PT Tip of the Month Archive

Shoulder fractures

What is the shoulder?

The shoulder is a ball-and-socket joint comprised of the humerus (upper arm bone), clavicle (collar bone), and the scapula (shoulder blade). The ball is comprised of the head of the humerus and the socket consists of the glenoid fossa of the scapula. To function as a normal joint, the ball glides and rotates in the socket with input and assistance from various shoulder muscles and ligaments. If there is a disruption of any of the bones, muscles, or ligaments, normal function of the shoulder is considerably more difficult.

 

Types of fractures

The first type of shoulder fracture is a clavicle fracture. The most common mechanism of injury for a clavicle fracture is a fall onto an outstretched arm. One telltale sign of this type of fracture is a bump, which is actually the prominent ends of the fracture under the skin. There may also be swelling around the site of the fracture on the clavicle. After this injury, range of motion of the shoulder tends to be limited because of pain and disruption of normal shoulder mechanics. Depending on the severity of the fracture, treatment may range from wearing a sling for 3-8 weeks to possible surgical intervention.

Another type of injury, though much less common, is a fracture of the scapula. The typical mechanism of injury for this fracture is usually a direct blow to the scapula, such as in a motor vehicle accident or a fall from a height. Again, treatment for this injury may be as simple as wearing a sling or may possibly require open surgery, especially if the glenoid (socket) is fractured.

The third type of fracture is a proximal humerus fracture (ball of the shoulder). The usual mechanism of injury for this fracture is a fall onto an outstretched arm, but it can also occur from a direct blow to the shoulder. Treatment for this fracture will usually depend on the appearance of the x-ray. If the fracture does not look displaced (out of alignment), then conservative treatment with a sling may be possible. However if the fracture looks displaced, surgery may be necessary and could require the use of plates, screws and wires to stabilize the shoulder. More intensive surgery requiring replacement of the humeral head is also sometimes necessary.

Rehabilitation after a shoulder fracture

When recovering from a shoulder fracture, it is likely formal physical therapy will be necessary. The main issues associated with shoulder fractures are pain, shoulder stiffness and shoulder weakness and each type of fracture will have different levels of severity in its side effects. A physical therapist will help guide a patient through the rehab process. Exercises can include various shoulder stretches, strengthening exercises and modalities for pain control. In addition to formal rehabilitation, it is also important to follow all guidelines from your orthopedic surgeon so as to allow for optimal fracture healing.

Regardless of your course of treatment, our licensed physical therapists are experienced in treating non-operative and post-operative shoulder fractures. Our goal is to help you return to your prior level of activity for both sports and work. Please contact one of our two locations if you have any questions about your injury.

33 Pond Avenue, Suite 107B Brookline, MA 02445 Tel: (617) 232-PAIN (7246) Fax: (617) 232-5196
1208B VFW Parkway, Suite 202 West Roxbury, MA 02132 Tel: (617) 325-PAIN (7246) Fax: (617) 325-7282