Bony healing occurs usually within 6 to 8 weeks in adults ... Scapular Stabilization a. Scapular clocks b. Scapular retractions (no shoulder extension) Scapula fractures have a high association with concomitant injuries. Low weight, high repetition exercises promote muscle hypertrophy and improve fatigue resistance. Indicated for non-op treatment or ORIF. • Anterior deltoid strength and scapular stabilization • General UE strengthening Cardiovascular Exercises • No restrictions Progression Criteria • DC to HEP References: Godges, Joe, DPT, MA, OCS. Abnormal scapular position or movement, called scapular dyskinesis, is commonly seen in patients with shoulder injury or pain.1–7 There are multiple causes of scapular dyskinesis including bony (e.g. Rehabilitation protocol adopted from the Massachusetts General Hospital Sports Physical Therapy program and the American Academy of Orthopedic Surgeons for non-surgical rehabilitation of clavicle fractures (7,15). Cervical ROM exercises; elbow, wrist, hand ROM; Active elbow flexion/extension; shoulder shrugs and scapula retraction; wall walking or table slides for flexion and abduction (all to as tolerated). To help prevent a recurrence of the injury, your physical therapist may advise you to:Maintain good, upright posture and avoid slouching.Maintain the strength in your scapula and shoulder joint muscles.Use proper athletic techniques when performing sports that require overhead arm movements. Place towel between elbow and side . Rehabilitation Therapy Protocols - Ortho Illinois. Remove the sling for exercises and personal hygiene. Indications: Proximal Humeral Fractures; Clavicle fractures ; Scapula / Glenoid fractures; This protocol is based on maintaining range of movement in the first phase and then gradually building strength in the middle to the last phase. Start the "Initial Exercises" straight away, ideally within the first 72 hours. Research shows that 80-95% of scapula fractures have associated injuries. Moseley JB, Jobe FW, Pink M, Perry J, Tibone J. EMG analysis of the scapular muscles during a shoulder rehabilitation program. Injury. Plaster to immobilise elbow until wound review. ! Your diagnosis is: Scapula (shoulder blade) Fracture The scapula is the triangle shaped bone at the back of the shoulder. The shoulder blade (scapula) is a triangular-shaped bone that is protected by a complex system of surrounding muscles. Scapular fractures usually are sustained as the result of severe trauma. long thoracic or accessory nerve palsy), and muscular dysfunction (e.g. Lie on your back or sit upright in a chair with your arms in front of you relaxed on your thighs. PHASE ONE: 0 – 4 Weeks Post-Injury Program GOALS: 1. Call Injury Express for: • Urgent Care • Walk-In Injury Care. Weeks 4-6. Scapular fractures are often associated with other injuries due to the high energy trauma that is usually the underlying cause: clavicle fracture. sternal fracture. Scapula. When available 196 data was pooled from nine studies that compared the rates of scapula spine fractures between 197 implant designs, the increase in the incidence of scapular spine fractures in the onlay group was 198 not statistically significant (p=0.09). Anatomy The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. Townsend H, Jobe FW, Pink M, Perry J. Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. ***Aquatics PROM after sutures … Prone scapular retraction exercises without weights Biceps and triceps exercises without weight Stairmaster ... Lee, Bong Gun, Nam Su Cho, and Yong Girl Rhee. T-stick in 0-20 deg flexion and 20 deg abduction. Scapula fractures rarely require surgery. A scapula fracture is an uncommon injury. Surgery for a scapular fracture may be recommended when:The angle of the bone causes a deformity in the limb (angular deformity) 3The bone positioning is no longer in its correct, anatomical position (displacement) 3The glenoid socket is fractured, causing instability of the ball and socket jointAdditional bones, such as the clavicle, are fractured 4 The unfavorable scapular anatomy, combined with the complexity of the approaches for fracture fixation, make the treatment challenging, even for experienced surgeons. Early Management: The first 72 hours 2. Express. 1lb limit. Fractures of the scapula are rare and usually associated with high-energy trauma. They are often caused by high energy blunt trauma such as a fall from height. SHOULDER ANATOMY External Rotation Attach theraband to a stable object at waist level Roll shoulders back and down and maintain this position . Please use this protocol and the information below to guide this patient’s rehabilitation. Killers as strength, rehabilitation protocols are allergic to shoulder and a sling clean, and straightening the soft tissue inflexibility, a decrease pain. Complete LSSS failure, Floating shoulder, Ligament repair 3. About. The associated injuries may be multiple and/or life-threatening. (779) 771-7000. NWB. Active flexion in the plane of the scapula to 120 degrees without shrug Gradual restoration of … Scapula fractureStage 2 exercisesStart these exercises 3 weeks post injury and to do 4-5 times a day: Use your other hand to lift your arm up in front of you as shown in ...Active Forward flexion: With your thumb facing up, try to move your arm up, keeping it close beside your body. ... American Journal of Sports Medicine. PHASE IV Week 10+ Advanced progressive resistance exercises Progress to overhead exercises Ice. C-spine AROM. Keep arm in plane of scapula Week 3 – 4 AAROM and Isometrics Week 3 Active Assisted ROM 1. Proximal Humerus Fracture Repair and Rehabilitation. Shoulder Fracture Fixation. Many muscles elicited by the arm will talk with me. 5. AAROM>AROM as tolerated; PROM Goals: FF 120°, ER 50°, IR 50°, Active FF 100°. Begin pulley for flexion and abduction 4. It is also recommended to consult the operative report for further information on the surgical procedure. Tears of muscles that pain and Clinical and radiological examination. 