Internal rotation of the humerus can lead to a whole host of injuries down the line if not addressed so several excellent articles have been written to teach you how to treat this condition with simple stretching and strengthening exercises.

Here’s a commonly test you can do to determine if you have interally rotated humerii.  Hold a pencil in your hand and relax your arm by your side.  If it points directly forward as in the photo below, it is said that you don’t have internal rotation.

However, if the pencil points inwards, as in the next photo, it is believed that you do have internal rotation and you should do something about it before it becomes a problem.

If you don’t have a pencil handy, one other quick assessment is to look at yourself in the mirror.  If you can see the backs of your hands while they’re resting by your sides, you are said to be internally rotated.

This would lead most folks who have a positive test to believe that they need to instantly start stretching their internal rotators (pecs, lats, subscap, etc) and training the hell out of their external rotators (infraspinatus, teres minor).  But hold on there sparky.  While these tests are sometimes a decent guide to tell you to examine this issue further, they are often inaccurate and the problem could very well be something else entirely.

As Eric Cressey pointed out HERE, if the shoulder blades are abducted (i.e., away from the spine) it can lead to this very same posture.  In fact, a person can fail the test above, but not be internally rotated at all.  Doing a program to correct this issue could lead to further injury because it didn’t address the actual issue.  In fact, I’ve seen many cases where a person looked internally rotated based on these tests, but when there shoulder blades were placed in a neutral position they were actually externally rotated.  The treatment (aside from dealing with the weak muscles that hold the shoulder blades in place) would include stretches that are the exact opposite of the ones that might have been used otherwise.

More importantly, here’s the one people miss.  Even when the shoulders are in the right position a failed test does not mean the humerus is internally rotated.  Often the wrist flexors are tight in many people (especially those who use computers a lot) and these can make the hands face backwards as well.  In this case there is absolutely no problem at the shoulder at all, but careless assessment and treatment would have you doing things to try to fix what isn’t broken.

Here’s how to take a quick inventory:

1.  Do the test above or at least look in the mirror to see if the backs of your hands are showing.  If they are, proceed to step 2.  If not, do it anyway.

2.  Either have someone look at you from the back or have someone take a picture of you.  Ideally this would be done with no shirt or a sports bra (if you’re female) so you can see the shoulder blades.  If they appear to be pulled away from the midline (i.e., far away from the spine) try pulling them back into a normal position and see if this fixes the problem.  If it does, you need to strengthen your scapular retractors including your middle traps, lower traps, and possibly your rhomboids.  Also, I’d highly suggest that you work on your serratus anterior with this corrective exercise.

Note: If your shoulder blades are drifted apart, postion them in neutral and take another picture before continuing.  It is possible that you have more than one problem.

3.  If your shoulder blades appear to be in the right position the next step is to look at your elbows from the back to determine which way are they facing.  If they’re pointing outwards it is likely that you actually do have a true internal rotation of the humerus.  If the shoulder blades are in the correct position and your elbows are both pointed straight back, but your hands are still facing backwards it has to be from something going on below the elbow.

4.  Finally, position your elbows at your side bend your elbows to 90 degrees so your hands are out in front of you.  Now try to turn the hand so that the palm faces all the way up.  If you find that you cannot fully rotate the hand into this position then your wrist flexors are probably tight.   If this is you, you probably have problems with chin ups because your hands can’t supinate all the way or are painful when doing so.

You’ll likely find that doing a wrist flexor stretch such as the one below will be of great value.  Try doing this 3 times daily for at least 30 seconds to improve improve the rotated positon of your lower arm.  If you’re using a computer often, do it every time you take a break from typing.  Note that taking the shirt off for this exercise is completely optional and does not improve the effectiveness of the exercise.

What you might learn from doing this is that you have more than one issue and that you need to treat them all individually.  Do the test for yourself and let us know how it goes in the comment section below.