A muscle is surrounded by an outer sheath that allows it to move smoothly over the surrounding tissues as it contracts. Your deltoid muscles are in your shoulder, which is the ball-and-socket joint that connects your arm to the trunk of your body.
Deltoid muscles help you move your arms in different directions. They also help protect and stabilize your shoulder joint. Your deltoid muscles work alongside your other shoulder muscles, such as the rotator cuff muscles, to help you perform a variety of movements. Deltoid muscle functions include the following:
- Flexion and extension – Moving your arm forwards, towards an overhead position, then moving your arm backwards, behind your body.
- Stability – Stabilization of your shoulder joint to prevent dislocations as you lift your arm or while you carry weight with your arms at your side.
- Compensation – Compensation for lost arm strength if you have an injury, such as a rotator cuff tear.
- Arm abduction – This means raising your arm out to the side of your body.
A muscle strain is the stretching or tearing of muscle fibers. Most muscle strains occur for one of two reasons; either the muscle has been stretched beyond its limits, or it has been forced to contract too strongly. In mild cases, only a few muscle fibers are stretched or torn, and the muscle remains intact and strong. However, in most severe cases, the strained muscle may be torn and unable to function properly.
Deltoid strains are common injuries in people that do a lot of strenuous exercises or in athletes that use their shoulders and deltoid muscles repetitively. The deltoid can be overextended with some movements such as throwing a baseball or lifting too much weight. Many people working on strength training, or bodybuilding, focus a whole workout on their shoulders alone.
These long periods of overuse and abuse to the shoulder muscles can easily produce strains (minor tears in muscles and / or tendons) that can be felt as a deep pain in the shoulder. A fall or sudden injury that jars the shoulder joint or even dislocates the shoulder can also cause major damage to the deltoid muscle.
Causes & Symptoms
Generally, deltoid muscle strains are usually classified into a total of three grades, such as:
Grade 1 deltoid strain
A grade 1 deltoid strain is considered a minor tear of the muscle (approximately 10% of the muscle fibers). You may be able to continue your regular activities because the pain is a minor twinge inside your shoulder. You may feel an increase in pain when bearing added weight in the arms. The shoulder muscle feels achy and tight for 2-5 days prior to the injury, recovering for healing is 7-10 days.
Grade 2 deltoid strain
Grade 2 deltoid muscle strains are known to be partial tearing of the muscle (over 50% of the muscle fibers). You will feel sharp pain and minor to moderate swelling of your shoulder. Lifting your arm to the front, side, or back and carrying a small load will cause significant pain and may be difficult to do. If you press your finger into the deltoid muscle, you will feel an increase in pain. The shoulder muscle feels achy and tight for at least a week after the injury. The average recovery duration is about 4-6 weeks.
Grade 3 deltoid strains
A grade 3 deltoid strain involves a complete tear / rupture of over 90% of the deltoid muscle. This is the most painful of all the grades of shoulder deltoid pain, causing immediate severe pain, considerable bruising, and swelling in the shoulder. You will find that you are unable to move your arm. A slight flex of the muscle might produce a bulge and the contract of the muscle will be extremely painful. You may not be able to fully use your arm for daily activities. Recovery for your deltoid muscle may take 3-4 months.
Most deltoid muscle strains occur due to activities that have over-stressed the deltoid muscle. Common activities to injure the deltoid muscle are skiing, weightlifting, carrying children, and carrying heavy loads of items.
Highly repetitive activities are often problematic and can even include activities such as typing and gardening. Additionally, a sharp blow to the shoulder can result in a deltoid strain. A strain in your deltoid muscle is a common problem for those who have suffered a shoulder dislocation or even a vehicle accident.
Symptoms of a deltoid strain depend on the severity of the injury. Some of these symptoms include:
- Swelling and bruising – Swelling in the deltoid muscle is a common result of soft tissues becoming inflamed; this typically occurs with a more serious strain. In addition, warmth and redness may accompany swelling in most severe cases.
- Weakness – Weakness or complete loss of function of the muscle can be experienced as a result of a pulled muscle. Symptoms may make it difficult for you to raise your arm, throw a ball, or attach a seatbelt in your car.
- Popping noise – After you experience a deltoid strain, you may notice a popping or snapping sensation at the shoulder and can often be heard and felt when your deltoid muscles are currently tearing.
- Decreased flexibility – You may experience stiffness or decreased range of motion as a result of a deltoid strain. The sudden tightness at the outer arm extending from your shoulder will make it difficult to raise your arm upward. Your sleep may also be affected if the stiffness causes discomfort.
Who gets a Deltoid Strain?
The following risk factors below may increase your chances of having a deltoid muscle strain:
- Sports – Certain sports, such as skiing, soccer, basketball, and tennis, can all increase your risk of injuring your deltoid muscle (or your shoulder in general).
- Occupational activities – Occupations such as carpentry or house painting require heavy arm motions, often overhead, that can suddenly damage the deltoid muscle over a period of time.
- Age – Patients who are over the age of 50 are more susceptible to straining their shoulder due to general wear and tear of their muscles.
How Does it Affect You? How Serious is it?
As mentioned earlier, deltoid strains can be partial or severe, with partial tears causing bruising and swelling, while severe tears also have swelling and bruising. However, severe deltoid strains may also cause your upper arm and shoulder muscles to become deformed or misshapen.
