The Correct Way to Perform the Sleeper Stretch

Sleeper Stretch TechniqueThe sleeper stretch is one of those exercises that unfortunately gets abused.  As I have said, I don’t really like the sleeper stretch and I do not use it often – go back and read why I don’t use the sleeper stretch.  The stretch is probably overused and often times used used so aggressively that it may actually be doing more harm than benefit.

But I do see the need for the sleeper stretch for certain individuals.  Just like everything else, there is a time and a place to use it, but when something is very popular, it probably gets overused.  Plus, the sleeper stretch has been shown to be effective in restoring posterior shoulder tightness in overhead athletes.  So there is definitely some validity to it’s use, especially if done safely, but more on this below.

 

Who I Think Will Benefit from the Sleeper Stretch

There are a couple of groups of people that I think are very appropriate for the sleeper stretch:

1. People that have shoulder tightness

We talked about how the sleeper stretch causes strain on the posterior capsule.  That is great if you are trying to stretch the posterior capsule.  That is also great if you have carefully assessed the person and found them to have posterior capsule tightness.  But you have to assess and determine that the posterior capsule is tight.  Don’t just assume that if they have decreased shoulder internal rotation that their posterior capsule is tight, there are many other structures that may be involved including the muscles and boney tissue.

You can not assume that if someone has a loss of internal rotation that their posterior capsule is tight.

Do you know what two types of people that I would consider is this group?  People with adhesive capsulitis (or frozen shoulder) and people that had shoulder surgery and lost motion.  These groups probably are not athletes.  Sure, there are always exceptions, that is why we have to carefully assess.

For athletes, I actually have found that tightness of the shoulder often comes from overuse and soft tissue restrictions.  Work on the posterior shoulder musculature and their tightness goes away, no aggressive sleeper stretch needed.

2. Athletes Without Help

There is a group of athletes that could benefit from the sleeper stretch, those that do not have a skilled person working with them.  This mostly applies to the young athlete, such as the Little League pitcher.  Any form of stretching is probably better than no stretching, and the sleeper stretch is an effective stretch that you can perform by your self when done correctly.  But again, realize that there are negatives to this stretch, so again, go back and read my article on why I don’t like the sleeper stretch.

 

How to Perform the Sleeper Stretch

OK, so you want to perform the sleeper stretch.  Here is how I would recommend that you perform the sleeper stretch.  Just my opinion and I am sure that some may disagree, so take this with a grain of salt.  Here is a video demonstrating what I feel is the proper form for performing the sleeper stretch followed by my 3 keys to performing the sleeper stretch correctly:

 

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3 Keys to Performing the Sleeper Stretch Correctly

  1. Scapula position.  Roll onto your side and make sure that your scapula is retracted, meaning that you do not want to lay flat on your scapula with your shoulder rounded, you want to lay mostly on your rib cage and the outside border of your scapula.  I usually roll forward towards my arm to get my scapula off the ground and then roll back.
  2. Shoulder position.  Next, make sure that your body is not straight up and down.  You actually want to roll backwards so you body is facing upward at close to a 45 degree angle.  This will get your shoulder out of the sagittal plane, which places too much strain on the posterior capsule, and into the scapular plane that stretches more of the posterior musculature.  I am also trying to keep my head in neutral with my body position.  I would normal use a yoga block or something similar to relax my head but it would have blocked the camera.
  3. Intensity.  Lastly, you want to gently push down until you feel a MILD stretch and hold for 30 seconds.  Most people will push WAY to hard.  You do not want to feel anything in the front of your shoulder.  The goal is to feel a mild stretch in the back of your shoulder and to hold this position.  Do this gently for a few reps and you will see improvement without cranking on the arm aggressively.  Notice the amount of IR that I am achieving.  It’s not a large movement but as you can see it is close to 45 degrees of internal rotation, which is plenty.  Your hand is not supposed to touch the ground, that is WAY too much motion.

That last point could be the most important and what I likely see abused the most, the intensity of the stretch.

If you do not feel any stretch at all before starting to feel anterior shoulder pain, stop, the sleeper stretch is not for you.

You are now putting too much stress on the shoulder joint and not achieving the posterior shoulder stretch we are looking for with the sleeper stretch.  Remember above when I referred to a study that showed that the sleeper stretch was effective in restoring posterior shoulder mobility in overhead athletes?

Well, interesting enough, the sleeper stretch did not change motion in healthy, non-overhead athletes.  So if you don’t have posterior shoulder tightness, you don’t need the sleeper stretch and may just irritate your shoulder.

Shoulder PerformanceThese are some of the points that Eric Cressey and I really wanted to hammer home when we decided to make our DVD Optimal Shoulder Performance.  There are usually very specific people that need exercises like the sleeper stretch, but not everyone is a candidate.  We wanted to get this information out there to help people make the right decisions.

In summary, if you need to perform the sleeper stretch, I feel that there is a safer way to perform the stretch that minimizes you chance of inflaming the shoulder joint.  But I still feel like there are ways to achieve the same results without having to be aggressive with the sleeper stretch.  Click the link below to read about some alternatives that I feel are pretty effective:

Regardless, if you are going to try this, at least understand what I consider the correct way to perform the sleeper stretch.

