The previous blog post recalled all the anatomy of the shoulder as a general summary, if you need to read it again before addressing today’s topic do not hesitate to go to the article “The shoulder and its instability”. Now we leave the general overview of this joint and deal with the muscular plane, specifically the superficial one, the deltoid muscle. This muscle is the cause of pain due to overuse and is involved in most sports.
What does the deltoid muscle look like?
The deltoid muscle is divided into three main groups of fibres: the anterior, middle and posterior fibres. They all insert into the deltoid tuberosity of the humerus (creating the deltoid V) and the difference is in their origin. Anterior fibres are on the anterior border, anterior surface and lateral third of the clavicle. The medial fibres on the lateral border and upper surface of the acromion. Posterior fibres are on the inferior border of the posterior border of the spine of the scapula.
The main action of this muscle is abduction of the shoulder joint, performed mainly by the medial fibres, with stabilisation of the anterior and posterior fibres. In addition, the anterior fibres flex and, in the supine position, internally rotate the shoulder. In contrast, the posterior fibres extend and, in the prone position, externally rotate.
Innervation is provided by the axillary nerve (C5-C6).
What injuries does the deltoid have?
The injury par excellence of the deltoid muscle is due to overuse, mainly caused by sports practice but also by work that involves repeated use of the shoulder in abduction, i.e. opening the arms. Injury to the deltoid can also be caused by sudden strain following a major effort or accident. Other causes are associated with other pathologies, such as bursitis, rheumatoid arthritis, fibrillar ruptures of adjacent muscles…
When this muscle is injured, the patient usually has pain or tenderness in the anterior, middle and/or posterior part of the shoulder, especially when abducting the arm. The muscle can go from overload to fibrillar rupture and bruising will appear, so the symptoms range from mild muscle tension to intense, restrictive and limiting pain. Taking into account the intensity of the injury and the patient’s pain tolerance level, this injury sometimes makes arm mobility difficult, even decreasing the articular range of the shoulder.
How to prevent deltoid injuries?
As with all muscle injuries, it is necessary to analyse whether the movement pattern is correct. If this is the case, the intensity and duration of sports training or activities that cause pain should be reduced. If the pattern is incorrect, muscle activity should be re-educated and rebalanced to achieve optimal work.
Preventive work in sport is to respect all the stages, to carry out a good warm-up, a sporting activity that never leads to pain and a much-needed return to calm. In addition, the rest times between sessions must be controlled. This routine is indicated for sport but it is important not to forget that if a person works lifting objects in a warehouse and moving them from one place to another, their work becomes a sport as it requires a high muscular load, they should also warm up and cool down.
Tips to avoid deltoid injury
- Stretching: bring the arm into adduction until you feel the stretch in the deltoid area, hold the position for one minute. Repeat the exercise by bringing the arm back until you feel stretching in the anterior fibres.
- Self-massage with percussive therapy gun.
- Pressure technique (Jones inhibition technique):
- Locate the point of pain.
- Press the point and increase the pressure progressively until localised pain appears and in other areas.
- Maintaining the pressure, mobilise the joint throughout the range until the pain disappears (neurological silence).
- In this pain-free position, maintain the pressure for 90 seconds.
- Slowly remove the pressure and return the joint to its natural position.
- Apply ice after intense activity for 10 minutes (never in direct contact with the skin).
What is the treatment for deltoid pain?
Many people are in the habit of waiting too long before seeing a healthcare professional because they think that the pain will go away on its own. This is a serious mistake because many complaints can be solved in mild degrees and chronicity can be avoided.
At the deltoid level, medical treatment is protocolised as relative rest, use of ice and anti-inflammatory and muscle relaxant drugs depending on the patient’s symptoms.
Simultaneously, physiotherapy treatment based on techniques to reduce pain, restore normal muscle tone and recover function must be carried out. To achieve this, manual work on the damaged and accessory musculature, the use of electrotherapy, joint techniques to restore shoulder mobility, dry needling to eliminate trigger points, kinesiology tape to aid recovery and therapeutic exercises to restore muscle strength are used.
How to perform kinesiology tape of the deltoid?
To help the muscle to function correctly, either at the beginning of the injury to reduce the symptoms or to improve sports practice, a kinesiology tape is applied to the 3 beams.
One consideration prior to the technique would be to decide on the shape of the bandage. If the patient is large, 3 I-bands will be used, if the patient is a standard size, a Y-bandage and an I-bandage, and, finally, if the patient is very small or a child, 3 I-bands will be used, but of lesser thickness. The second option will be described here, but in the case of another type of patient, only minor adaptations will be necessary.
Shoulder pain is very common, whether it is caused by work, daily life or sporting activities, it is likely to appear at some point in a person’s life. The muscle to which we are going to refer this pain at first is the deltoid muscle because it covers the entire surface of the shoulder. As it is the outermost layer, it is the one that will have the first contact, a reflex action when something bothers to press it, in this case the deltoid will be pressed.
The content of this blog already shows some guidelines so that a poorly performed work or a slight discomfort does not develop into an injury. In addition, physiotherapy provides a very useful tool such as kinesiology tape. It is important to remember that the application must always be adapted to the symptoms and the origin of the patient’s injury.
Carried out by the Technical Department of Calvo Izquierdo S.L.
How to cite this blog:
- Calvo Izquierdo. BLOG: deltoid [Internet]. Calvo Izquierdo SL. 2023. Available at: https://calvoizquierdo.es/blog-deltoid/
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