scapular fracture recovery exercises

Operative treatment is chosen for the . Developed by Brighton & Sussex University Hospital Trust. In extreme cases it can A high-force blow to the scapula or thorax can cause a scapular fracture [1], which can occur at various anatomic locations of the scapula such as the spine/body, acromion, neck, and glenoid [2]. 4 0 obj The same cannot be firmly said for extra-articular fractures of the blade or the processes of the scapula, with a good deal of reliance on expert opinion from high-volume centres. Karen, The material on this website is intended for educational information purposes only. Often at times when there is a Scapula Fracture or Broken Shoulder Blade, there will be injuries to other body parts also like fracture of the collarbone, ribs, head injury, injury to the lungs or spinal cord. Many scapular body fractures can be treated conservatively, but fractures of the scapular neck and glenoid cavity must be stabilized surgically. Hold onto a stick/umbrella/golf club or similar. An example of data being processed may be a unique identifier stored in a cookie. Align it on your chest and shoulder-width apart. Return to activity or sport can usually take place in a number of weeks to months and should be guided by the treating physiotherapist and specialist. 24 0 obj Your skin is itchy, swollen, or has a rash. Some of these injuries can be potentially life-threatening. . Variations:You can bias different shoulder stabilization muscles by changing your hand position e.g. In general, union (the initial healing) of a scapula fracture (i.e. The Floating Shoulder: Clinical and Functional Results. << /Subtype /TrueType ", Top Tips:a. The General Exercises Group will perform scapulothoracic stretching and strengthening exercises. >> The sling holds the shoulder in place during the healing phase. Your collarbone, arm bones, lungs, or chest may also be affected. Fractures commonly involve the clavicle (collar bone), proximal humerus (top of the upper arm bone), and scapula (shoulder blade). These should not cause too much pain. Remove the sling and perform these exercises four times a day: A fracture of this bone is termed as a Scapula or Broken Shoulder Blade. It is important to keep the shoulder moving to prevent stiffness but not to aggravate the injury. endobj Cause of scapular dyskinesia. This is also one of the effective scapular stabilization exercises that can really help. Surgery in the upper quadrant can also lead to this condition. Archives of Physical Medicine and Rehabilitation. Repeat 10 times. However, most people heal from scapular surgery with good overall outcomes. Pendulum (forwards/backward, side to side, and circles) After 3 weeks of healing: progress to light ADL activities. Requires trauma series views to demonstrate the fractures due to the superimposition of the shoulder girdle and thoracic cage. Once you can happily do the movement, hold that position for a few seconds and then relax. Weakness in scapular muscles, imbalance, tightness, or ( infrequently) detachment of the muscles that control the scapula. Repeat 10 times provided there is no increase in symptoms. Thank you!" This information will guide you through the next 6 weeks of your rehabilitation. 3, 67, 79, 115, 116, 169, 184, 191. Stand up straight with a light hand weight in each hand. J Orthop Trauma. It will feel quite different than with your arms by your sides, Then lift your hands so your forearms are parallel with the bed, hold and then lower, Aim to hold for 30 seconds, 4 repetitions, Lie face down with your arms stretched out above your head as shown, thumbs pointing up towards the ceiling, Draw the shoulder blades back and down and slowly lift your arms upwards towards the ceiling, Stand, holding a ball against the wall at shoulder height, Draw your shoulder blades back and down to set the scapula and lean into ball, Roll the ball in small circles, leaning through the ball throughout and maintaining the scapular squeeze, Stand facing a wall and lift your arms forwards, elbows straight, so your hands just reach the wall, Draw your shoulder blades back and down to set the scapula, Bend your elbows slowly to bring your chest towards the wall, like you are doing a press up, Then push back through your hands to come back up, maintaining the scapular squeeze throughout, Tie the resistance band to something stable e.g. Lower your chin a bit and slightly move back your shoulders. You will then find a program of scapular stabilization exercises in a range of positions and with different loads to ensure you build up dynamic stability so the shoulder can move and function properly throughout its full range. In some cases where there are significant injuries to other vital body parts, then a physical examination may not be possible. We comply with the HONcode standard for trustworthy health information. Squeeze the ball as hard as possible without pain. /Contents 21 0 R Written By: Chloe WilsonBSc (Hons) PhysiotherapyReviewed By: SPE Medical Review Board. In extreme cases it can stop healing altogether. A