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16 Responses to “The Correct Way to Perform the Sleeper Stretch”

  1. Mike nice follow-up post. You suggest that only patients with posterior capsule tightness require the sleeper stretch. How do you determine clinically that a patient has posterior capsule tightness as opposed to posterior rotator cuff tightness, or just humeral retroversion?

    • Thanks Stephen. I really didn’t say “only patients with posterior capsule tightness require the sleeper stretch.” Sorry for not being clear on that.

      All three things you mention have different methods of assessment , to assess posterior capsule tightness you need to test the joint mobility. Testing a motion, such as IR, does not distinguish “why” there is lost motion. But if you assess posterior capsular laxity or translation bilaterally, you should be able to assess if the posterior capsule is tight.

      Sounds like this may have to be an article of it’s own…

  2. Hi Mike. Very interesting commentary. What are your thoughts on the L-bar IR performed in the supine position? Thanks.

    • Brian, thanks for the comment. The L Bar or Rotator bar in the supine position are both useful tools for assisted IR and home stretching. The difference is the plane of motion (scapular vs sagittal). Same concept applies with intensity. Also, with these tools make sure you only push until you feel a mild stretch and the shoulder remains down.

  3. Spectacular stuff as always.

    Rick Kaselj of http://ExercisesForInjuries.com

    .

  4. Hey Mike,

    We get a lot of athletes, not just overhead ones, that show lack of internal rotation at 90 deg of ABD. They are often avid lifters as well. We also see this in our general population clients. Should these two groups be treated differently for basically the same thing?

    Other than the sleeper stretch, what methods do you use to correct this lack of internal rotation? Ive used the side lying cross body stretch for some, but most dont feel anything with it.

    I have your OSP DVD and love it, maybe i need to watch it again. However, I think it would be a great idea to have an article/video on how you determine clinically that a patient has posterior capsule tightness as opposed to posterior rotator cuff tightness, or just humeral retroversion as stated earlier.

    Thanks!!

  5. Hi Mike,
    I noticed you wrote above to “gently push down until you feel a MILD stretch and hold for 30 seconds” and to “Do this gently for a few reps…” which is how I typically perform/teach Static stretching with my patients. However, in your video of the correct way to perform the sleeper stretch, it appears that you go to the point of that “gentle stretch” but only seem to hold it for ~3 seconds and repeat several times. I will admit, I am new to your website…did I miss something? How do you typically perform your stretching, for how long, and why?
    Also, while I’m at it, what do you think of Dynamic vs. Static stretching? (I’m under the general assumption of static for loss of motion and dynamic as more of a warm up if already have adequate flexibility…but curious of your thoughts/approach)

    This series on the sleeper stretch is perfectly pertinent to a patient I just started working with – I can see your point and have modified how I approach her Tx as a result. Thanks!!

    • Good question and observation, just thought a video of me holding a stretch for 30 seconds would be boring! Do as I say not as I do! Would agree with your other thoughts on static vs. dynamic. Thanks

  6. I get pinching pain around the biceps tendo when I do the sleeper stretch. I get pain is the same spot when I do the Apley Scratch Test. I think it’s from scapula instability like winging, especially when I reach up my back.

    Can you please suggest stretches that would be good for this? I’m already doing the Push-up Plus (serratus anterior) and band external rotation for strengthening.

  7. Mike,

    I am a high school baseball player, and I am having some pain on the outside of my elbow on both the inside and outside near the tricep. I visited my school trainer, and he highly suggested the sleeper stretch because I have an extremely tight shoulder area (sorry im unaware of the actual name), along with tight hip flexers. He said if I do it 2-3 times a day I will see improvement in my elbow pain because my range of motion with my shoulder will be improved. Do you agree with him? Do you have any advice to help benefit my elbow? Thanks a lot!!!

    • Mitchell, I would not recommend that, even without seeing you. I would recommend you get checked out by a doctor, you don’t want to throw through something like a growth plate injury. Sleeper stretch isn’t going to help that and may actually make you worse. Good luck.

Trackbacks/Pingbacks

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    [...] do the sleeper stretch properly if it is to be done and alternatives to the sleeper stretch as well here and here.  Anything else you guys can think of we might typically throw at them with the basic [...]

  2. Shoulder Rehabilitation…Another piece of the puzzle « Dave Leyland - June 22, 2012

    [...] do the sleeper stretch properly if it is to be done and alternatives to the sleeper stretch as well here and here.  Anything else you guys can think of we might typically throw at them with the basic [...]

  3. Shoulder pain, GIRDs and Sleeper Stretches…. « The Sports Physio - January 27, 2013

    [...] However, I do think the sleeper stretch has a place and a role in dealing with GIRDs, I think if taught correctly and the position (ie height of the elbow) is adjusted to the individual tightness and pain levels, then the sleeper stretch can be an effective method of reducing a GIRD, again Mike Reinold shows us how to do the sleeper stretch correctly and safely here [...]

  4. Should Pitchers Stretch to Increase External Rotation? « BetterPitching.com - April 29, 2013

    [...] The more I discuss with industry professionals, the more I learn that it’s all about the individual. Many, including Mike Reinold (another fantastic resource), feel that too much sleeper stretch can actually work against you. He does a great job explaining and demonstrating the stretch in this article. [...]

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