Deltoid Pain: Causes, Exercises and Treatment

The deltoid is a large muscle that wraps around the shoulder and upper arm. It is responsible for raising the arm and helps stabilize the shoulder joint.

Most times, deltoid pain is caused by muscle strain and should get better over a few days. You should see your doctor if the pain persists, is severe, or if you have additional symptoms.

What Causes Deltoid Pain?

1. Muscle Strain

A muscle strain is when muscle fibers, the tendon connecting the muscle to the bone, or the connection between the muscle and the tendon tears.  The deltoid muscle can be strained by heavy tasks such as carrying heavy weight over your head, pulling a lawnmower, or using a chainsaw.  Improper warm-up may increase the risk of getting a muscle strain.  The muscle strain can be classified into grade levels. These levels are:

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    • In a grade 1 strain, where only a few fibers are torn – there is mild pain but there is still good ability to use the muscle.
    • In a grade 2 strain, there is a significant, but partial tear in the muscle – there is often difficulty using the muscle.
    • In a grade 3 strain, there is a complete tear in the deltoid –  there is usually severe pain and inability to use the muscle.

2. Overuse

Overusing the deltoid muscle or doing activities that use the deltoid muscle a lot like swimming or weight lifting can cause deltoid pain.  This is often attributed to micro-tears in the muscle or tendon.

3. Contusion

A contusion is an injury to the blood vessels in the muscle which is usually caused by trauma such as direct impact. It usually leaves a bruise at the are of injury. A contusion in the deltoid muscle leads to pain.

4. Cervical Radiculopathy

This is when a herniated intervertebral disc at the cervical spine compresses the surrounding nerves. The nerves that supply the deltoid muscle and overlying skin come from the cervical spine and once a nerve(s) is compressed, it can cause pain.

5. Heart Attack

Certainly less common than muscle strains, the symptoms of a heart attack can sometimes be pain into the shoulder area, but are usually associated with other symptoms such as jaw pain, chest pain, whole arm pain, shortness of breath, fatigue, abdominal pain, nausea and/or vomiting, or dizziness.

6. Splenic Rupture

Associated with abdominal trauma, a ruptured spleen can cause referred pain to the left shoulder and is usually accompanied by abdominal pain and/or signs of shock such as dizziness, sweating, and fainting.

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Associated Symptoms with deltoid strain

  1. Pain at the shoulder joint
  2. Swelling overlying the deltoid
  3. Reduced movement at the affected shoulder
  4. Tenderness to palpation at the deltoid muscle

When To See Your Doctor

Most strains can get better over a few days. However, you should see your doctor if:

  • the pain is very severe
  • it persists more than a few days
  • you’re unable to move your arm
  • you have other symptoms like numbness, pain all the way down the arm, chest pain, or difficulty breathing

Diagnostic Tests

An X-ray may be recommended to rule out a fracture or dislocation. An MRI scan will give a clearer picture of the muscle if the doctor feels that it is necessary.

Treatment

Medications

Anti-inflammatory medications like ibuprofen or diclofenac are usually prescribed to help relieve pain and reduce swelling.

P.R.I.C.E. Protocol

P.R.I.C.E. is an acronym that is used for any form of muscular injury for the first 3-5 days after the injury happens. It stands for:

Protection: immobilize or pad the area to prevent further injury

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Rest: Reduce or stop all activities that involve the shoulder joint in order not to worsen the injury at the deltoid muscle.

Ice: Ice the affected area using ready-made ice packs or making your own ice packs at home. This can be done by placing ice cubes in a damp towel on the deltoid muscle.

Compression: Helps to reduce swelling that can occur at the deltoid muscle. A compression bandage can be wrapped around the muscle but it must not be too tight because it can reduce blood flow and slow down the healing process.

Elevation: This is the position an injured part of the body should be placed. The shoulder can be placed on stacked pillows above or at chest level. Elevation helps in reducing swelling.

Physiotherapy

A referral to the physiotherapist is often written by the doctor to help in recovery from muscular pain. The physiotherapist will assess you to ensure that there is no associated condition and to try and pinpoint the major cause of pain. Realistic goals with treatments to speed up the recovery process are designed after the assessment. The physiotherapy goals will involve:

      • Pain relief using ice and gradually changing to heat, deep tissue massage with an analgesic cream containing an active ingredient like ibuprofen or diclofenac.
      • Strengthening the deltoid muscles and other muscles that support the movement of the shoulder joint using exercise.
      • Increase the range of movement by reducing stiffness at the shoulder joint. Exercises or manual manipulation can be used to increase movement at the affected shoulder joint.
      • Modify your lifestyle by educating you on proper posture, lifting techniques, and stretches that can be done anywhere and anytime.

Exercises For Deltoid Pain

Your doctor or physiotherapist may recommend exercises to help with your recovery. Some of these are:

1. Static Shoulder Abduction Exercises

      • Stand with the affected side facing the wall
      • Lift your affected arm slowly and let your hand touch the wall
      • Hold this position for 20 – 30 seconds
      • Relax

2. Arm Circles

      • Lift your arms out to the side
      • Use your lifted arms to draw 10 small circles in a clockwise direction and then in an anticlockwise direction
      • Draw another 10 circles in a clockwise direction
      • Then as the injury heals, draw big circles in an anticlockwise and a clockwise direction
      • This warms up the muscles in the upper limbs and also strengthens the deltoid muscles

3. Shoulder Abduction Exercises

      • Stand with your feet slightly apart
      • Lift the affected arm to the side slowly till it is in line with the shoulder joint
      • Return the lifted hand to your side and repeat it 10 times.
      • This exercise can be done with a weight or resistance band.

4. YTW

      • Take your two hands out in front of you at shoulder level
      • Take them over your head and return to starting position (Y)
      • Take them out to the sides and return to starting position (T)
      • Then bend your elbows with your palms facing the wall in front of you and your elbows trying to touch themselves at the back (W)
      • Return to starting position and repeat 5 times.

5. Deltoid Stretch

      • With your shoulders relaxed by your side, take your right arm across your body towards the left
      • Place your left palm on your right upper arm to stretch the deltoid muscle
      • Hold for 20 seconds and repeat on the other arm

6. Shoulder Flexion Exercises

      • The deltoid muscles assist in shoulder flexion
      • Lift your affected arm in front of you
      • Hold for 5 seconds then relax the arm
      • Repeat 10 times
      • As the injury heals, weights or resistance bands can be held to help strengthen the deltoid muscle.

7. Shoulder Extension Exercises

      • Take the affected arm to the back as far as you can go
      • Ensure you do not bend your upper body forward
      • Hold for 5 seconds then relax
      • Repeat this 10 times

Complications

Deltoid pain can lead to weakness in the deltoid muscles. If the pain is not treated or well treated, it can lead to:

  • Reduced muscle size
  • Inability to properly use the affected arm
  • Shoulder joint stiffness
  • Altered body mechanics when compensating for the injured muscle that affects other areas of the body

Prevention

  1. Always warm-up before carrying out any serious physical activity
  2. Take stretch breaks especially when are doing a lot of “over-the-head” activities
  3. Adequate rest after exercise to allow your muscles time to recover.
  4. Do not stay in one position for too long. Move about and shake up your body. This can be like a mini warm-up at work
  5. Strengthen all of the muscles around the shoulder, not just the deltoid, as they all work together.
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