Rehabilitation Therapy Protocols - Ortho Illinois. Tears of muscles that pain and 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. To date, it is not clear how these | Low weight, high repetition exercises promote muscle hypertrophy and improve fatigue resistance. Scapular Stabilization a. S/L scapular clocks b. American Journal of Sports Medicine. Int J Shoulder Surg. Positioning full time in sling with abduction pillow. 1lb limit. The associated injuries may be multiple and/or life-threatening. Goal: Increase strength of scapular stabilizing . The scapula joins with the long bone of the upper arm (humerus) to form the shoulder joint (figure 1). Clinical and radiological examination. 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. Scapula fractures are not very common. PHASE IV Week 10+ Advanced progressive resistance exercises Progress to overhead exercises Biceps Tenodesis Protocol Biceps Tenotomy Protocol Capsular Release and Comprehensive Arthroscopic Management Latarjet (Anterior Stabilization of the Shoulder) Protocol Latissimus Dorsi Tendon Transfer Protocol Open Shoulder Anterior Stabilization Posterior and Posterior Inferior Capsular Shift Protocol About. Begin gentle Theraband resistive exercises at five weeks. 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. 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. ! Summary. 1lb limit. FRACTURES JOINT REPLACEMENT SPORTS MEDICINE CLAVICLE FRACTURE ORIF PROTOCOL (Dr. Sean Griffin) Weeks 1-3 Full time in sling Avoid IR behind the back, lifting more than 1-2 lbs, and horizontal adduction. size of surgery. 5. Scapular retraction Office Visit Call 617-726-7500 to reach your doctor; 617-643-9999 to reach MGH Sports Physical Therapy. 1992;20;128-134. Prone scapular retraction exercises without weights Biceps and triceps exercises without weight Stairmaster Lee, Bong Gun, Nam Su Cho, and Yong Girl Rhee. 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. ! Remove the sling for exercises and personal hygiene. Gently lift your arms straight out in front of you, perpendicular to your torso. Emphasize scapular strengthening under 90. Scapula (Shoulder Blade) Fractures. rib fracture. Scapula fractures rarely require surgery. Try not to aggravate it. Remove the sling several times a day. brachial plexus injury. AAROM>AROM as tolerated; PROM Goals: FF 120, ER 50, IR 50, Active FF 100. Rehabilitation Protocol: Post-Operative Cervical Spinal Fusion Department of Neurosurgery Lahey Hospital & Medical Center, Burlington 781-744-7580 Lahey Neurosurgery at Emerson Hospital 978-287-3194 scapular-thoracic re-education (shoulder shrugs, shoulder rolls, Many muscles elicited by the arm will talk with me. A clavicle fracture is also known as a broken collarbone. You have sustained a fracture to your scapula (shoulder blade). The unfavorable scapular anatomy, combined with the complexity of the approaches for fracture fixation, make the treatment challenging, even for experienced surgeons. Weeks 6-12. Scapula Body Fracture Non-operative. Most commonly the body of the scapula is involved and nonoperative management remains the mainstay of treatment for these fractures [].As these patients are usually high-demand young adults, it is important to ensure treatment will have a Call Injury Express for: Urgent Care Walk-In Injury Care. Motion: Continue pendulum ROM exercises. Ice. PHASE ONE: 0 4 Weeks Post-Injury Program GOALS: 1. long thoracic or accessory nerve palsy), and muscular dysfunction (e.g. It is also recommended to consult the operative report for further information on the surgical procedure. Plaster to immobilise elbow until wound review. Scapular fractures occur relatively infrequently, accounting for 0.4% to 1.0% of all fractures. Strengthening: Begin gentle isometric exercises at four weeks. Associations. Forward Flexion. spinal fracture. Depending on how severe the fracture is, you might need to start exercises within a week after the injury, while others require two to four weeks before beginning the exercises. Whats Causing Unstable Shoulders?Use it or lose it! The sad truth is, most of us dont learn how to control or use our scapulae properly. Posture. Surprise, surprise! Overtraining. Overtraining certain exercises, although likely done in an attempt to stay fit, can actually contribute to shoulder instability.Misinformation. Seated scapular retractions Week 3 4 AAROM and Isometrics 1. This step-by-step guide is similar to a shoulder program your PT may use during your rehab to help you get control of your scapula. 2. 0-3 Wear the sling all the time - even in bed at night. Passive ROM > 90 degrees after week one. Anterior deltoid strength and scapular stabilization General UE strengthening Cardiovascular Exercises No restrictions Progression Criteria DC to HEP References: Godges, Joe, DPT, MA, OCS. Physical therapy is a part of any treatment approach to proximal humeral fractures with few guidelines available as to staging of interventions to maximize range of motion, strength, and optimize activities of daily living. Keep arm in plane of scapula Week 3 4 AAROM and Isometrics Week 3 Active Assisted ROM 1. May begin scapular retraction and depression *Sling Arm in sling at all times for 2 weeks except for exercises and bathing (includes nighttime) Other Continue Cryotherapy Incision mobilization and desensitization Modalities to decrease pain and inflammation !1 Shoulder Fracture ORIF: Postoperative Protocol It is also recommended to consult the operative report for further information on the surgical procedure. Keeping your arm at your side, bend and straighten the elbow, flex the wrist, hand and fingers. Bending over to perform pendulum exercises is recommended 3 Fractures of the scapula are rare and usually associated with high-energy trauma. 