Shoulder pain comes in two primary flavors: anterior (front) and posterior (back). Anterior pain typically involves the biceps tendon, pec minor, or anterior capsule — often from bench pressing or forward-rounded posture. Posterior pain usually involves the rotator cuff or posterior capsule — from overhead work or sleeping position.

Fitness Considerations

Front-of-shoulder pain and back-of-shoulder pain have different causes and different fixes. Anterior pain responds to pec release, external rotation work, and thoracic extension. Posterior pain responds to rotator cuff release, internal rotation stretching, and scapular stabilization. Don’t guess — match the protocol to the location.

A stiff thoracic spine is the most common upstream cause of shoulder pain. When the t-spine can’t extend or rotate, the shoulder compensates by impinging during overhead movements. Always include thoracic mobility alongside shoulder-specific work.

Chronic shoulder pain often indicates weakness, not just tightness. The rotator cuff, lower traps, and serratus anterior need to be strong enough to stabilize the shoulder through its range. Pair these protocols with progressive strengthening once acute pain subsides.

Prescriptions

# Protocol Description
53.01 Anterior Shoulder Pain Front-of-shoulder protocol: pec release, capsule mob, external rotation
53.02 Posterior Shoulder Pain Back-of-shoulder protocol: rotator cuff release, internal rotation, scapular work
53.03 Upper Back & Trap Tweak Upper trap and rhomboid spasm protocol