior angle of the scapula and
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let her body weight push my fingers down. I'm going to grip the humeral condyles
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and pull her back into flexion and a little bit of external rotation. She
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probably will feel this right in her armpit. This is subscapularis and teres
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major. Now if I want to stretch the lats I'm going to put the legs into a hook
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lying position, posteriorly tilt the pelvis, that's going to help lengthen the
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lats down here, I want the scapula to upwardly rotate and
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posteriarly tilt, and I want to protect the humeral head from shifting anteriorly, so
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I'm going to use this lumbrical grip up here, let the scapula move up into my
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hand, but push it back into the table, as well as the humeral head, and then pull
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into flexion, distraction, retraction, and external rotation to the first
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resistance there. I hope you enjoy these stretches. I think as your technique will
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get better, you'll get bigger and bigger results from your clients. Use a little
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bit of functional anatomy knowledge to refine which structures you're going after.