Beginner 3 min read

Posterior Shoulder Pain Prescriptions

Posterior shoulder pain typically presents as a deep ache or tightness in the back of the shoulder, often aggravated by overhead movements, pulling exercises, or reaching behind the back. Common contributors include tight posterior capsule, overworked infraspinatus and teres minor, and poor scapular mechanics.

Warning

This protocol is for mechanical posterior shoulder pain. Seek professional evaluation if you experience: sharp pain that radiates down the arm; a “dead arm” sensation; significant weakness in external rotation; pain following a trauma, fall, or forceful overhead movement; or numbness/tingling in the hand.

Protocol

Step 1: Soft Tissue Work

Release the posterior shoulder structures that are tight and overworked.

  • Posterior shoulder release: Lie on your side with a lacrosse ball under the back of the shoulder (infraspinatus/teres minor area). Make slow arm movements — overhead, across body, behind back. 60–90 seconds per side.
  • Lat release: Lie on your side with a foam roller under your armpit. Roll slowly from the armpit toward the mid-back. 60 seconds per side.
  • Upper trap release: Stand against a wall with a lacrosse ball on the upper trap. Slowly move the arm while pinned. 60 seconds per side.

Step 2: Mobilization

Restore internal rotation and horizontal adduction — the movements that are typically restricted.

  • Sleeper stretch: Lie on the affected side with the shoulder at 90 degrees. Gently push the forearm toward the floor. Hold 30 seconds per side.
  • Cross-body stretch: Pull the arm across the body at shoulder height. Hold 30 seconds per side. Focus on feeling the stretch in the back of the shoulder.
  • Thread the needle: From all fours, reach one arm under and through, rotating the upper back. Hold 20–30 seconds per side.
  • Open book stretch: Lie on your side with knees bent. Open the top arm and rotate, keeping knees together. Hold 20–30 seconds per side.

Step 3: Movement Reset

Rebuild balanced strength and scapular control.

  • Banded pull-aparts: Hold a band at arm’s length, pull apart to form a T. 15–20 reps, squeezing the shoulder blades.
  • Side-lying external rotation: Lie on your side with a light weight. Rotate the forearm upward, keeping the elbow pinned at your side. 12–15 reps per side.
  • Scapular push-ups: In a plank position, protract and retract the shoulder blades without bending the elbows. 10–12 reps.

When to Use

  • Before upper body training, especially pulling movements
  • When experiencing deep aching in the back of the shoulder
  • After heavy overhead or pulling sessions
  • As maintenance if you have a history of posterior shoulder tightness

When to Seek Professional Help

  • Pain persists beyond 3–4 weeks of consistent work
  • Significant weakness compared to the opposite side
  • Clicking, catching, or locking sensations in the shoulder
  • Inability to sleep on the affected side despite consistent treatment
  • Pain that worsens with the protocol rather than improving
  • History of rotator cuff tears or labral injuries