Stubborn Shoulder Pain? Check the Triceps
Written by Jared Packer
The shoulder can be perplexing to treat, as many sources can contribute to pain. The triceps is usually seen as an arm and elbow muscle, but did you know that part crosses the shoulder joint?
Working on this muscle might be helpful if you are stuck troubleshooting shoulder pain or losing shoulder mobility. For this reason, the triceps is often an overlooked source of discomfort and restriction in the shoulder joint.
Triceps are overlooked if you are a pitcher or overhead athlete, as you often use your triceps in the deceleration phase of your throw.
In this blog, we will look at ways to assess and treat dysfunction of the triceps that may be contributing to shoulder pain.
Tricep Anatomy
The triceps is composed of 3 sections or heads. The long head, medial head, and lateral head. When speaking of the shoulder, we are most concerned with the long head of the triceps, which runs along the back-inside part of the arm, partly because of its connection to the shoulder blade, as seen below.
Shoulder Pain Anatomy
Cadaveric studies have shown that fibers from the long head of the triceps attach to the underside of the shoulder capsule, giving it direct connection to the shoulder joint.
The medial and lateral tricep heads can indirectly contribute to a mobility restriction from fascial connections, which means that shoulder pain may be connected to tricep pain near the shoulder, particularly from the long head of the triceps.
Tricep Assessment
To assess the long head of the triceps, you need to combine elbow and shoulder flexion.
If you can't come close to touching the top of your opposite shoulder blade, you lack "normal" mobility range. It might look something like this:
While everyone is different, this is especially true if there is a large discrepancy from one side to the other.
If you feel pain at the end range of the motion, see if straightening your elbow provides relief.
If you have a large limitation at the top of the motion, see if straightening your elbow allows you to move your shoulder significantly more.
If either is true, you may benefit from working on your triceps.
Soft Tissue Work
Place a lacrosse ball, tennis ball, accumobility ball, or whatever object you want on the triceps, as shown in the picture below. Anywhere from an inch above the elbow to behind the armpit is fair game. Working on the long head is key, but try working on the other parts of the triceps.
Find a level 3-4/10 pain spot and maintain pressure until the tenderness is mainly gone. Slow exhales ~6 seconds in length. While doing this can help to reduce tone in your muscle by relaxing the nervous system.
Alternatively, perform around ten holds and stretches per spot, as demonstrated in the video below. Do this up and down along the muscle until the tenderness subsides.
Try both and see which method is most effective for your body. The less sore the triceps, the better.
Tricep Exercis
Isn't this the same as the assessment? Yes, but that's okay because that's the motion we want to improve. Along those same lines, use this to see if you can reach farther than before or if the pain had subsided relative to when you assessed it.
With this triceps exercise, you should not be moving into pain/aggravating your symptoms unless a rehabilitation specialist has specifically instructed you to do so.
Related Blog Post: My Top 3 Shoulder Mobility Drills
It’s helpful to do this directly after soft tissue work to reinforce any changes you’ve introduced to your nervous system.
If you are actively rehabbing or trying to address mobility, perform 20 repetitions a few times throughout the day. After doing this for a week, you can taper off.
Related Blog Post: Shoulder Pain When Doing Push-Ups
If, after trying this, you are still struggling with shoulder pain, have one of our physical therapists help you.
This blog is not a substitute for medical advice. If you are experiencing symptoms, consult a licensed healthcare provider.
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March 7, 2023