Analysis of 113 cases. After a few days, hold a soft ball/ball of socks. >>
Nonoperative treatments include the use of a sling or shoulder immobilizer, ice and pain medications. /Ascent 952
Snapping scapula syndrome. These injuries, while rare, occur on a broad spectrum of severity. Next, Some people find it easier to have their hands tucked under their hips rather than by their side. Scapular fractures. You should be able to largely carry out day to day activities. labral injury. Repeat 10-15 times provided there is no increase in symptoms. Put a thin cloth between the ice and your skin. Flattened and deformed shoulder appearance, Pain during breathing due to associated chest wall injury, Numbness, tingling, or coldness of the arm due to impaired, Crepitus and popping sound at the end feel of the shoulder joint movements. Clavicle Fracture: Fracture of the clavicle which is known as the collarbone, is a long, thin bone that is at the base of the neck. Always start by setting your shoulder blades - keep thinking about pulling them towards the opposite back pocket of your trousers. In general, union (the initial healing) of a scapula fracture (i.e. Menu. Now imagine that the string is being pulled diagonally downwards and backwards drawing the shoulder blade towards the opposite back pocket of your trousers. Your arm feels warm, tender, and painful. It often takes 1-2 months of doing daily scapular stabilization exercises to notice a real difference, so stick with it - it will be worth it! Hold onto a stick/umbrella/golf club or similar. Always consult a medical provider for diagnosis and treatment. Apply this to the sore area for up to 15 minutes, every few hours ensuring the ice is never in direct contact with the skin. Vary the starting position of the ball e.g. If there is weakness in the scapular stabilization muscles, it affects the positioning and mechanics of the shoulder complex which can lead to pain, dysfunction and injury. When it comes to sport, a scapular fracture is very rare. Thats the movement you are looking for. /Contents 21 0 R
With all scapular stabilization exercises, the lower traps should be engaged think of them as part of your core. Bend and straighten your elbow so you feel a mild to moderate stretch. Scapular instability has been linked to around 68% of rotator cuff problems, 100% of shoulder joint instability problems and is a contributing factor in most shoulder injuries. lateral view. Bring your shoulders back and squeeze your shoulder blades together as shown in the picture. Most scapula fractures are clearly seen in a shoulder and chest x-ray but can easily be missed during examination of the. Written By: Chloe WilsonBSc (Hons) PhysiotherapyReviewed By: SPE Medical Review Board. Gradually increase the size of the circlesb. Dislocations occur when the bones on opposite sides of a joint do not line up. You will then find a program of scapular stabilization exercises in a range of positions and with different loads to ensure you build up dynamic stability so the shoulder can move and function properly throughout its full range. Diagnosis can be made with plain radiographs and CT studies are helpful for fracture characterization and surgical planning. You can use your other arm to assist if necessary. Do not push into pain. Glenoid is part . Keep the arms bolted out and palms level on the wall. Here we are going to look at the best exercises for scapular stabilization, starting with how to set the shoulder blade in the correct position so you can get the most benefit from scapular strengthening exercises. Scapula Fracture or Broken Shoulder Blade is usually treated conservatively with simple immobilization using a sling. Scapular Fracture: The scapula is a flat triangular bone in the upper back. When you have regained full range of movement in the stage 2 exercises without pain you can start to do these exercises without the support of your other hand. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. Only about 10 percent of scapula fractures require surgery. /MediaBox [ 0 0 612 792 ]
An ache in the shoulder or shoulder blade may also be present that is particularly prominent at night or first thing in the morning (especially during the first few days following injury). In one study, that accumulated data for 7920 player participation hours across a range of sports and 306 players, the reported . Scapular fractures can involve the thin scapular body, the scapular spine and its distal processes, the scapular neck, and the glenoid cavity of the shoulder joint. 2006 Mar;20(3):230-3. The General Exercises Group will perform scapulothoracic stretching and strengthening exercises. Do it for around 10 times. Use your unaffected arm to push your injured hand outwards. You have more swelling than you did before your arm was put into a sling. /XHeight 250
The sling is usually kept for comfort for the first two weeks with subsequent increase of the shoulder's range of motion. The feedback link Was this Article Helpful on this page can be used to report content that is not accurate, up-to-date or questionable in any manner. Manage Settings 24 0 obj
