Shoulder joint is indeed one of the most important and central joint of the body that is required for all basic functional activities. Believe it or not, all basic motor operations require a functional shoulder joint like standing from sitting position or vice versa, eating, working, cooking, lifting and carrying loads. Before we go on to discuss on the recovery tips for shoulder fracture, it is better to find out what does a shoulder joint consists of.
Shoulder joint is a ball and socket joint that is made up of scapula, humerus and clavicle. The three primary bones join together with the help of numerous ligaments, tendons and supportive connective tissues to strengthen and stabilize the shoulder joint. Most of the people take shoulder joint fracture as one entity (on the contrary, shoulder joint is made up of three joints, Sternoclavicular joint, Acromioclavicular joint and Glenohumeral joint). The trauma, injury or destabilization of any one of these joints can lead to shoulder fracture. However, the most frequently involved joint is the glenohumeral joint.
What are the causes of shoulder fracture?
The most common cause of shoulder fracture is injury (that may be accidental, road traffic accidents, whiplash injury or fall on an outstretched hand). Other common causes of shoulder fracture are assault, sports-related activities, occupational injuries or other similar causes.
Regular physical activity is helpful in strengthening shoulder joint. Most athletes tend to focus on large group of muscles leading to significant hypertrophy (or increase in the size and volume of muscle fibers). However, smaller groups of muscles are normally missed during mainstream gym exercises. This increases the risk of shoulder fracture significantly. Additionally, weaker group of muscle fibers undergo tearing or injury but the symptoms are usually mild or even absent due to small size of fibers.
However, as a result of injury, inflammatory responses set in that makes the surrounding tissue much weaker. Eventually, the weak shoulder muscles or connective tissue elements undergo complete dissolution that decreases the strength and support of shoulder joint leading to fracture with a normal or slightly stronger push on shoulder joint.
What are the symptoms of shoulder fracture?
Shoulder fracture is mostly symptomatic and a lot of people can tell that the injury is severe. Most common symptoms that help in differentiating a minor injury from a more serious injury like fracture are:
- Pain that may be moderate to severe.
- Aggravation in the intensity of pain with even the lightest movement. Shoulder support with the help of arm sling and immobilization by plaster helps in relieving the symptoms of pain by reducing the activity across the fractured ends of the bones.
- Swelling and bruising that may severe at the site of fracture but may involve neighboring tissues as well.
- Inability to move the shoulder.
- A grinding sensation when the shoulder is moved.
- A visible deformity.
- Bleeding or hematoma formation.
What are the common risk factors for shoulder fracture?
Weak and vulnerable joints are obviously at much higher risk of developing fractures or injuries as compared to strong joints. Following risk factors contribute to the pathogenesis of shoulder joint fractures:
- Osteoporosis or weak bones: Osteoporotic shoulder joint fractures are reported more frequently in elderly population (ideally in women and men of 60 to 80 year age group) as per the results released by Johnell (1). Additionally, the risk of fracture is highest if you have ongoing bone metabolic disorders, hormonal aberration or bone tumors.
- Certain occupations: Occupational activities like heavy involvement in sports (or professional athletes like those involved in weightlifting or boxing, racquet sports and basket ball) are at highest risk of developing shoulder joint fractures.
10 Recovery Tips For Shoulder Fracture
Shoulder fracture significantly affects the quality of life of the individual. Depending upon the area of shoulder joint involved, the total duration of recovery or rehabilitation varies significantly. In most moderate injuries, the full return of activity usually takes 6 to 8 weeks with an initial period of joint stiffness and irritation after which the symptoms resolve spontaneously and with exercise or physical therapy.
Since shoulder joint is the strongest joint of the body, a little stronger force of impact is needed to cause fracture of the shoulder joint. Likewise, the healing of shoulder joint will also be a stepwise process and thus you have to be really patient and calm during the entire process.
Here are the 10 helpful recovery tips that can significantly benefit your shoulder joint throughout the healing process.
- Healthy nutritious diet
Always remember that optimal healing requires strength and support from all your body tissues. A healthy diet plays a very important role in the repair and remodeling process like calcium, vitamin D, vitamin C, zinc and other micro-nutrients like magnesium and manganese.
Regular physical activity is required for prevention of shoulder joint fracture and also to promote early healing. However, it is highly recommended to perform all the exercises under the supervision of a healthcare provider. Bone strengthening exercises like strength training and conditioning exercises can be performed after 4 – 6weeks of joint injury. Make sure to use strength training shoulder bands to minimize stress and strain on affected shoulder.
- Physical therapy
Physical therapy is an effective solution to boost your speed of recovery many folds with the benefits below:
- Physical therapy exercises helps in decreasing the swelling and inflammation without causing pain and discomfort.
- Physical therapy promotes blood supply, nourishment and nutrients to healing tissues. It also helps in the elimination of toxins and inflammatory mediators from the site of joint injury.
- Regular physical therapy helps in preventing long-term issues pertinent to the range of motion of shoulder joints like frozen shoulder.
