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Therapy for upper arm fracture
You may or may not require surgical intervention when you have a broken upper arm bone but it’s necessary to have complete or adequate healing or joining of the ends of the broken bone before physiotherapy begins.
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It’s essential to ensure that there is no mal-union or non-union of the two ends of the upper arm bone before therapy begins as this would provide a poor outcome and cause further injury to the
You may notice that the arm is immobilised – using a cast/POP - for a period of time for healing of the bone to occur.
Investigations – an X-ray may be conducted - are usually performed to ascertain whether adequate healing/joining of the two bones have occurred when the cast is removed after a period of time.
After the bones are joined adequately and the cast is removed, you may experience slight discomfort when you attempt movement in the fingers, wrist, elbow or shoulder.
The discomfort experienced may be as a result of a prolonged period of inactivity in the affected arm and initial treatment may address the discomfort to encourage more movement in the affected arm.
Also the affected arm may feel weak and hence exercises are graduated or progressive over a period of time to slowly build the strength in the arm without causing further injury to the arm.
The plan or goals for treatment depends on the severity and type of fracture and it’s tailored to the individual in order to obtain an optimal outcome.
Some of the goals of therapy include:
• Education about the condition,
• Pain relief
• Improving the limitations in available movement in the affected elbow joint,
• Reducing stiffness in the elbow joint,
• Improving strength in the affected arm,
• Preventing complications or recurrence of the injury and
• Improving the use of the affected arm in daily activities.
Exercises for upper arm fracture
These exercises are performed when there is adequate joining of the two ends of the upper arm bone and it’s safe to begin movements.
The exercises are performed daily and repeated as often as can be tolerated during the day to improve outcome.
The exercises are tailored to the needs of the individual and should not induce or exacerbate pain.
• Lie down with your affected arm placed besides you; gently straighten the elbow of the affected arm so that it touches the bed or the floor.
If you are unable to straighten it completely, you may straighten it to the point that you can tolerate and maintain the position briefly before you bend at the elbow.
In bending the elbow, you should allow your fingers to touch your shoulder but this may prove difficult in the initial stages so you may begin by bending to the point that can be tolerated.
You may alternate between these two movements to improve the range of movements at the affected elbow joint. You need to repeatedly perform the movements during the day to improve outcomes.
This exercise may also be performed while standing. with your back against a wall, allow the affected arm to touch the wall as you straighten the elbow.
• Sit comfortably and place your affected forearm on a table. Slowly turn your forearm in a way that will position your palm to face the ceiling/upwards or to the point you can tolerate and hold the position.
Then turn your forearm so that your palm faces the table and hold the position. You may repeat the movements frequently during the day.
• An aspect of your function that may also be affected as a result of the condition is your ability to firmly grip objects.
You may begin exercises which strengthen the muscles of your hand and forearm using a soft ball. Place the ball in the palm of your hand and gently squeeze the ball, hold for a few seconds before you loosen your grip on it. This can be repeated often throughout the day.
The writer is a Senior Physiotherapist at the37 Military Hospital
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