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Our 17-year-old son participated in a sports screening clinic prior to starting his senior year in high school. They told him he has tight shoulders and should start a stretching program. Evidently the backs of his shoulders are what's tight. What's the best way to work on this problem?

Your son may be experiencing some tightness or restriction in what is commonly referred to as the posterior shoulder capsule. The posterior capsule is a band of fibrous tissue that interconnects with tendons of the rotator cuff of the shoulder. The rotator cuff is made up of four muscles and their tendons. They cover the outside of the shoulder and form part of the posterior capsule to hold, protect, and move the joint. Athletes who are involved in overhead throwing sports tend to develop too much motion in the anterior (front of the shoulder) capsule while compensating by tightening up in the back. There are several different ways to stretch the posterior capsule. There's the towel stretch, the sleeper stretch, and the cross-body stretch. Even though experts in sports rehab recommend some type of stretching for a tight posterior shoulder capsule, there aren't very many studies comparing these various techniques to find out which one works best. Based on the results of one study so far, there's some evidence that the cross-body stretch works best. The exercise is done sitting or standing. Reach the involved arm across the body. Keep the elbow straight and the hand out as if reaching to shake someone's hand. Use the other hand to hold the elbow and gently pull the arm across. Hold for 30 seconds. Repeat several times. Perform stretches three to five times each week. Whether these work better by doing them before sports activity, after practice or play, or both remains a topic for further research and discovery. It probably won't hurt to do both.

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