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30 SECONDS OF THERAPY:  CLAVICLE AND SCAPULA FRACTURE

Mar 10

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START: 


CLAVICLE FRACTURE

  1. Acute Phase (Weeks 1-2) Weeks 1-2)

    1. Goal: Pain management, swelling reduction, and healing support.

      1. Ice (15 min, every 2 hrs, first 72 hrs), NSAIDS (as prescribed), Immobilization in a Figure eight brace or sling.

  2. Early Mobilization (Weeks 2-6) 

    1. Goal: Prevent stiffness, maintain muscle activation, and restore movement.

      1. AROM (Flexion -160°, ER - 30°), Pendulums, Scapular Retractions 15 x 5sec hold, Isometrics: (Shoulder Abduction, Flexion, Extension Hold 10 x 10sec, Grade 2 (AP/ Inferior SCJ mobs, AP / Inferior ACJ mobs)

  3. Functional Rehab (Weeks 6-12+)

    1. Goal: Restore stability, function, and return to activity.

      1. Prone Ys/Ts/ s (12 reps 2 to 3 Sets), Resisted Theraband (Internal & External Rotation progressing from at side to overhead) Wall slides, quadruped rock backs, Body Blade, BOSU Push Ups, Functional Training (Overhead reaching, return-to-sport drills).



SCAPULA FRACTURE

  1. Acute Phase (Weeks 1-2)

    1. Goal: Pain control, swelling reduction, and fracture stabilization.

      1. Ice 15 min every 2 hrs, first 72 hrs). NSAIDs (as prescribed). Immobilization: Shoulder sling for 2-3 weeks to allow bone healing. Activity Modification: Avoid lifting, pushing, or reaching overhead.


  1. Early Mobilization (Weeks 2-6)

    1. Goal: Maintain joint mobility, prevent stiffness, and begin gentle muscle activation.

      1. PROM / AAROM  Pendulums (2-3x/day) Flexion (0-90°), External Rotation (0°-30° pain-free), Retractions (15 reps, hold 5 sec) Isometric Strengthening (Begin Week 3-4): Isometric Shoulder Flexion, Extension, Abduction, and Adduction (5-10 sec hold, 10 reps)  Grade 2 scapulothoracic mobs and soft tissue massage to alleviate muscle tightness .


  2. Functional Rehabilitation (Weeks 12+ & Return to Activity)

    1. Goal: Restore full range of motion, return to work/sport, and improve endurance.

      1. Overhead Press with Light Resistance, Medicine Ball Wall Drills for Shoulder Stability, Push-ups (progress to full range)




STOP: 


  1. Excessive Immobilization (Beyond 3-4 Weeks) 

  2. Neglecting Kinematics: Rather Focus on Scapular Clocks & wall slides with ER(week 5-6), Push up pls (6-7).

  3. Avoiding Stabilizers: Rather activate trapezius, serratus anterior, and rhomboids slowly and progressively. (Wall Angles, Serratus Punches, Scapular Retract and Depress)

  4. Addressing Extension: Thoracic extension mobility must be addressed to promote full scapular depression and posterior tilt. (Foam Roller Tspine Extension, Open Book Stretch, Thread the Needle) 


Exercises: 

i. Scapular Retraction & Depression: Pull shoulder blades back and down. Hold 5 sec, 10-15 reps, 2-3x/day.

ii. Wall Angels: Keep arms against a wall and slide them up/down. 10-15 reps, 2-3x/day.

iii. Serratus Anterior Punches: Push arms forward with resistance bands. 10-15 reps, 2-3x/day.


  1. Neglecting Thoracic Mobility:  Restricted thoracic mobility can impair scapular positioning and overall shoulder mechanics.


Exercises: 

i. Thoracic Extension on Foam Roller: Lie back on a foam roller and extend. Hold 10 sec, 10 reps, 2-3x/day.

ii. Thread the Needle Stretch: Rotate under and across the body from a quadruped position. 10 reps each side, 2-3x/day.

iii. Open Book Stretch: Lie on your side, rotate your top arm open. Hold 10 sec, 10 reps per side.


WHY: 


Optimizing Functional Recovery.


i. mobilizations and early mobility help minimize adhesions in the SCJ and ACJ and foster optimal synovial fluid production thus minimizing the risk of frozen shoulder and future impingement.


ii. AROM and Isometrics promote blood flow and prevent muscular shortening allowing for proper kinematics and optimal joint movements, alignment, and proper GHJ mechanics fostering improved overhead activities and overall return to daily activity.



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