The posterior glenohumeral recess is the synovial extension of the glenohumeral joint between the posterior glenoid labrum and the posterior humeral head. It lies between the posterior labrum medially and the posterior capsule laterally, between the infraspinatus above and the teres minor below. In overhead athletes the posterior capsule and posterior recess may become thickened and contracted, producing glenohumeral internal rotation deficit (GIRD).
The posterior glenohumeral recess is the site of capsular contracture in thrower shoulder, where repetitive micro-trauma thickens the posterior capsule and reduces internal rotation. Posterior capsule release (posterior capsulotomy) or posterior capsular stretching addresses GIRD in overhead athletes. A posterior labral tear (reverse Bankart lesion) from a posterior stabilising failure event produces a posterior pouch of synovial fluid within this recess, visible on MRI arthrography. The HAGL lesion (humeral avulsion of glenohumeral ligament) may extend to involve the posterior recess.
Repetitive deceleration loading in throwers causes posterior glenohumeral capsular fibrosis and recess tightening, reducing internal rotation (GIRD) and creating a glenohumeral shift that leads to internal impingement and superior labral tears, managed with posterior capsular stretching exercises and arthroscopic posterior capsular release in resistant cases.
Posterior glenohumeral instability from a posterior force mechanism tears the posterior labrum, producing a posterior labral detachment from the posterior glenoid rim with fluid tracking into the posterior recess on MRI, managed by arthroscopic posterior labral repair through a posterior portal.
