Professional Baseball Strength & Conditioning

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Why We Don’t Do the Sleeper Stretch in Baseball

By Nate Friedman, CSCS and Scott Cline, CSCS, Arizona Diamondbacks

A common complaint that strength coaches, athletic trainers and physical therapists in professional baseball hear from players is that their posterior shoulder is tight. Given the throwing volume that these players do on a daily basis, this is a completely warranted complaint. (Data indicates that most professional baseball players make approximately 20,000 throws per year). In years past, one of the most widely used treatment methods for this complaint was the sleeper stretch.

When performing the sleeper stretch, a left-handed pitcher, for example, lies on his left side with his left shoulder and elbow flexed 900. From this position, he applies a gentle force to the back of the hand or wrist with his right hand moving the shoulder into as much internal rotation as tolerated. The goal is to stretch the posterior shoulder musculature by taking the shoulder into its opposing range of motion.

There are several reasons why this stretch was so popular for a long time. First, it usually made the player feeling like his shoulder received the stretch it needed. Second, it was a simple exercise the player could do on his own without the help of a strength coach, ATC or PT. Third, it checked the box of traditional thought that believed – “if the posterior shoulder was tight, you can remove the tightness by stretching it.” Recent research and practical experience have led many in baseball to move away from the sleeper stretch in favor of other treatment options for treating a tight posterior shoulder.

There are several reasons why this stretch has fallen out of favor with strength coaches and medical staff.

  1. The number one reason is that it puts the athlete in an impingement position similar to that used in the Hawkins-Kennedy test for shoulder impingement. Without going into detail, most sports medicine professionals believe that actively putting the shoulder into an impingement position and then taking it further into that impingement range of motion is not the best way to treat shoulder discomfort.

  2. A second reason is that most athletes who throw overhand, especially pitchers, due to the high-force, repetitive nature of the sport, have some degree of posterior shoulder instability. Torquing an unstable shoulder can strain the posterior capsule, irritate the rotator cuff and biceps tendon and potentially increase joint instability. You don’t want make an already loose athlete looser by stretching the posterior capsule and reducing joint stability.

  3. A third reason is that some athletes get too aggressive with the stretch. More is not better. Being too aggressive can flare up the shoulder instead of making it better.

  4. The sleeper stretch, especially when performed by younger, inexperienced and unsupervised athletes, is often performed with poor technique.

  5. Finally, if the shoulder feels tight (lacks mobility), aggressively torquing into that loss of mobility has the potential to make the shoulder feel worse.

Now that we have discussed the rational for moving away from using the sleeper stretch, it’s time to suggest what we should do in its place. Some primary muscles that need to be targeted in our treatment to help relieve posterior shoulder tightness are the pec major, pec minor, and latissimus dorsi. The following three exercises can be used to stretch and/or mobilize the tissue of these muscles to help reduce tension in the muscles of the posterior shoulder.

  1. Soft tissue work on the pec major and minor. Place an acumobility ball or lacrosse ball on the wall and lean into it with your chest as tolerated. Once in this position you can move your body against the ball in all directions to loosen the tissue around the anterior portion of the shoulder of your throwing arm. Perform this for 30-60 seconds, and then move the ball to a rack or post and assume the same position. While in this position against the rack or post, you can perform shoulder flexion and abduction to mimic a pin and stretch technique. Perform 3-5 reps per motion and repeat as needed on other tight areas in your pecs.

  1. 1-arm banded lat stretch. Attach a band to the top of a rack or a cable column and loop the opposite end of the band around your wrist. Assume a split stance position and lean away from the rack or column slightly to allow your arm to gradually lengthen as much as possible. For an added stretch effect, turn your palm to the sky (taking the arm into external rotation), lean away and hold this position for 30-60 seconds

  1. Cross body horizontal adduction shoulder stretch. Stand with your feet shoulder-width apart. Set your core and stabilize your scapula, then bend your left arm to approximately 900, raise it to shoulder-height and cross it in front of your body letting your left hand go across the top of your right shoulder. Place you right hand on you left elbow and pull it back towards your body. Hold for 20-30seconds, relax and repeat 2-3 times.

References

  1. Wilk K, Macrina L, Fleisig G, Aune K, Porterfield R, Harker P, Andrews A. Glenohumeral Passive Range of Motion and the Correlation to Elbow Injuries in Professional Pitchers.  Orthop J Sports Med 2013 Sep, 1(4 Suppl)

  2. Wilk K, Macina L, Fleisig G, Aune K, Porterfield R, Harker P, Andrews J.  Glenohumeral Passive Range of Motion and the Correlation to Shoulder Injuries in Professional Pitchers.  Orthop J Sports Med 2014 Sep; 1(4 Suppl)

  3. Wilk K, Macrina L, Arrigo C. Passive Range of Motion Characteristics in the Overhead Baseball Pitcher and their Implications for Rehabilitation. Clin Orthop Relat Res. 2012 Jun; 470(6): 1586-1594

  4. Reinold M, Gill T.  Current Concepts in the Evaluation and Treatment of the Shoulder in Overhead-Throwing Athletes, part 1: Physical Characteristics and Clinical Examination.  Sports Health 2010 Jan; 2(1): 39-50.

  5. Urayma, M., et. al., Function of the 3 portions of the inferior glenohumeral ligament: a cadaveric study, J Shoulder Elbow Surg. 10(6): 589-94, 2001

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Nate Friedman is a Minor League Strength and Conditioning Coach and Scott Cline is the Assistant Major League Strength and Conditioning Coach for the Arizona Diamondbacks.

Other flexibility, mobility and range of motion posts on baseballstrength.org

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