proximal humerus fracture exercises pdf
Proximal Humerus Fracture Exercises PDF: A Comprehensive Guide
This guide provides comprehensive exercises in PDF format for proximal humerus fracture rehabilitation. It covers both non-operative and operative approaches. The protocol emphasizes early physical therapy‚ adequate pain management‚ and protecting the fracture site. The goal is to reduce stiffness‚ improve range of motion‚ and promote healing.
Proximal humerus fractures involve the upper part of the arm bone‚ near the shoulder joint. These fractures are common‚ particularly in elderly individuals with osteoporosis‚ but can also occur in younger people due to trauma. Understanding the nature of these fractures is crucial for effective rehabilitation.
Treatment options range from non-operative management‚ involving immobilization and physical therapy‚ to surgical intervention‚ such as open reduction internal fixation (ORIF). The choice of treatment depends on factors like the fracture pattern‚ displacement‚ and the patient’s overall health.
Rehabilitation plays a vital role in restoring function after a proximal humerus fracture‚ regardless of the treatment approach. Early and continuous physical therapy‚ coupled with adequate pain control‚ are essential for optimal recovery. This guide provides a structured approach to rehabilitation‚ outlining exercises and protocols for both non-operative and post-operative settings. The emphasis is on protecting the healing fracture while gradually regaining range of motion and strength. Remember to consult with your healthcare provider for personalized guidance.
Understanding the Fracture and Healing Process
A proximal humerus fracture disrupts the bone’s integrity‚ initiating a complex healing process. Bone healing typically takes 6 to 8 weeks in adults‚ but this can vary based on age‚ health‚ and fracture severity. Understanding this timeline is essential for setting realistic rehabilitation goals.
The healing process involves several stages‚ including inflammation‚ soft callus formation‚ hard callus formation‚ and remodeling. During the initial inflammatory phase‚ pain and swelling are common. Controlled movement and protection are crucial to prevent further injury.
As healing progresses‚ a soft callus forms‚ providing initial stability. Gentle range-of-motion exercises can begin to promote circulation and prevent stiffness. The soft callus gradually transforms into a hard callus‚ increasing stability.
Rehabilitation exercises must be carefully progressed to avoid disrupting the healing fracture. Factors like fracture displacement and angulation influence the healing process. Non-displaced fractures generally heal faster. The remodeling phase involves reshaping the bone to its original form. Full function is gradually restored through progressive strengthening and functional exercises.
Non-Operative Rehabilitation Protocol: Phase 1 (Weeks 1-3)
Phase 1 of the non-operative rehabilitation protocol for proximal humerus fractures typically spans the initial 1-3 weeks post-injury. The primary focus during this period is to manage pain and protect the fracture site. Immobilization is often employed using a sling‚ worn at all times except during hygiene activities and specific exercises.
Range of motion exercises for the elbow‚ wrist‚ and hand are encouraged to prevent stiffness in these adjacent joints. Grip strengthening exercises can also be initiated. Pendulum exercises for the shoulder are usually introduced to promote gentle movement without stressing the fracture.
Modalities such as ice can be used to control pain and swelling. It is crucial to avoid aggressive movements or lifting during this phase. The goal is to maintain range of motion in surrounding joints while preventing deconditioning.
Extension and internal rotation movements of the shoulder are typically avoided during this initial phase. Regular follow-up appointments with a physician are necessary to monitor healing progress and adjust the rehabilitation plan as needed.
Goals of Phase 1: Pain Management and Protection
The primary goals of Phase 1 in proximal humerus fracture rehabilitation are effective pain management and meticulous protection of the injured site. Pain management strategies involve modalities like ice to reduce inflammation and discomfort. Adequate pain control is essential to allow for participation in gentle exercises and prevent further complications.
Protecting the fracture site is paramount to ensure proper healing. This is achieved through immobilization‚ typically using a sling‚ which limits movement and prevents undue stress on the fracture. Patients are instructed to wear the sling consistently‚ removing it only for hygiene and prescribed exercises.
Maintaining range of motion in adjacent joints‚ such as the elbow‚ wrist‚ and hand‚ is another key objective. Gentle exercises for these areas help prevent stiffness and maintain functionality. Furthermore‚ preventing deconditioning is important.
