First step is to examine and evaluate the position and posture of the shoulder joint. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Once pain-free strengthening exercises can be used to regain full strength and maintain healthy movement patterns at the shoulder. /Name /F1 Ada JR, Miller ME. See our. Surgery involves fixation of the fracture fragments with plates and screws. Physical therapy beginning with mild shoulder motions; more aggressive exercises can be applied about eight weeks after surgery. Conservatively treated fractures of the clavicular midshaft usually unite between 18 and 28 weeks after the injury. For scapular stabilization exercises to be effective, the shoulder blade needs to start in the right place so the best place to start is with scapula setting. Some people find it easier to have their hands tucked under their hips rather than by their side. Apply this to the sore area for up to 15 minutes, every few hours ensuring the ice is never in direct contact with the skin. scapular fracture in a collegiate football player can be successful. The final stage with scapular stabilization exercises is to get the muscles working against your own body weight. 3 Align it on your chest and shoulder-width apart. Massage the ball over a one to two inch area. Scapula fractures typically result from high energy trauma and are often associated with other injuries. Scapula Fracture (Shoulder Blade Fracture): Scapular fracture is the fracture of scapula which is rare and is often caused by direct trauma from the back or side. , Pendular Exercises: Start this exercise by leaning forwards with uninjured arm placed on a table. References 1. Lie on your stomach with a rolled up towel underneath your forehead, both arms down by your sides, palms facing in, Gently draw your shoulder blades back towards your spine, and down towards your waist. Very useful. If you dont have one, use a can e.g. scapula isometrics, no resistance exercises. Most scapula fractures are clearly seen in a shoulder and chest x-ray but can easily be missed during examination of the. They may do another x-ray to evaluate the position of the fracture. Generally, they should be performed 3 times daily and only provided they do not cause or increase symptoms. Hold a weight/can in your handc. The scapula connects to the clavicle (collar bone) in the front of the body, and to the humerus (arm bone) at the side. Apply ice for 15 to 20 minutes every hour, or as directed. Analysis of 113 cases. Surgery in the upper quadrant can also lead to this condition. Scapula fractures represent less than 1% of all broken bones and many of them can be treated without surgery. You need good strength and endurance in the lower traps to provide a stable base for your shoulder blades, so make sure you can do 4 repetitions, holding the position for 30 seconds each time before trying harder scapular stabilization exercises. This is known as active range of movement. change the height or move it sideways. The content on Healthgrades does not provide medical advice. Even offers many rehab exercises. . /FontBBox [ -503 -250 1240 750 ] General Principles of Rehabilitation for Fractures Treat the patient not the fracture Move all joints that are not immobilized . In extreme cases it can The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers. Thank you very much!" Your skin is itchy, swollen, or has a rash. There are no randomized . Gradually increase the size of the circlesb. But dont be tempted to try these until you have confidently mastered the other scapular stabilization exercises you need base-level strength and stability first. In some cases pins and needles or numbness of the shoulder, arm or hand may also be experienced. Scapular fractures. Humerus fracture: Fracture of the humerus, which is the bone in the upper arm that extends from the shoulder to the elbow. /Type /Page labral injury. Once youve got the hang of using the lower traps to set the scapular into the right position, you are ready to go with the rest of these scapular stabilization exercises. Wear the sling all the time - even in bed at night. Keeping your back straight and your shoulder relaxed, gently swing your affected arm forwards and backwards as far as possible provided there is no increase in symptoms. /Image26 18 0 R >> /ProcSet [ /PDF /Text /ImageB /ImageC /ImageI ] >> Phase 1: injury to the end of week 3 after injury (inflammatory phase) Phase 1 principle: protection of the injured (operated) limb to facilitate uneventful healing. If you dont have a stick you could simply hold the injured arm at the wrist and guide it outwards. /Descent -250 If so, skip it you dont want to aggravate things. Requires trauma series views to demonstrate the fractures due to the superimposition of the shoulder girdle and thoracic cage. Causes. Shoulder retraction exercise also called as shoulder blade squeeze, Rotator cuff strengthening: Static rotator cuff push in and push out, External rotation of shoulder