GIRD (Glenohumeral Internal Rotation Deficit) – Interactive Rehab Checklist

Dr Srinivas B S Kambhampati MS (Ortho), FRCS (Eng & Glasg), FRCS (Tr & Orth), Dip (Applied Biomechanics) Consultant Orthopaedic Surgeon, Sri Dhaatri Orthopaedic, Maternity & Gynaecology Center, Vijayawada

This tool helps track shoulder motion (IR/ER), total arc, red flags, and a structured GIRD rehab plan. It is educational and should be individualized by your surgeon/physiotherapist.

Plan: Athlete (overhead)
Phase: Phase 1

IR/ER & Total Arc Calculator

40°
110°
60°
90°
Affected Total Arc (IR+ER)
150°
Other Total Arc (IR+ER)
150°
IR Deficit (Other − Affected)
20°
Total Arc Difference
0°
Possible GIRD (≥20° IR deficit) – focus on posterior capsule + scapula

Typical screening: GIRD often uses an IR deficit ≥20° compared with the other side. Also check total arc. Rehab usually focuses on posterior shoulder mobility + scapular/kinetic chain control.

Self-check & Red Flags

Stop & contact your surgeon/physio urgently if any are present

Contact

📞 0866-2542656
💬 WhatsApp 8500227323
✉️ sridhaatri@gmail.com

Quick guidance

Choose a plan (Athlete/Non-athlete) and phase. Tick checkboxes as you complete tasks. Save to keep progress on this device.

✅ Phase-based Rehab Checklist
The checklist updates based on Plan (Athlete vs Non-athlete) and Phase. Focus is on posterior shoulder mobility, scapular control, and kinetic chain.
📌 Exercise Quick Library

Posterior capsule stretches

• Sleeper stretch (modified, pain-free) • Cross-body adduction stretch (stabilize scapula) • Posterior shoulder soft-tissue release

Scapular control

• Serratus activation (wall slides, plus) • Lower trap (prone Y) • Scapular retraction/depression drills

Rotator cuff & stability

• ER/IR band at 0° abduction • Side-lying ER • Rhythmic stabilization • Closed-chain weight-shifts

Tip: Keep stretches low-load, long-duration and pain-free. Avoid forcing internal rotation or aggressive ER stretching if instability symptoms.

📚 Evidence-informed Notes (for clinicians)

Key themes across classic GIRD literature: posterior shoulder tightness/capsule changes, scapular dyskinesis and kinetic-chain contributions, and focusing on restoring total arc rather than IR alone.

  • Burkhart SS et al. – “Disabled throwing shoulder” (concepts: posterior capsular tightness, internal impingement)
  • Wilk KE et al. – GIRD, posterior shoulder tightness and rehab emphasis
  • Myers JB et al. – posterior shoulder tightness and internal impingement associations
  • Kibler WB – scapular dyskinesis and shoulder injury framework

This tool is not a diagnostic instrument; it supports structured education and rehab tracking.