Glenohumeral Internal Rotation Deficit in Overhead Athletes Part 2: Measurement Techniques

A routine evaluation is pivotal in identifying glenohumeral internal rotation deficit (GIRD) in overhead athletes and is a crucial step to prevent subsequent, debilitating injuries. There are two common approaches to measure GIRD: direct angle measurement with a goniometer and the Apley scratch test.

Direct angle measurement with a goniometer requires patients to lie supine on the examination table to allow assessment of both sides with direct comparison. At the initial position, the shoulder is abducted 90° and the elbow is flexed 90° (Figure 1). The examiner stabilizes the scapula by applying manual pressure anteriorly over the front of the shoulder and coracoid process. Each shoulder is passively rotated externally and then internally fully. If one arm is injured, the healthy arm is measured first to gauge normal rotation.

Using a goniometer, the angle formed from the starting position and the forearm at full internal rotation is documented, and the same measurement is performed at full...