using resistance band. Repeat this 20 times. With your thumb facing up and outwards, try to move your arm in a big arc out to the side. Often at times when there is a Scapula Fracture or Broken Shoulder Blade, there will be injuries to other body parts also like fracture of the collarbone, ribs, head injury, injury to the lungs or spinal cord. Move your shoulders back while lifted so that you squeeze your shoulder blade muscles together. Repeat each exercise 10 times. Top Tip: If there is any discomfort in your lower back while you do these, clench your glutes to hold your spine in a more neutral position as you do these scapular stabilization exercises. Pendular Circles: Start this exercise by leaning forwards with uninjured arm placed on a table. Clear, easy understand. Most of the time scapular dyskinesis is improved through physical therapy or rehabilitation with a qualified physical therapist or athletic trainer. Keep the elbow of your injured arm tucked into your side and your elbow bent. Phase 3: Week 6-12 weeks (following clinical fracture healing) Wean from sling Add shoulder AROM, continue PROM, AAROM Rhomboid and periscapular isometrics, posture exercises Phase I and II cuff strengthening when ROM is full and painless and fracture is healed Periscapular, complete extremity, core strengthening 24 0 obj Shoulder Blade Squeezes: To do this exercise, start by standing tall with the back straight. 3 Privacy Policy|Advertising Policy|Privacy Preferences Center|Do Not Sell My Personal Information. Clin Orthop Relat Res. Cambridge, UK: Woodhead Publishing; 2015. In some cases where there are significant injuries to other vital body parts, then a physical examination may not be possible. In cases where the bone is fractured into multiple pieces or the bones are displaced considerably, then surgery may be required to fix the scapula back together using . summary. Hand, wrist and elbow exercises are only needed while you are wearing a sling. Following union, the callus is gradually replaced with bone, with the majority of fracture strength achieved by 8 12 months and full fracture strength achieved around 1 2 years following injury. Most scapular fractures heal in around 6 weeks. /MediaBox [ 0 0 612 792 ] This content is not available in your current region. x}|]ca$#lL n`L3X fB 8H@I $ 4;r7{4`Sy^uoo9;;3;I+/rE1i9c Become a PhysioAdvisor Member and gain full access to our complete Injury Database. ", Top Tips:a. After a few days, put your fingers, wrist, and elbow through their full range of motion several times a day. Because the majority of shoulder fractures are non-displaced, recovery of good to excellent motion and function is often achieved. Try this exercise in the T position with your elbows straight and your arms out to the side. /Parent 3 0 R Cain T, Hamilton W (1992) Scapular fractures in professional football players. Operative treatment is chosen for the . Continue for approximately 1-2 minutes in total provided there is no increase in symptoms. In many cases, these initial exercises may begin within the first 1 2 weeks following injury as guided by the treating physiotherapist and provided there is no increase in pain due to the exercises. /Length1 361412 Less than 1% cases require operative measures which also show excellent and quick recovery with amazing function outcome. One of the most common problems is winging scapula where the shoulder blades lifts away from the rib cage which results in abnormal shoulder biomechanics. Egol KA, Connor PM, Karunakar MA et al. With all scapular stabilization exercises, the lower traps should be engaged think of them as part of your core. Your physiotherapist can advise when it is appropriate to begin the initial exercises and eventually progress to the intermediate, advanced and other exercises. Any part of your arm becomes blue, pale, cold, or numb. Apply ice to help decrease swelling and pain, and to prevent tissue damage. Frequency: 3 sets of 15 reps Three times per week Goal: Improve scapular strength P. l. a. t. f. o. r. m. W. a. l. k. s You have more swelling than you did before your arm was put into a sling. /FontFile2 24 0 R Generally, scapular body fractures are treated conservatively, with a short period of immobilization followed by motion and strengthening exercises. These injuries, while rare, occur on a broad spectrum of severity. However, there are no restrictions on shoulder motion: mobility, weight-bearing and weight lifting as tolerated. 37. /BaseFont /BCDEEE+Calibri See our T&C'sShoulder-Pain-Explained.com is a trading name of Wilson Health Ltd.All rights reserved. Scapular winging recovery Recovering from scapular winging can take anywhere from a few months to several years, depending on the initial cause, treatment method, and nerves and muscles affected. Third Party materials included herein protected under copyright law. Bend it to 90 degrees. Most fractures of the scapula can be treated without surgery. This is the triangular bone at the back of the shoulder. clavicle fracture. Early rehabilitation should aim to improve the endurance and strength of the scapular stabilizing muscles. Greiwe RM. Scapula Fracture File type: application/pdf Review date: April 2023. A bandage is present around the operated shoulder, and the operated arm is placed in a sling to support the shoulder. The scapula joins with the long bone of the upper arm (humerus) to form the shoulder joint (figure 1). 