Distal clavicle closed fracture - surgical intervention - no longer requires immobilization - but unable to lift arm?
Hello, Doctor! I have a distal clavicle closed fracture and underwent surgery in early November.
On December 17, the doctor said I could stop using the sling.
I have a type of internal fixation with wires.
The doctor mentioned that I can do any movements, just take it slowly and avoid pain, but of course, I shouldn't lift heavy weights! However, I still have some questions:
1.
I currently have a limited range of motion when raising my arm, regardless of the direction, to about 90 degrees or less.
If I try to raise it further, my shoulder becomes very tight and even painful, making it impossible to lift.
Is it advisable to push through this limitation?
2.
The X-ray of the fracture site shows that it has healed together.
Will raising my arm forward, sideways, or backward affect or disrupt the healing process?
3.
The doctor mentioned a follow-up appointment in early February to assess my condition.
In the meantime, can I do rehabilitation exercises on my own, and what kind of exercises should I do to avoid impacting bone growth?
4.
How can I raise my arm straight up without affecting the healing of the fracture?
Thank you for your kind response!
A Cheng, 30~39 year old female. Ask Date: 2015/12/20
Dr. Shi Guozheng reply Orthopedics
Once the fracture has healed, joint mobility exercises can be initiated gradually during rehabilitation.
Typically, recovery can occur as long as the movements do not cause pain in the joint.
Both forward elevation and backward extension movements can be performed.
Reply Date: 2015/12/20
More Info
Recovering from a distal clavicle fracture can be a challenging journey, especially when it comes to rehabilitation. It's great to hear that you've had surgery and are on the path to recovery. Here are some insights and tips that may help you navigate your rehabilitation process effectively.
Understanding Your Condition
A distal clavicle fracture typically occurs at the end of the collarbone, and it can be classified as either closed or open, depending on whether the bone breaks through the skin. In your case, since you had a closed fracture and underwent internal fixation, the healing process will largely depend on how well the bone has aligned and how your body responds to rehabilitation.
Rehabilitation Tips
1. Gradual Progression: It's essential to follow your doctor's advice regarding movement. Since your doctor has indicated that you can perform movements as long as they don't cause pain, it's important to listen to your body. If you experience pain, it's a signal to ease off and not push through it. Pain can indicate that you are stressing the healing bone.
2. Range of Motion Exercises: Start with gentle range of motion exercises. These can include pendulum swings, shoulder shrugs, and wall slides. These exercises help maintain mobility without putting too much stress on the healing area. Aim to perform these exercises several times a day, gradually increasing the range as tolerated.
3. Strengthening Exercises: Once you have regained some range of motion without pain, you can begin to incorporate strengthening exercises. Resistance bands can be a great tool for this. Start with light resistance and focus on exercises that target the shoulder girdle, such as external and internal rotations. Avoid heavy lifting until you have full clearance from your physician.
4. Avoiding Overhead Movements: As you mentioned, lifting your arm above shoulder height is currently limited. It's crucial to avoid any overhead movements that cause discomfort or strain on the shoulder. This includes activities like reaching for items on high shelves or lifting heavy objects.
5. Monitoring Healing: Regular follow-ups with your orthopedic surgeon are vital. They will monitor the healing process through X-rays and assess whether the bone is healing correctly. If you notice any unusual symptoms, such as increased pain, swelling, or a change in the shape of your shoulder, report these to your doctor immediately.
6. Physical Therapy: If you haven't already, consider working with a physical therapist. They can provide a tailored rehabilitation program that focuses on your specific needs and goals. A therapist can also guide you through exercises that promote healing while ensuring you don't overdo it.
7. Home Exercises: You can perform gentle stretching and strengthening exercises at home. For example, wall push-ups can help build strength without putting too much strain on the shoulder. Use a mirror to ensure proper form and avoid compensatory movements that could lead to further injury.
8. Patience and Consistency: Recovery takes time, and it's essential to be patient with yourself. Consistency in your rehabilitation exercises will yield the best results. Set small, achievable goals for yourself to stay motivated.
Conclusion
In summary, your recovery from a distal clavicle fracture involves a careful balance of rest, gradual movement, and strengthening exercises. Always prioritize pain-free movements and consult your healthcare provider before making any significant changes to your rehabilitation routine. With time, dedication, and the right approach, you can regain strength and mobility in your shoulder. Remember, the goal is to return to your daily activities without pain or limitation, so take it one step at a time. Good luck with your recovery!
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