The overall aim is to create an environment conducive to healing while minimizing pain and preserving function in the surrounding areas. Avoiding any activities that could compromise fracture stability is crucial during this initial phase. Regular monitoring by a healthcare professional is necessary to track progress and adjust the treatment plan as needed.
Exercises in Phase 1: Pendulum and Range of Motion
Phase 1 rehabilitation for proximal humerus fractures focuses on gentle exercises to promote healing and prevent stiffness. Pendulum exercises are a cornerstone of this phase. The patient leans forward‚ allowing the arm to hang freely‚ and gently swings the arm in small circles‚ forward and backward‚ and side to side. These exercises encourage gentle motion without stressing the fracture site.
Range of motion (ROM) exercises for the elbow‚ wrist‚ and hand are also crucial. These include wrist flexion and extension‚ elbow flexion and extension‚ and gentle gripping exercises. These movements maintain joint mobility and prevent stiffness in the surrounding areas.
Shoulder ROM is strictly limited to passive or assisted movements‚ avoiding active shoulder movements that could compromise the healing fracture. These exercises must be performed within a pain-free range.
Exercises should be performed several times a day‚ with short durations to avoid overexertion. Proper technique is vital‚ and patients should be instructed by a physical therapist. Regular monitoring ensures exercises are performed correctly and progression is appropriate. The focus remains on pain control and protecting the fracture during this early phase.
Non-Operative Rehabilitation Protocol: Phase 2 (Weeks 2-6)
Phase 2 of the non-operative rehabilitation protocol for proximal humerus fractures‚ typically spanning weeks 2 to 6‚ marks a transition towards restoring greater function and mobility. The primary goals remain centered on pain management and continued protection of the healing fracture. During this phase‚ the focus shifts towards gradually increasing the range of motion of the shoulder joint while carefully monitoring the patient’s response and pain levels.
The rehabilitation program incorporates gentle active-assisted range of motion exercises‚ where the patient uses the unaffected arm to help move the injured arm. This approach allows for controlled movement without placing excessive stress on the fracture site. Exercises like gentle shoulder flexion‚ abduction‚ and external rotation are introduced‚ progressively increasing the range as tolerated.
Isometric exercises for the shoulder muscles are also initiated to enhance strength and stability without causing joint movement. These exercises involve contracting the muscles against resistance‚ such as a wall or a therapist’s hand. Maintaining range of motion in the elbow‚ wrist‚ and hand continues to be important during Phase 2.
Progression of Exercises in Phase 2
In Phase 2 (Weeks 2-6) of non-operative proximal humerus fracture rehabilitation‚ exercise progression is crucial. Starting with pendulum exercises for gentle mobilization‚ advancement involves active-assisted range of motion. This means using the uninjured arm to guide the affected arm‚ carefully increasing shoulder flexion‚ abduction‚ and external rotation.
As pain decreases and tolerance improves‚ transition to active range of motion exercises‚ engaging the shoulder muscles directly. Isometric exercises‚ where muscles contract without joint movement‚ are introduced to build strength. These can include pressing against a wall or using light resistance bands.
Scapular stabilization exercises are also vital‚ focusing on controlled movements of the shoulder blade to improve posture and shoulder mechanics. Remember to maintain elbow‚ wrist‚ and hand mobility throughout. Monitor for pain or swelling‚ adjusting the intensity accordingly. Consistent communication with a physical therapist ensures safe and effective progression‚ optimizing healing and restoring function.
Operative Rehabilitation Protocol: Phase 1 (Weeks 1-3)
Phase 1 of the operative rehabilitation protocol (Weeks 1-3) following ORIF (Open Reduction Internal Fixation) of a proximal humerus fracture prioritizes protecting the surgical repair. Immobilization is key‚ typically involving a sling worn at all times‚ except during specific exercises and hygiene activities.
Early interventions focus on minimizing pain and swelling using modalities like ice and gentle compression. Range of motion exercises for the elbow‚ wrist‚ and hand are initiated to prevent stiffness in these joints. Pendulum exercises‚ allowing gravity to gently move the shoulder‚ can begin under the guidance of a physical therapist.
The primary goal is to promote early healing while preventing stress on the fracture site. Active shoulder movements are strictly avoided during this phase. Patients should adhere to prescribed pain medication and attend regular physical therapy sessions for proper guidance and monitoring. Strict adherence to the protocol is crucial for optimal outcomes.
