HypothesisWe hypothesize recovery of the ability to elevate the shoulder with massive rotator cuff tear through rehabilitation has a relationship to the thickness of the deltoid muscle.Materials and methodsAmong patients examined between March 2006 and December 2011 at our clinic, 21 patients were unable to elevate their shoulder joint over 60 degrees while in an upright position because of massive rotator cuff tear (pseudoparalysis). Rehabilitation was performed for these 21 patients and was focused on training of the deltoid, scapular, and remaining rotator cuff muscles for 5 months. After 5 months they were divided into 2 groups: those that could elevate the shoulder joint to more than 150 degrees (group A) and those that were unable to elevate their shoulder joint (group B). The thickness of the deltoid muscles on MRI were compared between groups.ResultsThe mean thickness of the deltoid muscle in groups A and B was 7.2 mm and 3.6 mm, respectively, showing a statistically significant difference.DiscussionThe patients with pseudoparalysis who had a deltoid muscle thickness of less than 6 mm were unlikely to show improvement of impaired elevation despite continued rehabilitation. With regard to treatment for pseudoparalysis, it is believed that patients with deltoid muscle thicknesses greater than 6 mm will respond to conservative treatment. Consequently, although surgery should be decided with care, it is considered to be the preferred choice for patients with deltoid muscle thicknesses of less than 6 mm. HypothesisWe hypothesize recovery of the ability to elevate the shoulder with massive rotator cuff tear through rehabilitation has a relationship to the thickness of the deltoid muscle. We hypothesize recovery of the ability to elevate the shoulder with massive rotator cuff tear through rehabilitation has a relationship to the thickness of the deltoid muscle. Materials and methodsAmong patients examined between March 2006 and December 2011 at our clinic, 21 patients were unable to elevate their shoulder joint over 60 degrees while in an upright position because of massive rotator cuff tear (pseudoparalysis). Rehabilitation was performed for these 21 patients and was focused on training of the deltoid, scapular, and remaining rotator cuff muscles for 5 months. After 5 months they were divided into 2 groups: those that could elevate the shoulder joint to more than 150 degrees (group A) and those that were unable to elevate their shoulder joint (group B). The thickness of the deltoid muscles on MRI were compared between groups. Among patients examined between March 2006 and December 2011 at our clinic, 21 patients were unable to elevate their shoulder joint over 60 degrees while in an upright position because of massive rotator cuff tear (pseudoparalysis). Rehabilitation was performed for these 21 patients and was focused on training of the deltoid, scapular, and remaining rotator cuff muscles for 5 months. After 5 months they were divided into 2 groups: those that could elevate the shoulder joint to more than 150 degrees (group A) and those that were unable to elevate their shoulder joint (group B). The thickness of the deltoid muscles on MRI were compared between groups. ResultsThe mean thickness of the deltoid muscle in groups A and B was 7.2 mm and 3.6 mm, respectively, showing a statistically significant difference. The mean thickness of the deltoid muscle in groups A and B was 7.2 mm and 3.6 mm, respectively, showing a statistically significant difference. DiscussionThe patients with pseudoparalysis who had a deltoid muscle thickness of less than 6 mm were unlikely to show improvement of impaired elevation despite continued rehabilitation. With regard to treatment for pseudoparalysis, it is believed that patients with deltoid muscle thicknesses greater than 6 mm will respond to conservative treatment. Consequently, although surgery should be decided with care, it is considered to be the preferred choice for patients with deltoid muscle thicknesses of less than 6 mm. The patients with pseudoparalysis who had a deltoid muscle thickness of less than 6 mm were unlikely to show improvement of impaired elevation despite continued rehabilitation. With regard to treatment for pseudoparalysis, it is believed that patients with deltoid muscle thicknesses greater than 6 mm will respond to conservative treatment. Consequently, although surgery should be decided with care, it is considered to be the preferred choice for patients with deltoid muscle thicknesses of less than 6 mm.