This information will guide you through the next 6 weeks of your rehabilitation. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery.
|About your injury:||
The shoulder is a ball and socket joint and you have fractured the ball part. The shoulder joint does not respond well to being injured and longstanding stiffness is almost inevitable. Following this type of injury you may never be able to fully lift the arm straight up in the air again. The main aim is to regain enough movement to perform day to day activities.
|Healing:||This injury normally takes 6-12 weeks to heal.|
Take pain killers as prescribed.
You may find it easier to sleep propped up with pillows.
Using your arm:
It is important to keep the shoulder moving to prevent stiffness but not to aggravate the injury.
Follow the management plan below.
The fracture is in a good position and only has a small chance of moving. You will see a Shoulder Specialist 3 weeks after your injury. You will have another x-ray and they will assess your shoulder and guide the next stage of your rehabilitation.
If you have not received an appointment letter within one week then please contact your hospitals Appointment Line.
Area of your injury
If you are worried that you are unable to follow this rehabilitation plan, or have any questions, then please phone the Fracture Care Team for advice.
Or, if you are experiencing pain or symptoms, other than at the site of the original injury or surrounding area, please get in touch using the telephone or e-mail details at the top of this letter.
What to expect
Wear your sling all the time - even in bed at night.
Remove the sling for personal hygiene and exercises every day.
Start your exercises straight away, ideally within the first 72 hours. It may take a few days of practice to become comfortable with the pendulum exercises.
You will have an appointment with the shoulder specialist.
Continue to wear the sling.
Start the Stage 2 exercises.
X Do not lift your arm above shoulder height or do any heavy lifting.
The fracture is largely healed.
Try not to use the sling.
Begin normal light activities with the arm and shoulder.
Increase your movement using the Stage 3 exercises.
Increase you day to day activities.
X Heavy tasks may still cause some discomfort and swelling.
Start to lift your arm overhead if possible.
Advice for a new injury
Cold packs: A cold pack (ice pack or frozen peas wrapped in a damp towel) can provide short term pain relief. Apply this to the sore area for up to 15 minutes, every few hours ensuring the ice is never in direct contact with the skin.
Rest: Try to rest your shoulder for the first 24-72 hours. However, it is important to maintain movement. Gently move your shoulder following the exercises shown. These should not cause too much pain. This will ensure your shoulder does not become stiff and it will help the healing process.
Medical evidence suggests that smoking prolongs fracture healing time. In extreme cases it can stop healing altogether. It is important that you consider this information with relation to your recent injury. Stopping smoking during the healing phase of your fracture will help ensure optimal recovery from this injury.
For advice on smoking cessation and local support available, please refer to the following website: http://smokefree.nhs.uk or discuss this with your GP.
If you have stiffness in your elbow or hand from wearing the sling, you may wish to perform these exercises first. However, once they become easy you can start with the posture and pendulum exercises.
Initial exercises to do 4-5 times a day:
Finger and wrist flexion and extension
Open and close your hand as shown 10-15 times.
Then move your wrist up and down 10-15 times.
After a few days, hold a soft ball/ball of socks. Squeeze the ball as hard as possible without pain.
Hold for 5 seconds and repeat 10 times.
Elbow Bend to Straighten
Bend and straighten your elbow so you feel a mild to moderate stretch. You can use your other arm to assist if necessary. Do not push into pain.
Put your elbow at your side. Bend it to 90 degrees. Slowly rotate your palm up and down until you feel a mild to moderate stretch. You can use your other arm to assist if necessary. Do not push into pain.
Repeat 10-15 times provided there is no increase in symptoms.
Bring your shoulders back and squeeze your shoulder blades together as shown in the picture. Do this with or without your sling on.
Hold the position for 20-30 seconds and repeat 5 times provided there is no increase in symptoms.
Shoulder pendulum exercises
Stand and lean forward supporting yourself with your other hand. Try to relax your injured arm and let it hang down.
Continue for approximately 1-2 minutes in total provided there is no increase in symptoms. Remember to try and relax your arm.
Stage 2 exercises
Start these exercises 3 weeks post injury and to do 4-5 times a day:
Active assisted Shoulder flexion
Use your other hand to lift your arm up in front of you as shown in the pictures.
Repeat 10 times provided there is no increase in symptoms.
Active assisted External rotation
Keep the elbow of your injured arm tucked into your side and your elbow bent. Hold onto a stick/umbrella/golf club or similar. Use your unaffected arm to push your injured hand outwards. Remember to keep your elbow tucked in. Push until you feel a stretch.
If you don’t have a stick you could simply hold the injured arm at the wrist and guide it outwards.
Hold for 5 seconds and then return to the starting position. Repeat 10 times provided there is no increase in symptoms.
Stage 3 exercises
When you have regained full range of movement in the stage 2 exercises without pain you can start to do these exercises without the support of your other hand. This is known as active range of movement. The, when you have regained full movement without helping with your other arm, you can build up your regular day to day activities.
Start these exercises 6 weeks after your injury and to do 4-5 times a day.
Perform these exercises 10 times each. Only go as far as you can naturally, without doing any trick movements to try and get any further. The movement should increase over time and should not be forced.
Active Forward flexion:
With your thumb facing up, try to move your arm up, keeping it close beside your body.
With your thumb facing up and outwards, try to move your arm in a big arc out to the side.
Active External Rotation
With your elbow by your side, rotate your forearm outwards, keeping your elbow at about 90 degrees in flexion.