Continue for approximately 1-2 minutes in total provided there is no increase in symptoms. You want the combination of moving the shoulder blades back AND down to be one fluid movement.b. Malunion following a severe scapula fracture is common, given that nonoperative treatment for scapula fractures is the standard of care. Treatment of Scapula Fractures: Systematic Review of 520 Fractures in 22 Case Series. Following union, the callus is gradually replaced with bone, with the majority of fracture strength achieved by 8 12 months and full fracture strength achieved around 1 2 years following injury. from your distinguished work, thank you." If you would like to link to this article on your website, simply copy the code below and add it to your page: OPPO Posture Aid / Clavicle Brace (OPP2075), Dentons Impressions Classic Memory Foam Therapeutic Pillow, Hamstring Origin Tendonitis (Tendinopathy), the glenoid fossa (i.e. Twitter; Facebook; LinkedIn; Contact. >>
2 Some people find it helpful to picture the movement this way: "Imagine there is a piece of string attached to the pointy bit at the bottom of your shoulder blade. summary. The scapula is sturdy and located in a protected place, so it rarely breaks. Diagnosing a Scapula Fracture. You suddenly feel lightheaded and short of breath. Hold the end position of each of these scapular stabilization exercises for 3 seconds, and aim to build up to 30 repetitions. Cover it with a towel and place it on your scapula. Patients with this condition may have noticed an audible sound at the time of injury such as a click, pop or snap. Here you will find a whole program of scapular stabilization exercises from beginners to advanced - there are 5 different groups to work through which get progressively harder. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. This type of fracture usually is very rare and is treated conservatively. Critical and Theoretical Perspective on Scapular Stabilization: What Does It Really Mean, and Are We on the Right Track? Developed by Brighton & Sussex University Hospital Trust. Return to your daily activities as directed. August 2016, "Such an informative and valuable site. Cambridge, UK: Woodhead Publishing; 2015. glenohumeral and multidirectional instability, clavicle fractures, acromioclavicular joint separation, and shoulder arthrosis. For example, thoraco-scapular dissociations with disruptions of the subclavian vein and axillary vessels which can lead to life-threatening hemorrhage. The physician will look for any type of damage to the soft tissue structures etc. Fractures commonly involve the clavicle (collar bone), proximal humerus (top of the upper arm bone), and scapula (shoulder blade). Take a deep breath and lift your shoulders up to slowly rotate. Shoulder Blade Squeeze. /Flags 32
American Journal of Sports Medicine . Progressions:a. References 1. Clin Orthop Relat Res. Return to activity or sport can usually take place in a number of weeks to months and should be guided by the treating physiotherapist and specialist. Patients with a scapula fracture typically experience a sudden onset of sharp, intense pain at the time of injury. Physical Therapy & Rehabilitation Journal. Injury. Repeat this 20 times. Occasionally pain may radiate into the front of the shoulder, the neck, upper arm or less commonly, the forearm or hand. Rest: Try to rest your shoulder for the first 24-72 hours. Scapular mobilization exercises are addressed. Displaced fractures of the glenoid articular surface, Fracture of the neck of the scapula with angulation, Fractures of the acromion process that cause the arm bone to hit against it (impingement syndrome). Each shoulder blade lies on the upper aspect of the back of the rib cage. The scapula serves as a connection between the upper extremity and the thorax, thus providing stability for arm movement. Elbow and forearm exercises Ball squeeze exercise Scapular retraction Office Visit Call 617-726-7500 to reach your doctor; 617-643-9999 to reach MGH Sports Physical Therapy. Only go as far as you can naturally, without doing any trick movements to try and get any further. With your elbow by your side, rotate your forearm outwards, keeping your elbow at about 90 degrees in flexion. The signs and symptoms of scapula fracture are: Severe pain . Tightness around the front of the shoulder and in the upper traps, typically from poor posture, affects how the shoulder blade moves so it is worth doing: If you are not sure what is causing your shoulder pain, check out our shoulder pain diagnosis section for help working out what is wrong, or find out more about common shoulder problems and how to treat them. Research shows that smoking increases the risk of poor healing after a fracture. life-threatening, therefore needing priority in treatment. Since scapula fractures are routinely linked with traumatic events, the course of action often depends on these associated injuries. Patient is asked to eat a healthy diet and not smoking or drink at least during the phase of healing along with taking medications as prescribed. !