1) An exercise bar, which lets the patient use the uninjured left shoulder to passively move the affected right side. Weeks 6-12. Adam Seidl, MD Highlands Ranch Hospital Assistant Professor (720) 516-4090 Shoulder/Elbow Surgery Inverness Department of Orthopedics (303) 694-3333 University of Colorado Anschutz Medical Campus (720) 848-1900 Rehabilitation Protocol Seated scapular retractions Week 3 – 4 AAROM and Isometrics 1. The socket of the shoulder joint is a part of the scapula. It is also recommended to consult the operative report for further information on the surgical procedure. This is a very common fracture that occurs in people of all ages. You have sustained a fracture to your scapula (shoulder blade). Most series report motor vehicle or motorcycle accidents as the cause of injury in more than 50% of the cases. Summary. ... Scapular retraction Office Visit Call 617-726-7500 to reach your doctor; 617-643-9999 to reach MGH Sports Physical Therapy. • Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day. • Sutures are all underneath the skin and will dissolve on their own. Begin a progressive range of motion exercises as soon as the pain subsides. Strengthening: Begin gentle isometric exercises at four weeks. The sling is usually kept for comfort for the first two weeks with subsequent increase of the shoulder’s range of motion. Bend and a treatment protocol for classification for me and Non-displaced means less than 1cm of displacement and less than 45° of angulation 2. Hold 3 sec. Scapula Body Fracture – ORIF.....27 Humeral Shaft Fracture – Non-Operative .............................................................................28 Humeral Shaft Fracture – ORIF .............................................................................................29 Once the fracture begins to heal it is important to keep the shoulder moving; this stops it becoming stiff. External rotation on side (no resistance). "Effect of two rehabilitation protocols on range of motion and healing rates after arthroscopic rotator cuff repair: aggressive versus limited early passive exercises." It might take a few days practice to feel comfortable with them. Keeping your arm at your side, bend and straighten the elbow, flex the wrist, hand and fingers. Physical Therapy Protocols. Scapular strengthening – prone scapular series (rows and I’s). Scapula Body Fracture – Non-operative. 5,38,47 Coracoid fractures have been reported to account for 0% to 7% of all scapular fractures, based on studies using plain radiography. Arc out which may heal, endurance using a complete range of this site of evidence. Nonoperative Treatment of Proximal Humerus Fracture Rehabilitation Considerations o Usually nonoperative care is selected for those patients O thopae ic institute of Ohio Samir Patel, who are medically unfit for surgery or have a minimally to nondisplaced fracture o Depending on the severity of the fracture the best outcome may Its tendon or from scapular fracture protocol for helping or shoulder region, open reduction of the absence of the deltoid to shoulder. Rehabilitation plan. Rehabilitation Protocol for Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF) ... • Scapular retraction and mobility exercises Criteria to Progress ... displaced proximal humerus fractures in the elderly: A prospective study. Three times a day. 4. Begin gentle Theraband resistive exercises at five weeks. Each shoulder blade lies on the upper aspect of the back of the rib cage. Scapular fractures can be categorized by the affected region of the bone: namely, the coracoid, the acromion, the glenoid, the scapular neck, and the scapular body. Treatment: The majority of fractures are treated non-operatively. Associations. This case report describes the physical therapy intervention for a patient with an open reduction and internal fixation of a scapula fracture with decreased shoulder strength, Description. The scaphoid begins ossification around the 4th year of age and may be earlier in females than males. Emphasize scapular strengthening under 90°. Continue passive ROM and scapular exercises. AAROM>AROM as tolerated; PROM Goals: FF 120°, ER 50°, IR 50°, Active FF 100°. Begin pendulum (Codman) exercises 3. Most fractures of the scapula can be treated without surgery. Scapula fractures are frequently the result of high-energy trauma thus there should always be concern for associated injuries and a complete physical exam should be performed. Clavicle fractures are very common injuries in adults (2–5%) and children (10–15%) and represent the 44–66% of all shoulder fractures. Physical Therapy While you are wearing the sling, you will likely lose muscle strength in your shoulder. As stated, high speed automobile accidents, blunt trauma, or significant fall are some of the causes of a Scapula Fracture or Broken Shoulder Blade. Treatment involves immobilization with a sling or a shoulder immobilizer, icing and pain medications. Protect Clavicle: Arm sling for 6 weeks 2. Educate patient to mobilize neighboring joints immediately (elbow, forearm, hand) Prevent shoulder stiffness with exercises (10x each set, repeat 4-5x/day) for: Shoulder retraction. Forward Flexion. The scapula, or shoulder blade, is the triangular-shaped bone on each side of your upper back. rib fracture. Non-operative treatment in the form of sling immobilization followed by rehabilitation is indicated for the vast majority of scapula fractures. Frequency: 1 set. Limited by pain. Pendulum (forwards/backward, side to side, and circles) After 3 weeks of healing: progress to light ADL activities.

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