Musculoskeletal Health

Shoulder Mobility: Causes, Significance, and Improvement Strategies

By Hart 8 min read

Inability to touch hands behind your back often indicates restricted shoulder mobility due to muscular tightness, joint capsule stiffness, postural imbalances, or previous injury.

What Does It Mean If You Can't Touch Your Hands Behind Your Back?

Inability to touch your hands behind your back, often assessed by the Apley Scratch Test, typically indicates limitations in shoulder mobility, specifically restricted internal and external rotation, and can stem from muscular tightness, joint capsule restrictions, or postural imbalances.

Understanding Shoulder Mobility: The Anatomy Behind the Movement

The shoulder is the most mobile joint in the human body, a complex interplay of bones, muscles, ligaments, and tendons designed for a vast range of motion. When attempting to touch your hands behind your back, you are primarily engaging two key movements:

  • Internal Rotation: The ability to rotate the arm inward towards the body's midline. The hand reaching up from below requires significant internal rotation.
  • External Rotation: The ability to rotate the arm outward away from the body's midline. The hand reaching down from above requires external rotation.
  • Extension: Moving the arm backward away from the front of the body.
  • Flexion: Moving the arm forward and upward.
  • Adduction: Moving the arm towards the midline.

The primary joints involved are the glenohumeral joint (the ball-and-socket joint of the shoulder) and the scapulothoracic joint (the articulation of the shoulder blade with the rib cage). Both must move synergistically to achieve full range of motion. Key muscles that facilitate and can restrict this movement include:

  • Rotator Cuff Muscles: Supraspinatus, infraspinatus, teres minor (external rotators); Subscapularis (internal rotator).
  • Pectoralis Major and Minor: Often tight, pulling the shoulders forward and limiting external rotation and extension.
  • Latissimus Dorsi: A large back muscle that, when tight, can restrict overhead mobility and external rotation.
  • Posterior Deltoid and Teres Major: Can limit internal rotation if tight.

Why Can't You Touch Your Hands? Common Causes of Restriction

Several factors can contribute to limited shoulder mobility, preventing you from performing the "hands behind the back" maneuver:

  • Muscular Tightness and Imbalances:
    • Tight Pectoralis Muscles: Prolonged sitting, computer work, or over-emphasis on pushing exercises (e.g., bench press) can shorten the pectoralis major and minor, pulling the shoulders forward (protraction) and limiting the arm's ability to extend and externally rotate.
    • Tight Latissimus Dorsi: This large back muscle can restrict shoulder flexion and external rotation, hindering the arm's ability to reach overhead and behind the back.
    • Tight Internal Rotators (e.g., Subscapularis): Overuse or imbalance can lead to tightness, directly limiting external rotation.
    • Tight Posterior Shoulder Muscles (e.g., Posterior Deltoid, Teres Major): These can restrict internal rotation.
  • Joint Capsule Stiffness:
    • The joint capsule, a fibrous sac surrounding the glenohumeral joint, can become tight or restricted due to disuse, aging, or inflammation. This is common in conditions like adhesive capsulitis (frozen shoulder), which severely limits all shoulder movements.
  • Postural Dysfunctions:
    • Upper Crossed Syndrome: Characterized by rounded shoulders, a forward head posture, and a hunched upper back. This imbalance typically involves tight chest muscles and weak upper back muscles (e.g., rhomboids, lower trapezius), directly impacting shoulder blade position and arm mobility.
    • Scapular Dyskinesis: Impaired movement or control of the shoulder blade can prevent the arm from achieving full range of motion.
  • Previous Injury or Surgery:
    • Fractures, dislocations, rotator cuff tears, or surgical interventions can lead to scar tissue formation, joint stiffness, or altered biomechanics, limiting mobility.
  • Osteoarthritis:
    • Degenerative changes in the shoulder joint can lead to pain, stiffness, and reduced range of motion.
  • Nerve Impingement or Referred Pain:
    • While less common as a primary cause of inability to perform the movement, pain from nerve impingement (e.g., cervical spine issues) or other shoulder pathologies can inhibit voluntary movement and limit range of motion.

The Significance of This Mobility Limitation

Beyond the simple inability to perform a specific movement, restricted shoulder mobility can have several implications:

  • Impact on Daily Activities: Simple tasks like dressing, reaching for objects on a high shelf, or fastening a bra can become challenging.
  • Increased Risk of Injury: Compensatory movements due to limited range of motion can place undue stress on other joints (e.g., elbow, wrist, neck) or lead to impingement syndrome, rotator cuff strains, or tendinitis in the shoulder itself.
  • Reduced Athletic Performance: Athletes involved in throwing, swimming, racket sports, or weightlifting (e.g., overhead press, snatch, clean and jerk) will experience significant performance limitations and increased injury risk.
  • Poor Posture: Limited shoulder mobility often correlates with poor upper body posture, which can contribute to neck pain, headaches, and general discomfort.

Assessing Your Shoulder Mobility

The Apley Scratch Test is a common clinical assessment for shoulder mobility, specifically for internal and external rotation.

  • External Rotation & Abduction (Reach from above): Reach one hand over your shoulder and down your back as far as possible, attempting to touch the inferior angle of the opposite scapula.
  • Internal Rotation & Adduction (Reach from below): Reach the other hand up your back from below, attempting to touch the inferior angle of the opposite scapula.

