TrP 1
TrP1
Location. Lower back of shoulder blade
Pain referral. Back of shoulder, down arm
- Back of shoulder
- Deltoid area
- Back of arm
Atlas · Shoulder
Teres Minor
Localized deep aching at posterior deltoid region intensifying with arm use
Body region
Shoulder
Trigger points
3
documented in this muscle
Common symptoms
12
patterns cataloged
Common causes
14
contributory factors
Trigger points
TrP 2
TrP2
Location. Near infraspinous border of scapula
Pain referral. Posterior shoulder and upper lateral arm
- Posterior deltoid area
- Upper lateral arm
- Infraspinous fossa laterally
- Posterior glenohumeral joint
- Mid-deltoid region
TrP 3
TrP3
Location. Inferior border near axillary margin
Pain referral. Posterior shoulder and posterior upper arm
- Posterior deltoid region
- Posterior upper arm
- Infrascapular region (mild)
- Axillary fold (posterior)
- Triceps area (proximal)
Symptoms patients report
Posterior shoulder pain. Localized deep aching at posterior deltoid region intensifying with arm use
Weakness in external rotation. Reduced external rotation strength impairing deceleration during throwing activities
Difficulty reaching behind. Pain and restriction when attempting behind-back movements like fastening garments
Sharp posterior shoulder pain. Teres minor trigger points create sharp localized pain at the posterior glenohumeral region
Pain with external rotation. External rotation loads the teres minor maximally provoking trigger point-mediated posterior shoulder pain
Difficulty reaching behind back. Internal rotation and adduction stretch the taut teres minor bands creating posterior shoulder restriction
Posterior shoulder catching sensation. Taut bands create uneven rotator cuff mechanics producing a catching sensation during arm movement
Posterior shoulder ache. Deep posterior shoulder pain from teres minor trigger point at inferior axillary border
Pain reaching behind back. Internal rotation and extension required for reaching behind back stretches sensitized teres minor
Posterior arm heaviness. Referred heaviness and ache down posterior upper arm from teres minor trigger point referral
Difficulty with external rotation. Inhibited teres minor reduces external rotation strength impairing shoulder function
Sleep disruption lying on affected side. Compression of teres minor trigger points during side-lying causes nocturnal shoulder pain
Common causes
Throwing sports. Eccentric overload during deceleration phase strains teres minor muscle belly repeatedly
Swimming. Continuous external rotation demands during freestyle recovery phase fatigue teres minor
Overhead activities. Sustained arm elevation requires teres minor stabilization causing cumulative contractile fatigue
Poor posture. Rounded shoulders alter scapulohumeral rhythm increasing teres minor compensatory workload chronically
Repetitive overhead throwing. Throwing demands eccentric teres minor deceleration during follow-through creating cumulative overload
Swimming (backstroke and freestyle). Repetitive shoulder rotation during swimming strokes overloads the teres minor as an external rotator
Sleeping on the affected shoulder. Lateral sleep compresses the posterior shoulder against the mattress irritating teres minor trigger points
Chronic internal rotation posture. Sustained shoulder internal rotation stretches and weakens the teres minor creating trigger points
Rotator cuff strain or overuse. General rotator cuff overuse involves teres minor as it shares the posterior cuff load
Repetitive external rotation activities. Repeated shoulder external rotation overloads teres minor as a primary external rotator muscle
Throwing sports (deceleration phase). Eccentric teres minor loading during throw deceleration phase creates high-force fiber damage
Swimming (backstroke). Backstroke arm recovery requires repetitive external rotation overloading teres minor cyclically
Post-rotator cuff repair guarding. Protective muscle splinting after rotator cuff surgery creates sustained teres minor contraction
Sleeping with arm overhead. Sustained arm elevation during sleep stretches teres minor creating positional trigger points
Treatment & self-care
immediate
Cross-body shoulder stretch
Stand or sit with good posture. Bring your affected arm across your chest at shoulder height. Use your opposite hand to gently pull the arm closer to your body until you feel a stretch at the back of the shoulder. Keep the affected shoulder relaxed and down, not shrugged up toward your ear. The stretch should be felt in the posterior shoulder region where the teres minor is located. Hold for 20-30 seconds and release slowly.
