Sharp Pain in Front of Shoulder, with Tight Low Back

Your pain pattern,
What aggravates it,
How to get relief,
and more…

How People Describe This Pain Pattern

People complain of pain in the shoulder that is sharp and sudden when reaching up and/or forward. This may occur during a tennis serve or when getting something off of a high shelf. This can also occur when a dog yanks them forward on a leash. This creates sharp pain in the shoulder at the end of the stretch created in exercises like pullovers and seated triceps extensions.

These people may complain of pain in the shoulder while sleeping on that side, especially when the arm is pulled up and forward so that the border of the lat is pressed into the ribs. Some talk about the “only position” in which they can get comfortable to sleep, is on their stomach, as the low back pain may wake them as well.

The referral in the low back is usually described as “stiffness” or some sort of restricted motion when bending to the opposite side. It is seldom described as pain, except when this becomes very active or when the muscle is compressed by sitting in a hard-back chair or sleeping on it.

Often, these people have already tried a number of things stretches, exercises and therapy without success. This muscle is often missed in the assessment of shoulder problems and low back problems as it is not thought of as being either. When the right combination of moves occurs this muscle unexpectedly stretches and the referral is experienced.

How You Activate and Intensify This Pain Pattern


This is usually activated by some activity that jerks the arm up and forward, like jerking pull-ups or allowing the end of a pull-down motion to create a bouncing stretch in the back. It can also be activated by reaching up to grab something as you are falling.

Once it is activated, activities that press down, like weeding, stuffing a sleeping bag into its bag, or pressing into the arms of a chair to get up may become aggravating.

Also, activities like pitching or reaching into a high cabinet can produce a sudden, sharp pain. Also, you’re going in the water with a boatload of pain, if you’re scheduled to go on American Ninja Warrior.

The Musculoskeletal Anatomy Behind Your Pain

This is a complicated muscle that attaches to a lot more than you’d think. You can read about it in this post on latissimus dorsi anatomy.

Very Similar Pain Pattern, Different Muscle

This trigger point produces almost the same pattern of pain in the front of the shoulder when reaching forward. It is a different muscle with very different self-care. Take a look at this post.

Getting Relief on Your Own

Clinically Proven
Self-Care Recommendations.

This post has strategies for getting relief on your own. Explore how to change your activities, stretch, and other strategies that relieve the pain associated with this trigger point.

Treatment Notes for Therapists

Better Bodywork
Through Shared Expertise.

This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach. 

This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.

Weekly Featured Post

Optimizing Tension for
the Best Day Ever

This post explores this idea and optimizing tension for our best performance.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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