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Atlas · Shoulder

Teres Major

Teres major links the inferior shoulder blade to the front of the upper humerus. It helps pull the arm down and inward and contributes to the posterior axillary fold. Pain after climbing, swimming or heavy pulling should be assessed as a load or injury problem.

Teres Major
Body region
Shoulder
Trigger points
3
documented in this muscle
Common symptoms
3
patterns cataloged
Contributors
3
Factors to assess

Muscle overview

Symptoms and first steps

Practical first steps

  • Reduce heavy pulling and keep comfortable shoulder movement.
  • Avoid deep pressure into the posterior armpit.
  • Resume sport with a gradual pulling progression.

When to seek assessment

  • Arrange prompt examination for traumatic weakness or inability to raise the arm.
  • Persistent night pain, increasing movement loss or neurological symptoms warrant reassessment.

Teres major inserts on the medial lip of the humeral intertubercular groove. Its action overlaps latissimus dorsi, but it is not a rotator-cuff muscle.

Examination, palpation and treatment evidence

Illustrated overview

Teres Major · Regional source example

Teres major: source anatomical and surface examples. Panel A uses red referral fields; panel B retains the original dark stippling. Travell and Simons, Fig. 25.1, p. 588. Regional illustration; not an individual map of a selected numbered point.

Open full-size image

Trigger points

1. TrP1

Location. Lower back of shoulder blade

Trigger point map
Teres Major — Trigger point mapOpen full-size image

Shared muscle diagram; it may show several trigger points.

Referred pain map
Teres Major — Teres Major · Regional source exampleOpen full-size image

Regional muscle reference; this is not an individual map of the selected numbered trigger point.

Pain referral. Back of shoulder, posterior arm

Pain Pattern

  • Back of shoulder
  • Posterior arm
  • Deltoid area

What This Pain Feels Like

A posterior-shoulder or axillary-fold ache may intensify during pulling and inward rotation. Examine the task and any injury history rather than presuming a misdiagnosed cuff problem.

What Patients Report

  • Pain in back of shoulder
  • Pain when pulling
  • Posterior arm ache

What Makes It Worse

  • Pulling movements
  • Internal rotation
  • Adduction
Browse related exercises (1)

Symptoms patients report

Posterior-axillary pulling pain Compare a light row or pulldown with the provoking sport.

Discomfort at overhead reach Test supported motion rather than forcing a lat stretch.

Reduced pulling force Sudden weakness after injury needs examination.

Contributors to assess

Climbing or pulldown increase A rapid increase in pulling load may provoke pain.

Swimming workload Review repeated pull-through demand and recovery.

Acute forceful pull Bruising or a pop raises concern for a muscle/tendon injury.

For clinicians and supervised training

Clinical reference

Posterior-axillary pain and restricted reach cannot isolate teres major from latissimus, cuff or joint structures.

Anatomy and palpation

Anatomical relationships

Teres major arises near the posterior inferior scapular angle and inserts on the medial lip of the humeral intertubercular groove, assisting adduction and internal rotation.[1]

  • Inferior scapular angle.
  • Posterior axillary fold, shared with latissimus dorsi.

Nearby structures. Teres minor is superior; the long head of triceps separates nearby anatomical spaces. Axillary nerves and vessels are not pressure targets.

Palpation

Patient position. Side-lying with arm supported forward in slight abduction.

Find the landmarks

  • Find the inferior angle of the scapula.
  • Trace the broad posterior axillary fold toward the proximal humerus, acknowledging the adjacent latissimus fibers.

Examination sequence

  1. Ask for a light pull toward the hip to orient to contractile tissue.
  2. Relax and compare gentle contact along the accessible belly.
  3. Relate familiar pain to the same pulling task; do not attempt to separate every fiber from latissimus.

Document the findings

  • Record belly versus tendon-region pain and any swelling or bruising.

Limits and precautions

  • Omit firm palpation after acute tearing symptoms; avoid deep axillary pressure.
[1]

Examination and tests

2

Resisted shoulder adduction and extension[1]

Assess the symptomatic pulling direction.

Position
Seated with elbow bent and upper arm slightly forward, trunk steady.
Technique
Apply gentle resistance as the patient draws the elbow down and back toward the hip. Compare force and posterior-fold pain.
Positive finding
Familiar pain or repeatable force loss.
Interpretation
Guides load selection; acute substantial weakness suggests injury assessment.
Limitations
Latissimus, pectoralis and other muscles contribute; no isolated teres-major diagnostic cutoff exists here.

