Posterior Deltoid Manual Static Release

Differentiation

1. The posterior deltoid is a superficial muscle comprising the posterior 1/3 of the deltoid .
2. It can often be visualized if your patient reaches across to touch their opposite shoulder (90° of flexion and horizontal adduction). A line may be present that "separates" the deltoid muscle from the triceps.
3. Palpation of the muscle is generally not difficult, although "pinning" dense nodules and taut bands may take some practice.

Potentially Sensitive Tissues

• Case studies have reported damage to the axillary nerve during injection; however, it seems very unlikely that manual therapy poses any significant risk.

Trigger Points

• The most common posterior deltoid trigger points are in the center of the muscle belly.

Release Technique

1. This technique is most comfortable with the patient lying in supine and the practitioner standing on the affected side.
2. Ask the patient to reach across and touch their opposite shoulder (90° of flexion and horizontal adduction). Similar to the "Yocum's Test Position " for the arm.
3. The practitioner can use a lumbrical grip around the elbow to aid in controlling the arm with the hand closest to the patient.
4. The other hand can wrap around the deltoid with a lumbrical grip, so the fingers can control scapular elevation via the acromion shelf, and the lies in line with the length of the posterior deltoid .
5. Using relatively short horizontal strokes, perpendicular to the posterior deltoid fiber direction, attempt to locate any taut bands.
6. Once a taut band is located, the length of the band may be explored for a dense nodule.
7. The direction of force may be adjusted to aid in pinning and compressing a dense/sensitive nodule. Generally, a downward force toward the table (distal to proximal), with a bit of horizontal adduction to increase tension in the muscle, aids in pinning dense nodules.
8. Consistent pressure is held until the nodule softens under the practitioner's fingers, or tissue density/sensitivity is significantly reduced (generally 30 - 120 seconds).