6. Scapula. The 1) An exercise bar, which lets the patient use the uninjured left shoulder to passively move the affected right side. Bony healing occurs usually within 6 to 8 weeks in adults Scapular Stabilization a. Scapular clocks b. Scapular retractions (no shoulder extension) Rehabilitation Scapular Winging SC Joint Shoulder Arthroplasty Shoulder Instability ST 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. Proximal Humerus Fracture Rehabilitation Protocol Your shoulder rehabilitation program begins while you are in the hospital. Main (815) 398-9491. 4. Express. External rotation on side (no resistance). Proximal Humerus Fracture Repair and Rehabilitation. 2013 Jul;7(3):105-9. doi: 10.4103/0973-6042.118911. 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 Passive flexion and ABD to 90, ER as tolerated at 0 ABD, IR to as tolerated. 2. Early Management: The first 72 hours ! Early rehabilitation should aim to improve the endurance and strength of the scapular stabilizing muscles. Used for sleeping only for weeks 6-8. Attachments and scapula fracture treatment protocol for scapula fractures dictate an improved understanding of the bones at. Treatment: The majority of fractures are treated non-operatively. Killers as strength, rehabilitation protocols are allergic to shoulder and a sling clean, and straightening the soft tissue inflexibility, a decrease pain. 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 As a result, diagnosis and treatment of scapular injuries may be delayed or suboptimal. Your diagnosis is: Scapula (shoulder blade) Fracture The scapula is the triangle shaped bone at the back of the shoulder. DNF and proper postural positioning with all RC/SS exercises. Scapular fractures are often associated with other injuries due to the high energy trauma that is usually the underlying cause: clavicle fracture. 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). Use the sling for the first three weeks to allow the soft tissues to settle. Begin active-assisted ROM progressing to active ROM in all planes. Weeks 4-6. The scaphoid begins ossification around the 4th year of age and may be earlier in females than males. Bend and a treatment protocol for classification for me and Repeat 12 -15 times . C-spine AROM. The scapula, or shoulder blade, is a wide, flat bone that sits behind the rib cage. Townsend H, Jobe FW, Pink M, Perry J. Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. Start the "Initial Exercises" straight away, ideally within the first 72 hours. Begin active motion in plane of scapula, AAROM pulleys, sub-max pain-free isometrics in neutral, scapular Rate of recovery and the prognosis from scapular fracture will depend on a number of factors: Severity Minor fractures do well with immobilization and physical therapy, while fractures that are more severe and require surgery or effect joint integrity take longer to recover.Patients may have residual motion and strength deficits, especially if the rotator cuff is Low to moderate cardiovascular work. The Scaphoid bone is one of 8 carpal bones in the wrist. 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). Physical Therapy While you are wearing the sling, you will likely lose muscle strength in your shoulder. Sutures are all underneath the skin and will dissolve on their own. Clasp your hands together, straighten your elbows, and relax your affected shoulder. Scapula Body Fracture ORIF..27 Humeral Shaft Fracture Non-Operative ..28 Humeral Shaft Fracture ORIF 29 fracture), neurologic (e.g. ***Aquatics PROM after sutures the age of the patient. 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 Active flexion in the plane of the scapula to 120 degrees without shrug Gradual restoration of Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day. Moseley JB, Jobe FW, Pink M, Perry J, Tibone J. EMG analysis of the scapular muscles during a shoulder rehabilitation program. Most fractures of the scapula can be treated without surgery. Indicated for non-op treatment or ORIF. 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 Anatomy The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. Each shoulder blade lies on the upper aspect of the back of the rib cage. Fixation of Proximal Humerus, Clavicle, Scapula and Glenoid fractures. Olecranon Fracture Rehab Protocol. Day 1 - 3 weeks Begin pulley for flexion and abduction 4. Lie on your back or sit upright in a chair with your arms in front of you relaxed on your thighs. Injury. As stated, high speed automobile accidents, blunt trauma, or significant fall are some of the causes of a Scapula Fracture or Broken Shoulder Blade. SHOULDER ANATOMY External Rotation Attach theraband to a stable object at waist level Roll shoulders back and down and maintain this position .