This booklet gives you advice on how to manage your condition and appropriate exercises that will aid your recovery. It is a guide only and the therapy you receive may vary depending on individual circumstances.
Physiotherapy aims to regain/improve movement, strength and function in your limbs after surgery.
You have a vital role to play in your own recovery and it is important that you follow the advice we give you.
There are many ways of fixing a fracture of the upper arm bone (humerus). Internal fixation is used for more serious and complex fractures where the bone may have difficulty healing properly unless the pieces of broken bone are fixed together with metalwork.
After your surgery there will be a period of time where you will not be moving your arm. The length of time will be determined by your orthopaedic consultant.
Pain Control
- If you have a nerve block your arm will feel numb for a few hours immediately after surgery.
- It is important for your pain to be well controlled at all times such as when lying or sitting, moving in bed, getting in and out of bed and especially when walking.
- If your pain relief is making you feel sick or unwell, please let the ward nurses know or if you are at home notify your GP.
- If your arm is preventing you moving about or doing an activity, you need to ask the nursing staff for pain relief. If you are back home, ask your GP for a pain review.
Ice Therapy
Ice may offer temporary relief of pain by reducing swelling and inflammation that can be a source of pain.
You can apply ice for 12 to 15 minutes every 2 hours to the area of your surgery, making sure it is wrapped up in a damp tea towel.
When using ice make sure you look after your skin. If it remains red and sore after removing the ice, seek medical advice.
Polysling
On returning to the ward following your operation, your arm will be in a polysling. This will support the weight of your arm and help ease any discomfort.
Your consultant will specify how long you need to wear the polysling and when it can be discarded.
In bed, placing pillows under your whole arm so that your hand is just above shoulder level may help reduce swelling and discomfort and help you get to sleep.
During the day you may remove your polysling to carry out certain activities such as washing your face, washing under armpit, eating, drinking and writing. You will be able to do some exercises with the polysling on but for others the polysling will need to be removed.
You will be given the Polysling Management leaflet as a guide to putting the polysling on and off or you can refer to the video by scanning the QR code below:
Putting your Polysling on:
- Have your arms resting across your body.
- Sitting on a bed or chair, rest your arm on a pillow for support.
- Put the polysling on your arm making sure your elbow is as far back as it will go.
- Velcro the strap across your forearm.
- Make sure the strap from the elbow is placed across your back and over your shoulder and not pulling on your neck.
- Clip the buckle or Velcro together at the front of the polysling at the wrist.
Taking your Polysling off:
- Sitting on a bed or chair with your arm resting on a pillow for support.
- Unclip the buckle or Velcro at the wrist and remove the shoulder strap.
- Undo the Velcro strap that lies across your forearm.
- Slowly slide the polysling down, pushing it into the pillow so that you can remove it from your arm.
Washing and Dressing
DO NOT bath or shower for the first 2 weeks after your surgery. You will need to strip wash at the sink in your bathroom. This will keep the dressing and the wound dry and reduce the risk of infection.
It could be difficult washing under your arms. A good way to do this would be to lean forward and let your arm hang towards the floor. This would allow you to wash under your arm without actively moving your arm at the shoulder.
You may require some assistance to wash your back. It is advisable to seek help from family or friends to do this.
Getting dressed might be easier with loose-fitting clothes.
Always lead with your operated arm followed by your non-operated arm. When undressing lead with your non-operated arm followed by your operated arm.
The Wound
The nursing staff will provide information on how to look after your wound.
It is important to keep the dressing in place and wound dry until it is well healed.
Should the dressing start to come away once you are home, please contact your GP or practice nurse so that the wound can be redressed to reduce the risk of infection.
Smoking Cessation
Evidence suggests that smoking can slow down fracture healing times. In extreme cases it can prevent the fracture healing. Giving up smoking during your rehabilitation will most likely aid the fracture healing process.
Exercises
Throughout your rehabilitation always be guided by your pain. It is important you adopt a sensible balance between activity and rest. Try to get to know your limitations.
Do not force your arm into positions of high resistance or significant pain.
You may experience increased discomfort when you first start doing the exercises and/or when introducing a new exercise or trying to progress an exercise. Stop if you do experience severe pain. As previously mentioned, the exercises are to help regain movement, strength and function in the joints and muscles.
It is important to remember that not all operations are the same and the rate of progress/improvement can vary from one person to the next. Rehabilitation can take between 6 to 12 months and in some cases longer.
