Shoulder pain is a frequent complaint among adults. The origins of shoulder pain are manifold. Recently, a relationship between musculoskeletal pain and stacking fascia has been reported. Herein, we report a patient with intractable shoulder pain that was improved by hydrorelease. The patient visited our hospital after experiencing pain on motion and a limited range of motion in the left glenohumeral joint for 6 months. Hydrorelease (xylocaine + saline) was performed around the scapula, and betamethasone + xylocaine injections were added to the subacromial bursa and long head of the biceps tendon (LHBT), but the symptoms did not improve. A physical therapist performed a passive shrug on the patient's left shoulder joint from the first position, which elicited pinpoint pain in the anterior aspect of the shoulder. The patient was found to have tenderness in the same area, and ultrasonographic evaluation revealed stacking fascia in the transverse ligament around the LHBT. Following hydrorelease, the patient experienced relief of the symptoms.Passive shrug of the shoulder joint elicited pain in a region of the stacking fascia that had not been identified by other physical examinations. By identifying the source of the pain through a physical examination by a physical therapist, we were able to effectively treat the patient and obtain pain relief.