Proximal Humerus Fracture Exercises
Recovering from a Proximal Humerus Fracture
A proximal humerus fracture is a break near the top of the upper arm bone, close to the shoulder joint. Most fractures heal successfully with conservative treatment, followed by a structured rehabilitation programme to restore movement, reduce pain and gradually rebuild shoulder strength.
This guide explains each stage of your recovery and the exercises that will help you safely return to everyday activities.
Weeks 0–3
Wearing Your Sling
For the first three weeks, wear your sling 24 hours a day, removing it only to complete your exercises.
Aim to remove your arm from the sling every few hours to perform gentle movements and prevent stiffness.
Early Exercises
Complete these exercises little and often throughout the day.
Pendulum Exercise
Stand beside a table and support yourself with your unaffected arm.
Allow your injured arm to hang freely and gently swing away from your body.
Repeat 5 times.
Neck Rotation
While sitting:
- Slowly turn your head to one side.
- Hold for 2–3 seconds.
- Repeat 5 times on each side.
Elbow Movement
With your upper arm tucked close to your body:
- Slowly bend and straighten your elbow.
- Repeat 5 times.
Wrist and Hand Exercises
Support your forearm on a table.
Practice:
- Making a full fist
- Straightening your fingers
- Lifting your wrist up and down
Repeat 5 times.
From 3 Weeks
Removing Your Sling
Begin gradually reducing how often you wear your sling.
Many people find it helpful to continue wearing it:
- In crowded environments
- During longer walks
- If the shoulder becomes tired
Supporting your arm on cushions while sitting can continue to improve comfort.
Using Your Arm
Begin using your arm for light daily activities.
Initially:
- Lift no more than the weight of a cup of tea.
- Keep your elbow bent.
- Keep movements within your field of vision.
- Avoid heavy lifting.
- Avoid lifting your arm straight forwards or directly out to the side.
Pain Relief
It is common for discomfort to increase slightly as your activity levels improve.
Pain relief, if appropriate, together with heat or cold therapy, can help you continue your exercises more comfortably.
Mobility Exercises
Gradually increase your shoulder movement, allowing your injured arm to do more of the work over time.
Assisted External Rotation
Sit or stand with your elbows bent to 90°.
Place a rolled towel between your elbow and your side.
Using a stick held in both hands:
- Slowly rotate your shoulder outwards.
- Move only as far as comfortable.
Assisted Shoulder Lift
Lie on your back with both elbows bent.
Support your injured wrist using your unaffected hand.
Lift your upper arm as far as comfortable before lowering slowly.
Table Slides
Sit or stand at a table with a towel beneath both hands.
Slide your hands forwards across the table while allowing your unaffected arm to assist the movement.
Standing Wall Stretch
Stand facing a worktop or kitchen counter.
Place both hands on the surface and gently walk backwards to stretch your shoulder comfortably.
From 6 Weeks
Continue all previous exercises while gradually increasing how much you use your injured arm during everyday activities.
As your movement improves, reduce the amount of assistance provided by your unaffected arm.
From 8 Weeks
Begin Strengthening
Once your clinician advises it is safe, begin gentle strengthening exercises.
Isometric External Rotation
Stand or sit with your elbow bent to 90°.
Attempt to rotate your hand outwards while resisting the movement with your opposite hand.
- Hold for 5 seconds
- Repeat 5 times
Isometric Internal Rotation
Using the same position:
Attempt to rotate your hand inwards while resisting with your opposite hand.
- Hold for 5 seconds
- Repeat 5 times
From 12 Weeks
Continue progressing your strength using light weights such as a partially filled bottle of water.
Increase the resistance gradually as your shoulder becomes stronger.
Shoulder Shrugs
Lift your shoulders towards your ears before lowering them slowly.
Front Arm Raises
Hold light weights with your hands resting against your chest.
Raise both arms upwards before lowering under control.
Side-Lying External Rotation
Lie on your side with a folded towel between your arm and body.
Holding a light weight:
- Rotate your forearm upwards.
- Lower slowly under control.
Wall Push-Ups
Stand facing a wall with your arms straight.
Keeping your body in a straight line:
- Bend your elbows.
- Lower your chest towards the wall.
- Push back to the starting position.
Recovery Timeline
| Stage | Typical Timeframe |
|---|---|
| Sling worn full time | Weeks 0–3 |
| Gentle shoulder exercises | From Week 3 |
| Increase arm use | From Week 6 |
| Begin strengthening | From Week 8 |
| Progressive strengthening | From Week 12 |
Recovery varies depending on the severity of your fracture, your age and your overall health.
When to Seek Medical Advice
Contact your healthcare professional if:
- Your pain becomes significantly worse.
- Your shoulder movement decreases.
- You notice numbness or tingling.
- Your shoulder becomes increasingly swollen or red.
- Your recovery is not progressing as expected.
Frequently Asked Questions
How long should I wear my sling?
Most people wear their sling continuously for the first three weeks, removing it only for exercises and personal care.
When can I start moving my shoulder?
Gentle shoulder exercises usually begin from three weeks, with strengthening exercises introduced later as healing progresses.
When can I start strengthening exercises?
Light strengthening exercises generally begin from eight weeks, with progressive strengthening from 12 weeks using light weights.
Can I lift heavy objects?
Heavy lifting should be avoided until your clinician confirms your fracture has healed sufficiently.
Why is rehabilitation important?
Following a structured rehabilitation programme helps restore shoulder movement, rebuild strength, reduce stiffness and support a safe return to normal daily activities.
