Broken Shoulder (Fractured Humerus)

Broken Shoulder (Fractured Humerus)

Article by John Miller

Broken Shoulder

Fractured Humerus

What is a Broken Shoulder?

A fracture is a medical term for a broken bone. A broken shoulder (fractured shoulder) is most commonly a fractured humerus. The humerus is your upper arm bone between your shoulder and elbow.

Common Shoulder Fractures

When your humerus fracture is near or at the ball of your shoulder joint, it is commonly known as a broken shoulder. Your humerus can fracture in many places, and the fracture usually is described by its location, e.g. a fractured neck of the humerus.

broken shoulder

The location of these fractures can impact your treatment because of the bone attachment of your essential shoulder muscles.  If you use a force attached to a broken section, this can be very painful or cause 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, a second shoulder fracture will often co-occur.

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” section.

An Orthopaedic Surgeon should assess all shoulder fractures.

Broken Shoulder Treatment

broken shoulder treatment

After your broken shoulder diagnosis via an X-ray, a collar and cuff sling will typically support your arm at the wrist. The sling allows the weight of the elbow to pull the humerus downwards. The downward gravity pull helps the broken bones to heal in the correct position.

It would be best if you did 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. Depending on your surgeon’s recommendations, you will need to wear the collar and cuff for at least six weeks. You may wear it outside your clothes. You may remove it to wash.

Yes! Your shoulder will be pretty 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

If you don’t require surgical intervention, your arm will usually be in a collar and cuff for six weeks.  It would help to 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 your physiotherapist’s advice 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

Washing

You may remove the collar and cuff to wash.  Wash under your arm using a hanging pendulum position.

Driving

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.

Work

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.

Sport

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 the exercises.

Smoking

It would be best if you did 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, You might require surgery to correct the situation or insert an artificial shoulder joint.

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 a prevalent 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

Adhesive Capsulitis

Shoulder Bursitis

Shoulder Instability

Acromioclavicular Joint

Bone Injuries

Post-Operative Physiotherapy

Muscle Conditions

Systemic Conditions

Referred Pain

Shoulder Treatment

Researchers have discovered that managing your shoulder injury with physiotherapy is usually successful. Typically, you have two options: a 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  - either trial a non-operative/conservative treatment approach or condition and prepare your shoulder and body for a surgical procedure.

Post-operative physiotherapy will safely regain your normal range of movement, strength and function.

PhysioWorks physiotherapists have a particular 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 to attain the best possible outcome for your shoulder injury.

For specific information regarding your shoulder, please consult your trusted shoulder physiotherapist.

Acute Injury Signs

Acute Injury Management.

Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.

For detailed information on specific injuries, check out the injury by body part section.

Don't Ignore these Injury Warning Signs

Joint Pain

Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.

Tenderness

If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.  

Swelling

Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.

Reduced Range of Motion

If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.

Weakness

Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.

Immediate Injury Treatment: Step-by-Step Guidelines

  • Stop the activity immediately.
  • Wrap the injured part in a compression bandage.
  • Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
  • Elevate the injured part to reduce swelling.
  • Consult your health practitioner for a proper diagnosis of any serious injury.
  • Rehabilitate your injury under professional guidance.
  • Seek a second opinion if you are not improving.