A person suffering from pain in teres major or teres minor pain can feel symptoms of pain at the back of the upper arm when they stretch their arm forward to reach up something. Teres major and minor pain or injuries can be treated with various types of exercise, gels, therapy wraps, and workouts.

1. PT STRATEGIES IN TERES
MAJOR & MINOR STRAIN
By: Dr Raj Maheshwari (PT)

2. INTRODUCTION
• Teres muscles are the two muscles in the shoulder region that help in shoulder and
arm movement.
• here are two types of teres muscles – Teres Major and Teres Minor.
• Teres Major is one of the four rotator cuff muscle located at the upper back region
of the shoulder; it connects the shoulder blade to the upper arm.
• The teres major muscle is an important muscle as it is responsible for a number of
shoulder movements in multiple directions.
• Some of the movements that this muscle controls are – adduction, extension and
inward rotation.

3. INTRODUCTION
• Teres Minor is the slender stretched out muscle of the rotator cuff; it helps in
rotating the arm sideways and in bringing the arm towards the body.
• Due to prolonged and regular use of arm and shoulder muscles some people are
prone to teres major and teres minor injuries that can be quiet painful.
• This includes – handball players, swimmers, basketball players, painters, volleyball
players, wood choppers, rock climbers, and baseball pitchers.

4. INTRODUCTION

5. CAUSES
• Teres Major and Teres Minor pain typically occur during various types of arm and
shoulder movements.
• This injury can be divided into two types – acute tear injury and chronic tear injury
of the teres major and teres minor.
• Acute teres major and teres minor pain can happen due to a sudden movement like
holding a rope during water sports or while throwing a powerful pitch in baseball.
• Chronic pain in the muscle develops over a period of time. Typically, chronic pain is
located near the tendon and happens due to the tendon touching against the
primary bone.

6. CLINICAL PRESENTATION
• The teres major and teres minor pain can sometimes feel like a neurological pain
due to burning sensation, stinging feeling and numbness in the affected area.
• Location : Usually a person suffering from teres major and teres minor pain
experiences a spreading pain that may apply to the infraspinatus, posterior deltoid
and triceps areas.
• The teres minor muscle can cause a deep pain in the shoulder which can sometimes
be misconstrued as bursitis.
• Severe teres muscle injury usually occurs to professional athletes. Hence, it is very
important for them to get it treated quickly, so that it does not hamper their sport.

7. CLINICAL PRESENTATION
• Symptoms of teres major or teres minor pain can also include a stinging feeling in
the fourth and fifth finger.
• Depending on the trigger points in the muscle the pain can be at the exact location
or it can also spread to other parts of the body.
Trigger Point

8. DIFFERENTIAL DIAGNOSIS
• Thoracic outlet Syndrome
• Supraspinatus tendinitis
• Adhesive capsulitis or Frozen shoulder
• Dislocation of Glenohumeral joint
• Subdeltoid/Subacromial bursitis
• Post-injection soreness
• Charcot’s joint.

9. EXAMINATION

10. TREATMENT
• CONSERVATIVE: Cold therapy gel method is also an effective treatment method for
this muscle pain. Some studies have shown that the cold gel method decreases pain
two times more than ice and the relief lasts longer too. Those who suffer from
chronic teres major and minor strain can keep the gel in hand and use it as required.
• ELECTROTHERAPY: Modalities like US, low frequency Currents and microcurrents
can be used for enhanced healing and muscle relaxation.
• Van Gelder Frequency : Muscles shoulders 76 can be used

11. TREATMENT
• Release trigger point for Teres group of muscles.
• Additional Muscle for Trigger Point Release
• Latissimus Dorsi
• Triceps Brachii
• Subscapularis
• Back Deltoid
• Fourth finger extensor
• Average Triceps

12. EXERCISES
• Door Frame Stretching Exercise to get Relief from Teres Major and Teres Minor
Pain: Stand in front of an open door frame. Stretch the right arm below shoulder
height, behind you. Reach back and hold the edge of the doorframe with your
thumb pointing to the ground while keeping the elbow straight. Spin your arm
outwards so that the elbow fold is in front of the ceiling. Stay in this position for 20-
30 seconds and repeat the movement thrice, before switching to the other side.

13. EXERCISES
• Tennis Ball Exercise to Reduce Teres Major and Teres Minor Pain: Stand in front
of the wall with the affected side facing the wall. Next, position the ball on the wall
at the height of your armpit and press it with your body’s side so that it reaches the
injured area. You must take care to not let the ball slide to the rib cage. Now start
massaging the injured muscle with slow and deep strokes. When you encounter the
sore muscle, stay on that spot and work on it precisely.

14. EXERCISES
• Stretching Exercises for Teres Major and Teres Minor Pain: Put right arm over
the head with elbow bent. Grab the right wrist with the left hand and pull it gently
till you feel a stretch. Stay in this position for 10-15 seconds and then repeat it on
the other side. Repeat the entire cycle thrice and do the stretches at least three
times a day to get good results.

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