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Root Causes of Teres Major Pain (and How To Fix It!)

 

If your shoulder has been acting up, you might be dealing with teres major pain. The possibility of rupturing this muscle is considered rare and isn’t typically discussed in literature. If you’re experiencing pain in the back area of your shoulder, it could be your teres major!

If you play sports (such as football or baseball) or do repetitive overhead movements, the teres major is working hard for you! 

Time to dive into essential info about the teres major and what to do if you have teres major pain. 


Teres Major Pain: Anatomy

Your teres major muscle is located on the bottom side of your scapula and tucks into the a groove on your humerus. If you were wondering if there is a teres minor, indeed there is, and the teres major hangs out right below it. 

The teres major provides important connections to the deltoid and makes up the back part of the axilla (armpit) with the latissimus doors muscles and subscapularis. [1] 

Function

The teres major’s function was defined as, “to extend, medially rotate and adduct the humerus. It also plays a role in the stabilization of the humeral head. This muscle is not alone in these functions. The latissimus dorsi also aids in medial rotation and adduction of the humerus.” [1]

Moving your arm overhead or away from your body? Your teres major has got your back. (Well.. your arm.)

Any movements involving adduction, extension and internal rotation… your teres major is working for you! 

The latisimmus dorsi and teres major function as one muscle unit - with injuries rarely affecting only the teres major. [2]

Symptoms of Injury

Yes, pain is a major symptom, but not the only one! Other symptoms may include…

  • Decreased range of motion (weakness during movement)
  • Swelling
  • Bruising
  • Sensitive to touch
  • Pain that worsens with activity  

While everyone’s experience may differ slightly, the pain can also radiate to the armpit area, since this is where part of the teres major connects to. 


Teres Major Pain: Causes

You may find there are common root causes for muscular pain as noted in other articles on the QL Blawg. While this type of injury isn’t necessary limited to elite athletes, some causes to be aware of include: 

  • Incorrect posture
  • Trauma or injury (motor vehicle accidents)
  • Repetitive actions (Throwing, overhead movements)
  • Lack of adequate warm-up

Some occupations that are at risk for teres major pain include baseball pitchers, or those who do repetitive movements such as wood chopping. Watch out lumberjacks. 

Teres Major Pain: Diagnosis

Thorough examination by a healthcare professional is a good place to start for a diagnosis. Not only can they assess which muscle your pain is coming from but also they can suggest effective interventions for you to achieve full recovery. 

Magnetic resonance imaging (MRI) is the first choice for an imaging technique. An MRI can help distinguish the difference between a strain and a tear on your teres major. 

Ultrasonography may also be ordered to analyze bruising of the area. [2] 

If you’re experiencing pain that doesn’t improve, getting a professional assessment is essential! Not only can they help define which muscle is affected, but also ensure that nothing more serious is taking a toll. 

 

Teres Major Pain: Treatment and Management

Hopefully your pain is easily treated with conservative methods. If you haven’t made a doctor’s visit yet, remember PRICE protocol!

P - Protection

R - Rest

I - Ice

C - Compression

E - Elevation

This intervention is: easy to do at home, doesn’t need much added equipment, and can be done right away.

The elevation part ought to be more of keeping your arm and shoulder in a neutral position and of course, not to apply any pressure.

Physical Therapy

Your necessary treatment may require physical therapy. A therapist can help provide the appropriate stretching and strengthening exercises to help you regain your strength and range of motion. 

While you can easily adopt a stretching routine at home, it can be a tricky endeavor to know what types of stretches and exercises are safe without exacerbating your pain. A useful rule to abide by is to rest if moving is still painful. 

Medication Options

Treating muscle pain can initially be done with over-the-counter medications, however, injury caused by inflammation will take time to improve. Consulting with your doctor to ensure that you’re indeed experiencing muscle pain is an important step before treating with medication. Ideally, if PRICE hasn’t helped to improve your pain, more interventions will be necessary. 

Teres Major Pain: Trigger Point

A trigger point or knot in your teres major can be massaged or even be treated with acupuncture. Because of the location of this muscle, seeing a massage therapist may be your best bet. Find an expert with myofascial release or deep tissue massage. 


