• Alyson Vasconcellos, PT, DPT, CSCS


If you have ever been in physical therapy for shoulder pain, you have probably heard the term “GIRD”. In the world of physical therapy, GIRD is Glenohumeral Internal Rotation (IR) Deficit and it is associated with a myriad of other shoulder pathologies like SICK scapula, instability, impingement and structural pathologies due to compensatory changes.

GIRD is commonly associated with overhead athletes and individuals with poor posture. In its true sense, GIRD is more than just a deficit in IR range of motion; rather it is defined as the loss of IR with a total decrease in rotational range of motion compared to the contralateral shoulder. That means, both sides need to be assessed and compared before diagnosing. This loss in range will often lead to a compensatory increase in external rotation, especially in the throwing athlete. It may also lead to a change in humeral head position through retroversion as the posterior rotator cuff muscles become tight.

But is “GIRD” used too liberally with patients? I would argue most throwing athletes need some loss of internal rotation in order to achieve that increase in external rotation in their dominant arm. If the total arc of motion is within 10 degrees of the non-dominant arm, maybe there isn’t much pathology after all. It is critical to look at the whole picture. What is the total arc of motion? Is it the capsule or the posterior rotator cuff that is tight? Is