- Duration
- 20-30 seconds per repetition, 3 repetitions
- Frequency
- 3-4 times daily, especially before and after shoulder activities
- Expect
- Improved posterior shoulder flexibility and reduced tightness within 1-2 weeks of consistent stretching
immediate
Tennis ball against wall for posterior shoulder release
Stand with your back to a wall and place a tennis ball between the wall and the back of your shoulder, just below the bony spine of the scapula where the teres minor muscle sits. Lean into the ball with comfortable pressure and slowly move your body up and down or side to side to roll the ball across the muscle. When you find a particularly tender spot, hold sustained pressure for 20-30 seconds. You can also bend and straighten your knees to control the rolling motion.
- Duration
- 3-5 minutes per session
- Frequency
- 1-2 times daily, especially after activities that aggravate the shoulder
- Expect
- Reduced posterior shoulder tenderness and deep joint-like aching within 1-2 weeks of consistent self-massage
exercise
External rotation strengthening with resistance band
Stand with your elbow bent to 90 degrees and a folded towel tucked between your elbow and your side to maintain proper positioning. Hold a light resistance band that is anchored at waist height to your opposite side. Slowly rotate your forearm outward away from your body, keeping your elbow pinned to the towel at your side. Control the return to the starting position over 3 seconds. The movement should be pain-free or cause only mild discomfort.
- Duration
- 3 sets of 10-15 repetitions
- Frequency
- Once daily, progressing to twice daily as tolerated
- Expect
- Improved external rotation strength and reduced posterior shoulder pain with daily activities within 3-4 weeks
exercise
Sleeper stretch for internal rotation mobility
Lie on your affected side with your shoulder and elbow each bent to 90 degrees, so your forearm points toward the ceiling. Using your other hand, gently push your forearm down toward the surface you are lying on, rotating your shoulder inward. You should feel a stretch at the back of the shoulder. Move slowly and stop if you feel any sharp pain. The stretch should be a gentle pulling sensation in the posterior shoulder area.
- Duration
- 20-30 seconds per repetition, 3 repetitions
- Frequency
- Once daily, preferably after warming up the shoulder with heat
- Expect
- Improved internal rotation range of motion and reduced posterior shoulder tightness within 2-3 weeks
lifestyle
Sleep position modification for posterior shoulder pain
Avoid sleeping directly on the affected shoulder as this compresses the teres minor and aggravates the trigger point. If you are a side sleeper, sleep on the unaffected side and hug a pillow to support the affected arm in front of you. If you sleep on your back, place a small pillow or folded towel under the affected arm to keep it slightly elevated and supported. Avoid sleeping with the affected arm overhead or tucked under your pillow.
- Duration
- Ongoing nightly adjustment
- Frequency
- Every night until symptoms resolve
- Expect
- Reduced morning shoulder pain and stiffness within 1-2 weeks of consistent positioning changes
professional
Professional rotator cuff assessment
If posterior shoulder pain persists beyond 3-4 weeks of self-care, or if you experience significant weakness, catching, or locking sensations, consult an orthopedic specialist or sports medicine physician. A professional can differentiate between a teres minor trigger point and a structural rotator cuff tear through clinical tests and potentially imaging such as MRI or ultrasound. A physical therapist can provide targeted manual therapy including friction massage and joint mobilization to the posterior shoulder.
- Duration
- Initial evaluation typically 30-45 minutes
- Frequency
- As recommended by the provider, typically 1-2 sessions per week for 4-6 weeks
- Expect
- Definitive diagnosis distinguishing trigger point pain from rotator cuff pathology, with targeted treatment leading to significant improvement within 6-8 weeks
- Localized deep aching at posterior deltoid region intensifying with arm use
- Reduced external rotation strength impairing deceleration during throwing activities
- Pain and restriction when attempting behind-back movements like fastening garments
- Teres minor trigger points create sharp localized pain at the posterior glenohumeral region
- External rotation loads the teres minor maximally provoking trigger point-mediated posterior shoulder pain