Rehabilitation after humeral fracture surgery?
I apologize, but Dr.
Wang has some questions to ask.
My mother (in her 60s) was in a car accident in mid-September 2020, and she was taken to the emergency room and underwent surgery.
Currently, the doctors have advised aggressive rehabilitation and observation, and there is no need for further surgery to remove anything.
However, my mother’s rehabilitation progress seems to be slow; she is making gradual improvements, but the extent of improvement is not significant.
She still cannot lift her arm on her own, and when she tries to lift it, she experiences considerable pain.
Even when not in contact, she sometimes feels a tingling sensation.
1.
The X-ray image below was taken at the end of December 2020.
https://imgur.com/PmCcVC6
2.
The orthopedic and rehabilitation doctors currently treating her have instructed her to use her injured hand to climb up the wall to the highest point using her own strength and to perform lifting motions at various angles.
I would like to know if there are other suitable rehabilitation methods and exercises that can be done at home.
3.
Currently, her hand is easier to lift right after completing rehabilitation exercises, but it becomes very stiff and difficult to lift after resting for a while.
Is this a normal condition?
4.
Are there any other aspects that need attention or suggestions? I am very concerned about my mother’s health, so I hope to hear some different recommendations.
I apologize for the many questions, and I thank the doctor in advance.
Jason, 30~39 year old female. Ask Date: 2021/02/08
Dr. Wang Zhaomin reply Rehabilitation
Basic self-rehabilitation exercises, as mentioned in your letter, can improve joint mobility after performing range of motion activities.
However, it is possible that the range of motion may revert to being limited after activity.
If pain and joint restriction persist, consider arranging for physical therapy.
A proper assessment can only be made through an in-person examination; online consultations cannot replace an actual visit.
Please consult an orthopedic or rehabilitation specialist for an accurate diagnosis and to receive appropriate medication or rehabilitation treatment.
Reply Date: 2021/02/08
More Info
Post-surgery rehabilitation for humerus fractures can be a challenging process, especially for older adults. It’s essential to approach rehabilitation with patience and a structured plan to ensure the best possible recovery. Here are some insights and tips based on your mother’s situation and general medical knowledge.
1. Understanding the Healing Process: After a humerus fracture, especially in older adults, the healing process can take time. The pain and stiffness your mother is experiencing are common as the body adjusts and heals. It’s important to remember that progress may be slow, but consistent rehabilitation can lead to improvements over time. The presence of pain during movement is often a sign that the body is still healing, and it’s crucial to differentiate between normal discomfort and pain that signals a problem.
2. Home Rehabilitation Exercises: In addition to the wall climbing exercise suggested by her doctors, there are several other exercises that can be beneficial for her recovery at home. Here are a few:
- Pendulum Exercises: Lean forward slightly and let the affected arm hang down. Gently swing the arm in small circles or back and forth. This can help improve mobility without putting too much strain on the shoulder.
- Assisted Shoulder Flexion: While sitting or standing, use the unaffected arm to assist the affected arm in raising it overhead. This can help build strength and range of motion gradually.
- Isometric Exercises: These involve tensing the muscles without moving the joint. For example, she can press her hand against a wall or a table without moving her arm. This can help maintain muscle strength during the healing process.
- Stretching: Gentle stretching of the shoulder and arm can help improve flexibility. Encourage her to stretch within her pain tolerance, holding each stretch for 15-30 seconds.
3. Managing Stiffness and Pain: It’s normal for the shoulder to feel stiff after rehabilitation exercises, especially if she has not used it much. To combat this, encourage her to perform her exercises regularly, even if they are gentle. Applying heat before exercises can help relax the muscles, while ice afterward can reduce inflammation and pain. Additionally, ensuring she maintains a good posture during daily activities can help minimize discomfort.
4. Monitoring Progress: Regular follow-ups with her orthopedic and rehabilitation specialists are crucial. They can assess her progress and adjust her rehabilitation plan as needed. If she continues to experience significant pain or if her range of motion does not improve, it may be worth discussing further imaging studies to rule out any complications.
5. Psychological Support: Recovery from a fracture can be frustrating, especially if progress feels slow. Providing emotional support and encouragement can make a significant difference in her motivation and outlook. Engaging in light social activities or hobbies that do not strain her shoulder can also help improve her mood and overall well-being.
6. Nutrition and Overall Health: Ensure she is consuming a balanced diet rich in calcium and vitamin D to support bone healing. Staying hydrated and maintaining a healthy weight can also contribute positively to her recovery.
In summary, rehabilitation after a humerus fracture requires a multi-faceted approach that includes physical exercises, pain management strategies, and emotional support. Encourage your mother to stay consistent with her rehabilitation exercises, communicate openly with her healthcare providers, and remain patient as she progresses through her recovery journey. If you have further concerns or questions, don’t hesitate to reach out to her medical team for personalized advice.
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