Posterior Capsule Tightness Confirmed by a Loss of Internal Rotation

• To confirm tightness in the posterior capsule the patient is placed in ¾ side lying so that the scapula is stabilized against the table
• The shoulder is abducted to 90 degrees then IR is introduced
• The therapist makes sure that the shoulder stays flat on the table as the arm is passively internally rotated
• Normally the patient’s fingertips should comfortably reach the table top (70 degrees of IR)
• The test is repeated to both sides for comparison
• Note a limitation for IR on the right side in this patient who presented with posterior capsular tightness on the R side

Note: It is extremely important that the therapist is able to differentiate between tightness of the pectoralis minor versus a tight posterior capsule as their treatments are very different. If a patient with a tight posterior shoulder capsule is given a pec minor stretch the patient’s condition can be made much worse.