Is the sleeper stretch bad for your shoulders?

Not when it is done gently by someone who needs it, but it is debated. The position resembles a clinical impingement test, so some physical therapists avoid it, and anyone who feels a pinch at the front of the shoulder should roll back, ease off or choose a different stretch.

Is the sleeper stretch or the cross-body stretch better?

Neither has clearly won. In a four-week trial in people without shoulder pain who had lost internal rotation on one side, the cross-body group gained about 20 degrees and the sleeper group about 12, and only the cross-body gain was significantly larger than in a group that did not stretch, though the two stretches did not differ significantly from each other. Many programs use both, since the Cross-Body Shoulder Stretch also reaches the back of the shoulder through a different direction.

How long should I hold the sleeper stretch?

Hold each stretch for about 30 seconds and repeat it 3 to 5 times on the side you are working on. Once a day is a common schedule for a shoulder that has lost internal rotation.

Will the sleeper stretch fix the internal rotation I have lost in my throwing arm?

Only part of it, at most. Throwing from a young age twists the upper arm bone itself, which shifts the arm's rotation toward external rotation, and no stretch changes that bony part, so a clinician comparing the total rotation of both arms can tell you how much of the difference is actually tightness.

What is the support under my head for?

It keeps your neck in line with your spine while you lie on your side, so you can relax into the stretch. A pillow, folded towel or foam roller all work.

Sleeper Stretch

What Is the Sleeper Stretch?

Sleeper Stretch is an isolation exercise that primarily targets the shoulders, lengthening the infraspinatus and teres minor at the back of the shoulder along with the back of the shoulder joint capsule. It is a beginner-level movement done lying on your side, with the bottom arm raised in front of you at shoulder height and the elbow bent to a right angle, and it needs nothing beyond something to rest your head on.

The stretch is aimed at internal rotation, the ability to turn the upper arm inward, which is the direction the back of the shoulder limits when it gets stiff. Baseball pitchers, tennis and volleyball players and other overhead athletes often lose internal rotation in their throwing or hitting arm, and this stretch became a staple of their arm care programs for that reason. In overhead athletes with a large internal rotation deficit, a six-week sleeper stretch program increased internal rotation by about 13 degrees and slightly widened the space under the acromion, which did not change in a group that did not stretch.

Lying on the shoulder being stretched pins the shoulder blade between your body and the floor, so the forearm turning down rotates the shoulder joint itself instead of letting the shoulder blade slide forward. That is the main difference from the Cross-Body Shoulder Stretch, which pulls the arm across the chest and loads the back of the shoulder through horizontal adduction rather than rotation. Rolling the upper body back slightly, a version often called the modified sleeper stretch, keeps the arm out of the position that crowds the front of the shoulder. The Stick Shoulder Internal Rotation Stretch works on the same direction of movement standing, with the hand behind the back.

The stretch is also one of the more debated ones in shoulder rehab. Its position closely resembles a test clinicians use to provoke impingement pain, so some physical therapists modify it and others avoid it altogether, and whether it does more than the cross-body stretch is still an open question. It suits people who have actually lost internal rotation, such as overhead athletes and lifters whose shoulder feels tight at the back, rather than everyone as a routine. Anyone new to shoulder stretching can start with the cross-body stretch, and anyone with a history of shoulder dislocation or ongoing shoulder pain should get assessed before adding it.

Muscles Worked

MuscleActivation

Infraspinatus: Primary
Teres Minor: Primary
Deltoid: Low

Instructions

Lie on your side on a mat, on the shoulder you want to stretch, and rest your head on a pillow or firm roll so your neck stays in line with your spine.
Bend one or both knees to keep yourself steady on your side.
Raise your bottom arm straight out in front of you to shoulder height, so the upper arm points away from your chest at a right angle to your body.
Settle onto the outer edge of your shoulder blade rather than the point of the shoulder, rolling your upper body back slightly if needed.
Bend the bottom elbow to 90 degrees so the forearm points up toward the ceiling.
Hold the bottom arm just above the wrist with your top hand.
Keeping the elbow bent and the upper arm resting on the floor, gently press the forearm down toward the floor in front of your stomach.
Stop at the first clear stretch at the back of the shoulder, well before the hand reaches the floor, and hold for about 30 seconds while breathing slowly.
Ease the forearm back up to vertical, repeat 3 to 5 times, then switch sides.

