The Deltoid Muscle

Pain in the Deltoids is most often mistaken for bursitis or a rotator cuff injury

Deltoid Anatomy and Trigger Points - Dr. Jonathan Kuttner

The deltoid, along with supraspinatus and associated rotator cuff muscles, will regularly develop myofascial trigger points as result of reduced core efficiency.

Failure to translate forces from the lower body to the shoulder will result in arthrokinematic stress and the formation of active myofascial trigger points.

The restoration of core neuromuscular efficiency will provide a foundation for myofascial trigger point therapy, utilizing neuromuscular therapy and medical exercise.

Pain is felt as a dull ache for the most part, with increased pain on contraction of the muscle or when attempts are made to move the arm.

Pain is most often mistaken for bursitis or rotator cuff injury. It is worthwhile checking the muscles that refer pain into the deltoid (SITS, pectorals, and scalenes) as the true source of deltoid pain.

Deltoid myofascial trigger points are more often than not satellite myofascial trigger points.

Deltoid Trigger Points

Deltoid - Common Trigger Point Sites

Trigger Point Release | Dry Needling | Deltoid Muscle

Dry Needling the Deltoid Muscle

Anatomy

The deltoid is composed of three parts: anterior, middle, and posterior. Only the middle part is multipennate, probably because its mechanical disadvantage of abduction of the shoulder joint requires extra strength.

Origin

Clavicle, acromion process, and spine of scapula.

Insertion

Deltoid tuberosity situated halfway down lateral surface of shaft of humerus.

Action

Anterior fibers: flex and medially rotate humerus.
Middle fibers: abduct humerus at shoulder joint (only after the movement has been initiated by supraspinatus).

Posterior fibers: extend and laterally rotate humerus.Antagonist: latissimus dorsi.

Nerve

Axillary nerve, C5, 6, from posterior cord of brachial plexus.

Basic Functional Movement

Examples: reaching for something out to the side; raising arm to wave.

Trigger Point Referred Pain Patterns

Generally refer pain localized to trigger point and within a 5–10 cm zone.

Trigger Point Therapy Treatment Techniques

Spray and Stretch	YES
Dry Needling	YES
Wet Needling	YES
Deep Stroking Massage	YES
Compression	YES
Muscle Energy Techniques	YES
Positional Release	YES

Indications

Post-trauma rehabilitation, shoulder pain, decreased range of motion (especially in abduction), shoulder pain which worsens with motion and eases at rest, reduced range of motion and some loss of strength above 90 degrees.

Causes

Swimming, weight lifting, soccer (blows), basketball, jerky and vigorous repetitive movements, fishing, power tools, sudden blows, rifle rebound, skiing falls, injections into shoulder, dislocations, holding small baby.

Differential Diagnosis

Impingement syndromes. Sub-acromial bursitis. C5 radiculopathy. Rotator cuff tendinopathy. Osteoarthritis of glenohumeral or acromioclavicular joint.

Connections

Supraspinatus, infraspinatus, biceps brachii, teres minor, subscapularis, pectoralis major (clavicular head), rotator cuff issues, tendonitis, arthritis, C5 nerve issues, neck problems, often satellite trigger points from other problems (e.g. scalenes, pectoralis major), long head biceps brachii tendon problems.

Find a Trigger Point Professional in your area

More Articles About Shoulder Pain / Injuries

NAT 5 Step Shoulder Technique

Dry Needling for Trigger Points

NAT Professional Courses

Certify as a Trigger Point Therapist

Trigger Point Workbooks

Education Membership Plans

NAT Digital Health Award Trigger Point Therapy

NAT Education Membership Plans from $19.95/monthly

Trigger Point Therapy Diploma Online Course CEU CPD

NAT TRIGGER POINT THERAPY DIPLOMA COURSE

This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.