Your humerus is the strong bone in your upper arm that connects to the radius and ulna at your elbow and to the scapula at the shoulder. The upper portion of the humerus that helps to form part shoulder joint is known as the proximal humerus, and if a fracture develops here, it can cause problems for both your arm and shoulder. Dr. Holloway has extensive experience treating proximal humerus fractures (PHF), and we want to showcase what that recovery may look like if you suffer one of these injuries. Below, we explore a conservative care routine for a proximal humerus fracture.
Nonoperative Management Of Proximal Humerus Fractures
Proximal humerus fractures are a pretty common type of injury, especially in older adults. In fact, PHFs account for roughly 5.7% of all fractures. Of the roughly 370,000 adults who seek out emergency department care for a humerus fracture each year, about half of those patients are classified with a proximal humerus fracture. Because a proximal humerus fracture involves a break in the upper portion of the bone, it’s imperative that healing goes as expected to maintain normal function and movement in the arm and shoulder region.
Proximal humerus fractures tend to occur when a significant force is applied to the arm, with ground-level falls being the most common source of injury. Falling directly on the arm or landing with your arms outstretched can cause stress to overload the humerus, resulting in a proximal fracture. These types of injuries can also occur during contact sports or as a result of a motor vehicle accident.
Symptoms of a PHF will present in the upper arm and shoulder region, and they include:
- Pain
- Weakness
- Tenderness
- Decreased range of motion
- Swelling
Odds are it will be clear that there is an obvious issue with your arm, but you may not know the true extent until you connect with an orthopedic specialist or an emergency room physician who can conduct a physical examination and order some imaging tests. An x-ray can reveal the presence of a fracture and whether or not the bone has become displaced. Most proximal humerus fractures are considered stable and non-displaced, which means that conservative care is the standard treatment course.
Conservative Treatment For Proximal Humerus Fractures
If your doctor is confident that the fracture will heal as expected without surgical intervention, they’ll walk you through a standard course of conservative care. For most patients, that means spending some time in a sling. Oftentimes the patient is confined to a shoulder sling for 4-6 weeks, but that isn’t the only form of treatment that will be pursued during this time.
Your specific physical therapy recommendations will be dependent on your fracture pattern and your recovery goals, but most patients will begin some passive mobilization exercises within a week or two of the original fracture. Your physical therapist will help to manipulate your arm and shoulder in a few different ways to begin restoring movement in the area, as early movement exercises are key for establishing a full range of motion.
Around the 3-6 week mark, you’ll begin some active PT exercises, meaning you’re performing the motions completely on your own. This again helps with range of motion, but it also starts to strengthen the area. Most people can ditch their sling around the 4-6 week mark, and from then on physical therapy becomes more aggressive at working to strengthen the area. Most patients pursue strength training PT exercises for another 6-10 weeks. Patients typically return to normal activities including labor-intensive work and contact sports by the 12-16 week mark.
Dr. Holloway has helped countless patients overcome proximal humerus fractures and get back to all their normal activities, and he can help you do the same. For more information about PHFs, or for assistance with a different shoulder injury, reach out to his office today at (865) 410-7887.
