Rehabilitation Tips for Improving Shoulder Mobility After Fracture

Right shoulder comminuted fracture?

Hello Dr.
Lee, two months ago I had a motorcycle accident that resulted in a comminuted fracture of my right shoulder.
I underwent surgery and had a plate inserted for stabilization, which has been in place for about two months now.
However, I still cannot lift my right arm.
The doctor said the plate is stable and advised me to try to lift my arm, aiming to reach the same height as before, but after two months, I still cannot lift it.
What rehabilitation exercises should I do to regain my ability to lift my arm, or is it true that once the shoulder has been operated on, I will never be able to lift it again?

Sunny, 40~49 year old female. Ask Date: 2018/12/14

Dr. Li Weiqiang reply Rehabilitation

Hello, if the surgeon is fixed, rehabilitation should begin, although the extent may vary.
A comminuted fracture requires the bone to heal to a certain degree, which takes longer than a simple fracture.
The inability to lift may be due to soft tissue tightness around the fracture site, which needs to be gradually loosened through joint mobility exercises.
After two months, you can start; I recommend finding a rehabilitation physician to assess and design your rehabilitation program.
Wishing you safety and health.
Sincerely, Dr.
Li Wei-Chiang, Attending Physician, Department of Rehabilitation, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2018/12/14

More Info

Rehabilitation after a shoulder fracture, especially following surgical intervention, is crucial for restoring mobility and function. It is understandable to feel frustrated when progress seems slow, but with the right approach, significant improvements can be made. Here are some rehabilitation tips to help improve shoulder mobility after a fracture:
1. Consult with a Physical Therapist: Before starting any rehabilitation exercises, it is essential to consult with a physical therapist who specializes in orthopedic rehabilitation. They can assess your specific situation and develop a tailored exercise program that considers your current limitations and goals.

2. Start with Passive Range of Motion Exercises: Initially, focus on passive range of motion exercises. These exercises involve moving the shoulder joint without using the muscles around it. You can use your other arm to assist in lifting the injured arm or use a pulley system to help with movement. This can help maintain joint flexibility without putting too much strain on the healing tissues.

3. Progress to Active Range of Motion Exercises: Once you have regained some passive motion, you can start incorporating active range of motion exercises. These involve using your own muscles to move the shoulder. Start with gentle movements, such as shoulder flexion (lifting your arm forward) and abduction (lifting your arm to the side). Gradually increase the range of motion as tolerated.

4. Strengthening Exercises: After achieving a reasonable range of motion, you can begin strengthening exercises. Focus on the rotator cuff muscles and the deltoid muscle, which are crucial for shoulder stability and function. Resistance bands can be a great tool for this. Exercises like external rotations, internal rotations, and shoulder presses can help build strength.

5. Stretching: Incorporate stretching exercises to improve flexibility. Gentle stretches for the shoulder and chest can help alleviate tightness and improve overall mobility. Hold each stretch for 15-30 seconds and repeat several times.

6. Heat and Ice Therapy: Applying heat before exercises can help relax the muscles and improve blood flow, making it easier to move. After exercising, ice can be applied to reduce any swelling or discomfort.

7. Consistency is Key: Rehabilitation takes time and consistency. Aim to perform your exercises daily or as recommended by your therapist. Keeping a routine will help reinforce the movements and improve your shoulder's function over time.

8. Listen to Your Body: While it is important to challenge yourself, it is equally important to listen to your body. If you experience significant pain or discomfort during exercises, stop and consult your therapist. Pain is a signal that something may not be right, and pushing through it can lead to setbacks.

9. Functional Activities: As you progress, incorporate functional activities that mimic daily tasks. This could include reaching for objects, lifting light weights, or performing overhead movements. Gradually increase the complexity of these tasks as your strength and mobility improve.

10. Patience and Positive Mindset: Recovery from a shoulder fracture can be a slow process, and it is essential to maintain a positive mindset. Celebrate small victories along the way, and remember that progress may not always be linear.

In conclusion, while it may feel discouraging that you cannot lift your arm as you used to, it is important to remember that recovery is a gradual process. With the right rehabilitation program and guidance from healthcare professionals, you can regain your shoulder mobility and strength. Always consult with your physician or physical therapist before starting any new exercise regimen to ensure it is safe and appropriate for your specific condition.

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