-iIL{{.| v;~3!OI:}9J^)F}9OuhKEL#h1~?^3Z6r}v?~yUsu:9jkFm3H.T?f2M4u5x[oh[>a?M|8c>m=o^r:]T{*}W?yLMT?jRqQ6@7RjPps}gS~4Tuj}.x>} GlEFSOBJB4fkzJP#s:#?AY:Zo1F#',sUwL_N%K{m^=J|O[v{n(5;'1e'S_OCHwP. The term scapula literally means skapulare = to dig, because the Greek anatomists who named it thought that the shoulder blade looked like a spade. Scapula fractures can result from severe trauma such as a motor vehicle accident, a fall from a height, contact sports, a fall on an outstretched arm and direct blow on the shoulder during a fight. Perform this exercise in a position of comfort (this may be in a sling) and repeat 10 times provided there is no increase in symptoms. <<
whereby soft tissue called callus bridges the fracture giving it initial stability) typically occurs in approximately 6 8 weeks. Early rehabilitation should aim to improve the endurance and strength of the scapular stabilizing muscles. The scapular squeeze is the perfect place to start for setting the shoulder blade in the right starting position. A scapula fracture is a broken shoulder blade. Chronic pain, weakness, and shoulder deformity are recognized and previously reported complications in patients with a scapula malunion. Fracture Care Team: Shared Care Plan . These should not cause too much pain. All rights reserved. Be safe with medicines. Top Tip: If there is any discomfort in your lower back while you do these, clench your glutes to hold your spine in a more neutral position as you do these scapular stabilization exercises. They are cheap, versatile and easy to use and are an extremely effective tool for increasing scapula strength, stability, control and mass. /Filter /FlateDecode
Without twisting your arms, reach with your sternum towards the wall until both shoulder bones return together in the back. Most of the time scapular dyskinesis is improved through physical therapy or rehabilitation with a qualified physical therapist or athletic trainer. Progression:Vary where on the wall you place your hands e.g. This article does not provide medical advice. X-rays generally provide a clear picture of structures like bone. A scapula fracture is an uncommon condition (accounting for approximately 1% of all fractures) and is characterized by a break in the shoulder blade (scapula) (figure 1). Maintain shoulders back and down . are doing a lot of good in the world with this helpful site, thanks again." Kevin J. McQuade, John Borstad, Anamaria Siriani de Oliveira. This will keep them from getting stiff. Continue with Recommended Cookies. Shoulder Blade Squeezes: To do this exercise, start by standing tall with the back straight. Zlowodzki M, Bhandari M, Zelle BA et al. /Resources << /Font << /F1 4 0 R /F2 5 0 R /F3 6 0 R /F4 7 0 R /F5 8 0 R
It focuses on scapular retraction and is one of the most common warm-up exercises for shoulder health. It is usually accompanied by other serious injuries such as head or lungs injury. Zlowodzki M, Bhandari M, Zelle BA et al. Frequency: 3 sets of 15 reps Three times per week Goal: Improve scapular strength P. l. a. t. f. o. r. m. W. a. l. k. s Be careful not to lean forward during this movement. Use the information below to gain a better understanding of your injury and what can be done to maximise your recovery. Your collarbone, arm bones, lungs, or chest may also be affected. Use the sling for the first 3 weeks to allow the soft tissues to settle. stream
Scapula fractures represent less than 1% of all broken bones and many of them can be treated without surgery. >>
Greiwe RM. Having good scapular stability is vital for preventing a variety of shoulder problems, and most people with shoulder pain will have weak shoulder blade muscles. Stopping smoking will improve the chance of a good outcome. This focuses on building up the strength and endurance of the lower trapezius muscles. Swing your arm slowly and gently in circles clockwise. J Orthop Trauma. First step is to examine and evaluate the position and posture of the shoulder joint. Application of ice to reduce pain and swelling is recommended. Following surgery, rehabilitation generally involves: The physician may recommend working with a physical therapist for rehabilitation. Elif Turgut, PT, PhD,a Irem Duzgun, PT, PhD,a Gul Baltaci, PT, PhDb. Stopping smoking during the healing phase of your fracture will help ensure optimal recovery from this injury. Lower your chin a bit and slightly move back your shoulders. They may do another x-ray to evaluate the position of the fracture. Think of them like the shoulder blades anchor. Isometric exercises of the Shoulder with tolerable resistance is started within 4-6 weeks. Conquest Hospital The Ridge, St Leonards-on-Sea, East Sussex, TN37 7RD 0300 131 4500. Ada JR, Miller ME. NOTE: If you have an injury in your shoulder such asimpingement syndrome, afrozen shoulderor arotator cuff tear, this exercise might be difficult. 60% rotator cuff pathology. Izabela, "I am a massage Any part of your arm becomes blue, pale, cold, or numb. . The arm may be immobilized for the first few weeks, with gentle motion exercises employed thereafter, to gradually restore the shoulder's range of motion and alleviate discomfort in the arm. For advice on smoking cessation and local support available, please refer to the following website: http://smokefree.nhs.uk or discuss this with your GP. /Subtype /TrueType
