Your humerus is the upper arm bone that forms part of your shoulder and elbow joints. Roughly one in every 20 of all arm fractures occur in this bone. Protocols, or guidelines, for physical therapy following a humerus fracture vary according to a number of factors, including the location and severity of the injury.
Basics
You can break your humerus in three separate places. Proximal fractures, which appear in the part of the bone in or near your shoulder joint, commonly occur when you fall on your shoulder. Midshaft fractures, which appear in the middle of the bone, commonly occur when you're involved in an accident or fall on your elbow. Distal fractures, which appear in or near your elbow joint, commonly occur in children and in people who fall from significant heights or are involved in motor vehicle accidents.
Proximal Fractures
If you're recovering from a proximal humeral fracture, the specific protocol used by your physical therapist depends on factors that include the precise location and severity of your injury, the way in which your fracture was repaired and the structural integrity of your bone when rehabilitation begins. Typical overall goals for therapy include reduction of any pain and restoration of normal function in your shoulder joint. In addition to range-of-motion and strengthening exercises for your shoulder, you usually need to perform exercises for your elbow, wrist and hand to meet these goals. Your therapist will take your occupation and everyday routines into account when creating your rehabilitation plan.
Distal Fractures
As with proximal fractures, the specific protocol used for a distal humeral fracture depends on a variety of factors. If you didn't undergo surgery to repair your fracture, rehabilitation typically begins after you've kept your arm immobilized for a period of several weeks. Rehab following surgery may begin within a day or two after your procedure. Initially, your physical therapist will focus on exercises to restore normal movement in your elbow and forearm. She will then add exercises designed to strengthen these areas. Physical therapy protocols also typically require you to limit use of your elbow for roughly six to 12 weeks.
Midshaft Fractures
Midshaft fractures usually heal without the need for surgery or a cast, according to Texas Orthopedics. In some cases, these types of fractures cause damage in your radial nerve, which supplies sensation to the back of your arm, as well as your forearm and hand. If you have radial nerve damage, physical therapy protocols typically include reduction of any pain and swelling, and restoration of your normal nerve functions. Methods used to achieve these therapeutic goals include ice or another cold source, massage and range-of-motion exercises for your fingers, hand, wrist and elbow.
References
- American Academy of Orthopaedic Surgeons; Broken Arm; July 2007
- MD Guidelines: Fracture, Humerus, Proximal
- American Academy of Orthopaedic Surgeons; Distal Humerus Fractures; April 2010
- MD Guidelines: Neuropathy of Radial Nerve (Entrapment)
- Bone Fractures: Humerus Bone Fracture
- Texas Orthopedics: Humerus Fracture -- Broken Upper Arm
