Deltoid Tendonitis: Causes, Symptoms, Treatment, Exercises

Any type of injury to the deltoid muscle is referred to as Deltoid Tendonitis. The deltoid muscle is one of the most important muscles of the shoulder joint. Any movement of the arms to the sides, to the front, and lifting the arm upwards is facilitated by the deltoid muscle. It is basically divided into three parts namely the anterior deltoid muscle used for flexion and moving the arm forwards, the mid deltoid muscle, and the posterior deltoid muscle used for moving the arm backwards.^[1]

Deltoid muscle originates from the lateral portion of acromion and clavicle and goes through the lateral humerus. The most important aspect of the deltoid muscle is that is plays a vital role in various athletic activities.^[2]

Thus an injury like Deltoid Tendonitis can severely hamper the performance of an athlete especially those who participate in events like javelin, shot put, or discus throw which are heavily dependent on the strength of all of the shoulder muscles.

Deltoid Tendonitis can be caused due to various reasons.

Deltoid Tendonitis Caused Due to Sporting and Repetitive Stress Injury. An individual can overstretch the deltoid muscle while participating in sporting activities like weightlifting or swimming. Certain activities which involve repetitive movements like lifting heavy items, gardening, or typing for long periods of time can also put excessive stress on the deltoid muscle causing Deltoid Tendonitis.

Deltoid Tendonitis Occurring As a Result of Motor Vehicle Collisions. Certain motor vehicle collisions jar the deltoid muscle due to the impact causing conditions like shoulder dislocation.

Axillary Nerve Damage Causing Deltoid Tendonitis. The axillary nerve which can be found around the neck works by promoting the function of the deltoid muscle.^[3] Any damage to this nerve can significantly impact the functioning of the deltoid muscle resulting in Deltoid Tendonitis. The axillary nerve can be damaged due to a direct blow or trauma to the neck, excessive pressure being put on the neck normally when recuperating from an upper extremity fracture with a sling attached to the neck to support the fractured extremity.^[4]

As is the case with any sprain/strain injury, the symptoms of Deltoid Tendonitis are also quite similar in nature. There will be clear swelling around the arm with associated skin discoloration, bruising, and erythema.

The person suffering from Deltoid Tendonitis, will have intense pain while at rest or when moving the arm. The muscles of the arm will feel extremely stiff. It will be very difficult to move the shoulder or arm in any direction making it very difficult for the individual to carry out activities of daily living.^[5]

Depending on how severe the injury is Deltoid Tendonitis can be classified as.

Grade-I Deltoid Tendonitis. In this type of deltoid tendonitis, there is minimal damage done to the deltoid muscle. The individual experiences minimal pain and swelling. There may be some limitation of motion and muscle stiffness but that will not hamper the individual to carry out activities of daily living even though sports related and repetitive activities may be a bit difficult.

Grade-II Deltoid Tendonitis. This type of deltoid tendonitis occurs when there is a partial tear of the deltoid muscle. In such cases, the intensity of the shoulder pain is much more. The swelling is fairly pronounced. Additionally, it will be quite difficult to move the arm and perform household and sporting activities.

Grade-III Deltoid Tendonitis. In this type of injury, there is complete tear of the deltoid muscle. There is severe pain and swelling associated with this form of Deltoid Tendonitis. There is also skin discoloration and erythema at the site of the injury. The affected individual will not be able to move the arm to any significant degree. Completing household chores will be a big challenge for the patient.^[6]

As is the case with any strain/sprain, Deltoid Tendonitis has similar treatment protocols.

The physician will advise complete rest and abstaining from all activities that may aggravate the condition of deltoid tendonitis. The physician will advise the patient to follow the RICE protocol which rest, ice, compression and elevation. The of deltoid tendonitis patient will also be given NSAIDs like Tylenol or ibuprofen for pain relief.

Once the swelling and inflammation caused due to of deltoid tendonitis has calmed down after about two to three weeks the patient will be sent to physical therapy for stretching and strengthening of the deltoid muscle. Physical therapy is only suggested for Grade III Deltoid Tendonitis where there is complete tear of the muscle.

Otherwise, for Grade I and II Deltoid Tendonitis, application of ice for 15-20 minutes two to three times a day, wearing compression wraps to calm down the swelling, and use of NSAIDs diligently is the frontline treatment.^[7]

Before embarking on exercises to speed up the recovery process of Deltoid Tendonitis, proper warm up techniques should be utilized. The patient can go to a physical therapist for proper training on exercises before doing it at home. Exercises not only improve flexibility and strength of the deltoid muscle, it also prevents further injury and hastens the recovery process after Deltoid Tendonitis. Some basic stretches that an individual with Deltoid Tendonitis can do are.

Arm Dangling Exercise. This exercise for Deltoid Tendonitis loosens up the stiff deltoid muscle and calms down the pain. To do this exercise, the individual needs to bend slightly forward and allow the affected arm to dangle. Now, the individual should move the dangling arm back and forth gently. Repeat this process for about 10 minutes every day till the Deltoid Tendonitis pain completely subsides and normal function returns of the arm.

Doorway Chest Stretch Exercise for Deltoid Tendonitis. This exercise also loosens the stiff deltoids and calms the pain and swelling. It is a simple exercise to do. The individual just needs to stand in front of an open door and place the hands on the frame of the door. Now, he needs to lean on the door and place on the arms on either side of the frame. The individual needs to continue this exercise for Deltoid Tendonitis for about half a minute. Doing it about three times a day till the arm feels strong and pain resolves is optimum.

Arm Swinging Exercise. This is also quite an easy exercise to do to strengthen the deltoid and get rid of Deltoid Tendonitis. Lie flat on a bed and raise the injured arm such that the fingers are pointing towards the roof. Now swing the injured arm towards the foot and then back towards the head for about five minutes. Doing this exercise every day will allow the deltoid muscles to become loose and restore normal functioning of the arm.^[8]

Some of the ways to prevent Deltoid Tendonitis are”

• Warm up properly before starting any exercise and allow time for the muscles to relax after finishing a strenuous activity
• To prevent Deltoid Tendonitis due to occupational hazards, make sure to wear all the safety equipment and take frequent rests to allow the muscles to calm down.
• If an individual is an athlete, then getting a massage after the event to relax the muscle helps in preventing conditions like Deltoid Tendonitis^[9]

References:

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