Physiotherapy Plan for Shoulder Fractures

Physiotherapy is essential in the rehabilitation of shoulder fractures to restore mobility, strength, and function. The approach is typically divided into three phases: immobilization, mobility restoration, and strengthening. Below is a detailed plan tailored for shoulder fractures.

Phase 1: Immobilization and Acute Recovery (0-6 Weeks)

Goals:

• Manage pain and swelling.
• Prevent joint stiffness and muscle atrophy.
• Protect the healing fracture.

Interventions:

1. Immobilization:

   • Use of a sling or brace as prescribed by the physician.
   • Encourage gentle hand, wrist, and elbow movements to maintain circulation and mobility in the surrounding joints.

2. Pain Management:

   • Ice application to reduce inflammation.
   • Electrotherapy (e.g., TENS) if needed for pain relief.

3. Passive Range of Motion (PROM):

   • Gentle pendulum exercises under supervision.
   • Gradual, pain-free assisted movement to maintain shoulder joint flexibility.

Phase 2: Mobility Restoration (6-12 Weeks)

Goals:

• Improve range of motion (ROM) in the shoulder.
• Begin gentle strengthening exercises.

Interventions:

1. Active Assisted Range of Motion (AAROM):

   • Wall crawls (fingers walking up a wall).
   • Use of pulleys or a therapist’s assistance for controlled shoulder movements.

2. Active Range of Motion (AROM):

   • Gradual introduction of unassisted movements like:
     • Shoulder abduction and flexion within pain-free limits.
     • External and internal rotation exercises.

3. Strengthening Exercises (Initial):

   • Isometric exercises (contracting muscles without joint movement):
     • Shoulder flexion, extension, and abduction.
     • Scapular stabilization exercises (e.g., scapular retraction).

Phase 3: Strengthening and Functional Recovery (12+ Weeks)

Goals:

• Restore full strength and range of motion.
• Prepare for functional activities or sports.

Interventions:

1. Progressive Resistance Training:

   • Use of resistance bands or light weights for exercises like:
     • Shoulder presses.
     • External and internal rotations with resistance.
     • Rows and lat pull-downs for scapular stability.

2. Functional and Dynamic Movements:

   • Gradual reintroduction of overhead activities (if applicable).
   • Specific exercises tailored to the patient’s daily or athletic needs.

3. Proprioception and Stability:

   • Balance exercises with unstable surfaces (e.g., therapy balls) to improve joint stability.
   • Plyometric exercises for athletes (e.g., medicine ball throws).

General Considerations

• Frequency of Therapy:

  • Initially 2-3 sessions per week, tapering as the patient gains independence.

• Duration of Program:

  • Full recovery may take 3-6 months or longer, depending on the severity of the fracture.

• Home Exercise Program:

  • Incorporate daily exercises to complement in-clinic therapy sessions.

• Monitoring Progress:

  • Regular assessments of ROM, strength, and pain levels.
  • Adjust exercises based on tolerance and milestones achieved.

When to Seek Advanced Care

If the patient experiences increased pain, swelling, or reduced range of motion during rehabilitation, consult the physician or orthopedic specialist for further evaluation.

This structured physiotherapy plan ensures a stepwise recovery while minimizing the risk of complications or re-injury. Let me know if you need detailed exercise instructions or specific visual guides!