Name: Manual Latissimus Dorsi and Shoulder Internal Rotator Stretch
Uploaded: 2023-04-23T07:03:38.000Z
Duration: 5 min 37 s

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https://stream.mux.com/VIjlb01aN82O6OuOI00xzS5Q02PPUZCcKhTklUNMOkXZZQ.m3u8

Learn how to properly perform the manual latissimus dorsi and shoulder internal rotator stretch in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides expert coaching on setup, positioning, alignment, and safe stretch application to improve latissimus dorsi and shoulder internal rotator flexibility and shoulder mobility. Enhance shoulder flexion and external rotation range of motion while supporting optimal scapular mechanics with this targeted stretching technique. Perfect for athletes, fitness enthusiasts, and rehabilitation clients seeking to reduce shoulder tightness, improve mobility, and restore optimal shoulder mechanics while reducing injury risk.

Introduction to Stretching Techniques for Shoulder Muscles

Stretching Internal Rotators: Techniques and Application

Specifics of Stretching Latissimus Dorsi

Understanding the Relationship Between Muscle Tightness and Upper Body Dysfunction

Review of Techniques for Internal Rotators and Latissimus Dorsi

Manual Latissimus Dorsi and Shoulder Internal Rotator Stretch

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

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Have your client/patient assume a supine position on the table.

Have them slide to the side of the table so their shoulder is off the table and free to move, but the scapula is supported.

Approach your client from the side, at about the level of their axilla.

Use the hand closest to their head to grasp the arm at the elbow (or wrist) with a lumbrical grip, and move the arm into flexion short of end range.

Use your other hand to stabilize the scapula by placing your palm on the inferior angle of the scapula. Note: This is easiest with your hand supinated so that your fingers slide slightly under your patient/client's torso.

Now gently take the shoulder to end range by increasing the amount of flexion, abduction, and external rotation, while keeping their inferior angle of the scapula stabilized. Unlike the pectoralis major stretch above, this stretch will be primarily flexion and abduction (towards the ear).

Hold this stretch and wait for the discomfort to subside or for a “release” (generally 30 – 120 seconds).

Move deeper into the stretch or move on to the next muscle to be stretched.

For those patients/clients who exhibit a significant amount of range of motion loss, you can reduce the amount of work you have to do. Stabilize the inferior angle, have your patient or client place their hand behind their head, and gently press the elbow toward the table.

More is not better: A mild sensation of stretch is plenty. Increasing tension to a point of moderate discomfort or pain will only result in muscle guarding, an increased risk of injury, and/or a less effective stretch.

Manual Latissimus Dorsi and Shoulder Internal Rotator Stretch

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