Proximal humerus fracture exercise videos

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This guidance is for people that have suffered

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a proximal humerus fracture, and these are for people

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that have been referred to these resources

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by the consultant, physiotherapist or

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a specialist healthcare professional looking after them.

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Patients that have suffered this fracture are usually recommended to wear a sling.

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We recommend that for the first two weeks

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you wear the sling all the time unless you need to take your arm out

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for personal hygiene,

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feeding yourself or washing,

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and then gradually over the next 2 to 4 weeks,

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start weaning yourself out of the

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sling and only

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where the sling for social protection.

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And then by six weeks.

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We would hope that you fully discarded the sling.

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So we’re going to go

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through the exercises now,

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and these are the early stage

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exercises for patients

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that have a proximal humerus fracture

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that we would expect you

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to be doing within the first

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0 to 2 weeks of your injury.

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So the first exercises

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you do in standing or sitting,

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trying to keep your neck mobile,

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so bending your head

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forward, ear to shoulder,

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both directions

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and turning to look over your shoulder,

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in case you develop

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any muscle tension

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from wearing the sling particularly.

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Also doing some exercises to maintain

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some mobility of your wrist and hand,

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particularly

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while you're wearing the sling

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a lot of the time, and it may stiffen up.

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So bending your hand

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up towards the ceiling

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as far as you can,

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and doing your hand

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down towards the floor,

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holding for a

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few seconds in each direction,

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and turning your palm

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towards the ceiling, and palm down

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away from you.

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Then we would want you to

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do some exercises

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with your elbow as well.

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So bending the elbows far as you can,

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and particularly straightening it out

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because this can become stiff

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when you've

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had your arm in a sling a long time.

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Then we would like to start

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doing some exercises

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for the shoulder as well.

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The first exercise

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is a pendulum exercise,

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so with your good arm,

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you might want to lean on something

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to give you a bit of support,

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and then you're going to let your bad arm

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relax down

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and let your arm swing forwards

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and backwards.

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You can use your body weight

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to swing forwards and backwards

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to help with that movement,

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and you can go forwards and backwards,

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go across your body

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and do some

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circular movements.

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The final

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two exercises for this phase,

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you can do sitting or standing.

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For exercise one,

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you're going to slide your arms

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forward, whilst in a sitting position.

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If you find it difficult

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to do this exercise,

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if it doesn't slide very easily,

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you could get a bin bag,

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and then put a towel over the top

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and that will make it a bit easier.

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Sliding forward and backwards.

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And then the last exercise

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for this phase is

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starting

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with your affected arm, across the body,

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trying to, using a stick,

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move the arm into this position,

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so that the forearm is in line

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with your shoulder.

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You may be able to go a few degrees

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further into that stretch,

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but do not force it.

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Take it

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gently, stop

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if you get any discomfort or resistance.

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With all

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these exercises, we're

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aiming for little and often.

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So if you're able to manage

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to do them

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three times, 2 to 3 times a day,

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and starting with about five repetitions,

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building up to 5

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to 10 repetitions for each exercise.

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These are the exercises for phase two.

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So this is for approximately week

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2 to 6 following your fracture

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of your proximal humerus.

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So the first exercises

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that you will be adding

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into your exercise program

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you can do lying down.

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With your affected arm,

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try and have the elbow bent

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and use your good arm

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to help lift the arm back

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as far as you can tolerate

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within comfort, not forcing it,

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taking the hand back towards

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the pillow behind you.

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And then you can gradually make

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that harder

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and progress

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that exercise by doing it

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with the elbows straight.

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It's the same movement,

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but this time keeping the elbow

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straight

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and stretching the arm back behind you.

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So that's the first exercise,

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you can also start doing some exercises

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in standing with a stick.

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So if you have a stick at home,

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if not a broom or a mop,

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you can be creative.

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You're going to do the work

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with the good arm, the better arm.

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And the affected arm is holding

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the stick lightly,

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and the good arm is helping stretch

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your arm up

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towards the ceiling forwards

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in front of you.

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And remember, you're not forcing any of

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these movements, you're just

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moving into a

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bit of that

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discomfort and a bit of resistance

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so you can stretch forward

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as well as stretching the arm

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out to the side.

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And the final exercise

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is to help with that

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external rotation movement

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that we started from the last video.

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So rather than just taking

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the arm to midline,

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see if you can start stretching it

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a bit further into

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that external rotation movement.

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We're moving on to phase three now,

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which is for 6 to 8 weeks post injury.

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And we’re

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progressing on

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from using the stick with those movements

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and we're going to try

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and do it on our own.

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So trying to lift the arm up

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towards the ceiling

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and back down, and I would recommend

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if you're able

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to, do it

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both sides because that will help

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get better movement.

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So you're lifting the arm

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as high as you can,

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forwards in front of you,

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out to the side, all the way up, so that

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abduction movement

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we did before with the stick.

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And going into

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that external rotation movement,

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not forcing it,

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just nudging into that discomfort

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and that resistance.

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Then we’re going to start

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doing a hand behind back movement,

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so trying to take the hand behind you

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and with time, try

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and take the hand higher up the back

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as you do that.

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And the last exercise to add in during

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this phase is a bit of strengthening.

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So you’re going

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have your hand in this position

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in that 90

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degree angle,

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use your other hand as resistance.

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So you're trying to pull out,

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I'm trying to pull this arm out

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into the resistance of my hand

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and relax.

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And the same pushing in

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and my hand is blocking

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that movement, providing some resistance.

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These are the final stage

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of exercises for our videos that we're doing.

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So it's for late stage, so for eight weeks

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plus following your fracture.

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You may have been sent out a theraband by your physiotherapist

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and if you have been, then please use that for this exercise.

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For that you will be pulling the arm out,

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both arms out into a bit of resistance and then taking a step forward,

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and as you do that, reaching your arms forwards in front of you, step forwards

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and reach the arms up whilst keeping that

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resistance into the band.

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If you don't have a band and then you can use a wall

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to do a similar thing, so you'll be pushing into the wall

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with that rotation movement that I spoke about rather

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than leading the whole body in, that's not what we want.

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So you're pushing the arm out in that rotation movement

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and then you're going to slide your hand up the wall, maintaining that pressure

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and step back.

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So that's exercise one.

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Then the next exercise you can start adding in that's

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a bit more challenging for the shoulders, is having your hands on a wall

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and then doing a wall push-up.

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So trying to bend your elbows, bring your chest to the wall,

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and then push back and straighten the arms.

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And the way to make that harder,

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if you need to, is to take the feet further away from the wall.