The goal is to determine how close your hands can get, or ideally, if they can touch or overlap. Significant differences between sides or an inability to get close are indicators of mobility restrictions. For a comprehensive assessment, a healthcare professional or qualified fitness expert might also evaluate:

  • Active Range of Motion (AROM): How far you can move your arm independently.
  • Passive Range of Motion (PROM): How far your arm can be moved by an external force (e.g., a therapist).
  • Scapular Control: The stability and movement patterns of your shoulder blade.
  • Strength Imbalances: Weakness in key stabilizing muscles.

Strategies to Improve Shoulder Mobility

Improving shoulder mobility is a gradual process requiring consistency and a multi-faceted approach.

  • Soft Tissue Release:
    • Foam Rolling: Target tight areas like the latissimus dorsi, pectorals (carefully), and upper back.
    • Myofascial Release Tools: Use lacrosse balls or massage sticks for more localized pressure on trigger points.
  • Stretching:
    • Doorway Stretch: To lengthen the pectoralis muscles.
    • Latissimus Dorsi Stretch: Reaching overhead with a slight side bend.
    • Sleeper Stretch: To target the posterior capsule and external rotators (perform gently).
    • Cross-Body Stretch: For posterior deltoid and shoulder capsule.
    • Thoracic Spine Mobility Drills: Cat-cow, thread the needle, and foam rolling the upper back can improve spinal extension and rotation, which directly impacts shoulder blade movement.
  • Mobility Drills:
    • Shoulder Pass-Throughs (Dislocates): Using a PVC pipe or resistance band, slowly move your arms from in front of you, overhead, and behind you, focusing on controlled movement.
    • Controlled Articular Rotations (CARs): Slow, controlled circles of the shoulder joint through its full available range of motion.
    • Scapular Control Exercises: Focus on protraction, retraction, elevation, and depression of the shoulder blades to improve stability and awareness.
  • Strengthening Opposing Muscles:
    • Strengthening the muscles that oppose the typically tight ones is crucial for long-term balance and stability. Focus on:
      • Rhomboids and Lower Trapezius: (e.g., Face pulls, band pull-aparts, seated rows).
      • External Rotators: (e.g., External rotation exercises with light dumbbells or resistance bands).
      • Serratus Anterior: (e.g., Scapular push-ups, wall slides).
  • Postural Correction:
    • Conscious effort to maintain an upright posture, avoiding rounded shoulders and forward head posture, is fundamental. Regularly check your posture throughout the day, especially if you have a sedentary job.

When to Seek Professional Help

While many mobility limitations can be improved with consistent self-care, it's important to seek professional guidance if:

  • You experience persistent pain that doesn't improve with rest or self-care.
  • There was a sudden loss of range of motion or pain after an injury.
  • Your mobility issues significantly impact your daily life or ability to perform necessary tasks.
  • You suspect an underlying medical condition (e.g., frozen shoulder, arthritis).
  • You need personalized guidance for a safe and effective exercise program tailored to your specific limitations.

A physical therapist, chiropractor, or certified athletic trainer can provide a thorough assessment, diagnose underlying issues, and prescribe targeted interventions to restore optimal shoulder function.

Ultimately, the inability to touch your hands behind your back is a clear signal from your body that your shoulder mobility needs attention. Addressing these limitations proactively can prevent future injuries, improve functional movement, and enhance overall quality of life.

Key Takeaways

  • Inability to touch hands behind your back, often assessed by the Apley Scratch Test, indicates limitations in shoulder mobility, particularly restricted internal and external rotation.
  • Key causes of restricted shoulder mobility include muscular tightness (e.g., pectorals, latissimus dorsi), joint capsule stiffness (like frozen shoulder), postural imbalances (Upper Crossed Syndrome), and previous injuries or arthritis.
  • Limited shoulder mobility can hinder daily activities, increase the risk of injuries (like impingement or rotator cuff strains), impair athletic performance, and contribute to poor posture.
  • Improving shoulder mobility involves a multi-faceted approach, including soft tissue release, targeted stretching, specific mobility drills, strengthening opposing muscle groups, and consistent postural correction.
  • Professional help from a physical therapist or similar expert is recommended for persistent pain, sudden loss of motion, significant impact on daily life, suspected underlying conditions, or for personalized guidance.

Frequently Asked Questions

What is the Apley Scratch Test for shoulder mobility?

The Apley Scratch Test is a common assessment for shoulder mobility, evaluating internal and external rotation by attempting to touch your hands behind your back, one reaching from above and the other from below.

What are the common causes of being unable to touch hands behind your back?

Common causes of limited shoulder mobility include muscular tightness (e.g., pectorals, latissimus dorsi), joint capsule stiffness (like frozen shoulder), postural dysfunctions such as Upper Crossed Syndrome, previous injuries or surgeries, and conditions like osteoarthritis.

How does restricted shoulder mobility affect daily life and well-being?

Limited shoulder mobility can significantly impact daily activities like dressing, increase the risk of shoulder injuries (e.g., impingement), reduce athletic performance, and contribute to poor posture, leading to neck pain or headaches.

What strategies can help improve shoulder mobility?

To improve shoulder mobility, you can use soft tissue release techniques (foam rolling), perform specific stretches (doorway stretch, sleeper stretch), incorporate mobility drills (shoulder pass-throughs), strengthen opposing muscles, and consciously correct your posture.

When should I seek professional help for shoulder mobility issues?

You should seek professional help if you experience persistent pain, a sudden loss of range of motion after an injury, if mobility issues significantly impact your daily life, if you suspect an underlying medical condition, or if you need personalized guidance for an exercise program.