15 Jul How To Improve Reaching Behind Your Back
The ability to reach behind your back does not seem so important until it is taken away from you. Washing your back, grabbing your wallet, taking off your bra, putting on a belt, you name it. All of these simple activities of daily life can become quite difficult the moment you can no longer do them without an issue! However, you can get this motion back with the right exercises, discipline, and ultimately patience. In this article, you’ll learn high quality strategies of how to improve reaching behind your back.
What Is This Motion? Improve Reaching Behind Your Back
Reaching behind your back involves physiologic motion at the shoulder and the shoulder blade. Specifically, shoulder extension and internal rotation as well as physiologic motion in all planes of movement at the shoulder blade. This includes scapular rotation, elevation, depression, and abduction/adduction depending on where you’re reaching. Ideally, you should be able to reach behind your back and place your hand on your opposite shoulder blade.
Improve Reaching Behind Your Back: Why Do We Lose This Motion?
Ultimately, why someone would lose the ability to reach behind their back can be due to a few things. We are going to explain why this could be due to boney changes, shoulder capsule restrictions, or soft tissue mobility deficits. However, it is important to note with these different etiologies of motion loss, the amount of range of motion loss and the amount of pain may not be the same across the board.
Humeral and glenoid retroversion is a common osseous adaptation in overhead athletes, especially baseball pitchers, due to the torsional forces exhibited on the throwing arm with repetitive motions and stress. This is believed to occur within a specific time frame (adolescent ages) while the growth plates are still open. Humeral/glenoid retroversion leads to an increase in shoulder external rotation and a decrease in shoulder internal rotation range of motion (ROM). However, this is not necessarily an issue as long as there is a normal side-to-side total shoulder ROM (sum of internal and external ROM). This may not be as big of an issue with reaching behind your back as say capsular tightness would be. On the other hand, shoulder osteoarthritis is a separate type of boney change that can definitely limit reaching behind your back. You can learn more about humeral retroversion by clicking here
Above is an appreciation of the glenohumeral (shoulder) joint capsule. Think of the capsule as a big sock around the shoulder that covers it. The shoulder capsule is made up of strong, fibrous connective tissue. This is a good thing as it provides stability to the shoulder, which is inherently a less stable joint. However, if there is an insult to the capsule that causes a clinical condition such as adhesive capsulitis (frozen shoulder), then the capsule can become very stiff and less pliable. This ultimately restricts physiologic shoulder motion and reaching behind your back can be very restricted.
Improve Reaching Behind Your Back: Understand Shoulder Soft Tissue
A more likely culprit, especially if you are suddenly having difficulty with reaching behind your back, is soft tissue flexibility deficits. Looking at the image above, the post cuff musculature can limit shoulder internal rotation. Specifically, the teres minor and infraspinatus muscles. Also, you could argue muscles in front of the shoulder that contribute to shoulder flexion and horizontal adduction such as the pecs could limit shoulder internal rotation. The good part about this is that if it is truly soft tissue flexibility deficits, a handful of stretches that are performed correctly and consistently will do the trick!
Sometimes, a loss in our shoulder range of motion may not only lead to difficulties with reaching behind your back, but with other upper extremity related tasks, such as bench pressing or push ups for example. We have a previous podcast where Arash dives into how you can warm-up properly before performing bench presses or push ups and ultimately avoid pain with these activities!
How Do You Improve Reaching Behind Your Back?
Regardless of the reason, if reaching behind your back is limited and painful, it can be a real burden. Don’t fret! Below are various exercises focused on improving motion in different areas of the body that ultimately can improve reaching behind your back. You will find we start with the thoracic spine followed by a combination of shoulder and shoulder blade movements in efforts to improve reaching behind your back.
Improve Reaching Behind Your Back: Mid Back Foam Rolling
Getting the mid-back moving more and moving well is a crucial first step in reaching behind your back. The mid back is known anatomically as the thoracic spine. Often times, due to prolonged sedentary positions, this area of the body can become stiff, and motions can become restricted if we do not move it! Moreover, as we elevate our shoulder such as when reaching above our head, our thoracic spine has to extend, sidebend, and rotate as well! Just try reaching behind your back and then think about it, your mid back moves too! As a result, if our thoracic spine mobility is limited, this may lead to limited shoulder mobility as well.
Improve Reaching Behind Your Back: Seated Thoracic Rotation
This is one of my go-to exercises for the thoracic region as you’re driving thoracic rotation with scapular motion. Follow along in the video and you’ll learn the cueing for driving reciprocal scapular motion. Scapular motion is really important for reaching behind the back, especially if you are working with a really tight shoulder due to other circumstances like a frozen shoulder. Also, working on the thoracic region and scapular movements is great when directly moving the shoulder hurts.
Seated Cat Cow
This is a great exercise to perform at work if you have to be seated for long periods of time and you can’t get on the ground to do traditional cat cows. This is also a great follow-up exercise to foam rolling your mid back.
Cross Body Stretch
This is a really good stretch to directly target the posterior rotator cuff muscles that were referred to earlier in this article. The traditional sleeper stretch is tough for people who are working on the ability to reach behind their back as they typically have shoulder internal rotation limitations. Try this one out instead!
Rhomboid Doorway Stretch
Watch someone reach behind their back with a shirt off and you’ll notice, especially if their shoulder ROM is limited, that they can make up for it with good scapular mobility. Improving rhomboid flexibility to allow scapular abduction (shoulder blade moves away from the spine) is another good stretch to perform, especially if shoulder internal rotation is limited and painful.
Hand Behind Back With Towel Assist
Once reaching behind your back is tolerated and the stretches are going well, its time to directly start working on the range of motion. I often start this exercise at the same time as the stretches, I will just recommend people to do the stretches first! Let your arm go for a ride with the towel if actively reaching is too much. However, as you get more comfortable with this exercise you want to start helping and directly assist the motion.
Hand Behind Back With Hip Hinge
This is a really good exercise to try if the towel assist or any of the hand lift off exercises below are giving your shoulder some trouble. This exercise focuses on indirectly improving hand behind back motion by moving and stretching other areas, including the opposite pec muscles. Try it out, see how your hand behind the back motion is before and after!
Ultimately to make reaching behind your back easier and your new ROM gains stick, you want to strengthen your muscles in the new ranges. Shoulder I’s, or shoulder extension, is a really good starting place!
[P]Rehab Free Workout
Prone Lift Offs
This is another really good starting place if you can tolerate it when it comes to strengthening exercises. Get your arm and hand in a comfortable position, (don’t overdo it especially the first time), and follow along with the video for important cues!
Standing Lift Offs
This is an alternative to the prone version above. However, with the standing version there tends to be more moving parts giving people the opportunity to compensate.
Reserved for the advanced that have good ROM and want to improve their shoulder strength and mobility, I give you prone hovers! This is an excellent shoulder and scapular strengthening exercise that works on shoulder internal rotation as well as external rotation!
Words of Wisdom
I cannot reiterate this enough – improving the ability to reach behind your back takes time. Ask anyone that has dealt with this limitation before, you have to be patient, you cannot rush it, and often times it does not feel great. However, this ultimately depends on the underlying reason why reaching behind your back is limited. Stay disciplined and you will find some level of success!
The Shoulder [P]Rehab Program is a physical therapist developed, step-by-step program that teaches you how to optimize your shoulder health. This 4-phase program will expose you to various scapula and shoulder strengthening and stabilization exercises supported by science. This program will bulletproof your shoulders for anything life throws at you! Learn more here