Teres Minor Strain: Overview and Evidence Summary

Condition Overview

A teres minor strain refers to an injury of the teres minor muscle or its tendon, located at the back of the shoulder as part of the rotator cuff complex. While less commonly injured than the supraspinatus or infraspinatus, the teres minor plays a critical role in external rotation and maintaining stability of the glenohumeral joint—especially during overhead or high-velocity activities. Its contribution becomes even more important when the infraspinatus is fatigued or overloaded, as the teres minor often takes on additional stabilizing demand.

Strains may arise from sudden forceful movements, such as an unexpected pull on the arm, a powerful serve in tennis, or the deceleration phase of throwing. More commonly, however, the injury develops gradually as a result of repetitive overhead loading, poor scapular control, or muscular imbalance within the rotator cuff. Many patients describe deep, localized pain in the posterior shoulder, sometimes radiating toward the upper arm. Discomfort often increases with resisted external rotation or reaching back, such as when fastening a seatbelt.

Because teres minor strain can mimic symptoms of infraspinatus strain or posterior deltoid overload, careful clinical examination is essential. Fortunately, prognosis is typically excellent when the condition is identified early and managed with appropriate rehabilitation. With progressive strengthening, load management, and neuromuscular retraining, most individuals return to full activity without long-term limitations.

Summary of Current Evidence for Teres Minor Strain

Evidence-Based Management Discussion

Non-Operative Management as the Gold Standard

The overwhelming majority of teres minor strains respond to non-operative management. The first step is helping the patient understand the nature of the injury and the importance of progressive loading. Many individuals initially avoid using the arm, but prolonged rest can weaken the rotator cuff and prolong recovery. Instead, early controlled activation of the external rotators helps maintain neuromuscular coordination and prevents stiffness.

Load modification is essential. Activities that provoke sharp pain—often high-velocity or high-load external rotation—should be temporarily adjusted. However, maintaining functional movement within comfortable limits prevents deconditioning of the shoulder complex.

Exercise Therapy

Rehabilitation centers on gradually restoring external rotation strength, endurance, and dynamic control. Several specific strategies are supported by rotator cuff rehabilitation principles:

• Isometric loading reduces pain sensitivity and helps reestablish baseline activation patterns.

• Eccentric exercises improve tendon resilience and tolerance to stretch under load, particularly useful after repetitive overload.

• Heavy–slow resistance (HSR) builds strength and supports tendon remodeling in cases where symptoms have become chronic.

• Angle-specific activation—training external rotation in varying degrees of abduction—ensures functional carryover to sport or occupational tasks.

Scapular stability training is equally important. Limited upward rotation or poor posterior tilt of the scapula increases the load on posterior rotator cuff muscles, prolonging recovery.

Manual Therapy

Manual interventions can help reduce guarding and restore comfortable movement early in rehabilitation. Techniques may include posterior glenohumeral joint mobilisations, myofascial techniques, soft tissue work along the teres minor-infraspinatus interface, or stretching of surrounding musculature. These methods can make active rehabilitation more tolerable, but long-term improvement relies on progressive loading rather than passive modalities.

Medications and Injections

NSAIDs may reduce discomfort in the acute phase but should not replace an active rehabilitation approach. Corticosteroid injections are seldom warranted for isolated teres minor strain and are typically reserved for broader rotator cuff pathology with significant inflammation.

Surgical Considerations

Surgery is rarely required. In the rare cases where symptoms persist despite structured rehabilitation, imaging may reveal additional issues such as labral pathology, partial cuff tearing, or suprascapular nerve irritation. Addressing these underlying factors usually restores function without surgical intervention.

References

American Academy of Orthopaedic Surgeons. Management of Rotator Cuff Injuries: Clinical Practice Guideline. 2025.

Kibler, W., Ludewig, P., et al. “Scapular Contributions to Shoulder Dysfunction in Overhead Athletes.” Sports Medicine, 2013.

Reinold, M., and Wilk, K. “Posterior Shoulder Injury Mechanisms and Rehabilitation Principles in Overhead Athletes.” Journal of Sports Health, 2010 and updates.

Myers, J., et al. “Rotator Cuff and Scapular Muscle Activation During Shoulder Rehabilitation Exercises.” Journal of Shoulder and Elbow Surgery, 2005.

Donatelli, R., et al. “Clinical Perspectives on Rotator Cuff Muscle Function and Rehabilitation.” Journal of Orthopaedic & Sports Physical Therapy, 2014.

Disclaimer

The information in this article is intended for educational purposes and is designed for qualified massage therapists, manual therapists, and rehabilitation professionals. It is not a substitute for medical advice, diagnosis, or treatment. Practitioners must work within their legal scope of practice and regional regulations. Hands-on techniques should only be performed by appropriately trained and licensed individuals. Niel Asher Education is not responsible for any injury, loss, or damage resulting from the use of this content.