Proximal Humerus Fracture — Non-Operative

University of Colorado / Denver Shoulder Surgeon · Dr. Adam Seidl MD; Dept. of Orthopedics, Anschutz Medical Campus

Weight-Bearing

Sling at all times except exercises and bathing (including at night); sleeping in recliner optimal; D/C sling between wks 2-4

Key Restrictions

No cuff strengthening wks 2-8; no cross-body adduction Phase 2; no IR behind back Phase 2 (only IR in scapular plane); no shoulder extension or IR until wk 9; check for specifications and precautions from ordering physician — fracture stability is variable

Timeline & Phases

4 phases: Phase 1 (wks 2-4, pendulums + cervical/elbow/wrist ROM, scap retraction/depression, grip), Phase 2 (wks 5-8, self-assisted FF to 90 deg progressing 20 deg/wk, self-assisted ER, grade I-II mobs), Phase 3 (wks 9-12, full FF/ER progression, posterior capsule stretching, IR behind back begins, grade III-IV mobs, sub-max isometrics then progressive isotonics), Phase 4 (>wk 12, full motion + progressive strengthening, vocation/sport specific)

Notes

.edu affiliated (U of Colorado Anschutz); PT starts wk 2; sling includes at night; ER progresses 20 deg/wk from wk 5; anterior deltoid and scapular stabilization emphasized Phase 3; upper trapezius/serratus anterior force couple emphasized; UBE low resistance Phase 3; aerobic conditioning throughout; modalities for pain/inflammation Phase 2

Surgeon / Author

Dr. Adam Seidl MD; Dept. of Orthopedics, Anschutz Medical Campus