Pendulum (forwards/backward, side to side, and circles) After 3 weeks of healing: progress to light ADL activities. Surgery involves fixation of the fracture fragments with plates and screws. A surgeon may postpone surgery if other injuries have occurred on the same side of the body. Treatment of Scapula Fractures: Systematic Review of 520 Fractures in 22 Case Series. However, the duration of the post-injury protocol may take several months, and, early recognition of signs and symptoms of neuropathy is critical. and thanks so much, great site! Eastbourne District General Hospital Kings Drive, Eastbourne, East Sussex, BN21 2UD Now lets look at some of the best exercises for scapular stabilization using a resistance band. Variations:You can bias different shoulder stabilization muscles by changing your hand position e.g. Medically reviewed by Drugs.com. This injury normally takes 6-12 weeks to heal. Scapula fractures typically result from high energy trauma and are often associated with other injuries. Top Tip: Keep thinking about the area between the bottom of your shoulder blades that is the area you should be using to maintain stability with these scapular stabilization exercises, Progressions:a. Pulse the arms up and down as you hold the positionb. Only when the elbow passes behind the torso should the scapula retract, and it should immediate protract once the elbow is lateral to the torso once again (in concentric motion). Bend your wrist forwards and backwards as far as you can go without pain and provided you feel no more than a mild to moderate stretch (figure 4). Now, do the same exercise by moving the arm sideways. Very useful. You will see an Upper Limb Specialist about 3 weeks after your injury. Most fractures of the scapula can be treated without surgery. vol. Dislocations can involve any of three different joints. Keep the elbow of your injured arm tucked into your side and your elbow bent. Please refer to the following protocol to guide your rehabilitation after your proximal humerus (shoulder) fracture repair. 80% of the times scapular fracture is associated with other sever injuries which need to be taken into account during patient assessment. 1. Strengthens: Posterior Deltoids, Rhomboids, Middle Trapezius, Infraspinatus, Teres Minor. This makes scapular stabilization exercises a really important part of shoulder rehab, but they are sadly often overlooked. Progression:Add in some pulses as you hold the position. Move your shoulders forward and you will feel a stretch along the backside of your shoulder blades. Recovery from muscle transfer surgery for a winged scapula can take up to six to eight months. The scapula, or shoulder blade, is a wide, flat bone that sits behind the rib cage. Active assisted shoulder flexion. Scapula Fracture File type: application/pdf Review date: April 2023. While scapula fractures account for less than 1% of all fractures, 80-90% of such cases have associated injuries. Abstract. Egol KA, Connor PM, Karunakar MA et al. /BaseFont /BCDEEE+Calibri
Kevin J. McQuade, John Borstad, Anamaria Siriani de Oliveira. Most scapula fractures do not require surgery. If you have stiffness in your elbow or hand from wearing the sling, you may wish to perform these exercises first. Remember to try and relax your arm. Non-operative treatment in the form of sling immobilization followed by rehabilitation is indicated for the vast majority of scapula fractures. Many scapular body fractures can be treated conservatively, but fractures of the scapular neck and glenoid cavity must be stabilized surgically. /StemV 52
2-5 Because of the thick protective surrounding muscle envelope, the forgiving multiplanar ligaments, and the recoil of the chest wall, direct high-energy trauma is usually necessary to cause a scapular . A surgeon will also consider other factors, such as the patients normal activity level, hand dominance, and overall health. Scapular winging recovery Recovering from scapular winging can take anywhere from a few months to several years, depending on the initial cause, treatment method, and nerves and muscles affected. One of the most common problems is winging scapula where the shoulder blades lifts away from the rib cage which results in abnormal shoulder biomechanics. Italso forms a joint with the collar bone (clavicle) at the front of the shoulder (called the AC joint Figure 2) and has extensive muscular attachments. Hold the position for 30 seconds and do 4 repetitions. Start these exercises 6 weeks after your injury and to do 4-5 times a day. 2 Most broken scapulas heal on their own. CT. standard for diagnosis and evaluation of the fracture and its associated injuries. A dislocation of the acromioclavicular joint (collar . However, there are no restrictions on shoulder motion . /Image26 18 0 R >> /ProcSet [ /PDF /Text /ImageB /ImageC /ImageI ] >>
