1 week
Note: Shoulders are internally rotated, elbows are maintained in 90 degree flexion.
ROM (joint mobility): Avoid shoulder movement, encourage wrist, hand and finger Full, aROM.
Muscle strength: Avoid shoulder strength training in the early stage due to pain. After 3-4 days of fracture, once pain is controlled, elbow and wrist start isometric strength training, encourage elbow to start active flexion and extension training, maintain biceps, triceps muscle strength.
Functional phase activity: complete ADL (ability to perform daily living) with the healthy side hand.
2 weeks
Note: The shoulder is internally rotated and the elbow is maintained in 90 degree flexion.
ROM: Gentle pendulum movements of the shoulder were started with pain tolerance.
ROM: Start isotonic muscle training for finger muscles and isometric muscle training for deltoid.
Functional activities: ADLs are completed with the healthy side hand.
4-6 weeks
Note: Limit abduction.
ROM: If there is no pressure or movement at the fracture site, good scab formation, Sling can be removed, shoulder tender aROM, limit abduction to no more than 80 and external rotation, avoid stress at the fracture site, elbow FullROM.
Muscle strength: at the end of 6 week, start rotator cuff muscle training, pendulum movement under weight loss,start to maintain hand grip.
Functional phase activity: complete ADL with the healthy side hand.
6-8 weeks
Note: Avoid sports.
ROM: Exercise in all planes of the shoulder until satisfactory joint mobility.
Muscle strength: Start shoulder resistance muscle training.
Functional activity: Start lighter ADLs on the affected side.
8-12 weeks
ROM: Shoulder motion in all planes to satisfactory joint mobility, various joint mobility techniques can be applied.
ROM: Shoulder resistance muscle training, gradually increase the difficulty.
Functional activity: The affected side may start with mild ADL and gradually return to normal.