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Proximal Humerus Fracture Rehab Protocol
Keys to a Successful Outcome
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Tuberosity healing must occur before active force is applied by the attached rotator cuff tendon
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"Slower rather than quicker" overall
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No not stress end range motions between 0-6 weeks while performing passive movements
Phase | Brace | ROM | WB Status | Exercises |
|---|---|---|---|---|
In Hospital | Worn at all times** | PROM | NWB | Passive FF while supine, gentle ER to neutral if comfortable, pendulum okay if comfortable |
Weeks 0-6* | Worn at all times** | PROM | NWB | Elbow/wrist AROM, grip strength, scapula isometrics, no resistance exercises |
Weeks 6-12 | Used for sleeping only for weeks 6-8 | AAROM>AROM as tolerated; PROM Goals: FF 120°, ER 50°, IR 50°, Active FF 100° | 1lb limit | Begin active motion in plane of scapula, AAROM pulleys, sub-max pain-free isometrics in neutral, scapular strengthening, assisted horizontal Add |
Weeks 12-16 | None | Progress AROM/PROM; AROM goals: FF 130° (scapular plane supine), ER 55°, IR 60° | 5lb limit | Initiate assisted IR behind back stretch, resisted IR/ER in scapular plane, begin supine active elevation strengthening(i.e. Therabands) |
Months 4-6 | None | FAROM | 10lb limit | Gradually progress strengthening, return to light recreational hobbies |
Months 6-12 | None | FAROM | 15lb limit | Avoid loading shoulder at extreme ROM, progress with strengthening activities as tolerated. |
*If surgery was not performed, PROM should not start until 3 weeks from the date of injury.
**to be worn day and night; off for hygiene and exercises