- Your therapist may advise you 2-dimensional physical therapy exercises like shoulder abduction, adductions and flexion or extensions.
- Make your recovery period shorter and hazard free
Shoulder joint fracture normally requires a lot of stabilization in the first few weeks to prevent wrong alignment of bones and other connective tissues. Consequently, you may be advised by your healthcare provider to sleep in the sitting posture and obviously sleeping on the chair is not only very uncomfortable but can also affect the quality of your sleep. You may want to substitute the chair with a recliner with a lot of pillows and cushions to give support to your affected arm and the body.
- Use non-pharmacological methods for pain relief
Although, it is totally insane to expect that you can manage without pain-killers absolutely. However, you can still minimize the dose of pain killers by relying onto different pain relieving agents like:
- Ice packs are considered very helpful in decreasing the extent and severity of swelling.
- Warm compresses that are helpful in giving soothing warmth to the healing tissues to alleviate pain and discomfort.
- Avoid unnecessary pain killers
Since shoulder fracture pain is severe, you may need potent pain-killers like Hydrocodone to relieve pain in the first few days. Hydrocodone is a prescription pain-killer and should not be used beyond the doctor advice due to moderate addiction possibility. Usually, a period of 2 to 3 weeks is recommended which not only provide excellent pain relief but also has minimal risk of addiction during that period.
- Increase your water intake
Once again, water acts as a perfect solvent that dissolves all the impurities, toxins and chemicals from your body. After moderate to severe injury affecting any part of your body, the process of inflammation takes up a lot of fluid. Additionally, your body produces a lot of toxins from the breakdown products of chemical mediators, inflammatory chemicals, stress hormones, inflammatory cells and metabolism of drugs that must be excreted from the body to minimize the risk of complications and damage to other tissues.
- Seek help from others if needed
Ideally, with a broken shoulder, you are definitely not able to take care of your occupational responsibilities. So it is better to get a medical leave of absence from work instead of taking heroic measures of continuing your job. Additionally, you may require support and physical assistance from people around you in doing small daily tasks like washing, bathing (you cannot take independent showers for at least first 5-6 weeks or more depending upon the intensity of injury). Simple alternatives are:
- Taking sponge baths.
- Arranging a nurse or seeking help of a friend, family member to wash your hair while you are sitting on the chair.
- Itching and remedies
A lot of people hate swelling, bruising and pain that follow after injury during initial healing period. On top of that, you may hate it even more when your joint enters in the final stages of healing and you will develop this intractable desire to itch the site of injury. Obviously it is discomforting but ideally it is recommended to avoid using your nails or finger tips to scratch. Instead, you can scratch slightly with a tooth brush (make sure to get a fresh and sterilized tooth brush and do not use that tooth-brush for other purposes).
- Avoid heavy weight lifting
Heavy weightlifting (or ideally, weightlifting of any type) is contra-indicated during early stages of healing. Any type of pull or pressure may aggravate pain and may also lead to dislocation of shoulder joint.
Common FAQs On Shoulder Fracture
- Can you have intercourse with fractured shoulder joint?
Although shoulder joint plays a very important role in tender love making but still it is not the most important organ. Good news is, you can still make love to your partner, provided the surroundings are extremely comfortable and your partner is being extra gentle with your fractured shoulder.
- When can you drive and resume your normal activities?
Certain activities (especially that involves twisting and twirling movement of your shoulder joint) like driving and other forms of physical labor should be avoided for at least 3 – 4 months after primary joint injury.
- What is the prognosis of shoulder fracture?
Almost 70 to 85% of all the moderate joint injuries heal without any complication. Still, some patients may develop transient or chronic joint stiffness, pain or cracking sensation that may last for months after initial injury.
Shoulder fracture is definitely a serious condition but in vast majority of cases, immobilization is sufficient to ensure optimal healing or by adopting the above recovery tips for shoulder fracture. It is however recommended to maintain excellent diet and minimize activity using the affected shoulder. Make sure to perform physical therapy and joint strengthening exercises after initial period of recovery after speaking to your healthcare provider.
1. Johnell, O., Kanis, J. A., Oden, A., Sernbo, I., Redlund-Johnell, I., Petterson, C., … & Jönsson, B. (2004). Fracture risk following an osteoporotic fracture. Osteoporosis international, 15(3), 175-179.
2. Ivers, R. Q., Cumming, R. G., Mitchell, P., & Peduto, A. J. (2002). Risk factors for fractures of the wrist, shoulder and ankle: the Blue Mountains Eye Study. Osteoporosis international, 13(6), 513-518.
3. Jonsson, B., Christiansen, C., Johnell, O., Hedbrandt, J., & Karlsson, G. (1996). Cost-effectiveness of fracture prevention in established osteoporosis. Scandinavian Journal of Rheumatology, 25(S103), 30-38.
4. Donatelli, R. A. (2011). Physical therapy of the shoulder. Elsevier Health Sciences.
5. Neviaser, R. J., & Neviaser, T. J. (1987). The frozen shoulder diagnosis and management. Clinical orthopaedics and related research, 223, 59-64.