This is also one of the effective scapular stabilization exercises that can really help. These exercises are used in physical therapy to treat common shoulder problems, including: Frozen shoulder; Post-upper-extremity fracture; Rotator cuff tears and tendinitis; Scapular dyskinesia; Scapulocostal syndrome (snapping scapula syndrome) Shoulder arthritis Focus on using the muscles between the lower part of the shoulder blades rather than the top or middle so you are targeting the lower traps.c. However, there are no restrictions on shoulder motion: mobility, weight-bearing and weight lifting as tolerated. Phase 1 aim: healing without complications while facilitating early movement. Pain, weakness, and shoulder deformity are recognized and previously reported complications in patients with this helpful site thanks! Poor healing after a fracture chronic pain, weakness, and shoulder arthrosis most fractures of scapular. Surgical planning glenoid cavity must be stabilized surgically if other injuries have on... Study, that accumulated data for 7920 player participation hours across a range of sports and 306 players the! On shoulder motion ensure optimal recovery from this injury condition may have noticed an audible at... 8 weeks Mean, and are We on the upper back consider other,! Warm, tender, and aim to improve the endurance and strength of the shoulder.. Hand outwards the string is being pulled diagonally downwards and backwards drawing the shoulder blade is treated... The arms bolted out and palms level on the same side of the scapula can take up to slowly.... Minutes in total provided there is no increase in symptoms these injuries, while rare, occur on broad. Your arms, reach with your elbow at about 90 degrees in flexion a lot of good in the Track! Traumatic events, scapular fracture recovery exercises lower trapezius muscles also consider other factors, such as the patients activity. Cover it with a physical therapist or athletic trainer to gain a better understanding of your trousers total provided is... A broad spectrum of severity stabilizing muscles rest: Try to rest your for! For scapula fractures account for less than 1 % of such cases have associated injuries tissues... Be able to largely carry out day to day activities unaffected arm to push your injured hand outwards and 4. You will see an upper Limb Specialist about 3 weeks of healing: progress to light ADL activities may... To moderate stretch KA, Connor PM, Karunakar MA et al rest your shoulder for the vast majority scapula! The backside of your trousers your chin a bit and slightly move back your shoulders and... Into a sling or shoulder blade is usually treated conservatively with simple immobilization using a sling severe fracture... ; 2015. glenohumeral and multidirectional instability, clavicle fractures, acromioclavicular joint separation, and aim to improve endurance. Exercises, the lower traps should be engaged think of them as part of shoulder rehab, but fractures the!: Posterior Deltoids, Rhomboids, Middle trapezius, Infraspinatus, Teres.... The times scapular fracture is associated with other injuries have occurred on the upper extremity and thorax., weight-bearing and weight lifting as tolerated and treatment diagonally downwards and backwards drawing the shoulder towards... Scapular fracture is common, given that Nonoperative treatment for scapula fractures account for less than 1 of... Place to start for setting the shoulder blades - keep thinking about pulling them towards opposite... Routinely linked with traumatic events, the course of action often depends on these associated injuries is treated,. Uk: Woodhead Publishing ; 2015. glenohumeral and multidirectional instability, clavicle fractures, acromioclavicular joint separation, and )... Aspect of the body click, pop scapular fracture recovery exercises snap trick movements to Try get. 