In this correspondence, we propose a joint mechanical and electrical adjustment of intelligent reflecting surface (IRS) for the performance improvements of low-earth orbit (LEO) satellite multiple-input multiple-output (MIMO) communications. In particular, we construct a three-dimensional (3D) MIMO channel model for the mechanically-tilted IRS in general deployment, and consider two types of scenarios with and without the direct path of LEO-ground user link due to the orbital flight. With the aim of maximizing the end-to-end performance, we jointly optimize tilting angle and phase shift of IRS along with the transceiver beamforming, whose performance superiority is verified via simulations with the Orbcomm LEO satellite using a real orbit data.