Anterior Deltoid Strengthening Programme Information for patients Physiotherapy Department Who is this leaflet for? This leaflet is for patients diagnosed with a large rotator cuff tear that is unlikely to benefit from surgical repair. Many people gain comfort and better function even without repair. This leaflet details the exercises that are recommended to help make your arm stronger and less sore. These exercises will be done at home. How do the exercises work? When there is a large tear of the rotator cuff tendon you may find it difficult to lift your arm. You may have pain and problems with day to day tasks. This can happen after an injury such as a fall, or sometimes it can happen gradually over time due to wear and tear. There is another strong muscle in the shoulder called the anterior deltoid. The anterior deltoid can compensate for the torn rotator cuff muscles. You can strengthen this to make it easier to lift your arm. If you are getting pain, this can also make your arm less sore. This programme changes with time. You start on simple exercises. As the muscles get stronger, you will stop the easy exercises. Then you will progress onto harder exercises to strengthen the muscles more. How long will I need to do the exercises? We recommend that you follow this programme for a minimum of three months. You should do the exercises three to five times per day. Are there risks to this treatment? If you follow the exercises as detailed in this leaflet it is unlikely that you will have any problems. Your physiotherapist or doctor will answer any questions you have. What else can be done? As well as doing these exercises, sometimes the pain is helped by a steroid injection. You can discuss this with your physiotherapist or doctor. Page 1 of 5
The exercises Warm up: pendulum exercises Stand leaning forward and hold onto a chair or table with your unaffected arm. Let your affected arm hang free. Gently swing your arm backwards and forwards, side to side and in circles clockwise and anticlockwise. To begin with, repeat for 2 to 3 minutes as a warm up before doing the next exercise. Anterior deltoid strengthening exercises Exercise 1: Lie on your back with a pillow supporting your head and your knees bent. Raise your affected arm so that it points to the sky. Use your unaffected arm to help lift it if required. Then let go with your unaffected arm and make small circular movements with your arm. Repeat in a slow smooth movement for 5 minutes or until the muscle gets tired. You will notice this getting easier as your arm gets stronger. Once you can do Exercise 1 easily you can stop doing it and move onto Exercise 2. Page 2 of 5
Exercise 2 Lie on your back with a pillow supporting your head and your knees bent. Start from the same position as Exercise 1 with your affected arm raised up so it points at the sky. Move your arm forward and back in a small arc as the diagram shows. Repeat in a slow smooth movement for 5 minutes or until the muscle gets tired. As your arm gets stronger you will manage to move your arm in a bigger arc. Aim to reach the arm to the pillow behind and forwards down to your thigh before progressing on to the next exercise. Once you can do Exercise 2 easily you can stop doing it and move onto Exercise 3. Exercise 3 Lie on your back. Repeat Exercise 2 but this time with a light weight in your hand. Your weight can be a half kilogram weight such as a tin of beans, or a small drinks bottle filled with water. Repeat in a slow smooth movement for 5 minutes or until the muscle gets tired. Once you can do Exercise 3 easily you can stop doing it and move onto Exercise 4. Page 3 of 5
Exercise 4 Half sitting with pillows propped at your back and your knees bent. Lift your arm so that it starts at shoulder height. Move the arm forward and back in a small arc. Increase the size of the arc as the arm gets stronger. Repeat for 5 minutes or until the muscle gets tired. Once you can do Exercise 4 easily with a large arc, you can stop doing it and move onto Exercise 5. Exercise 5 Half sitting with pillows propped at your back and your knees bent. Repeat Exercise 4 but this time with a light weight in your hand. Repeat for 5 minutes or until the muscle gets tired. Once you can do Exercise 5 easily with a large arc, you can stop and move onto the final exercise. Page 4 of 5
Exercise 6: Standing or sitting upright. Lift your arm up and down in a small arc to begin with. As the arm gets stronger increase the size of the arc. Repeat for 5 minutes until the muscle gets tired. Your physiotherapist is: They can be contacted on telephone number: Developed by Outpatient Physiotherapy staff and has been reviewed by staff and patients Reviewed: 03/2018 Review: 03/2020 LN0135 Page 5 of 5