The exercises should be done slowly and smoothly.
Start with 5 repetitions of each exercise and build up to 10 repetitions. If you find an exercise is easy to do go straight to 10 repetitions.
Repeat 3 times a day for the first 2 weeks or until you are reviewed by the physiotherapist in an outpatient setting.
Postural Awareness/Exercise
Sitting or standing.
Keeping your chin back (make a “double chin”) while looking straight ahead.
Then move your shoulder blades gently back and down.
Hold position for 10 seconds.
Repeat 5 times.
Neck Exercises
Neck flexion
In sitting.
Keeping your chin tucked in.
Gently lower your head down to your chest and return.
Repeat 5 times.
Side flexion
In sitting.
Move your head slowly and gently from side to side.
Repeat 5 times.
Rotation
In sitting.
Slowly and gently turn your head one way and then the other.
Repeat 5 times.
Elbow Exercises
Elbow flexion and extension
In sitting or standing, remove your polysling.
Bend and straighten your elbow as far as you can comfortably.
Repeat 5 times.
Palm up, palm down
In sitting or standing.
You can do this exercise in the polysling if you prefer.
With the elbow bent 90 degrees and kept in at the side of your body.
Turn your palm up to face the ceiling and then down to face the floor.
Repeat 5 times.
Wrist and hand exercises
You may keep your arm in the polysling for these exercises.
Wrist flexion and extension
In sitting, gently flex and extend the wrist.
Repeat 5 to10 times.
Grip strengthening exercise
In sitting, make a full fist then stretch your thumb and fingers out wide.
Repeat 5 to10 times.
Squeeze a bath sponge or sponge ball as hard as you can and then let go.
Repeat 5 to10 times.
Shoulder Exercises
Assisted shoulder flexion
In sitting, with the good arm supporting the operated arm, gently lift both arms forwards and upwards away from the body.
*Only move the arms to shoulder height and no further.*
Return to starting position, repeat 5 times.
Shoulder flexion
Sitting at a table with a duster or a piece of cloth under your arm.
Slowly and gently slide your arms forwards as far as you can comfortably and then back.
*Do not lean on the table or put weight through your arm.*
Repeat 5 to10 times.
Pendula Exercises
Standing with support of the kitchen counter, table or chair.
Remove your arm from the polysling and let it hang down loosely at the side of your body.
Lean forwards slightly and gently move your arm forwards and back and then in small circles.
Repeat each movement 10 to 20 times.
Active assisted shoulder flexion
Lying on bed.
Interlock your fingers.
Slowly and gently raise your arms up as far as is comfortable.
*Go no further than shoulder height.*
Slowly return to starting position, repeat 5 times.
Resuming normal activities
Timings for returning to functional activities are approximate and may vary depending on the individual. The earliest these activities may commence are:
- Driving: 4 weeks if you feel competent and safe to do so
- Lifting: heavy lifting should not commence for at least 3 months after the operation
- Swimming: breaststroke 6 to 8 weeks. Front crawl 3 months
- Golf: 3 months
- Contact sport: from 3 to 6 months (football, rugby, racquet sports, horse riding) but may be at consultants’ discretion
Note: These are guidelines only. Please ask your consultant or physiotherapist for individual advice.
After your operation you will be followed up in the physiotherapy outpatient department and any questions you have can be answered. If you are worried or have any concerns you can phone the physiotherapy department.
Phone between 8.30am and 4.30pm.
If no-one answers leave a message with your name, date of birth and telephone number and the reason you are calling. We will get back to you as soon as possible.
Contact details
Therapy department, Grantham Hospital, Manthorpe Road,Grantham, Lincolnshire NG31 8DG. Telephone: 01476 464253
Therapy department, Pilgrim Hospital Boston, Sibsey Road, Boston, Lincolnshire PE21 9QS. Telephone: 01205 445494
Therapy department, Lincoln County Hospital, Greetwell Road, Lincoln, Lincolnshire LN2 5QY. Telephone: 01522 573945
Therapy department, County Hospital Louth, High Holme Road, Louth, Lincolnshire LN11 0EU. Telephone: 01507 631234
Therapy department, Skegness Hospital, Dorothy Avenue, Skegness, Lincolnshire PE25 2BS. Telephone: 01754 613516
You can contact your consultant via the hospital switchboard if required.