A weak arm bone or humerus will fracture just below the shoulder joint or humeral neck when you catch yourself from a fall using your outstretched hand. If you are elderly, you are most susceptible to this type of arm injury because you began to lose bone mass around the age of 40. Rehab for a post humeral neck fracture should be completed under the guidance of a physical therapist.
Considerations
A fractured bone can heal and gain near-normal strength in as little as four months compared to almost a year for ligaments and tendons. Even an injured muscle can take up to six months to regain near-normal function.
Initial Protocol
The first week of healing from a bone fracture involves plenty of inflammation and cell proliferation. The injured area will be painful, swollen, warm and tender. The goal of physical therapy during this phase of treatment is to contain the injury, preventing damage to the surrounding healthy tissues. Shoulder and elbow immobilization is necessary. You can take a non-steroidal anti-inflammatory medicine such as aspirin to ease pain and swelling. Soft ice packs can be placed immediately around the fracture to reduce pain and swelling as well.
Electrical Stimulation
Electrical stimulation or e-stim is given using small currents in a physical therapy clinic. This is used to heal the soft tissues around the fracture. E-stim relieves swelling in the immediate area by pumping excess fluid through the lymph system, reducing pain. It can also be used to relax the muscles around the fracture if they are in spasm.
Manual Manipulation
Manual manipulation includes massage and trigger-point release for the soft tissues around your bone. Your therapist will also actively move your shoulder and elbow as you relax your arm muscles referred to as joint mobilization therapy. A heat pack is generally applied over your arm prior to such manipulations to enhance blood flow and flexibility.
Stretches
Depending on the extent of the fracture, you won't be able to begin rehab stretches for four to six weeks. Once you are given the go-ahead to move your arm, the goal of therapy is to first regain the range of muscles of your muscles and joints. Even such small movements apply a mechanical load to your bone so start slowly, advising your therapist of unusual pain and noise in your arm. Passive stretches with your arm in one position are incorporated and may last up to 20 minutes. Static stretches are done for multiple reps of six seconds.
Strengthening Exercises
Strengthening exercises begin with low resistance using 1- to 3-pound dumbbells, wrist weights or exercise bands. Such exercise include those you would normally do for your arm in the gym like biceps curls, lateral raises, front raises and triceps extensions. Each low-resistance exercise is done for at least three sets of 10 reps three days per week. Resistance is slowly increased based on your response to treatment.
References
- "Anatomy & Physiology"; Gary Thibodeau, Kevin Patton; 2007
- "Examination of Musculoskeletal Injuries"; Sandra Shultz, Peggy Houglum, David Perrin; 2005
- "Therapeutic Exercise for Musculoskeletal Injuries"; Peggy Houglum; 2005
