Stephen E. Alway, PhD, FACSM
23 April 2007
The deltoid is likely the most complex muscle in the human body. It's capable of many different functions because it works around the shoulder joint, which is the most mobile of human joints. Shoulder strength and mobility are critical to every sporting activity that utilizes the upper body. Unfortunately, this great mobility makes the ligaments, muscles and tendons around the shoulder vulnerable to injury, especially if there are any unbalances in muscle structure around this joint.  
   
The posterior region of the deltoid is one of the most neglected areas of the shoulder. The potential for shoulder injury will be minimized and success in many activities will be maximized if muscle symmetry is achieved in all regions of the deltoid and the muscles that assist shoulder movements. Strengthening this region of the deltoid will help the upper back muscles to pull the arm posteriorly (extension of the arm, which brings it backwards). Furthermore, strengthening the posterior deltoid will help stabilize the shoulder if it is hit from the back, or when falling on the shoulder. It takes a little more thought and work to develop a set of massive and symmetrical shoulders as compared to muscles that have only one function, but the rewards are worth the effort.  
 
    Shoulder Muscles 
Movements at the shoulder include rotation, flexion and extension- and the deltoid has a major role to play in all these functions. The deltoid muscle attaches on the lateral side of the humerus of the upper arm about one-third of the way from the shoulder joint to the elbow. This thick and powerful muscle caps the other muscles of the shoulder joint and covers the bony connections that make up the shoulder joint. The name "deltoid" was derived from the Greek letter delta, which is like an inverted triangle. Each side of this inverted triangle has a separate muscle region, which has different muscle attachments on the shoulder structures. As a result, the three regions all have different functions. 
   
The anterior (front) fibers of the deltoid attach along the lateral part of the clavicle (collarbone) above the shoulder joint. The anterior fibers produce strong flexion of the humerus at the shoulder (bringing the humerus bone of the upper arm forward), and produce medial rotation of the humerus at the shoulder. In medial rotation, the humerus bone rotates at the shoulder so that the anterior aspects of the arm and the palm of the hand are rotated toward the mid-line of the body. The posterior fibers of the deltoid attach along the upper and posterior side of the scapula. These fibers produce strong extension (bringing the humerus bone posteriorly) and lateral rotation of the humerus. Lateral rotation occurs when the humerus bone is turned at the shoulder such that if the palms were initially facing to the rear of the body, they would be rotated to the front, so that the thumb points laterally and away from the body.  The medial fibers of the deltoid circle around the lateral side of the shoulder by attaching between the anterior and posterior fibers of the deltoid. The medial fibers primarily abduct the humerus (raise it away from the side of the body).
   
The shoulder was designed for rotation and maximum mobility, but this structure has sacrificed joint stability. It is also a rather poor mechanical lever, so tremendous amounts of force have to be generated within the deltoid fibers even before the smallest of weights can be lifted. Thus, the deltoid has the potential to generate high and possibly injurious forces through this unstable joint. Bent-over dumbbell flyes help strengthen and thicken the posterior fibers of the deltoid. This helps prevent forward (anterior) displacement of the shoulder.

       Bent-Over Dumbbell Flyes (Bent-Over Lateral Raises)
The deltoid muscle works closely with other muscles including upper back, trapezius, arm and pectoral muscles. This makes it difficult to isolate the deltoid during most exercises. But, strict attention to exercise form, and  the use of cables or dumbbells instead of barbells, will help minimize involvement of these other muscles, and thus help you embark on a period of specialization and increased activation of your deltoid fibers.

1.    From a seated or standing position, bend over so your back is straight and parallel to the floor.  The seated position is best for anyone with lower back weakness or injury. Your arms should hang toward the floor with thumbs adjacent to each other in the bent-over position. If standing, your knees should remain slightly bent and remain at this position for both a better balance and to reduce the likelihood of reducing lower back strain.

2.    With elbows slightly bent, raise the dumbbells out to the side of your body and as high as possible. The trajectory of the dumbbells should fall slightly behind the shoulder joint, but the dumbbells should be raised to the same height as the level of the shoulder joint (or higher if possible). The elbows should be pointing toward the ceiling throughout the lift upward and downward.

