Q: As far as the total motion concept goes, is there a certain minimum of total degrees of motion that the “baseline” limb should have? For example, if a right-hand dominant person has fairly limited total motion on the left side and even more limitations on the right, would the goal be to get total motion symmetrical first and then improve both from there?

A: It is definitely population-specific, as overhead throwing, for example, will simply move that total motion to a different range. So, a symmetrical shoulder might be:

Right (dominant): 45°  IR + 125° ER = 170° Total Motion
Left (non-dominant): 55° IR + 115° ER = 170° Total Motion

The difference between the two would be attributed to retroversion (bony adaptations – more info HERE). A 10° internal rotation deficit would be completely normal in a unilateral overhead throwing population.

Of course, if you get a freestyle swimmer, thinks get a bit interesting. You have to go a bit more by end-feel, and mandate that they have at least 25° degrees of total internal rotation.

That said, in a “normal” weight training population, I like to have at least 90° of external rotation and 50+° of internal rotation. I wouldn’t consider those “good” measurements, but they would be workable (assuming symmetrical total motion).

Now, you are going to have situations here and there where someone has lost total motion in the non-dominant side.  My experience has been that this occurs in athletes who spend too much time in computers and those who get “100% shut down” after an injury.

Believe it or not, I once saw a pro pitcher with only 6° (yes, single digits) of internal rotation on his throwing shoulder, and the medical staff’s conclusion was to give him a cortisone shot and make him rest completely – no lifting, sprinting, stretching, anything (I wonder if they assigned an intern to him to help him wash his hair in the shower).  He basically just charted pitches for two months.  This guy lost total motion bilaterally, so the fact that he was forced into inactivity actually made his subsequent evaluation a bit more complex.  The good news is that these guys can generally be recognized by their terrible thoracic spine posture and increased body fat levels!

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