Broken bones, also known as fractured bones, occur when stress across the bone exceeds the bone’s tensile strength. A bone may fracture due to trauma such as a fall on an outstretched hand, or in the case of a weakened bone, can occur due to relatively normal forces. Fractures can occur in different patterns. They can be stable and nondisplaced and treated with a cast or splint or unstable or displaced and treated with either closed or surgical reduction and fixation followed by a cast or splint. A bone that is broken in several places or unlikely to heal well on its own often requires surgery to stabilize the fracture with some type of hardware.

Bone fractures heal in three phases. The first phase is the inflammatory phase which starts within hours of the break and is normally complete within a number of days. During this phase the body lays down a fragile matrix of new tissues to begin repairing the broken bone. During the next several weeks the reparative phase occurs in which a soft callus is initially formed by bone-producing cells and then transformed into a hard callus over time. The soft callus can easily be disrupted if the bone is not protected but the hard callus is much more durable. In the final stage, the remodeling stage, the callus is slowly removed and the bone is reshaped and smoothed out as it responds to the stress and activity placed on it by normal activity. This phase takes months to years to be completed but in most cases a fracture is considered healed in about 8 weeks.

The shoulder joint complex consists of three bones. The humerus is the large upper arm bone. It articulates at the top of the shoulder with the scapula or shoulder blade to form the glenohumeral joint. The clavicle or collarbone is also considered a part of the shoulder complex. A fall or force directly onto the upper arm is usually the cause of a shoulder fracture. A fracture near the head (top) of the humerus is usually what is referred to as a “shoulder fracture,” however, a fracture to the clavicle and even sometimes the scapula can also occur due to the nature of the injury.

Signs and symptoms of a broken shoulder include:

• Pain, tenderness and swelling over the upper arm, scapula or collarbone
• Redness and bruising near the shoulder
• Difficulty moving the shoulder or putting weight through the arm
• Signs of deformity or misalignment in the bones

Your PT will avoid manipulating or stressing the broken shoulder until the fracture is healed in order to prevent disruption of the healing bone. During this time, your physical therapist may recommend the following interventions:

If needed, strength training, stretching and range of motion of adjacent areas of the body may be prescribed to prevent stiffness and atrophy while the shoulder is healing Education on the healing process of bones Recommendations on how to adapt daily tasks to the use of one arm

Stretching, joint mobilization and range of motion to improve the flexibility and mobility of the wrist, elbow and shoulder Soft tissue mobilization to address any adhesions, scar tissue or tissue restrictions in the area Strengthening, motor control and coordination training of the hand, wrist, elbow and shoulder to allow you to grasp, hold, manipulate, lift and carry objects with the arm Sport and work specific training to help the injured shoulder return to higher impact and repetitive activities like throwing a ball, push ups, pull ups, overhead lifting and much more Education on how to adapt daily activities if any movement or motion restrictions persist