3.    As the dumbbells approach the top position, rotate the shoulder so that the lateral side of your hand (the side with the thumb) is pointing toward the ceiling.  This rotational movement is the opposite of what you might normally do for this exercise. Therefore, it might seem awkward at first, and it will likely take some retraining to perform this correctly. However, after you've learned to put this lateral rotation at the top of the bent-over dumbbell raise, you'll experience an extra burn in the posterior deltoid such as you have not felt before. 

4.    Hold the top position for a count of two; then slowly reverse the movement to the starting position. This will result in medially rotating the arm at the shoulder joint and then controlling the descent to a position with your arms perpendicular to the floor.

5.    Do not pause at the bottom or between repetitions, but immediately continue upward. The posterior shoulder should be under constant tension from the beginning to the end of the exercise.
Helpful Info
   
The bent-over dumbbell flyes are superior to rear machine flyes or other versions of this exercise because they incorporate both the shoulder extension and lateral rotation functions of the posterior fibers of the deltoid. Lateral rotation is one of the functions that does not occur very frequently in most training schedules. As a result, when it's added to your routine, you can expect some post-training soreness.
   
It is very important to rotate your arms (humerus bone) at the shoulder joint rather than at the hand and wrist in the top portion of this movement. Simply supinating and pronating your hand involves movements in your forearm, but that will do nothing to help your posterior deltoid. It's equally important to keep in the bent-over position throughout the exercise. Otherwise, the work of the posterior fibers will be minimized and the trapezius, medial deltoid fibers and other smaller scapular muscles will assume the majority of the benefit.

"Cheating" is rather easy in this exercise, but this should be avoided. When the deltoid becomes fatigued, the tendency will be to use momentum from the torso to help the weight move upward. However, this creates an unnecessary torque through the lower lumbar vertebrae, and risks injury to the intervertebral discs. Instead, minimize all spine movement after obtaining the correct initial starting position. Thereafter, move only your arms at the shoulder joint. If you become too fatigued, immediately put the weight down and pick up a lighter dumbbell to resume the set, or have a training partner help push lightly on your arms so you can continue the set for a few more repetitions.
   
Explosive twisting or ballistic rotational movements at the shoulder should always be avoided when doing this exercise. Since the shoulder is a very unstable joint and is literally held together by its muscle attachments, it's not wise to explode into this lift, especially during the lateral rotation part at the top of the movement. However, if your sport depends on those movements for its success, then you owe it to yourself to strengthen both the medial and lateral rotators of the shoulder to maintain muscle balance around the shoulder joint. Try to go for the best exercise form to create the optimal muscle "burn," rather than the maximal weight you can hoist in a sloppy fashion. The heavy weights will impress your friends, at least for the moment, but only your surgeon will benefit from such a decision in the end, because sooner or later you may be required to undergo shoulder reconstruction. Thus, a little common sense will prevent you from avoidable injury. Do not fall prey to the short-term mind games in the gym that have little benefit for long-term success.

References
Gagey, O., Hue, E., 2000. Mechanics of the deltoid muscle. A new approach.  Clin.Orthop., 250-257.
Halder, A.M., Zhao, K.D., Odriscoll, S.W., Morrey, B.F., An, K.N., 2001. Dynamic contributions to superior shoulder stability.  J.Orthop.Res. 19, 206-212.
Lorne, E., Gagey, O., Quillard, J., Hue, E., Gagey, N., 2001. The fibrous frame of the deltoid muscle. Its functional and surgical relevance.  Clin.Orthop., 222-225.
Reddy, A.S., Mohr, K.J., Pink, M.M., Jobe, F.W., 2000. Electromyographic analysis of the deltoid and rotator cuff muscles in persons with subacromial impingement.  J.Shoulder.Elbow.Surg. 9, 519-523.
Roman-Liu, D., Tokarski, T., Kaminska, J., 2001. Assessment of the musculoskeletal load of the trapezius and deltoid muscles during hand activity.  Int.J.Occup.Saf Ergon. 7, 179-193.
 

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