Proximal Humerus Fracture Rehabilitation Program

PHASE I: 1-3 WEEKS POST-OP

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)

PHASE II: 3-6 WEEKS POST-OP

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

PHASE III: 6-12 WEEKS POST-OP

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

PHASE IV: 12-24 WEEKS POST-OP

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

PHASE V: 6-8 MONTHS POST-OP

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

PHASE VI: 8+ MONTHS POST-OP

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

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