Post-Operative Goals: Protecting the Repair
Following operative intervention for a proximal humerus fracture‚ the paramount goal is to safeguard the integrity of the surgical repair. This involves adhering to specific post-operative guidelines to minimize stress on the healing bone and internal fixation.
Protecting the repair during the initial weeks is crucial for optimal bony union. Activities that place excessive strain on the shoulder‚ such as lifting‚ reaching‚ or sudden movements‚ should be strictly avoided. A sling is typically worn to immobilize the arm and limit unwanted motion.
Pain management is also vital‚ as uncontrolled pain can lead to compensatory movements that compromise the repair. Gentle range of motion exercises for the elbow‚ wrist‚ and hand are encouraged to prevent stiffness‚ but active shoulder movements are generally restricted. Regular follow-up appointments with the surgeon and physical therapist are essential for monitoring progress and ensuring proper healing. Patient education and adherence to the prescribed rehabilitation protocol are key to achieving a successful outcome.
Early Exercises after ORIF
After Open Reduction Internal Fixation (ORIF) for a proximal humerus fracture‚ initiating gentle exercises early is crucial for preventing stiffness and promoting circulation‚ while strictly protecting the surgical repair. These early exercises focus on maintaining range of motion in adjacent joints and initiating very gentle‚ controlled movements of the shoulder;
Typically‚ exercises begin with pendulum exercises‚ where the patient leans forward and allows the arm to hang freely‚ gently swinging it in small circles. This helps to reduce pain and stiffness without placing excessive stress on the healing fracture. Wrist and hand exercises‚ such as making a fist and wrist rotations‚ are also encouraged to maintain mobility in these areas.
Elbow flexion and extension exercises can be performed to prevent elbow stiffness. It’s crucial to avoid any active shoulder movements or lifting during this initial phase. The physical therapist will guide the patient through these exercises‚ ensuring proper technique and monitoring for any signs of complications. Pain should always be the guide‚ and exercises should be stopped if it increases significantly.
General Principles of Proximal Humerus Fracture Rehabilitation
Rehabilitation following a proximal humerus fracture‚ whether treated operatively or non-operatively‚ adheres to several key principles to optimize healing and functional recovery. A primary principle involves respecting the healing timeline‚ typically 6-8 weeks for bony union in adults. Early stages emphasize pain management and protection of the fracture site‚ minimizing stress while promoting gentle range of motion in surrounding joints like the elbow‚ wrist‚ and hand.
Progression is gradual‚ guided by pain levels and radiographic evidence of healing. Exercises advance from passive to active-assisted and eventually active range of motion. Strengthening exercises are introduced cautiously‚ starting with light resistance. It’s essential to avoid excessive external rotation and extension initially.
Individualization is crucial‚ considering fracture severity‚ patient factors‚ and surgical approach. Close communication between the patient‚ surgeon‚ and physical therapist ensures appropriate exercise selection and progression. Patient education is vital‚ empowering individuals to actively participate in their recovery and adhere to prescribed protocols. Monitoring for complications and adjusting the plan accordingly remains paramount throughout the rehabilitation process.
Importance of Pain Management and Monitoring Progress
Effective pain management is paramount in proximal humerus fracture rehabilitation‚ significantly influencing patient participation and outcomes. Uncontrolled pain can hinder exercise adherence‚ impede range of motion gains‚ and contribute to muscle guarding and stiffness. A multimodal approach‚ integrating medication‚ ice‚ and activity modification‚ is often necessary to achieve adequate pain control. Patients should be educated about pain expectations and strategies for managing discomfort during exercises.
Regular monitoring of progress is equally vital to guide rehabilitation and identify potential complications. This includes assessing pain levels‚ range of motion‚ strength‚ and functional abilities. Objective measurements should be documented to track improvements and detect plateaus or regressions. Radiographic imaging is used to monitor fracture healing.
Subjective feedback from the patient is crucial‚ allowing for individualized adjustments to the rehabilitation plan. Any signs of increased pain‚ swelling‚ or instability warrant prompt attention and potential modification of exercises. Consistent communication between the patient‚ therapist‚ and physician ensures a coordinated approach to optimize recovery. Monitoring also includes observing for signs of nerve injury.