Proximal Humerus Fracture Rehabilitation Program

Range of Motion

• Restore PROM (as tolerated)
• No AROM against gravity yet

Sling

• Immobilized in sling with abduction pillow at all times, may be removed for exercises and showering. Wear sling at night.

Therapeutic Exercise

• Codman’s Pendulums
• Scapular sets, shoulder shrugs, retraction/protraction
• Towel slides
• ER with broom handle
• Supine Active Assisted flexion
• Elbow, wrist, hand ROM
• Ball squeezes
• For Biceps Tenodesis:
  1. oNo Active elbow flexion until 3 weeks (AAROM ok)

Range of Motion

• Progress PROM
• Pool Therapy if available for AAROM (pool is the assistance)
• Goal to avoid post-operative stiffness

Sling

• Immobilized in sling with abduction pillow at all times, may be removed for exercises and showering. Wear sling at night.

Therapeutic Exercise

• Continue Phase I ROM exercises
• Supine AAROM
• Pulley exercises
• Light scapular strengthening (retraction/protraction) , shoulder shrugs, scapular setting
• Gentle joint mobilization and soft tissue mobilization
• For Biceps Tenodesis:
  1. Begin active elbow flexion against gravity, no strengthening until 8 weeks

Range of Motion

• Progress to full ROM without discomfort

Sling

• Transition away from sling

Therapeutic Exercise

• Stretching, mobs, ROM exercises
• NO ROTATOR CUFF RESISTANCE EXERCISES
• Progress supine to seated to standing AAROM
• Progress pool based AAROM if available
• Progress to full AROM against gravity

Range of Motion

• Full AROM without discomfort

Sling

• None

Therapeutic Exercise

• Begin light theraband resistance exercises for the rotator cuff when able to elevate arm against gravity without scapula hiking
• Begin strengthening for lats, biceps/triceps, pecs, rhomboids, deltoids
• Progress with theraband exercises slowly to tolerance
• Begin to add sport and job specific activities

Range of Motion

• Full ROM without discomfort

Sling

• None

Therapeutic Exercise

• If cleared by Dr. Roth, may now be able to return to:
  1. Weight Training
  2. Skiing
  3. Golf
  4. Basketball
  5. Manual Labor

Range of Motion

• Full ROM without discomfort

Sling

• None

Therapeutic Exercise

• If cleared by Dr. Roth, may now be able to return to:
  1. Throwing Sports
  2. Tennis
  3. Volleyball