Rib pain underneath Shoulder What is that pinch behind my shoulder blades? Pinching in behind shoulder blades can stem from a variety of causes including tension leading to stiffness in the ribs at the level of your shoulder blades. Ribs are meant to move as we breath, so any stiffness can cause a "pinch" or an "ache". This can lead to an uncomfortable sensation of a night time in behind the shoulder when you are trying to sleep. When the stiffness in the ribs lingers, it can