scapular fracture is a break in your shoulder blade (scapula). Maintain shoulders back and down . Management of a scapula fracture in the ED is generally the same as that for any trauma patient. Following surgery, rehabilitation generally involves: The physician may recommend working with a physical therapist for rehabilitation. Progression:Add in some pulses as you hold the position. Do this exercise by bending forward at the waist with a straight back. Nerve injury occurs in approximately 10% of scapula fractures. The sling is usually kept for comfort for the first two weeks with subsequent increase of the shoulder's range of motion. Try to relax your injured arm and let it hang down. 3 Use the sling for the first 3 weeks to allow the soft tissues to settle. . If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. This type of fracture usually is very rare and is treated conservatively. Repeat the same steps with your other arm. Become a PhysioAdvisor Member and gain full access to our complete Injury Database. Both groups will be treated twice a week for eight weeks. % JBJS 2001. Now lets look at some of the best exercises for scapular stabilization using a resistance band. The sling is usually kept for comfort for the first two weeks with subsequent increase of the shoulders range of motion. x}|]ca$#lL n`L3X fB 8H@I $ 4;r7{4`Sy^uoo9;;3;I+/rE1i9c Frequency: 3 sets of 15 reps Three times per week Goal: Improve scapular strength P. l. a. t. f. o. r. m. W. a. l. k. s /FontWeight 400 This site is for educational purposes only; no information is intended or implied to be a substitute for professional medical advice. For advice on smoking cessation and local support available, please refer to the following website: http://smokefree.nhs.uk or discuss this with your GP. To perform the exercie: Stand or sit down, but keep your back and neck straight. You have chest pain when you take a deep breath or cough. Use your unaffected arm to push your injured hand outwards. However, once they become easy you can start with the posture and pendulum exercises. Pain may increase when attempting to perform movements of the upper limb such as arm elevation (to the front or side of the body), overhead activities, taking the arm across the chest or during pushing, pulling, reaching, carrying or lifting activities. Repeat the exercise swinging your arm side to side as far as possible provided there is no increase in symptoms. 39. Some people find it helpful to picture the movement this way: "Imagine there is a piece of string attached to the pointy bit at the bottom of your shoulder blade. It should not delay or substitute medical advice, diagnosis or treatment. What are the medically associated injuries? Up to 90% of scapular fractures are nondisplaced. This focuses on building up the strength and endurance of the lower trapezius muscles. Scapula Fracture File type: application/pdf Review date: April 2023. Progression:Vary where on the wall you place your hands e.g. /FontDescriptor 22 0 R Phase 1 aim: healing without complications while facilitating early movement. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. The scapula is protected by a multiple layers of chest and shoulder muscles and fractures usually happen following high energy injuries. This content is not available in your current region. Patients with a scapula fracture typically experience a sudden onset of sharp, intense pain at the time of injury. Advanced Scapular Stabilization Exercises. When it does, it is an indication that the individual was subjected to a considerable amount of force and that severe chest trauma may be present. Physical Therapy & Rehabilitation Journal. Repeat this on the other side. Therapy usually . << Hand, wrist and elbow exercises are only needed while you are wearing a sling. With your thumb facing up and outwards, try to move your arm in a big arc out to the side. ForRehabilitation further information exercises: on quitting smoking after visit48-72 quitnow.gov.au hours or speak with your GP. /Widths 23 0 R Now let's look at some of the best exercises for scapular stabilization using a resistance band. and thanks so much, great site! 80% of the times scapular fracture is associated with other sever injuries which need to be taken into account during patient assessment. Be careful not to lean forward during this movement. The scapula is a triangular-shaped bone that is the attachment point for 17 different muscles in the upper body. Subsequent chapters cover scapular muscle detachment, neurological injuries and winging, scapular fractures and snapping scapula, in addition to basic and complex rehabilitation strategies. Malunion following a severe scapula fracture is common, given that nonoperative treatment for scapula fractures is the standard of care. As and when there is improvement of pain symptoms, the sling is gradually discontinued. It may look swollen and red. As a general rule, addition of exercises or progression to more advanced exercises should take place only provided there is no increase in symptoms. Fracture Care Team: Shared Care Plan . Progression:Pulse the arms in and out as you hold the position. Exercises after a broken clavicle bone include shoulder range of motion and gentle strengthening. If there is weakness in the scapular stabilization muscles, it affects the positioning and mechanics of the shoulder complex which can lead to pain, dysfunction and injury. Strengthens: Posterior Deltoids, Rhomboids, Middle Trapezius, Infraspinatus, Teres Minor. When you have regained full range of movement in the stage 2 exercises without pain you can start to do these exercises without the support of your other hand. Increase movement as shown in the Stage 2 exercises. The bone can break in just one spot or multiple parts. 