The "sleeper stretch", or internal rotation stretch with the arm flexed 90-degrees and the scapula stabilized, stretches the posterior capsule preferentially as shown in Illustration A. Posterior capsular tightness is felt to be a cause of decreased internal rotation (GIRD) often seen in baseball pitchers. The other capsular areas are not significantly addressed by this stretch.
Kibler et al provide a comprehensive discussion of shoulder rehabilitation, including principles of following a proximal-to-distal activation pathway, integrating various shoulder functions together in the rehab protocol, and emphasizing scapular control coupled with rotator cuff activation.
During the surgery an incision is made over the affected shoulder to expose the shoulder joint. The humerus is separated from the glenoid socket of the scapula. The arthritic part of the humeral head and the socket is removed and prepared so as to take the artificial components. The glenoid component is then pressed into the socket, and the humeral component is cemented into the upper arm bone. The humeral head component made of metal is then placed on the humeral stem. The artificial components are fixed in place. The joint capsule is stitched together. The muscle and tendons are then repaired and the skin is closed.