Ask a PT

156 Posts
 
Posted - 08/13/2007 :  12:16:26  Show Profile  Reply with Quote
Our user asked: "My mom fell and broke her humerus and dislocated her shoulder. She had surgery 6 weeks ago with a rod and clamps to repair the humerus break. Her doctor just took away her sling this past week. He told her that she didn't need any PT but to just get back into her routine, move her arm as normal and her mobility would come back. Well I have been working with her for a couple of days now and everytime she picks up arm to extend it, she picks up her clavicule and then she is lopsided and can't get much extension or movement. She can't seem to lift her arm without the clavicule moving up. I know it's too soon to see any progress but I haven't a clue if I'm doing the right exercises for her. I am writing all this because I would like to ask what exercises would be good for her. And if she will be able eventually to lift her arm without her shoulder going up also. I would also like to ask if she should have PT. I can't understand why the doctor told her she didn't need it. Thanks for any advise."

Ask a PT Response: "I am a strong believer for PT expecially after this type of injury/surgery. You mention your mother is elevating her shoulder girdle when she is attempting to bring her arm up. This is often quite common after a shoulder injury/surgery. This is a compensatory pattern to help the patient achieve more range of motion when the GH (shoulder joint) is affected. It is very important to maintain or improve the range of motion of the shoulder after this type of surgery to avoid adhesive capsulitis(frozen shoulder). Should frozen shoulder develop function and quality of life can be greatly reduced. Usually after this type of surgery a physical therapist's plan of care can include and is not limited to: hotpack, Codman's (pendulum exercises), seated GH AAROM exercises on a table, AAROM exercises with the patient lying down, GH isometric strengtheing exercises, pulleys and ice pack. Examples of these exercises can be found on the CyberPT exercise video page. These exercises can be painful for the patient, and the therapist usually performs them to the patient's tolerance. Often times if a physician does not order physical therapy initially, the patient can request it and they will oblige. In your case, from what you have written, I think it would be beneficial for your mother to participate in PT so that you can maximize her recovery time and return to her prior level of function. Good luck with your mother's rehab and please feel free to contact me should you have any further questions."