Post-fracture rehabilitation issues?
I have a proximal humeral fracture, and the incision from the surgery is on the side of my shoulder.
They used a titanium alloy plate and screws for fixation, but there is less muscle in that area.
Will the surgery have damaged the muscle to some extent? It has been a month since the surgery, and when I raise my shoulder, there is a noticeable difference between both sides.
The injured side feels like it cannot reach ninety degrees, and I find that my back is doing most of the work in lifting my shoulder rather than the shoulder muscles themselves.
Is this a normal phenomenon?
Bobo, 20~29 year old female. Ask Date: 2022/10/10
Dr. Chen Bochen reply Orthopedics
Hello Bobo, there will inevitably be some muscle damage during surgery, and joint stiffness after the operation is also a common phenomenon.
As long as the surgery is successful and the fracture heals, gradual rehabilitation and exercise will lead to a smooth recovery.
Wishing you a speedy recovery.
Reply Date: 2022/10/10
More Info
Post-fracture rehabilitation, especially after a proximal humeral fracture, can be quite challenging. Your situation, where you have undergone surgery with the placement of titanium plates and screws, is not uncommon. It is important to understand that surgical interventions can indeed affect the surrounding muscles and soft tissues, leading to changes in strength and range of motion.
Firstly, the surgical procedure itself may have caused some trauma to the muscles and soft tissues around the shoulder. This can lead to postoperative pain, swelling, and stiffness, which are common in the initial recovery phase. The fact that you are experiencing difficulty in raising your arm to shoulder level (90 degrees) is not unusual, especially one month post-surgery. It is essential to recognize that healing takes time, and the recovery process can vary significantly from person to person.
The asymmetry you are noticing between your injured shoulder and the uninjured one is also a typical observation during the rehabilitation phase. After a fracture, the muscles around the shoulder may weaken due to disuse, pain, or protective mechanisms that prevent you from using the shoulder normally. This can lead to compensatory movements, where other parts of your body, such as your back, assist in lifting your arm instead of the shoulder muscles themselves. This compensatory mechanism can further contribute to muscle imbalances and may lead to additional discomfort or dysfunction if not addressed.
In terms of rehabilitation, it is crucial to follow a structured physical therapy program tailored to your specific needs. Here are some key points to consider:
1. Physical Therapy: Engaging in a physical therapy program is vital. A physical therapist can guide you through exercises that promote healing, improve range of motion, and strengthen the shoulder muscles. They will likely start with passive range of motion exercises and gradually progress to active exercises as your pain decreases and mobility improves.
2. Pain Management: Managing pain effectively is crucial for rehabilitation. This may involve the use of ice, heat, and possibly medications as prescribed by your healthcare provider. Pain management can help you engage more fully in your rehabilitation exercises.
3. Gradual Progression: It is essential to progress gradually. Pushing too hard too soon can lead to setbacks. Listen to your body and communicate with your therapist about any pain or discomfort you experience during exercises.
4. Monitoring Recovery: Regular follow-ups with your orthopedic surgeon or healthcare provider are important to monitor your recovery. They can assess the healing of the fracture and the integrity of the surgical repair, ensuring that you are on the right track.
5. Home Exercises: In addition to therapy sessions, performing prescribed home exercises is crucial for recovery. These exercises will help maintain mobility and strength in the shoulder.
6. Patience and Realistic Expectations: Recovery from a shoulder fracture can take several months. It is important to have realistic expectations and be patient with your progress. Some individuals may take longer to regain full function, especially if there was significant muscle involvement during surgery.
In conclusion, while it is normal to experience differences in shoulder function and strength after surgery for a proximal humeral fracture, it is essential to engage in a comprehensive rehabilitation program. This will help you regain strength, improve range of motion, and return to your normal activities. If you have concerns about your recovery or if you notice any unusual symptoms, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.
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