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Physical Rehabilitation Medicine/Dislocated shoulder & broken Humerous Greater Tuberosity


I am a 57-year-old woman. Was in good condition. Was working out on machines, doing 100 " real" push-ups, and alternating each day with recumbent bike work.  My current sports are dog agility with two Alaskan Malamutes, and golf.  Two weeks ago I fell on black ice dislocating my shoulder and breaking, my humerous  of the greater tuberosity. I have never broken a bone or dislocated anything before in my life.  I have had many other injuries but always soft tissue and lower body ACL, MCL, meniscus etc.  My orthopedic surgeon did a CT scan and found that the break went vertically down further from the greater tuberosity.  He also felt that when, my shoulder was put back in place it seated the break enough that surgery was not needed.  The ER  put me in an immobilizer and then he put me in a sling. I have found the immobilizer more comfortable as the sling pulls on my neck and I get migraines easily.  I am in unfamiliar territory so my questions are numerous.

First will he take me out of the sling in a week when he sees me?  Will he be able to tell me about soft tissue damage at that visit?  Should he do an MRI in order to determine what soft tissue damage there is?  When I wear the immobilizer I can detach the Velcro on my wrist and do a lot with my right hand.  Is this doing any damage?  Why, when I leave the Velcro on my wrist, and push against the immobilizer just slightly I have severe pain in my shoulder?  What is this pain coming from? When I wear the sling or the immobilizer if I reach out slightly as a reflex action to catch something that might be falling, I have excruciating pain. What is that coming from?  Is it the dislocation, or the break? Could it be soft tissue issues? What if any soft tissue damage would you expect?  What is the order and time length of the recovery? When will I be able to get back to running dog agility? Will I be able to use the recumbent bike and what time frame? Now? HELP I In a very bad patient with little patience, particularly when I am blind In regard to an injury.  

This is written entirely with voice recognition. This is my right arm and I can't type or write worth...  Lastly when will the pain subside when I start to move my elbow slightly away from my body? Thank you for all your help I really appreciate it.

1.  He will take you out of the sling if he thinks the fracture is stable enough to tolerate range of motion.

2.  MRI's are often prescribed for soft tissue tears.  If he does not suspect one then it may not be needed.  Frequently after injured tissue has "calmed down" and pain is still present then an MRI might be indicated.

3.  I would keep the wrist and fingers moving...also the forearm (palm up and palm down) if it is not contraindicated.  By him leaving you in a sling vs a cast I would assume that forearm, wrist, digit ROM is ok.

4.  I don't know about this one...what motions?

5.  Same as #4

6.  I don't know again...could be any number of soft tissue problems.  Not really my place to say and is a question for your MD.

Length of recovery for injuries in general is ~12 weeks.  That's a VERY general estimate.  Some much longer.  Running dog agility I don't know...running should be cleared as soon as the bone has been cleared and there is no risk of further injuring the healing bone.  Recumbent bike is the same.  Usually bones heal in 6-8 weeks.  Bike, etc should be ok around week 4-6 as long as it's just stationary bike, no risk of falling, etc.

Pain is questionable.  Could last awhile but usually it subsides as things heal.  If not it's often an indication that something is still going on at the injury site.  Elbow from body around 5-7 weeks post-injury.  Depends on if the bone is stable enough to tolerate motion safely.

Whew...hope I answered those all.  Many are general and I apologize.

Good luck!

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Brian Neville, OTR/L, CWCE


I can answer questions about both conservative and post-operative rehabilitation for UPPER extremity injuries. These include but are not limited to: fractures, tendon repairs, tendon transfers, nerve repairs, lacerations, tenolysis procedures, TFCC injuries, repetitive motion disorders, reconstructive procedures. I have an advanced knowledge of UPPER extremity anatomy and industrial rehabilitation. I have extensive splinting skills for injuries to the upper extremity. Although not a physician or a surgeon I have worked closely with world renowned upper extremity specialists for over 10 years. I can give general information on what some of the most common upper extremity surgeries involve. I can reference those procedures as well. PLEASE DON'T ASK ME QUESTIONS ABOUT ANYTHING OTHER THAN THE NECK, SHOULDER, ARM/HAND. I'M NOT QUALIFIED AND KNOW ABSOLUTELY ZERO ABOUT BACKS/HIPS/KNEES/ANKLES/ETC. THANK YOU!!!


10+ years working closely with orthopedic and hand surgeons and their patients. I have treated patients with small lacerations to major reconstructive procedures. My knowledge base includes both conservative and post-operative rehab protocols and care for upper extremity injuries. I have treated patients all the way from day 1 post-op to return-to-work status.

Kentucky Occupational Therapy Association American Society of Hand Therapy National Nurses in Business Association Roy Matheson and Associates

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Occupational Therapist former Certified Hand Therapist (license currently inactive) Deep Physical Agent Modalities Instructor Certified Work Capacity Evaluator

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