Rehabilitation protocol · Deltoid

Deltoid Strengthening Exercise Protocol

Gradual strengthening of the deltoid muscle and improvement of active shoulder function – 4 stages of progression

10 repetitions per set2–3 sets per exercise½ kg weight

Translated (into Hebrew) from the Reading Shoulder Unit website – Prof. Levy and Prof. Copeland · Download PDF (Hebrew)

Purpose of the protocol

To work gradually with exercises that strengthen the deltoid muscle and improve active shoulder function – with controlled progression between levels of effort.

How to progress

  • The exercises are done in sets of 10 repetitions – 2 sets at first, and later 3 sets.
  • At every stage, start without a weight. As strength and movement improve, do the same exercises with a ½ kg weight.
  • When you can do the exercise easily with the weight, you can move on to the next stage – again starting without a weight and progressing to working with a weight.

The stages of rehabilitation

Stage 1: Exercises lying down – passive and active

Lying on your back with the head supported

Goal of this stage

  • Starting active use of the deltoid muscle and improving range of motion

How to do it – 3 sub-stages

  • a. Passive: take the affected arm and, with the help of the healthy arm, lift it to 90°. Let go of the arm and try to hold it in this position using the strength of the affected arm.
  • b. Active-assisted: move the arm up and down using the strength of the affected arm, with light help from the healthy arm. Do this continuously for about 5 minutes.
  • c. Fully active: as function improves, move the arm up and down without any help from the healthy arm. Do this continuously for about 5 minutes.

Precautions

  • Keep the movements controlled and slow
  • Stop if there is acute pain

Stage 2: Active movements with a weight, lying down

Lying on your back with the head supported

Goal of this stage

  • Strengthening the deltoid muscle against light resistance (½ kg)

How to do it

  • Lying down with the head supported, raise and lower the arm holding a weight of up to ½ kg.
  • Dose: 3 sets of 10 repetitions.

Precautions

  • Do not move on to the next stage until you can do this exercise correctly and easily with ½ kg
  • Slow, controlled movement – avoid swinging

Stage 3: Half-sitting – raising the arm to the side

Half-sitting (for example on the edge of the bed)

Goal of this stage

  • Improving strength against gravity in a semi-upright position

How to do it – 3 sub-stages

  • a. Assisted: raise the arm to the side with the help of the other arm, try to hold the position, and then lower it slowly without help.
  • b. Unassisted: raise and lower the arm to the side without any help – 10 repetitions per set.
  • c. With a weight: when you can do sets of 10 repetitions easily, you can progress to a weight of up to ½ kg.

Precautions

  • Keep a good posture and a slow, controlled movement

Stage 4: Standing

Standing – preferably with your back against a wall and knees bent

Goal of this stage

  • Returning to full function against gravity while standing

How to do it – 3 sub-stages

  • a. Assisted: raise the arm with the help of the healthy arm.
  • b. Unassisted: raise the arm fully without any help.
  • c. With a weight: lift a light weight of up to ½ kg – 10 repetitions, 2–3 sets each time.

Precautions

  • It is recommended to lean your back against the wall with your knees bent, for support and stability

Extra exercise: pushing upwards (isometric)

Can be added at any stage – static strengthening

Goal of the exercise

  • Static (isometric) strengthening of the deltoid muscle without moving the joint

How to do it

  • Make a fist with the affected hand.
  • Place the healthy hand on top of the fist.
  • Push the affected hand upwards against the resistance of the healthy hand – the joint does not move.

Precautions

  • Do not hold your breath during the effort – breathe normally

Official document

The official protocol document is in Hebrew: view the full document (PDF, Hebrew).

First page of the official protocol document, in HebrewOfficial protocol documentPage 1 of the full protocol, in Hebrew (PDF).Open the PDF →

Progression ladder

  1. Without a weight – free movement
  2. With a ½ kg weight → when the weight feels light, move on to the next stage

At every new stage, start without a weight and progress again.

When should you contact a doctor?

  • Fever above 38°C
  • Pain that is not relieved by painkillers
  • Heavy discharge from the wound

Further reading from leading medical sources

For readers who want to go deeper, here are reliable sources from the American Academy of Orthopaedic Surgeons (AAOS – OrthoInfo):

External sources in English · open in a new tab