Proximal Humerus ORIF
Download this rehabilitation protocol (PDF)
For patients and physiotherapists.
Week 0-2
Aims:
- Pain control
- Protect fixation
- Allow the wounds to heal
- Maintain overall mobility
Suggested treatment:
- Arm in sling
- Pain relief
Week 2-6
Aims:
- Wean out of sling
- Aim to regain PROM
- Minimal pain
Suggested treatment:
- Gradual increase range
- Commence with passive ROM, no restriction in this range
Restrictions:
- No heavy lifting/weight bearing on repaired side
- Lifting lighter objects (eg phone/cup) permitted
Week 6-12
Aims:
- Minimal pain
- Increased active ROM
- Wean out of sling completely
- Return to most normal activities
Suggested treatment:
- Progression in AROM
- Strengthening exercises including cuff strengthening
Restrictions:
- No heavy lifting
Week 12 and beyond
Aims:
- Protect fixation
- Improve endurance/power
- Return to higher demand activities
Suggested treatment:
- Commence isometric exercises
- Strengthening
- No lifting restriction
Some General Questions
What to expect after surgery:
- Most patients will stay a night post operatively
- After you wake up, you might notice some numbness to the forearm and fingers of the operated hand. This may be secondary to local anaesthetic and will wear off over 48-72 hours.
- The next morning, you will be seen by the medical team and physiotherapists prior to your discharge
- You will be sent home with medications or a script to help with pain relief
Time in Sling:
- Generally your sling should be on at all times (except for hygiene) in the first 2 weeks
- From 2-6 weeks, you can wean out of the sling gradually using it less and less each day. You do not need to use your sling at night/sleeping
- From 6 weeks, you should not need to use your sling at all
Return to Activity
- Driving: when adequate range of motion and pain to allow safe control of the car and to react appropriately in an emergency. Both arms must be fully functional and on the wheel for this to occur. Usually dependent on time in sling.
Return to driving from 6 weeks post op at earliest - Work: desk based roles should be able to return once pain has settled – usually approximately 2 weeks after surgery. Those with more manual occupations may need specific recommendations and light duties are usually recommended
- Swimming: water based exercise is very helpful after surgery. No swimming until the wounds have healed – usually 2 weeks post operatively. Breaststroke by 12 weeks and freestyle by 18 weeks.
- Golf: usually requires significant rehab and time before adequate protection of the rotator cuff repair has occurred. Usually from 3 months post op
- Non Contact Sports: or sports where patients have control of their arm/body and can minimise the chances of a fall onto their arm with body weight (pilates, yoga, swimming, running, cycling, racquet sports, gymnastics, fencing, rock climbing) Consider breaking down these sports into components and commence gradual return with increasing progression of difficulty from 3 months
- Contact sports: (eg hockey, football, rugby, martial arts, BMX riding)
As with non contact sports but with increased force and impact – need to train for unexpected impacts and ability to respond
Do not commence before 6 months
Concerns or questions?
If you have any concerns post operatively, or you would like further information, please contact Mr Lau through the VBJS on 03 5752 5020 or via email at admin@vbjs.com.au
If you need urgent medical help, call 000 or go to your nearest emergency department.
Patient information
These notes have been prepared by Mr Simon Lau. They are general overviews and information aimed for use by his patients. They reflect Mr Lau’s views, opinions and recommendations. They do not constitute medical advice. The contents are provided for information and education purposes only. Please seek Mr Lau’s specific advice with any questions regarding medical conditions and treatment.