Last updated: March 2020

Greater tuberosity fracture exercises

This exercise sheet is designed to guide you through the next few months with some simple exercises to gradually increase your movement, decrease your pain and steadily improve your function. Download the PDF leaflet with images to help with the exercises.

Sling

For the first 2 weeks keep your arm in the sling 24 hours a day.

Remove the sling and practice the first set of exercises to move your neck, elbow, wrist and hand.

Do this little and often through the day, a few of each movement.

1. First exercises

A:
Pendulum:

Stand beside a table, leaning on your forearm.

Gently let your other arm hang relaxed down – this will allow you to wash under your arm

B:
Sitting.

Tilt your head toward one shoulder until you feel the stretch on the opposite side. Hold approx. 2-3 seconds.

Repeat 5 times. Repeat to the other side

C:
Sitting.

Turn your head to one side until you feel a stretch. Hold approx. 2-3 seconds.

Repeat 5 times. Repeat to other side.

D:
Stand – remove the sling – keep your upper arm close to the body.

Slowly bend and straighten your elbow.

Repeat 5 times

E:
Stand with your elbow bent and palm turned down.

Turn your palm up and down rotating your forearm.

Keep your upper arm next to your body.

Repeat 5 times.

F:
Practice regularly throughout the day:

• Move your wrist up and down
• Make a full fist and fully straighten your fingers
• Touch your thumb to the tips of all your fingers

2. Exercises from 2 weeks

From 2 weeks – you still need to keep your sling on 24 hours a day but you can start practicing some exercises to gently move your shoulder.
Try these exercises little and often, moving your shoulder as far as is comfortable.

A:
Lie on your back with your arm by your side, slightly away from your body. Place a folded towel under the upper arm. Elbow is bent to 90 degrees and hand points towards the ceiling. Hold a stick with both hands so that the palm of the affected side is facing upwards.

Keep your elbow bent during the movement. Rotate your arm outwards to approx. 30 degrees. Return to the starting position – your uninjured arm should be doing the majority of the work.

You can also practice in sitting – but be careful to keep your body still.

B:
Lie on your back.

Use your un-injured arm to gently lift your injured shoulder up and over your head as far as is comfortable – try and increase movement gradually over time.

You can also practice in sitting – but be careful to keep your body still.

C:
Sit or stand. Place your hands on a table – with a towel under both arms.

Slide your hands along the table as far as you can. Let the un-injured arm help and the table will take the weight of the arm.

D:
Stand near the kitchen work surface or high table.

Place both hands on surface.

Gently walk away from your hands – gently moving your body away from your arm.

3. Exercises from 6 weeks

Removing your sling
Start weaning from your sling, the easiest way is to gradually use the sling less and less over a few days. You may find it useful to continue to wear it initially if you are out and about in a busy environment or for a long period of time. Continue to support the weight of your arm on cushions or pillows whenever you are sitting, this will help to keep your arm comfortable.

Using your arm
You can start using your arm gradually when you come out of the sling, light activities no more weight than a cup of tea. All movements should be with your elbow bent and within your field of vision. It is important at this early stage not to lift anything heavy and avoid lifting the arm straight in front of you or out to the side.

Pain relief
Your shoulder may feel comfortable while you have been in the sling and you may have stopped taking your pain relief. It is not unusual at this stage, when you start increasing your activities and exercises, that your shoulder may become more uncomfortable. It is important at this stage to take your pain relief if necessary, to allow you to gradually get your shoulder moving and increase your activity level.

 4. Exercises from 6 weeks

 Continue with the same exercises – but start to gradually increase how far you can move your arm and try and use your injured arm to do more of the work until you can do the exercises without the help of the un-injured arm.

5. Exercises from 12 weeks

From 12 weeks – if you feel you can comfortably lift your arm to touch your head you can start gently strengthening your shoulder.

Try the first 2 exercises initially and then gradually progress to the others.

Start gently with a small weight and gradually increase the weight as able – try a can of beans or a small amount of water in a bottle.

A:
Stand or sit. Hold your arm close to your body with your elbow at a right angle.

Try to move your hand inward, resisting the movement with the other hand. There should be no movement.

Hold 5 seconds.

Repeat 5 times

B:
Stand or sit. Hold your arm close to your body with your elbow at a right angle.

Try to move your hand inward, resisting the movement with the other hand. There should be no movement.

Hold 5 seconds.

Repeat 5 times

C:
Lie on your side. Place a folded towel between your upper arm and side. Bend your elbow to 90 degrees. Hold a small weight in your hand.

Lift your hand up and slowly back down.

D:
Lying on your back – hold a small weight in your hand.

Push your arm up to the ceiling and slowly reach over your head keeping your arm close to your ear.

E:
Stand tall. Hold small weights at shoulder height with your elbows pointing to the sides.

Press the weights up to straight arms. Return to the starting position in a controlled manner. Try and keep your elbows tucked in.

Note: try not to shrug your shoulders.

F:
Stand next to a wall. Place your hands on the wall, slightly wider than shoulder-width apart and fingers pointing upwards. Body is in a straight line.

Keep body in a straight line and shoulders down. Bend your arms and lower your chest towards the wall. Straighten your arms and push back away from the wall.

 

This information was provided by North Bristol NHS Trust‘s orthopaedic team.