Common Mistakes

Pushing too hard
Forcing the forearm down or bouncing it strains the front of the shoulder, when a mild, steady stretch at the back of the shoulder is all the movement needs.
Trying to touch the floor
Driving the hand all the way to the floor takes the shoulder through far more rotation than the stretch calls for, so stop at the first clear stretch.
Lying on the point of the shoulder
Stacking your body weight straight on top of the shoulder joint crowds the front of the shoulder, so lie on the outer edge of the shoulder blade with the upper body rolled back slightly.
Letting the shoulder roll forward
When the shoulder peels off the floor and rounds forward as the hand goes down, the shoulder blade moves instead of the shoulder joint and the stretch at the back fades.
Losing the arm position
Letting the elbow slide up toward the head, drift toward the hips or open past a right angle changes the angle of the stretch and lets the forearm drop without turning the shoulder.
Stretching through a pinch
A pinch at the front of the shoulder is a sign to roll back, ease the pressure or stop, not something to hold through.

Injuries

Sleeper Stretch is a low risk exercise when performed with proper technique. The risk comes from the position rather than the effort: with the arm raised to shoulder height and turned inward, the rotator cuff and biceps tendons at the front of the shoulder sit close to the bony arch above them, and pressing hard or lying straight on top of the shoulder can pinch them. The stretch should always be felt at the back of the shoulder.

Keep the pressure mild, and let the top hand guide the forearm down rather than shove it. Lie on the outer edge of the shoulder blade instead of the point of the shoulder, and roll your upper body back slightly if the front of the shoulder feels crowded. The hand does not need to reach the floor. Done gently, the stretch rarely flares a healthy shoulder; done hard and fast, it is one of the easier ways to irritate one.

People with a history of shoulder dislocation or instability, a recent shoulder surgery or a current flare of shoulder pain should get cleared by a physical therapist first, because stretching a shoulder that is already loose can make it looser. If the position is uncomfortable, switch to the Cross-Body Shoulder Stretch or the Stick Shoulder Internal Rotation Stretch. Progress by holding the stretch consistently over weeks, not by pressing harder.

Stop if you feel a pinch or pain at the front of the shoulder before any stretch at the back, sharp pain anywhere in the joint, or tingling or numbness running down the arm.

Overview

Primary Focus: Shoulders
Equipment: Body weight
Modality: Stretching
Difficulty: Beginner

Alternative Exercises

Frequently Asked Questions

Q: Is the sleeper stretch bad for your shoulders?: Not when it is done gently by someone who needs it, but it is debated. The position resembles a clinical impingement test, so some physical therapists avoid it, and anyone who feels a pinch at the front of the shoulder should roll back, ease off or choose a different stretch.
Q: Is the sleeper stretch or the cross-body stretch better?: Neither has clearly won. In a four-week trial in people without shoulder pain who had lost internal rotation on one side, the cross-body group gained about 20 degrees and the sleeper group about 12, and only the cross-body gain was significantly larger than in a group that did not stretch, though the two stretches did not differ significantly from each other. Many programs use both, since the Cross-Body Shoulder Stretch also reaches the back of the shoulder through a different direction.
Q: How long should I hold the sleeper stretch?: Hold each stretch for about 30 seconds and repeat it 3 to 5 times on the side you are working on. Once a day is a common schedule for a shoulder that has lost internal rotation.
Q: Will the sleeper stretch fix the internal rotation I have lost in my throwing arm?: Only part of it, at most. Throwing from a young age twists the upper arm bone itself, which shifts the arm's rotation toward external rotation, and no stretch changes that bony part, so a clinician comparing the total rotation of both arms can tell you how much of the difference is actually tightness.
Q: What is the support under my head for?: It keeps your neck in line with your spine while you lie on your side, so you can relax into the stretch. A pillow, folded towel or foam roller all work.