Broken Shoulder (Fractured Humerus)
What is a Broken Shoulder?
A broken shoulder (fractured shoulder) is most commonly a fractured humerus. A fracture is a medical term for a broken bone. The humerus is your upper arm bone between your shoulder and elbow.
Common Shoulder Fractures
The location of these fractures can have an impact on your treatment because of the bone attachment of your important shoulder muscles. If you use a muscle that is attached to a broken section, this can be very painful or could cause a deformity when your fracture eventually heals.
Below is a list of muscles that attach to different parts of the shoulder. Your physiotherapist or doctor will be able to explain what you should and shouldn’t do if you have a fracture of the following regions:
- Greater tuberosity – supraspinatus, infraspinatus & teres minor
- Lesser tuberosity – subscapularis
- Humeral Head
- A Shaft of Humerus – pec major (displaces shaft medially & internal rotation)
Due to the main reason for shoulder fractures being falls, often a second shoulder fracture will occur at the same time.
What’s Worse, a Fracture or a Break?
Despite what your friends say, there is no difference in severity between a fractured bone and a broken bone. Fracture is the medical term for a “broken bone”. Fractures have different grading:
- Greenstick (incomplete fracture)
- Transverse (across the bone)
- Spiral (spiral around the bone)
- Oblique (diagonal across the bone)
- Compression (crushed)
- Comminuted (3+ pieces)
- Segmental (the same bone fractured in two places resulting in a “floating” segment).
All shoulder fractures should be assessed by an Orthopaedic Surgeon.
Broken Shoulder Treatment
After your broken shoulder diagnosis via an X-ray, your arm will typically be supported at the wrist in a “collar and cuff” sling. The sling allows the weight of the arm to pull the humerus downwards. The downward gravity pull helps the broken bones to heal in the correct position.
You must not put anything under your elbow in an attempt to support the weight of your arm. This force would push your humerus upwards and move the bones into the wrong position. Hence, this is why a triangular sling is unsuitable. You must not rest your arm on a pillow when sitting or lying. You will need to wear the collar and cuff for at least six weeks, depending on what your surgeon recommends. You may wear it outside your clothes. You may remove it to wash.
Yes! Your shoulder will be quite painful for the first two weeks. Pain-relieving tablets may help to reduce your pain. Ask your doctor for advice.
Surgery is sometimes required to stabilise your broken shoulder.
Physiotherapy & Exercises for a Broken Shoulder
Your arm will usually be in a collar and cuff for six weeks if you don’t require surgical intervention. You must move your fingers and wrist while in the collar and cuff to prevent stiffness and swelling. Your doctor or physiotherapist will advise you when it is safe to recommend range of motion, active-assisted, active and then progressive strengthening exercises. DO NOT attempt to do too much too soon or you may disturb your shoulder fracture.
While it is essential to move your shoulder to prevent stiffness, your priority is the allow the shoulder fracture to heal. Be guided by your health professionals. They are the experts in getting your broken shoulder repaired and back moving again as soon as possible.
Even with diligent exercising your broken shoulder may become stiffer than average. Your physiotherapist is the best person to advise you what exercises to do, how often and when? Seek the advice of your physiotherapist within the two weeks after injury or surgery ideally, to attain your best outcome.
Will Your Broken Shoulder Fully Recover?
In most cases, Yes! Your broken shoulder will continue to improve for up to twelve months. However, your best results will occur early.
Broken Shoulder Tips
You may remove the collar and cuff to wash. Wash under your arm using a hanging pendulum position.
You cannot drive while your arm is in a collar and cuff. You will not have free movement of your arm for several weeks after removing the sling. Therefore you will not be able to drive for at least eight weeks.
When your return to work depends on your job, if you can work one-handed, you may be able to return to work two weeks after your injury. Travel requirements are also a consideration. If your job is manual, you will be unable to work for at least three months.
In most cases, you may participate in light non-contact sports about six weeks after your injury. When you start playing, you will not be able to play for as long as usual. Your shoulder will ache at the end of exercises.
You should not smoke while your fracture is healing. Research confirms that smoking slows down bone healing.
Broken Shoulder Complications
Occasionally, your broken shoulder may not heal properly. If this happens, an operation might be necessary. If the fractured shoulder heals in the wrong position, a surgery to correct the situation or to insert an artificial shoulder joint might be required.
General Advice for Broken Shoulder
After a broken shoulder, you will have dramatic bruising down your arm as far as the elbow. The bruising will take many days to disappear. It is very common injury in older patients. As a result, your shoulder usually ends up stiffer than average following this injury. If you have any problems or queries, please ask your physiotherapist or doctor.
Common Shoulder Pain & Injury Conditions
- Rotator Cuff Syndrome
- Shoulder Tendinopathy
- Rotator Cuff Calcific Tendinopathy
- Rotator Cuff Tear
- Bicep Tendinopathy
- Shoulder Impingement
- Swimmer's Shoulder
- Shoulder Dislocation (Instability)
- Subacromial Decompression
- Shoulder Arthroscopy
- Rotator Cuff Repair
- SLAP Repair
- Biceps Tenodesis
- Biceps Tenotomy
- Total Shoulder Replacement
Researchers have discovered that managing your shoulder injury with physiotherapy is usually successful. Typically, you have two options: non-operative or a surgical approach. Your condition will dictate which option is best for you at this time. Non-operative care is conservative rehabilitation.
If shoulder surgery is required, then your physiotherapist may undertake:
- Pre-operative rehabilitation - to either try a non-operative treatment approach or to condition and prepare your body for a surgical procedure.
- Post-operative physiotherapy - to safely and methodically regain your normal range of movement, strength, speed and function.
PhysioWorks physiotherapists have a special interest and an excellent working relationship with leading shoulder surgeons. Our physiotherapy team provide you with both conservative and post-operative shoulder rehabilitation options. We aim for you attaining the best possible outcome for your shoulder injury.