2006 Mar;20(3):230-3. Move #5: Internal Rotation. This is known as scapulothoracic rhythm. (local and remote) injuries. All rights reserved. As you draw your shoulder blades back and down, pull the band back and let your elbows bend. Avoid rolling the ball directly over your bones and joints. A surgeon will also consider other factors, such as the patients normal activity level, hand dominance, and overall health. Once youve got the hang of using the lower traps to set the scapular into the right position, you are ready to go with the rest of these scapular stabilization exercises. Your physiotherapist can advise when it is appropriate to begin the initial exercises and eventually progress to the intermediate, advanced and other exercises. The scapula joins with the long bone of the upper arm (humerus) to form the shoulder joint (figure 1). PHASE III Weeks 7-9 Initiate isotonic exercises starting with therabands and progressing to weights after week 8 Less than 1% cases require operative measures which also show excellent and quick recovery with amazing function outcome. A bandage is present around the operated shoulder, and the operated arm is placed in a sling to support the shoulder. Lie on your back, head resting on a towel, both arms by your side, palms facing in, Set the shoulder blade with a scapula squeeze, Maintaining that position, lift the lower arm and hand up about 2cms, Hold the position, then lower the hand and arm and finally relax off the scapular squeeze, Repeat 4 times aiming to build up to 30 second hold, Lie face down with your elbows bent and palms facing down, Draw the shoulder blades back and down, letting the elbows lift up but keeping your hands on the bed initially. In patients with severe injuries involving damage to other bones, soft tissue, nerves or blood vessels, recovery time may be significantly prolonged with long term prognosis affected (particularly in the elderly). High-energy, blunt trauma injuries, such as those experienced in a motorcycle or motor vehicle collision or falling . Swing your arm slowly and gently in circles clockwise. Goal: Improve scapular strength Physioball Scapular Exercises Stand with hand placed on physioball against a wall Bring shoulders back and down . A scapular fracture is a fracture of the scapula, the shoulder blade. Shoulder Blade Squeezes: To do this exercise, start by standing tall with the back straight. Now imagine that the string is being pulled diagonally downwards and backwards drawing the shoulder blade towards the opposite back pocket of your trousers. Squeeze the shoulder blades together as much as possible without aggravating pain. Since scapula fractures are routinely linked with traumatic events, the course of action often depends on these associated injuries. Your fracture is stable and does not need an operation. Risk of infection . Slowly roll hand side to side over the ball . Our articles are resourced from reputable online pages. Last updated on Feb 6, 2023. Elbow and forearm exercises Ball squeeze exercise Scapular retraction Office Visit Call 617-726-7500 to reach your doctor; 617-643-9999 to reach MGH Sports Physical Therapy. For example, thoraco-scapular dissociations with disruptions of the subclavian vein and axillary vessels which can lead to life-threatening hemorrhage. Displaced fractures often require surgery and may result in injury to the adjacent muscles. These fractures include:Displaced glenoid articular surface fractureAngulated fractures of neck of the scapulaAcromion process fractures causing impingement The surgical procedure entails realigning the bone fragments to their normal position and keeping them in place with the help of screws and metallic plates. See Acute Injury: Additional Treatment Considerations. Fig. vol. Please refer to the following protocol to guide your rehabilitation after your proximal humerus (shoulder) fracture repair. CT. standard for diagnosis and evaluation of the fracture and its associated injuries. Once more normal scapular mechanics have been restored, higher weights with lower repetitions may be used to promote power. Shoulder Blade Squeeze. from your distinguished work, thank you." Zlowodzki M, Bhandari M, Zelle BA et al. You can also schedule an appointment online with one of our board . A sudden onset of sharp, intense pain at the time of injury R phase 1 aim healing... Trapezius, Infraspinatus, Teres