Surgical treatment, such as an open repair, may be advised to repair your muscle strain to avoid further deformation. A surgeon will make an incision over the shoulder and detach one of the shoulder muscles to better see and gain access to the torn tendon.
During an open repair, your surgeon usually removes bone spurs from the underside of the acromion (this procedure is known as an acromioplasty). An open repair may be a great option if the tear is large or complex or if additional reconstruction, such as a tendon transfer, is indicated.
Recommended Treatment & Rehabilitation
Diagnosing your deltoid strain will greatly help determine the whole course of action necessary for the best treatment. If you have suffered from a muscle strain and you have lost power in your upper arm or shoulder, it is important to see a physician, as the shoulder region is often a location where pain from heart, lung, and bowel issues will appear. Furthermore, referred pain from trigger points may also mean the source of pain is elsewhere, so it is recommended to ensure you discover what is causing you pain.
In order to start a diagnosis for your deltoid strain, your doctor will begin with a medical history of your current condition and symptoms. He or she will inquire about the intensity of your present pain if you heard a sudden popping noise when you first experienced the injury, and the limitations you’re experienced. Afterward, a physical examination will be performed to determine if you have any signs of a deltoid muscle strain. Your doctor will assess and feel the muscles, bones, and other soft tissue in and around your arm/shoulder, as well as your opposite shoulder and arm to evaluate sameness, and identify pain and tenderness.
Physiotherapy can be very successful in treating deltoid strains. Therefore, you will work with a physiotherapist to devise a treatment plan that is specific to your condition and goals. This treatment program may include the following:
Your physiotherapist will help you indent and avoid painful movements to allow the strained tendon to heal. Ice, massage, or moist heat may be applied for pain management. Therapeutic modalities, such as electrical stimulation (TENS) may be applied.
Posture education is an important part of rehabilitation. For example, when your shoulders roll forward as you lean over a computer, the tendons in the front of the shoulder can become pinched. Your physiotherapist may recommend adjustments to your workstation and work habits. Your physiotherapist will also instruct you in ideal sitting, standing, and sleeping positions to help alleviate symptoms. Your therapist may suggest different ways to perform currently painful activities and show you movements to avoid while the shoulder is in a painful condition.
You will learn exercises and stretches to help your shoulder and shoulder blade move properly, so you can return to reaching and lifting without pain.
As your symptoms improve, your physiotherapist will help you return to your previous level of function, which may include household chores, job duties, and sports-related activities. Functional training can include working or lifting a glass into a cupboard or throwing a ball using proper shoulder mechanics.
Your physiotherapist may use manual techniques, such as gentle joint movements, soft-tissue massage, and shoulder stretches, to get your shoulder moving again with your shoulder blade.
Performing the right exercise for shoulder pain is important during recovery since these muscles are essential for everyday function. Here are some exercises for you to try:
Bend over at the waist and let the arm-hand down passively. Using your body to initiate movement, swing the arm gently forward and backward and in a circular motion. Perform this pendulum exercise for several minutes, then repeat 3-5 times a day.
Isometric shoulder external rotation
Standing in a doorway with your elbow bent at a 90-degree angle and the back of your wrist pressing against the door frame, try to press your hand outward into the door frame. Hold this position for about 5 seconds, then repeat the exercise 3 times a day.
Isometric shoulder internal rotation
Standing in a doorway with your elbow bent at a 90-degree angle and the front of your wrist pressing against the door frame, try to press your palm into the door frame. Hold for 5 seconds, then do 3 more sets of 10 repetitions a day.
Stand with your arms at your sides and with your elbows straight. Slowly raise your arms to eye level. As you raise your arms, they should be spread apart so that they are only slightly in front of your body (at about a 30-degree angle to the front of your body). Point your thumbs toward the ceiling. Hold this stretch for 2 seconds and lower your arms slowly before repeating the exercise with 3 sets of 10 repetitions.
Side-lying external rotation
Lie on your one side with top arm at your side and your elbow bent to 90 degrees. Keep your elbow against your side, raise your forearm and hold for 2 seconds. Slowly lower your arm, then do 3 more sets of 10 repetitions.
Alternative & Homeopathic Treatment
There are several ways for you to alleviate your shoulder pain. The key to this process is understanding that some movements and exercises can be very helpful, while others can harm your shoulder. Here are some homeopathic treatments to help relieve your deltoid muscle strain:
Applying ice reduces blood flow, which will decrease inflammation and swelling, and alleviate pain in the process; cold therapy is recommended immediately after pain strikes, and ice packs should be applied for 15-20 minutes, up to 5 times a day.
Applying heat to a painful shoulder increases blood flow and brings in oxygen and nutrients to the area, which will accelerate the healing process and alleviate pain; this is recommended a few days after the onset of pain and can be accomplished with an added hot shower directly on the shoulder or a hot pack applied to the affected area for 15-20 minutes a day.
Some patients with grade 1 deltoid strains can experience relief with pain medications that do not require a prescription, particularly non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naproxen; NSAIDs may alleviate pain by reducing inflammation.
Sleeping on your bad shoulder can make matters much worse, so it is recommended to try to sleep on your back or the side of your body that is unaffected by shoulder pain to avoid worsening the problem.
Gently massaging your shoulder will help alleviate stress and tension in the surrounding muscles, while also improving blood circulation and reducing swelling in the process, all of which can reduce your pain levels.