Can't reach overhead or behind your back

What it is

Full overhead reach is a whole-chain movement. The shoulder joint contributes about two thirds, the shoulder blade rotates upward for the rest, and the thoracic spine has to extend at the end to let the arm finish. Any of the three failing produces the same complaint.

Reaching behind the back is a different combination - internal rotation and extension - and it is usually limited by the posterior capsule and by the same soft tissue that holds the shoulder forward. People often lose one direction and not the other, which is a clue to where the restriction is.

What it feels like

• Reaching a high shelf needs a step or a rocking lean rather than just an arm
• Washing or drying hair is tiring on one or both sides
• Fastening a bra, tucking in a shirt or reaching a back pocket is awkward or impossible
• The low back arches to compensate when the arms go up
• A hard blocked stop rather than a stretchy one

What causes it

Most people have more than one of these at once, and they feed each other. Read the list looking for the two or three that sound like your week rather than for the one true answer — the ones that describe you are the ones worth acting on.

Capsular tightness

The joint capsule surrounding the shoulder can stiffen from disuse, after injury, or as part of a frozen shoulder. It produces a firm, unyielding endpoint that soft tissue stretching alone barely touches.

Short lats

Latissimus dorsi runs from the arm to the pelvis and the lower spine. When it is short it physically prevents the arm reaching full elevation without the low back arching to compensate - which is exactly what most people do.

Short pecs

Pectoralis major and minor hold the shoulder forward and down. That start position costs range at the top of the movement before it has begun.

A stiff thoracic spine

The last twenty or thirty degrees of overhead reach come from the upper back extending. A rounded, locked mid-back removes that range and the shoulder cannot supply it.

Weak or poorly coordinated scapular muscles

The shoulder blade must rotate upward through the movement. Without serratus anterior and the lower traps doing that, the socket does not follow the arm and the movement jams.

Protective guarding after pain

A painful shoulder is used in a smaller and smaller range, and the range not used is the range lost. This is how an episode of ordinary shoulder pain becomes a lasting restriction.

A tight posterior capsule

This one limits reaching behind the back and across the body specifically. It is common in throwers and racquet players and it is not addressed by the usual overhead stretches.

Frozen shoulder

Adhesive capsulitis produces loss of range in every direction, especially external rotation, with a hard endpoint and often severe night pain. It behaves differently from everything else here and needs to be recognised rather than trained through.

Simply never going overhead

Modern life almost never asks for full elevation. A range that is never used is quietly withdrawn, and most people do not notice until something requires it.

Who tends to get it

• Desk workers and anyone with rounded shoulders and a stiff mid-back
• Anyone who has had a painful shoulder episode and moved it less since
• Adults over forty, particularly women, in whom frozen shoulder is more common
• People with diabetes, where frozen shoulder is substantially more common
• Throwing and racquet sport players, for the behind-the-back direction

What makes it worse, and what settles it

The qFIT routine for this

Ready-made routineShoulder Relief & Overhead Range

qFIT already has this one built. It runs massage first, then stretching, then strength — the order that works on a body that is already sore — and every activity in it carries the reason it is there.

The button below opens your Checklist with this routine already selected, so instead of your whole list you land on just its Categories, Targets and Exercises, each with its checkbox, ready to tick as you work through them.

Have more than one problem? Tick yours under My Problems on My Profile and your Checklist's Routine list gains Recommended for my problems — every routine for the problems you picked, merged into one. Your picks stay private; that filter is the only thing they feed.

Get it checked if…

Sudden loss of range after trauma, or range loss with night pain and fever, needs assessment; progressive stiffness in a diabetic suggests frozen shoulder

And whatever the body part: chest pain or unusual breathlessness on exertion; a fever alongside the pain; unexplained weight loss; pain that is constant and unrelated to how you move; new numbness, weakness or loss of bladder or bowel control; or one calf that is swollen, warm and painful. Any of those, stop and get assessed.

How it usually goes

Where the limitation is soft tissue and thoracic stiffness, six to twelve weeks of daily work makes a substantial and lasting difference, and the thoracic component often produces the fastest visible change. Capsular restriction is slower. Frozen shoulder runs its own long course - typically one to three years through freezing, frozen and thawing phases - and it needs a different approach in each, so it is worth having identified rather than assumed.

Prevalence basis: Functional range studies

Others the same routine covers

These share the Shoulder Relief & Overhead Range routine, so the work is the same. If one of them also sounds like you, that is a reason to expect more from it, not less.

This is general information, not a diagnosis, and it cannot examine you. If it matches you, use it to ask better questions of a clinician rather than to replace one.