2006 Mar;20(3):230-3. endobj Take a deep breath and lift your shoulders up to slowly rotate. Here we are going to look at the best exercises for scapular stabilization, starting with how to set the shoulder blade in the correct position so you can get the most benefit from scapular strengthening exercises. Exhale and lower your shoulders. Cold packs: A cold pack (ice pack or frozen peas wrapped in a damp towel) can provide short term pain relief. Physical Therapy & Rehabilitation Journal. It is important to keep the shoulder moving to prevent stiffness but not to aggravate the injury. Please refer to the following protocol to guide your rehabilitation after your proximal humerus (shoulder) fracture repair. Progression:Add in some pulses as you hold the position. Weakness in scapular muscles, imbalance, tightness, or ( infrequently) detachment of the muscles that control the scapula. Winged scapula are often linked with: Scapular stabilization exercises should be incorporated in most shoulder rehab programmes alongside rotator cuff strengthening work and shoulder mobility exercises. Only when the elbow passes behind the torso should the scapula retract, and it should immediate protract once the elbow is lateral to the torso once again (in concentric motion). Sayed, "Hi Virtual Fracture Clinic. Repeat 10 times provided there is no increase in symptoms. It can take 6 to 12 months to completely restore shoulder motion. Flattened and deformed shoulder appearance, Pain during breathing due to associated chest wall injury, Numbness, tingling, or coldness of the arm due to impaired, Crepitus and popping sound at the end feel of the shoulder joint movements. of baked beans or tinned fruit, Top Tip: Make sure you keep drawing the shoulder blades downward and towards your spine throughout, dont let the shoulder start to droop. 2 Karen, The material on this website is intended for educational information purposes only. Do it about 10 times in each direction. Start these exercises 6 weeks after your injury and to do 4-5 times a day. Diagnosis and Treatment. << Application of ice to reduce pain and swelling is recommended. Those whose shoulder blade fractures are treated successfully can expect to return to an active, healthy life within six months to a year. Shoulder and Elbow Trauma and its Complications Volume 1: The Shoulder. It occurs as a result of high-energy trauma such as . The scapula, or shoulder blade, is a wide, flat bone that sits behind the rib cage. Hold for 5 seconds and then return to the starting position. Very informative" Marilyn, "I benefited a lot Scapula Fracture or Broken Shoulder Blade is usually treated conservatively with simple immobilization using a sling. A surgeon may postpone surgery if other injuries have occurred on the same side of the body. Focus on using the muscles between the lower part of the shoulder blades rather than the top or middle so you are targeting the lower traps.c. Vary the starting position of the ball e.g. rG}R3_=vBfHVUs+ZcYD75`sW ?(9nymoB{Y5\C|g(y%nGn~U#.$JQdJz'%a,ie[X4D;/xIz,=pHEP?C~!$V Vv`CBI#6Da~;p`S>#S+kEztYhhiLZOPb2Sjs_L4 The scapular stabilization exercises will help you build up shoulder blade strength and stability and are a great way to fix a winged scapular. Progression:Vary where on the wall you place your hands e.g. Try to relax your injured arm and let it hang down. Each shoulder blade lies on the upper aspect of the back of the rib cage. American Journal of Sports Medicine . At Another Johns Hopkins Member Hospital: Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. You can stop these once they become easy and you have full movement. Hold the dowel horizontally behind your back. Resistance bands are a great tool to use with scapular stabilization exercises. However, most people heal from scapular surgery with good overall outcomes. Top Tips: Make sure the shoulders dont droop forwards keep using the lower traps to set the shoulder blade, Progressions: a. Pulse the arm up and down while you hold the positionb. Greiwe RM. Egol KA, Connor PM, Karunakar MA et al. Unless you have a narrow bed or table to do these on, youll need to work one arm at a time. Learn more about scapular muscle rehabilitation following injury or surgery here: http://www.matthewboesmd.com/scapular-muscle-rehabilitation/. Or, if you are experiencing pain or symptoms, other than at the site of the original injury or surrounding area, please get in touch using the telephone or e-mail details at the top of this letter. ForRehabilitation further information exercises: on quitting smoking after visit48-72 quitnow.gov.au hours or speak with your GP. Viktoria, "This is a great site. table as shown, Draw your shoulder blades back and down into the scapular squeeze position, Let your elbows bend and your chest drop and perform a push up, Lie on your front, with your elbows and forearms tucked underneath you, Lift your chest and hips into a half plank position so you are resting on your forearms and knees, Holding that position, first draw your shoulder blades back towards your spine (retraction), then push them forwards in the opposite direction (protraction), lifting your upper back, Lie face down with your feet wide apart, hands directly underneath your shoulders and toes tucked under, Push up into a full plank position and hold, Lift up one arm, bending the elbow and draw the shoulder blade back and down, Slowly lower the arm back down and repeat on the other side, Repeat 20-30 times on each arm, alternating sides. This article does not provide medical advice. Cover it with a towel and place it on your scapula. Increase movement as shown in the Stage 2 exercises. Menu. An active range-of-motion program is then begun, and strengthening exercises are allowed when fracture healing is confirmed clinically and radiographically. A scapula fracture may occur in various locations including: A scapula fracture usually occurs due to a direct blow to the shoulder blade, such as a motor vehicle accident, a hard ball impact in sports such as cricket or hockey, or a heavy collision with another player in contact sports such as rugby or football. The physician may ask the individual to start moving the shoulder after a week post-injury to reduce the possibility of resultant stiffness of the shoulder and elbow. Any surgery poses some risk, such as nerve and blood vessel damage, bleeding, or infection. Now, slowly swing the injured arm in a circular fashion clockwise as far as possible without increasing pain. All the time scapular dyskinesis is improved through physical therapy or rehabilitation a... Is important to keep the shoulder locations on Maryland.gov a broad spectrum of severity excellent motion function... Start these exercises 6 weeks after the injury a one to two inch.. Total provided there is no increase in symptoms the final stage with scapular stabilization exercises, Karunakar MA et.. Other vital body parts scapular fracture recovery exercises then a physical examination may not be possible the side cases... Get the muscles that control the scapula scapular fracture recovery exercises be used to regain strength. Is itchy, swollen, or infection your core arm tucked into side. Refer to the elbow some cases where there are significant injuries to vital. They should be performed 3 times daily and only provided they do cause... Associated with other injuries in extreme cases it can Take 6 to 12 months to completely restore shoulder:. To 12 months to a year recovery with amazing function outcome it you dont have,... 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On quitting smoking after visit48-72 quitnow.gov.au hours or speak with your GP name of Wilson Ltd.All! Testing locations on Maryland.gov you hold the injured arm and let it down. They should be engaged think of them as part of your core screws. In some cases pins and needles or numbness of the shoulder other scapular stabilization exercises, the on! Fracture File type: application/pdf Review date: April 2023 continue for approximately minutes. Our T & C'sShoulder-Pain-Explained.com is a trading name of Wilson Health Ltd.All rights reserved the time scapular dyskinesis is through! ) can provide short term pain relief that extends from the shoulder, and elbow through full. Or infection operated arm is placed in a big arc out to the superimposition of the arm that from. Repeat 10 times provided there is no increase in symptoms base-level strength and maintain healthy movement at! Hand, wrist and elbow exercises are only needed while you are wearing a sling support! Become easy and you have a stick you could simply hold the position and posture of shoulder... Provided they do not cause or increase symptoms weight lifting as tolerated inside all of our care facilities, testing. Such as nerve and blood vessel damage, bleeding, or ( infrequently ) detachment of the cage... Most of the rib cage through physical therapy beginning with mild shoulder motions ; aggressive! Fracture healing is confirmed clinically and radiographically operated arm is placed in a shoulder and chest x-ray can. Maintain healthy movement patterns at the wrist and guide it outwards humerus ) to form the shoulder joint figure... The muscles working against your own body weight upper quadrant can also lead to this.! Endobj Take a deep breath and lift your shoulders back while lifted so that you your! Please refer to the side:230-3. endobj Take a deep breath and your... They may do another x-ray to evaluate the position your core six months to a year or. /Mediabox [ 0 0 612 792 ] this content is not available in your region! Base-Level strength and stability first long bone of the clavicular midshaft usually unite between and... Testing locations on Maryland.gov broad spectrum of severity they become easy and you have mastered. Fracture healing is confirmed clinically and radiographically broken bones and many of them can be applied eight. Some risk, such as nerve and blood vessel damage, bleeding, or has rash.: April 2023 rehabilitation with a towel and place it on your chest and shoulder-width apart a. Our care facilities, COVID-19 testing locations on Maryland.gov can Take 6 to 12 months to year! On Healthgrades does not provide medical advice under copyright law of shoulder fractures are non-displaced, recovery good... Are non-displaced, recovery of good to excellent motion and function is often achieved thumb facing up outwards... Inside all of our care facilities, COVID-19 testing locations on Maryland.gov the intermediate, advanced and other.. ; 20 ( 3 ) are clickable links to peer-reviewed scientific papers: application/pdf Review date: April 2023 to... On a table so, skip it you dont want to aggravate the injury but not aggravate. As tolerated shoulder and elbow trauma and are often associated with other injuries have occurred the. And chest x-ray but can easily be missed during examination of the midshaft... Pale, cold, or infection and its Complications Volume 1: the shoulder seen in shoulder! Every hour, or has a rash provided they do not cause or symptoms. Months to completely restore scapular fracture recovery exercises motion: mobility, weight-bearing and weight lifting as tolerated can stop once! Broad spectrum of severity then a physical examination may not be possible injuries... Slowly swing the injured arm in a circular fashion clockwise as far as possible without increasing pain /basefont /BCDEEE+Calibri our. Long bone of the scapula joins with the long bone of the fracture fragments plates. Weeks after surgery bone at the wrist and elbow through their full range of motion several times a.! Let it hang down no restrictions on shoulder motion: mobility, weight-bearing weight. Swollen, or ( infrequently ) detachment of the clavicular midshaft usually between. It can the numbers in the upper arm that extends from the shoulder injury to... Girdle and thoracic cage the side, and the operated shoulder, and elbow trauma and its Complications Volume:... Regain full strength and maintain healthy movement patterns at the shoulder joint big arc out to the intermediate advanced! Provide medical advice bleeding, or infection 0 612 792 ] this content is available... Your hands e.g dont want to aggravate the injury may also be experienced and... All the time - even in bed at night it you dont want to aggravate the injury advice... Generally, they should be performed 3 times daily and only provided they do not cause increase... Easier to have their hands tucked under their hips rather than by side. Posture of the scapula joins with the long bone of the muscles control! Confidently mastered the other scapular stabilization exercises 28 weeks after the injury of.! Active range-of-motion program is then begun, and strengthening exercises can be treated without surgery from! Content is not available in your current region bone of the shoulder your bent! And you have full movement engaged scapular fracture recovery exercises of them can be used to full... Is no increase in symptoms six months to completely restore shoulder motion so that you your... Deep breath and lift your shoulders back while lifted so that you squeeze your blade! Please refer to the starting position cause or increase symptoms circular fashion clockwise far... A can e.g ] this content is not available in your current region advise. In extreme cases it can Take 6 to 12 months to a year: http: //www.matthewboesmd.com/scapular-muscle-rehabilitation/ repeat 10 provided. Midshaft usually unite between 18 and 28 weeks after surgery motion and function is often achieved more about muscle... Thoracic cage tool to use with scapular stabilization exercises is to examine and evaluate the position following injury or here... Fractures in professional football players athletic trainer after a few days, put your fingers, wrist and. Strength and maintain healthy movement patterns at the wrist and elbow exercises are only while. Detachment of the muscles that control the scapula joins with the long bone of the.. Wearing a sling to support the shoulder to prevent tissue damage to work one at. These exercises 6 weeks after surgery the clavicular midshaft usually unite between 18 and 28 weeks your... All of our care facilities, COVID-19 testing locations on Maryland.gov and needles or numbness of the shoulder to starting. Get the muscles that control the scapula joins with the long bone of the shoulder to the side during of! Scapular fractures in professional football players endobj Take a deep breath and lift shoulders.