Physical therapy rehabilitation
in broken collarbone
Week 1
Work with your doctor and physical therapist to design
a custom rehab program. In general, this includes:
Standard Daily Exercise Routine.
Pendulum exercise. In
this exercise, you bend forward at the waist and let your injured arm hang down
toward the ground. Make small circles with your hand and let momentum move your
arm around effortlessly. Try to make clockwise and counterclockwise circles and
slowly increase their diameter.
Grip Strength Exercise. Squeeze a small
ball (a racquetball works well) with gentle but even pressure several times per
day.
Isometric or Static Exercises. During isometric exercises, you contract your muscles
without movement. There are several forms of isometrics you may do during your
rehab, including the following:
1. Isometric
Triceps Exercises. The triceps brachii is the muscle on the back of the
upper arm primarily responsible for extending the elbow.
a. Rest your injured arm on a table or counter top
with your elbow at 90 degrees.
b. Make a fist and press in to the tabletop with your
entire forearm, from fist to elbow.
c. Your arm will not move, but your triceps muscle
will contract.
2. Rotator Cuff Exercises. The muscles that make up the rotator cuff are often damaged or torn during shoulder injuries. Isometric internal and external rotation exercises are often prescribed to rebuild strength in the rotator cuff.
3. Isometric Shoulder Exercises. You may also be instructed to do isometric shoulder exercises that
include abduction, adduction, extension
and flexion,
with your arm at your side and resistance either
from your body or from a wall which allows the contraction but not the movement.
During this week, your physical therapist may also
work on any soft tissue injuries you may have sustained, including muscle
tears, pulls or strains.
If you feel up to it, you can continue to maintain
your overall fitness by using cross training and cardiovascular exercise, such
as walking, stair climbing and stationary cycling, during your rehabilitation
program.
Weeks 2 to 4
Your physical therapist will continue treating your
soft tissue injuries and identify structural imbalances caused by our clavicle
fracture.You will begin passive wall crawl (fig.1) or
easy pulley exercises (fig 2) twice a day to build shoulder
range of motion. To do the wall crawl, simply walk your fingers up a wall as
high as you can without too much discomfort in the shoulder. Each day, do a bit
more.You will begin building elbow range of motion with easy pivots and bending
and straightening the elbow and wrist.
Fig 1. passive wall crawl Fig
2. Easy pulley exercise
Weeks 5 to 8
If you are healing well, you'll start increasing your range
of motion exercises and begin strengthening exercises.
Rotator cuff range of motion exercises continue,
but now you may add some light resistance with bands or weights. Let pain be
your guide regarding how much exercise to do. You should, however, avoid
shoulder elevation, rotation or excessive movement. You may begin easy shoulder
range-of-motion exercises that your physical therapist prescribes.
Weeks 9 to 12
During this phase of rehab, you will work toward full
range of motion in all directions. Your strengthening exercise program will
continue to progress, but you should avoid heavy lifting. Focus on rebuilding
muscle endurance, with light weights and higher repetitions.
Weeks 13 to 16
If your physical therapist indicates you are ready,
you'll start a more aggressive strengthening program. Stop activity if you feel
pain, instability or "catches" in joint movements.Increase the
intensity of strength-training exercises. Begin sports specific skill drills
and exercises.Return to specific sports training and competition only when you
are cleared for activity and your functional testing shows that your injured
side is as strong and flexible as the uninjured side.
Fig 3
Strengthening exercises
Haralambos Haralambakis
Physiotherapist
Sources:
1. The American Academy
of Orthopaedic Surgeons, Broken Collarbone, Patient Information, Shoulder
Surgery Exercise Guide, 2007.
2. Massachusetts General Hospital, Sports Physical Therapy, Rehab
protocol for broken collarbone,
Illustrations Copyright © 2008 Idaho Sports Medicine
Institute