Active versus supported passive shoulder motion[2]

Distinguish painful effort from a substantial restriction of joint movement.

Position
Seated for active elevation; supine with scapula and arm supported for passive testing.
Technique
Record active elevation and external rotation, then gently compare examiner-assisted motion in the same planes. Note familiar pain, range and whether the shoulder blade substitutes early.
Positive finding
Active limitation with better passive range differs from marked restriction of both.
Interpretation
A large active/passive gap with weakness warrants cuff or nerve assessment; global passive restriction suggests a joint/capsular pathway.
Limitations
Pain, guarding and measurement position influence motion. Neither pattern identifies an individual trigger point.

Distinguishing other causes

Latissimus or teres-major strain/tear[1][2]

Findings that matter. Sudden pulling injury with bruising, swelling or clear strength loss.

Next step. Arrange injury assessment and targeted imaging if needed.

Rotator-cuff or glenohumeral disorder[2]

Findings that matter. Elevation/rotation pain or passive restriction extends beyond pulling alone.

Next step. Assess cuff strength and active/passive motion.

Axillary-nerve or cervical disorder[2]

Findings that matter. Numbness, deltoid weakness or neck-dependent symptoms.

Next step. Perform a neurological examination rather than deeper local pressure.

Treatment selection and progression

Self-care and activity

Temporarily reduce heavy pulling[1]

Consider when. Assessed overload without acute tear signs.

Reduce pulldown weight, climbing difficulty or swim volume while keeping easy nonprovoking activity.

Dose and review
Try the change during the provoking task and review its effect on pain and task tolerance before continuing.
Progression
Restore one load variable at a time.
Stop or reassess
Reduce the load for a lasting flare; new marked weakness, numbness or sharp injury pain requires reassessment.
Evidence and limits
The cited references support anatomical orientation or regional care. The activity and starting dose are clinical adaptations, with no isolated-muscle efficacy established by those references.

Exercise and rehabilitation

Supported overhead-reach practice[1][2]

Consider when. Tolerable but limited elevation.

Slide the forearms forward on a table and let the trunk move back gently, stopping before sharp posterior-axillary pain.

Dose and review
Starting example: one set of 5–8 comfortable repetitions on alternate days; adjust to irritability and the next-day response.
Progression
Increase comfortable reach before unsupported overhead work.
Stop or reassess
Reduce the load for a lasting flare; new marked weakness, numbness or sharp injury pain requires reassessment.
Evidence and limits
The cited references support anatomical orientation or regional care. The activity and starting dose are clinical adaptations, with no isolated-muscle efficacy established by those references.

Exercise and rehabilitation

Graded pull toward the hip[1]

Consider when. Preserved pulling function after assessment.

With light band resistance and elbow bent, draw the elbow toward the hip and return slowly without jerking or leaning backward.

Dose and review
Starting example: one set of 5–8 comfortable repetitions on alternate days; adjust to irritability and the next-day response.
Progression
Progress resistance, then sport-specific speed when symptoms remain stable the next day.
Stop or reassess
Reduce the load for a lasting flare; new marked weakness, numbness or sharp injury pain requires reassessment.
Evidence and limits
The cited references support anatomical orientation or regional care. The activity and starting dose are clinical adaptations, with no isolated-muscle efficacy established by those references.

Reassessment and follow-up

  • Repeat the same light pull and supported overhead reach.
  • Track swim/climb tolerance and any bruising or persistent weakness.
  • Record band resistance and controlled pulling repetitions without trunk substitution, checking for a sustained next-day loss of reach before increasing load.

Evidence and sources

  1. University of Washington Muscle Atlas: Teres Major

    2026 · University anatomical reference

    Accessed September 2026; access year. Used for attachments and actions, not treatment efficacy or point-map validation.

  2. Desmeules et al. Rotator Cuff Tendinopathy Diagnosis, Nonsurgical Medical Care, and Rehabilitation

    2025 · Clinical practice guideline

    Adults with cuff tendinopathy, including partial-thickness tears; not full-thickness tears. Recommends active rehabilitation, distinguishes calcific from noncalcific shockwave indications.

Associated Trigger Points