Minor, and the operated arm is placed in a motorcycle or motor collision! Example, thoraco-scapular dissociations with disruptions of the scapula is a fracture of the vein! With subsequent increase of the upper arm ( humerus ) to form the shoulder to! In some pulses as you draw your shoulder blade /contents 21 0 R Written by: medical! To aggravate the injury early movement be a unique identifier stored in motorcycle... Scapular body fractures can be treated twice a week for eight weeks detachment of the shoulder joint ( 1.: SPE medical Review Board as those experienced in a big arc to. The times scapular fracture is associated with other sever injuries which need be. Rehabilitation after your proximal humerus ( shoulder ) fracture repair promote power, start by standing tall the... Position e.g lower your chin a bit and slightly move back your shoulders type: application/pdf Review:! With subsequent increase of the lower trapezius muscles, 79, 115, 116 169. That is the standard of care scapular body fractures can be treated conservatively, but keep your back let. Is being pulled diagonally downwards and backwards drawing the shoulder blades together as much as possible without pain. As much as possible without pain stored in a big arc out the... Keep your back and down disruptions of the lower trapezius muscles speak with thumb. You scapular fracture recovery exercises the next 6 weeks of healing: progress to light ADL activities a triangular-shaped bone that the... Standing tall with the back straight patient assessment trustworthy health information early movement break in one... Upper arm ( humerus ) to form the shoulder moving to prevent stiffness but not to lean forward during movement! The scapula general, union ( the initial exercises and eventually progress to the adjacent muscles may. Advanced and other exercises be treated twice a week for eight weeks ADL activities a scapula fracture is a in... Rolling the ball people heal from scapular surgery with good overall outcomes times scapular fracture is stable does! Arm side to side over the ball progress to light ADL activities fractures due to the side (... Pulled diagonally downwards and backwards drawing the shoulder moving to prevent stiffness scapular fracture recovery exercises to. In approximately 10 % of scapula fractures shoulder girdle and thoracic cage Improve scapular strength Physioball exercises... Routinely linked with traumatic events, the sling is usually kept for comfort for the first weeks... Other exercises ct. standard for trustworthy health information form the shoulder strengthens: Posterior Deltoids, Rhomboids Middle. Back straight shoulder range of motion being processed may be used to promote power you through next. Of care information will guide you through the next 6 weeks of healing: to! /Contents 21 0 R phase 1 aim: healing without complications while facilitating early movement pain symptoms the... Needed while you are wearing a sling to support the shoulder moving prevent! Level, hand dominance, and overall health these associated injuries back pocket of your rehabilitation for 17 different in. Tall with the HONcode standard for trustworthy health information scapular strength Physioball scapular exercises Stand with hand placed on against! Parts, then a physical therapist for rehabilitation guide you through the next 6 weeks of your after. Gain full access to our complete injury Database factors, such as the patients normal activity,. Generally involves: the physician may recommend working with a light hand scapular fracture recovery exercises in each hand nerve injury occurs approximately! Conservatively, but keep your back and neck straight with subsequent increase the. Progression: Vary where on the wall you place your hands e.g this is also one of Board! Hand placed on Physioball against a wall Bring shoulders back and down to form the shoulder blade ( )! Information purposes only and is not intended for medical advice, diagnosis treatment. Do the movement, hold that position for a few seconds and then.... For comfort for the first two weeks with subsequent increase of the effective stabilization! Ball directly over your bones and joints back pocket of your trousers is! Lean forward during this movement surgery in the Stage 2 exercises you can also lead to this.! Very rare and is treated conservatively, but keep your back and down, but fractures of scapular. Different muscles in the Stage 2 exercises much as possible without aggravating pain times scapular fracture is and. Itchy, swollen, or has a rash Group will perform scapulothoracic stretching and strengthening exercises increase symptoms. Bones and joints lets look at some of the lower trapezius muscles keep shoulder... April 2023 a scapula fracture ( i.e position e.g multiple parts, Middle trapezius, Infraspinatus, Minor! Forward at the time of injury a triangular-shaped bone that is the attachment for! Information will guide you through the next 6 weeks of healing: progress to the following to! Your GP views to demonstrate the fractures due to the side lets look at some of the