A real mix of people. Most commonly I see it from rotator cuff issues, labral tears, or muscle imbalances. These can build into impingement or general tightness through the back of the shoulder. Sometimes it's not even coming from the shoulder at all. It can be referred pain from the neck, or related to arthritis in the joint.

Trauma-wise, the classic mechanism is falling onto an outstretched arm or elbow, which forces the humerus backward. That can cause a posterior dislocation or subluxation, sometimes with a labral tear, usually quite painful. Other falls cause a milder capsule strain that people barely notice at the time, just a bit of tightness in the back of the shoulder. Don't ignore that one because it can chip away at function if it keeps happening.

I also see it post-surgery, especially after rotator cuff repairs, and in throwers, gymnasts, and swimmers whose sport demands a lot of internal rotation. That movement tends to leave the external rotators (Infraspinatus and Teres Minor) tight and weak. If you've got a frozen shoulder, the posterior capsule is often part of that tightness too.

Across the board, the fix is the same starting point: release the tightness, then rebuild strength and scapula control.

You need both — release the tightness first, then build the strength back underneath it.

Start with trigger work on the posterior cuff (Infraspinatus and Teres Minor) using a Pocket Physio MAX or Pocket Physio Massage Ball. Do the same for the Lats if they're tight too.

Then stretch the lats and posterior shoulder with a Stretchband, and build rotator cuff and posterior deltoid strength with a red Powerband Make sure scapula stabilisation work is in there too, not just the cuff in isolation.

Done consistently, that combination is what actually shifts the pain and stops it coming back.

The ones I watch for are posterior dislocation, a fractured scapula, and rotator cuff tears. The dislocation and cuff tears usually come from falling onto an outstretched hand or elbow; a fractured scapula is more often a direct blow — a hard tackle, a bad landing, or coming off a motorbike.

I see these most in older adults, collision-sport athletes, and anyone doing high-impact jumping.

If it happens: ice it with an Ice Mate Pro to manage the pain, then get it checked and diagnosed properly as soon as you can.

It really depends on what's being repaired. If the shoulder's unstable — prone to repeated dislocations or subluxations — you're generally looking at around 20 weeks back to full activity. A straightforward subluxation, without surgery, is more like 12 weeks minimum.

Strains and general tightness usually don't cost you much time at all, though I'm more cautious with throwing athletes — baseball pitchers especially — since the demands on that joint mean we take healing a bit slower to avoid setting up a repeat injury.