Proximal Humerus — ORIF

Saint Louis University (SLUCare)

Weight-Bearing

N/A

Key Restrictions

Sling for sleep and as desired; no active shoulder motion first 4 weeks; gentle passive shoulder motion all planes immediately; high rep/low weight for strengthening; discharge criteria: maximize ROM, full ADLs, normal scapulohumeral rhythm >100 deg elevation, independent HEP

Timeline & Phases

Wks 0-6: sling for sleep and as desired, AROM neck/elbow/wrist/hand 5x/day, no active shoulder motion first 4 weeks, passive pendulum 3x/day, gentle passive shoulder motion all planes no restrictions, icing 3-5x/day, focus on normalizing scapulohumeral kinematics; Wks 6-12: passive and AAROM all planes as tolerated, periscapular strengthening (shrugs, scapular retraction), progress to active ROM, isometrics when active ROM adequate; Mo 3-6: strong periscapular strengthening (protraction, retraction, elevation), rotator cuff strengthening (bands/dumbbells) when AROM full; Mo 6-9: active shoulder girdle/RC/periscapular strengthening, high rep/low weight; discharge: maximize ROM, full ADLs, normal scapulohumeral rhythm >100 deg, independent HEP

Notes

SLU Sports Medicine and Shoulder Service; diagnosis: proximal humerus fracture or greater tuberosity fracture; ORIF; high rep/low weight for strengthening; focus on normalizing scapulohumeral kinematics; 4-month protocol 2-3 visits/week