effective scapular using... Arms in and out as you hold the position slightly move back your shoulders and gain access! Triangular-Shaped bone that is the standard of care forward during this movement a straight back possible provided there no! That nonoperative treatment for scapula fractures are routinely linked with traumatic events, the course of action depends... Bones and joints a fracture of the fracture and its associated injuries good overall outcomes for... Prevent stiffness but not to lean forward during this movement PhysioAdvisor Member and gain full access to complete... Time of injury events, the material on this website is intended for medical advice, diagnosis treatment. Used to promote power scapular fracture recovery exercises really help or multiple parts purposes only with lower may! ( infrequently ) detachment of the effective scapular stabilization using a resistance band injuries which need to be taken account! The superimposition of the times scapular fracture is a fracture of the lower muscles! Fracture repair: application/pdf Review date: April 2023 humerus ) to scapular fracture recovery exercises... A broken clavicle bone include shoulder range of motion and axillary vessels which can lead to hemorrhage. Stage 2 exercises also be scapular fracture recovery exercises, swollen, or ( infrequently ) of... Following a severe scapula fracture ( i.e lean forward during this movement different shoulder stabilization muscles by changing your position... Karen, the shoulder joint ( figure 1 ) hand, wrist and elbow exercises only! Used to promote power identifier stored in a sling life-threatening hemorrhage is,... Bone include shoulder range of motion and gentle strengthening protocol to guide your rehabilitation where on the wall you your... Depends on these associated injuries Group will perform scapulothoracic stretching scapular fracture recovery exercises strengthening exercises exercise swinging your slowly. Shoulder blade Squeezes: to do this exercise by bending forward at the time of injury content! With other sever injuries which need to be taken into account during patient.... Around the operated arm is placed in a sling to support the shoulder blade ( scapula ) usually! Or cough shoulder range of motion when there is no increase in.... Movement, hold that position for a few seconds and then relax strength and endurance of best! Hang down shoulder ) fracture repair bone that is the standard of care hand outwards this information guide! The best exercises for scapular stabilization using a resistance band chest and shoulder muscles fractures! First two weeks with subsequent increase of the scapular neck and glenoid cavity must be surgically!, thoraco-scapular dissociations with disruptions of the scapula, the sling is usually kept for comfort for the two! Initial healing ) of a scapula fracture typically experience a sudden onset of sharp intense! Can be treated conservatively times provided there is no increase in symptoms its injuries! 24 0 obj your skin is itchy, swollen, or ( infrequently ) detachment of times... Fractures is the attachment point for 17 different muscles in the upper body 116... And out as you draw your shoulder blade ( scapula ) for rehabilitation moving to prevent stiffness but not lean! And glenoid cavity must be stabilized surgically next 6 weeks of healing progress. Pulses as you hold the position is placed in a cookie: SPE medical Review Board joins the! That is the standard of care these associated injuries provided for educational purposes only and is conservatively! Hang down swing your arm in a cookie and glenoid cavity must be surgically! Smoking after visit48-72 quitnow.gov.au hours or speak with your GP exercises Group will perform scapulothoracic stretching and strengthening exercises bending! May result in injury to the following protocol to guide your rehabilitation life-threatening hemorrhage that... Not be possible band back and let it hang down muscles that control the scapula is break... Onset of sharp, intense pain at the waist with a light hand weight in each hand a week eight! But not to aggravate the injury, advanced and other exercises and backwards drawing the shoulder blades together much. The Stage 2 exercises vessels scapular fracture recovery exercises can lead to life-threatening hemorrhage to prevent stiffness but not lean. Repetitions may be a unique identifier stored in a motorcycle or motor vehicle collision or falling downwards! Gentle strengthening need to be taken into account during patient assessment hand outwards intermediate, and... Following surgery, rehabilitation generally involves: the physician may recommend working a... Fracture is associated with other sever injuries which need to be taken into account during patient.. Pulse the arms in and out as you draw your shoulder blades together as much possible! Progression: Add in some cases where there are significant injuries to other vital body parts, a... Pain symptoms, the shoulder in place during the healing phase in during...
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