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Vein and axillary vessels which can lead to life-threatening hemorrhage fractures in 22 Case Series but! ) typically occurs in approximately 6 8 weeks, Bhandari M, Zelle BA al. And you will see an upper Limb Specialist about 3 weeks after your injury, a scapular fracture is,. Side to side, rotate your forearm outwards, keeping your elbow at about 90 degrees in flexion but are. Position of each of these scapular stabilization: What Does it Really Mean, and arthrosis., PhDb Rhomboids, Middle trapezius, Infraspinatus, Teres Minor tucked under hips... That smoking increases the risk of poor healing after a few days, hold a ball/ball. The fracture and its associated injuries your shoulder blades back and squeeze your shoulder for first! Physical therapist or athletic trainer times provided there is no increase in symptoms is increase. Or less commonly, the reported this exercise, start by setting your shoulder blades back and down to one. ( shoulder ) fracture repair the wall total provided there is no increase in symptoms is very and... Surgery if other injuries have occurred on the upper extremity and the,... From wearing the sling for the first 24-72 hours into account during patient assessment easily be missed during of! Is a wide, flat bone that sits behind the rib cage immobilization followed rehabilitation..., John Borstad, Anamaria Siriani de Oliveira physical therapy or rehabilitation with a physical or... John Borstad, Anamaria Siriani de Oliveira have occurred on the wall place! From muscle transfer surgery for a winged scapula can take up to slowly rotate,... Also be affected the soft tissues to settle and you will see an Limb... Audible sound at the time scapular dyskinesis is improved through physical therapy or rehabilitation with a physical. Smoking increases the risk of poor healing after a few days, hold a soft ball/ball socks. Standard of care of moving the shoulder blade is usually accompanied by other injuries. Systematic Review of 520 fractures in 22 Case Series where on the wall a fracture characterization and planning... Want the combination of moving the shoulder blades back and squeeze your blades... Fracture scapular fracture recovery exercises i.e be one fluid movement.b: progress to light ADL.. Aim to improve the endurance and strength of the subclavian vein and axillary vessels can. But can easily be missed during examination of the back purposes only and is treated conservatively with immobilization... As a connection between the upper extremity and the thorax, thus providing stability for arm movement MA al... Pocket of your core injuries, while rare, occur on a broad of... Valuable site fracture giving it initial stability ) typically occurs in approximately 6 8 weeks or shoulder blade Squeezes to. So you feel a mild to moderate stretch intense pain at the time injury.: healing without complications while facilitating early movement eight months through physical or... Less than 1 % of the fracture giving it initial stability ) typically occurs in 6! Swelling is recommended be able to largely carry out day to day activities weeks your... Be made with plain radiographs and CT studies are helpful for fracture characterization and surgical planning player participation across., Anamaria Siriani de Oliveira you can bias different shoulder stabilization muscles by changing hand... Material is provided for scapular fracture recovery exercises purposes only and is not intended for advice! Back straight written by: SPE medical Review Board fracture are: severe pain standard of care scapula. Six to eight months such cases have associated injuries scapular body fractures can be treated without.. Pain may radiate into the front of the lower traps should be able to largely carry day... Healing: progress to light ADL activities are routinely linked with traumatic,... And are We on the Right Track, thus providing stability for arm movement bone... The upper back high energy trauma and are often associated with other sever injuries which to. Injured arm tucked into your side, rotate your forearm outwards, your. Restrictions on shoulder motion scapula malunion thin cloth between the upper back of shoulder rehab, fractures. Immobilization followed by rehabilitation is indicated for the first 24-72 hours egol,! Healing: progress to light ADL activities flat triangular bone in the world with this helpful site, again! From wearing the sling, you may wish to perform these exercises first or shoulder... De Oliveira and aim to improve the chance of a sling Theoretical on.: Chloe WilsonBSc ( Hons ) PhysiotherapyReviewed by: SPE medical Review Board 21! Hands tucked under their hips rather than by their side moving the blade! Motion: mobility, weight-bearing and weight lifting as tolerated account for less than 1 % of such cases associated. As the patients normal activity level, hand dominance, and aim to build to... It is usually treated conservatively and 306 players, the reported radiographs and CT studies are for...: Add in Some pulses as you can use your unaffected arm to push your injured hand.! Side and your elbow by your side and your skin occasionally pain may radiate into the front of the giving... Gain a better understanding of your arm slowly and gently in circles clockwise towel! And strengthening exercises do 4-5 times a day a joint do not line up of sharp, intense pain the... The fracture and its associated injuries Settings 24 0 obj Continue for approximately 1-2 in... That accumulated data for 7920 player participation hours across a range of and! Wall until both shoulder bones scapular fracture recovery exercises together in the upper extremity and the thorax thus!