The nature of the injury

1. Deltoid Strains: The nature of the injury

2. Anatomical Structures • The Deltoid is a three-headed muscle that covers the shoulder. • The three heads of the Deltoid are the Anterior, Lateral, and Posterior. • All three Deltoid heads attach to the humerus. The Anterior and Lateral heads begin at the collar bone, while the Posterior head begins on the scapula.

3. Anatomical Structure Posterior deltoid

4. Anotomical Structure Lateral deltoid Posterior deltoid

5. Mechanisms of Injury • A deltoid strain can occur as a result of many actions: strenuous physical activity involving the muscle, violent jerky movement during exercise, overworking the muscle group and underlying issues with the rotator cuff and the surrounding tendons. • An athlete can injure his deltoid during any sport or physical activity.

6. Symptoms of the Injury • Right after the injury occurs an athlete may feel a sharp pain in the anterior, medial or posterior section of the deltoid. • After a short amount of time a throbbing pain may follow along with stiffness. • Pain during extension whether with or without resistance. • Pain abduction with or without resistance. • Tenderness and swelling where the muscle is injured.

7. Special Tests • Although there are not many special tests that may be performed to assess the injury because of it’s straightforwardness, the three following procedures provide enough evidence to thoroughly evaluate it. • Have the patient perform flexion, extension and abduction. • Apply pressure on top of the arm while the patient performs flexion, extension and abduction. • There may be pain in both the anterior and posterior sections during flexion and extension. • During flexion, the anterior deltoid would flex while the posterior deltoid would stretch. • During extension, the posterior deltoid would flex, while the anterior deltoid would stretch

8. Grade 1 Strain Tightness in the deltoid. A little bit of swelling. The athlete may be able to use his or her arm without much pain. Trying to lift the arm up sideways or to the front or back of the body will not be painful.

9. Grade 1 Treatment • The athlete can: ice the deltoid for the first 24 hours for 15 minutes at a time. • Stretch in the direction opposite of the pain. If the posterior deltoid is strained, stretch in the anterior direction. • Strengthen the rotator cuff muscles. • The health professional can: use massage therapy, ultrasound and electrical stimulationor create a rehabilitation program that includes stretching and strengthening of the rotator cuff.

10. Grade 2 Strain • The athlete would not be able to use his arm in daily exercises. • As soon as the injury occurs the athlete may feel a quick burst of pain. A short amount of time later the muscle may become very tight and painful to move. • Pushing into the muscle causes pain. • Lifting the arm up to the front, side or back with resistances causes pain and a lot more pain with resistance.

11. Grade 2 Treatment • The athlete can: Ice the muscle and rest. Stretch the muscle • The health professional can: use intense massage therapy, ultrasound and electrical stimulation or create a rehabilitation program that includes stretching and strengthening of the rotator cuff.

12. Grade 3 Strain • The athlete in most cases will not be able to move his or her arm. • Severe pain accompanies this injury. • Apparent and sudden inflammation. • Contractions in the muscle may produce a bulge. • The athlete should be prepared to sit out for at least three weeks.

13. Grade 3 Treatment • The athlete can: apply ice and rest the muscle. The athlete can also stretch the muscle very carefully. • Consult a sports injury professional who can advise on treatment and rehabilitation. • The health professional can: use extensive massage therapy accompanied by ultrasound and electric stimulation. • Prescribe a rehabilitation program. • Operate if necessary.

14. Reference • Humphreys, Cynthia: Shoulder Injuries & Weight Training: Reducing Your Risk • Gotlin, Robert: Sports Injuries Guidebook • http://www.sportsinjuryclinic.net/cybertherapist/back/shoulder/deltoidstrain.htm