Anterior deltoid re-training

General advice

This exercise programme is most commonly advised for a person who is found to have a large/irreparable tear of the ‘rotator cuff’, (four small muscles supporting the shoulder joint). The aim is to train larger muscles at the front of your shoulder to compensate for the damaged muscles.

These exercises should be practised several times a day if possible, slowly altering your position from lying (exercise three) to upright (exercise six) as able.

These exercises take time to work, so expect to have to practise them for several months.

Exercises

1. Stand leaning on a table with the strong arm. Let your other arm hang relaxed straight down. Swing your arm, gently, forwards and backwards.

This exercise should be very relaxed. Aim to swing the arm for 15 to 30 seconds. Following the swinging, stand up straight and gently stretch your back.

2. Stand leaning on a table with the strong arm. Let your other arm hang relaxed straight down. Swing your arm to your left and then to your right.

This exercise should be very relaxed, aim to swing the arm for 15 to 30 seconds. Following the swinging, stand up straight and gently stretch your back.

3. Lie flat on the bed or floor. Lift the weak arm to a vertical position with the help of your other arm. Then, hold your weak arm in the vertical position with its own strength for ten seconds, keeping the elbow straight. Bring the weak arm back down to your side with the help of the other arm, if necessary. As your arm gets stronger, you will be able to lower it to your side without help.

4. As the vertical position becomes easier to maintain, the exercise can be progressed. Slowly start to move your arm forwards and backwards. Try to keep the arm moving in a slow, smooth, straight line. As your control improves, begin to increase the range of motion until the arm can move from the side of your body to touching the bed above your head and back again. When this exercise becomes easy, move to exercise five.

5. The next progression is to add a small weight, for example a tin of beans. Hold this in the hand of your weak arm and continue to move the arm from your side to above your head and back again in a smooth movement.

6. Once exercise five becomes easier to carry out, you can alter the starting position of the exercise by gradually moving from lying on your back, to reclined sitting and then into upright sitting or standing. Each time you change your starting position, go back to practicing the exercise without a weight until you have full control of the arm. When you have full control in reclined sitting, then add in the weight again.

Pain relief

To help us optimise your treatment, it is important that you have adequate pain relief. If you are suffering a high degree of pain, please seek advice from your GP.

Contacts/further information

Please be aware that this leaflet is to be used only as a guide. If you find these exercises painful, please seek advice from your physiotherapist or doctor.

Physiotherapy outpatients can be contacted on 01223 216633.

Physiotherapy inpatients can be contacted on 01223 216104.