Teres Major Pain: How to Prevent it!

The methods for preventing muscle pain are easy to do and require little to no equipment. Incorporating some of these actions today can help keep you strain-free!

Adequate warm-up

Do you ever find yourself skipping your warm-ups and cool-downs? This can be tempting because its importance goes overlooked or misunderstood. An article in Sports Med journal states, “The warm-up is considered beneficial for increasing body temperature, stimulating the neuromuscular system and overall preparing the athletes for the demands of training sessions and competitions.” [3]

The authors of this study argue that it’s difficult to study the instant effects of skipping a warm-up, as injuries were based on the long-term effects of skipping. The interpretation supports that injury prevention is effective if you are consistent with your warm-ups! [3]

Proper posture

Having proper posture is helpful in reducing strain in any muscles. Ideally this means positioning your shoulders back and down. Rounding your shoulders forward means your muscles (including your teres major) has to put in more work to stabilize your shoulder joint. 

Additionally, having a neutral spine can prevent muscles from having to compensate, which may lead to muscular imbalances. 

Recovery time

Making sure you have enough recovery time is essential for injury prevention. Not only does this help any small tears to heal but it also allows muscles to be ready for your next workout session. Getting enough rest can prevent muscular fatigue and contribute to better performance.

Getting ahead of any pain means taking the proper precautions when being active. While being aware of your posture might require some mindfulness, making the time for warm-ups and recovery means prioritizing a routine that works for you! 

Incorporate a stretching routine

You are in luck, BMS has published an article on 8 Effective Teres Major Stretches! Mosey on over and try some of them out, you won’t regret it! You’ll also find more useful information about the teres major, written by Sam Ayd. 


Teres Major Pain: Conclusion

Discomfort in your posterior shoulder area after a throw or repetitive arm movement can mean your teres major was strained. With the proper interventions, it can be effectively treated. Sure enough, a case was reported in which a football athlete’s pain and limitations were nonexistent after 18 days of conservative methods. Remember, there are easy measures to take so you can be proactive against teres major pain! 


Teres Major Pain FAQ

What causes pain in teres major?

Trauma, injury, repetitive movements, excess stress, and poor posture are some causes of pain in the teres major muscle. Repetitive movements that are shoulder-focused or overhead such as throwing or batting can contribute to teres major pain. 

How do you relieve teres pain?

RICE is an easy acronym to remember for relief. Rest, ice, compression and elevation! If your pain is persistent, over-the-counter medications can help as well. It is recommended to make a visit to the doctor so an accurate diagnosis can be made and a treatment plan can be tailored to your needs. 

For more information, check out our page on Teres Major Stretches.

How long does it take for a teres major strain to heal?

The answer to this question depends on the interventions you’re able to employ. As described in the study referenced in this article, healing from a teres major strain is doable and occurred in 18 days for an injured athlete.The extent of your injury is a major factor in how fast you’ll be able to heal.

How do you stretch teres major for pain?

There are several easy stretches you can try to loosen up your teres major! YouTube and even social media can be your friend when looking for some examples.

Some popular examples include:

  • Standing overhead stretch
  • Cross-body shoulder stretch
  • Child’s pose (with arm extension)

  • Most mobility exercises that involve shoulder and arm movement would stretch your teres major. 

    Tips for Stretching:

  • Make sure to do these stretches on both sides! 
  • Hold your stretched position for 20-30 seconds - you should be able to feel the stretch at the back of your upper arm and shoulder area.
  • Don’t force your stretches (you shouldn’t feel pain)
  • Be consistent - aiming for daily, if possible 
  •  




    Sources:

    [1] Syros, A., Rizzo, M. Anatomy, shoulder and upper limb, teres major muscle. StatPearls, 2023. 

    [2] Maciel, R., Zogaib, R., Pochini, A., Ejnisman, B. Isolated rupture of teres major in a goalkeeper. BMJ Case Reports, 2015.

    [3] Afonso et al., Revisiting the ‘whys’ and ‘how’s of the warm-up: are we asking the right questions? Sports Med, 2024. 



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