Proximal humerus (shoulder) fracture
A fracture is a break in the bone which usually happens as a result of a trauma such as a fall. Fractures in the shoulder tend to heal in around 8 weeks; however the rehabilitation process will often take place over several months.
What is it?
A fracture is a break in the bone which usually happens as a result of a trauma such a fall or car accident. A proximal humerus fracture is a break in the upper arm bone, which forms part of the shoulder joint.
Who does it affect?
Fractures can happen at any age, though they are more common as we age as we tend to fall more, and our bones and muscles become weaker. People with conditions affecting bone health, such as osteoporosis, are also more at risk of a fracture.
What is the treatment?
Most fractures do not require surgery. Following a diagnosis of a fracture, you will usually be provided a sling to wear, however this is often just for your comfort - the more you can start to gently move your arm as pain allows, the better it will heal and feel. You will usually be referred to physiotherapy within the first couple of weeks for advice regarding exercises to prevent the surrounding joints from becoming stiff and to help you gradually return to your usual activities such as driving, work and hobbies. If you have a physical job to return to, you may also be referred for an assessment by an occupational therapist in Group Rehabilitation.
How can I help myself?
You may find taking pain relief such as paracetamol beneficial. You may wish to speak to your GP or a pharmacist if you are unsure what to try, as pain relief may affect any other conditions you have or interact with other medications you are taking.
You may find it helpful to apply a bag of frozen peas or ice pack wrapped in a tea towel for 10 minutes at a time to reduce pain, swelling and bruising. Sleeping propped up with a pillow behind your shoulder can often feel more comfortable.
Smoking slows down the healing process, so cutting down or quitting altogether may help your recovery. If you would like to know more about smoking cessation you can visit Livewell website (opens in new window) >
When can I return to normal activities?
Try to spend as much time as possible out of the sling. You can start using your arm straight away for all light activities, such as washing, dressing and eating. It is helpful to get dressed by placing the injured arm into a sleeve first.
During the first 4-6 weeks avoid lifting anything heavy (for example, a kettle full of water).
You can return to driving once you have discarded your sling, and you have adequate strength and range of movement to control the car safely and comfortably. Most people feel safe to do this around 6-8 weeks.
If you have a desk-based job, you can return as soon as you feel able to. If you have a physical job you will usually be able to return at around 12 weeks.
Proximal humerus exercises and what to expect
Try and spend as much time as possible out of the sling. Here are some exercises you should start trying little and often throughout the day, to get your muscles gently working and prevent your shoulder getting stiff. It is normal for the exercises to feel uncomfortable, but you should avoid pushing into pain. You should hear from the physiotherapy department regarding your first appointment.
You may now begin some more advanced movement exercises, using support to take the weight of your affected arm. As your movements feel easier, you can reduce the amount of support.
6 weeks +
By now in most cases the fracture will have healed, however it is very normal to continue to experience discomfort and difficulties in moving the arm. Do try to move the arm as much as you feel able to, including for activities such as cooking and carrying shopping.