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Anterior Deltoid Exercises for Patients with Massive Rotator Cuff Tears

As a result of prolonged overuse, wear and tear or genetics, the muscles arising from the shoulder blade and attaching to the top of your humerus (arm bone) – the rotator cuff muscles – have become irreparably torn. This means you are no longer able to easily lift your arm above 90°. However, there is another powerful muscle on the outside of your arm – the deltoid muscle – that may be re-educated to compensate for the torn rotator cuff.

The following exercises should be done three to five times a day to strengthen your deltoid muscle. It will reduce your pain and improve both the range of motion and your arm function. These exercises must be done for at least 12 weeks and must always be performed starting lying down to begin with.

Exercises

  1. While standing, bend forward and let your arm dangle free and performed gentle pendulum motions for about five minutes.  This will help you in relieving pain and free up your muscles around the shoulder.Irreparable Cuff Tears
  2. Lie down flat on your back, with a pillow supporting your head
  3. Raise your weak arm to 90° vertical, using the stronger arm to assist if necessary.  The elbow should be straight and in line with your ear.Irreparable Cuff Tears
  4. Hold your arm in this upright position with its own strength.
  5. Slowly with your fingers, wrist and elbow straight move the arm forwards and backwards in line with the outside of the leg, as per the diagram (gentle movement from both sides of the arm up right position).  Keep the movements smooth and continuous for five minutes or until fatigue.Irreparable Cuff Tears
  6. As you get more confidence in controlling your shoulder movement, gradually increase the amplitude of movement until your arm will move from the side of your thigh to above your head, touching the bed, and return.  Keep the movements smooth and continuous for five minutes or until fatigue.Irreparable Cuff Tears
  7. As you get more confidence in controlling your shoulder movement, a light weight e.g. a can of soup or a small weight, should be held in the affected hand.  Repeat as above (5 and 6)
  8. Having more confidence in controlling your shoulder movement gradually go from lying down to sitting and eventually standing.  At this stage you may recline the head of your bed or put some pillows underneath your back to recline your position.  Repeat the same exercise again, this time against some gravity.  Start again from holding your arm in the upright position with its own strength.  Repeat as above (5, 6, and 7).  Start first without any weights and progress to use the same light weight you used before in the lying down position.Irreparable Cuff Tears
  9. Another useful exercise for re-education of concentric contracture of the deltoid muscle. Make a fist with the hand of the affected side.  The flat hand of the opposite side is providing resistance.  Push your affected side hand against resistance from the other hand.  While doing this you will notice that you can fully elevate your arm (above your head).  Repeat these exercises in order to “learn” and re-educate your deltoid muscle to perform this “concentric contracture” even without pushing against your other arm.  You should repeat these exercises 10 times in a session, three to five sessions per day.Irreparable Cuff Tears
  10. Stop exercising if your pain increases or you feel ill.

Complete article can be found in “The role of the anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears”, O. Levy, et al; J Shoulder Elbow Surg: Volume 17, Number 6, 863-870.

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