Stop Ignoring Pain in Back Side of Shoulder (Read This First)

You know the feeling. It isn’t the sharp sting of a fresh injury, but a dull, nagging throb that sits deep behind the joint. Dealing with pain in back side of shoulder is frustrating because it’s hard to reach and harder to diagnose on your own. It ruins your sleep, limits your gym performance, and makes sitting at a desk unbearable.

Most people try to stretch it out, assuming it’s just tightness. But blindly stretching an unstable shoulder can actually make things worse. We need to identify whether this is a muscular imbalance, a structural issue, or a referral pattern from your neck.

Quick Summary: What That Ache Means

• Postural Fatigue: Prolonged sitting causes the scapular muscles to lengthen and weaken, leading to a burning sensation.
• Rotator Cuff Strain: specifically the Infraspinatus or Teres Minor, often caused by repetitive overhead motions.
• Cervical Referral: The issue might actually be in your neck (C5-C7 vertebrae), sending pain signals down to the shoulder blade.
• The Fix: Usually involves a combination of thoracic mobility, posterior chain strengthening, and trigger point release.

The Anatomy of the "Backside" Ache

When you point to the back of your shoulder, you are likely pointing to a crowded intersection of muscles. It’s rarely just one thing.

You have the posterior deltoid (the outer muscle), the rotator cuff muscles underneath (specifically the infraspinatus), and the scapular stabilizers (rhomboids and traps). Understanding exactly where it hurts—whether it's deep inside the joint or closer to the spine—is the first step in fixing it.

It Might Be "Mouse Shoulder"

If you experience pain in backside of shoulder primarily during the workday, look at your mouse hand. When your arm is extended forward and slightly abducted (held away from the body) for eight hours a day, the muscles behind the shoulder remain under constant, low-level tension. This creates trigger points—tight knots in the muscle fibers that refer pain locally.

Under Shoulder Muscle Pain: The Hidden Culprit

Sometimes the pain feels deeper, almost like it is tucked under the shoulder blade. This is often under shoulder muscle pain related to the subscapularis or the serratus anterior, though it often manifests as a sensation in the back.

If the pain feels like it is under the blade itself, you might be dealing with a rib dysfunction or a strained serratus. This area is notoriously difficult to massage manually because the scapula bone covers the muscle tissue.

How to Address the Pain

Before you book surgery, try these conservative management strategies. However, if you have numbness, tingling, or loss of strength, see a doctor immediately.

1. The Lacrosse Ball Release

Forget foam rollers; they are too broad for this area. Take a lacrosse ball (or a tennis ball if you are sensitive) and place it between your shoulder blade and the spine. Lean against a wall. Roll slowly until you find a spot that feels "tender but good." Hold for 30 seconds. This releases the rhomboids and traps.

2. Face Pulls for Stability

Most back-of-shoulder pain is the result of weakness, not tightness. We spend our lives pushing things (doors, bench presses, heavy boxes). We rarely pull.

Incorporate Face Pulls into your routine. This exercise targets the rear delts and external rotators, pulling the shoulder back into a neutral, healthy position. High reps (15-20) with low weight are key here. You want to feel the burn, not max out.

My Personal Experience with pain in back side of shoulder

I’ve been there. A few years ago, I started waking up with a dead ache behind my right shoulder. I assumed it was from heavy bench pressing, so I stopped pressing. The pain didn't leave.

It wasn't the gym; it was my setup. I was working off a laptop at a kitchen table for three months. My right elbow was constantly hovering in the air, with no armrest support. The specific detail I remember vividly is the "crunch" sound my shoulder made every time I rotated my arm backward—like grinding pepper. It wasn't painful to pop it, but it felt gross.

I fixed it not by stretching, but by buying a cheap clamp-on armrest for my desk and doing band pull-aparts every single morning while my coffee brewed. The first week of doing the pull-aparts, the burning sensation was so intense I had to stop at 8 reps. That showed me just how weak those rear stabilizers had become. Now, if I skip them for a week, that familiar dull ache starts creeping back in.

Conclusion

Treating pain in back side of shoulder requires patience and a change in habits. It is rarely a quick fix because it likely took years of poor posture or repetitive motion to develop. Start strengthening your back, fix your desk ergonomics, and stop ignoring the warning signs your body is sending you.

Frequently Asked Questions

When should I worry about shoulder blade pain?

If the pain is accompanied by shortness of breath, chest pressure, or dizziness, seek emergency care, as this can sometimes signal heart issues. Musculoskeletally, if you cannot lift your arm or experience sudden weakness, see a physio to rule out a tear.

Should I use ice or heat for shoulder pain behind the joint?

For a dull, chronic ache (older than 48 hours), heat is usually better. It increases blood flow and relaxes tight muscles. Ice is best reserved for acute, sharp injuries that have just happened to reduce inflammation.

Why does my shoulder hurt when I breathe deeply?

This often points to a rib issue or an intercostal muscle strain rather than a shoulder joint problem. The ribs attach to the spine right next to the shoulder blade, so mechanical dysfunction there often masquerades as shoulder pain.