Shoulder fractures and surgeries
Shoulder and arm fractures are common injuries that can drastically affect your ability to move your arm, perform daily tasks and maintain independence. Some of these injuries require surgery, whereas some are treated with physiotherapy management. Here we talk about the different types of fracture, and how we can help you pre or post surgery.
The shoulder joint is a complex structure made up of three key bones: the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone). A fracture in any of these bones can cause significant pain, limit movement, and interfere with your normal routine.
Additionally, related injuries such as shoulder dislocations or separations of the acromio-clavicular joint (ACJ) can require specialised care to restore proper function and relieve discomfort.
What are the causes of shoulder and arm fractures?
Falls: Landing on an outstretched hand, directly on the shoulder, or the side of the arm during a fall is one of the leading causes of fractures. This is particularly common in older adults with weaker bones.
Sports Injuries: High-impact sports like football, rugby, skiing, or cycling can result in fractures due to sudden impacts, collisions, or falls.
Road Traffic Accidents: Car or motorcycle accidents often involve significant force, leading to fractures of the clavicle, humerus, or scapula.
Direct Blows: A direct hit to the shoulder or arm, such as during contact sports or an altercation, can cause fractures.
Repetitive Stress: Overuse or repetitive stress, especially in athletes or individuals performing heavy physical labor, may weaken the bone over time, increasing the risk of fractures.
Medical Conditions: Conditions like osteoporosis or bone tumors can weaken bones, making them more prone to fractures, even with minimal trauma.
What are the different types of shoulder and arm fractures?
Fractures of the shoulder and arm can occur in various bones and locations, each requiring specific treatment. The most common types include:
1. Clavicle Fracture (Collarbone Fracture)
The clavicle is one of the most commonly fractured bones in the body.
Common Causes: Falls onto the shoulder, direct trauma, or accidents.
Symptoms: Pain, swelling, and a noticeable bump at the fracture site.
2. Proximal Humerus Fracture (Upper Arm Bone Fracture)
A fracture near the shoulder joint at the top of the humerus.
Common Causes: Falls, especially in older adults, and high-impact trauma.
Symptoms: Pain around the shoulder, limited arm movement, and bruising.
3. Mid-Shaft Humerus Fracture
A break in the middle section of the humerus.
Common Causes: Falls, motor vehicle accidents, or direct blows.
Symptoms: Pain in the upper arm, inability to move the arm, and possible nerve involvement causing numbness or tingling.
4. Scapula Fracture (Shoulder Blade Fracture)
A less common injury due to the scapula’s protected position.
Common Causes: High-energy trauma, such as a car accident or severe fall.
Symptoms: Pain in the upper back or shoulder, difficulty moving the arm, and swelling.
5. Distal Humerus Fracture
A fracture near the elbow joint at the lower end of the humerus.
Common Causes: Falls onto an outstretched arm or direct impact.
Symptoms: Pain near the elbow, swelling, and difficulty bending the arm.
6. Acromio-Clavicular Joint (ACJ) Separation
Technically a joint injury but often discussed alongside fractures.
Common Causes: Falls or direct trauma to the shoulder.
Symptoms: Pain at the top of the shoulder, a visible bump, and limited arm movement.
7. Radius Fractures
Radial Shaft: Middle portion of the radius.
Distal Radius: Near the wrist; includes Colles’ fracture (dorsal displacement) and Smith’s fracture (volar displacement).
Radial Head Fractures: At the elbow joint.
8. Ulna Fractures
Ulna Shaft: Middle portion of the ulna.
Distal Ulna: Near the wrist.
Olecranon Fractures: At the elbow, involving the tip of the ulna.
How do I know if I have broken my arm?
If you have had an injury to your shoulder or arm, it can be hard to know if there are any broken bones. If in doubt, always take yourself to your local accident and emergency department, but here are a few things to look out for:
Intense pain, especially when moving the shoulder
Swelling and bruising around the injured area
Difficulty lifting or using the arm
Deformity, like a visible bump or the bone appearing out of place
Numbness or tingling if nerves are affected
You should seek advice from a doctor if you have symptoms that are worsening and not responding to rest or medication, loss of sensation in the arm or hand, or signs of infection such as a fever.
Do I need surgery for my shoulder fracture?
Some shoulder fractures heal well with non-surgical methods like slings or casts, followed by a period of physiotherapy to rehabilitate the muscles around the shoulder. However, surgery might be needed for severe fractures. Common surgical options include:
Fixation with Plates and Screws: Metal plates and screws are used to hold broken pieces of bone together.
Intramedullary Rods: A metal rod is placed inside the bone for stabilization.
Shoulder Replacement (Arthroplasty): For severe fractures near the joint, the shoulder joint may be replaced with an artificial one.
How can physiotherapy help a broken shoulder bone?
Physiotherapy plays an essential role in recovery by helping to reduce pain, swelling, and stiffness. It also focuses on improving shoulder movement and strength, which are often affected by fractures and periods of immobilisation when in a cast or sling.
Additionally, physiotherapy helps prevent muscle loss and supports your gradual return to daily activities, work, and sports.
A physiotherapy programme for shoulder injuries is tailored to individual needs and may include several approaches. Pain management techniques such as applying ice, heat, or electrical therapy can provide relief. Specific exercises can be prescribed to restore movement and strength.
Manual therapy, which involves hands-on techniques such as massage and manipulation, can improve joint mobility. Finally, functional training ensures you can safely and confidently return to your daily activities and hobbies.
When can you start physiotherapy?
The timing for starting physiotherapy depends on the severity of the fracture and the treatment approach. For minor injuries, physiotherapy may begin immediately with gentle exercises to prevent stiffness.
If the fracture requires immobilisation in a cast or sling, therapy typically starts after 4–6 weeks. After surgery, rehabilitation usually begins once the surgical site is stable, which is often within 2–6 weeks.
How can we at First Line Physio help you recover from a shoulder injury?
Our team of experienced physiotherapists specialises in shoulder rehabilitation. We provide personalised care to create a recovery plan that suits your goals and lifestyle. From managing pain and swelling in the early stages to restoring strength and function as you heal, we’re with you every step of the way.
We use evidence-based techniques to ensure the best possible outcomes for your recovery. Whether you’re recovering from a fracture, surgery, or a shoulder joint injury, we’re committed to helping you return to the activities you love. Book a consultation with us today, and let’s work together on your journey to recovery.
This is absolutely not written to substitute medical advice and it is always important to see a qualified healthcare professional for a formal diagnosis.