• Reference Number: HEY1293/2026
• Departments: Orthopaedics, Physiotherapy
• Last Updated: 30 April 2026

Introduction

This leaflet has been produced to give you general information about your injury. We understand you may not have seen a clinician face to face in fracture clinic however, most of your questions should be answered by this leaflet.  If after reading it, you have any concerns or require further explanation, please do not hesitate to contact the fracture clinic team. Contact details are available at the end of this leaflet.

What is a Proximal Humerus Fracture?

The humerus is the long bone in your upper arm. A fracture of the proximal part means that it is broken in the upper arm, near the shoulder joint. These fractures normally take between 6 to 12 weeks to heal. However, you may experience discomfort and stiffness for up to a year. In some cases, you may not regain full range of movement, but you should regain enough to be able to use your arm for everyday tasks.

How should it be treated?

Many proximal humerus fractures do not require surgery.  In the past, people were told to rest their shoulder in a sling all the time, however we now know that it is safe to begin movement early and this reduces the risk of stiffness.

This fracture can be treated in a sling for comfort. We encourage you to come out of this for light activities; for example, washing, dressing and eating. There is no set time period for how long you should wear your sling but once your pain is under control we advise early, gentle movement to prevent stiffness.

How can I help myself?

Pain

To manage your pain, we advise that you take simple pain relief regularly, which can be bought over the counter. If you have allergies or conditions, which prevent the use of pain-relieving medication, please seek advice from your doctor or a pharmacist.

In addition, in the first 3 weeks apply ice, for example a bag of frozen peas wrapped in a tea towel, to the upper arm for 10 minutes at a time. This can be done three times a day to reduce swelling and bruising. Please note, it is important that you wrap the ice in a tea towel, to prevent it from burning the skin.

Remember, you should:

• Only use an ice pack on areas that have normal skin sensation i.e. where you can feel hot and cold
• Not apply ice to an open wound
• Not apply an ice pack to an area that has poor circulation
• Check the skin every five minutes and stop using it if:
  • the area becomes white, blue or blotchy
  • the area becomes excessively painful, numb or tingles

Smoking

It is important to note that smoking will delay the healing process and so should be avoided. Talk to your GP, go to Quit smoking – NHS or download the app for more information

Dressing and Armpit Hygiene

You may find it is easier to use front button shirts and pull-up trousers with an elastic waistband in the first few weeks. When dressing put the injured arm into sleeves first and when undressing take the un-injured arm out first.

To wash under your arm, take your arm out of the sling and lean forward slightly so that your arm hangs slightly away from your body. You should then be able to wash under your arm and apply deodorant.

Sleeping

You may find more comfortable to wear the sling on a night and to sleep more upright than usual, using pillows to prop you up in bed or in a reclining armchair.

Lifting

You will not be able to pick up anything heavy for 6 weeks (for example a kettle full of water). The first time you pick up a cup or mug make sure the liquid is cool, just in case you drop it.

As your movement improves and pain reduces, little by little you can increase the amount of weight that you are able to lift.  Progressing quickly from lifting a cup of water to a heavy shopping bag for example would not be advisable, as is likely to result in overloading of the soft tissue and could consequently delay your recovery.

Can I do any exercises to help?

Injured arm: 0 to 3 weeks

Try to spend as much time as possible out of the sling.

The hand, wrist, elbow and neck can be moved gently through their full range as comfort allows from day one of your injury. This will prevent stiffness developing in these joints while your shoulder is in a sling.

Below is some guidance on the exercises you can do, all of them can be practised 3 to 4 times per day.

Finger flexion and extension

Whilst in your sling make a tight fist with your affected hand and now spread your fingers out as far as possible. Repeat 10 times

Wrist flexion and extension

Whilst remaining in your sling support your forearm with the unaffected arm. Using your wrist only, move your hand down towards the floor.

Hold the stretch for 10 seconds.

Now move your hand towards the ceiling. Repeat 10 times each direction.

Elbow Flexion/Extension

Remove the arm from the sling and straighten it down by your side.

Now bend the elbow as much as possible.

Repeat 10 times slowly in each direction.

Neck rotation

Sit upright in a chair and turn your head and neck as far to left as possible. Hold 5 seconds and return to start

Now repeat to the right as far as possible. Hold 5 seconds to return to the start.

Repeat 10 times slowly in each direction.

Neck side flexion

Sit upright in a chair and drop your ear down to your left shoulder as far as possible without lifting the shoulder. Hold 5 seconds and return to start

Now repeat to the right as far as possible. Hold 5 seconds to return to the start

Repeat 10 times slowly in each direction.

At 2 weeks, once your pain is under control, you can start regular pendular exercises. Do not feel you have to wean off analgesia too soon, as it is better to regain some movement first.

Pendular exercises

Rest your unaffected arm on a table and let the affected arm hang down freely.

Try to write each letter of the alphabet using this arm.

Do not force the movement.

Uninjured arm and legs

Research has shown that patients are able to return to normal function if they maintain the strength in the uninjured arm and legs. Inactivity can soon lead to muscle loss and so it is important to remain active where possible.

Below are some suggestions of exercises you can do daily. These exercises may be too hard or too easy for your level of fitness and so we advise you start with 5 or 10 repetitions of each exercise and increase or reduce as needed.

Stand facing a step and hold on to a firm support if required.

Step up and down and repeat

Swap the leading leg and repeat

In sitting make a fist with your uninjured arm. Now bend your elbow and push your fist up above your head. Slowly lower and repeat

To make this harder you could use a tin of soup or a small hand weight

In addition, if you have no problems with balance, it could be performed in standing

All photos with kind permission of ©Physiotec™

Do I require a follow up?

Fracture Clinic

A follow up appointment for fracture clinic will be booked for 1 to 3 weeks after your injury. If you do not receive an appointment, please contact the fracture clinic on the telephone number at the end of this leaflet.

Physiotherapy

Unless you have good movement at your fracture clinic follow up you will be directly referred to physiotherapy. The physiotherapist will tailor your exercises to your individual needs and goals.

You will receive a letter or phone call to book this physiotherapy appointment within 2 weeks of the referral being made. If you have not received one within this time, please contact the physiotherapy department on Tel: 01482 608939 or Tel: 01482 674880 between the hours 8.00am to 4.00pm Monday to Friday.

If you participate in an active hobby, then it is advisable that you do not return to this until you have full strength and good range of movement. Your physiotherapist will be able to advice you regarding this.

When can I return to normal activities?

Driving

You will not be insured to drive whilst you a wearing a sling. It is always good to check with your insurance company however, we advise it should be safe to return to driving when:

• You are no longer using the sling
• You can comfortably grip the steering wheel, move the gear stick, pull up the hand brake and activate the indicators
• You can perform an emergency stop

Returning to work

If you have a desk-based job you may return to work as soon as you feel able, typically this would be once the pain settles and your movements improve at around 4 weeks. If however you do manual work, you will need light duties or a longer period off work for up to 12 weeks.

How do I contact fracture clinic if I have an issue?

If you have any queries relating to this injury within the next six weeks, you can contact us on Tel: 01482 674378 during clinic hours 9.00am to 4.30pm Monday to Friday. Please do not choose an option and when prompted leave a message if there is no answer and we will aim to get back to you within the same working day. If you do not contact us in the six weeks after your injury, you will be discharged and should seek advice from your GP.

Your feedback matters to us…

To ensure we deliver a safe and quality service and to help us understand the experience you have of the care you receive from our staff we would value your thoughts about the service you received.

You may be contacted as part of our quality assurance programme which is where we visit our teams and staff and talk to them about the care they provide to our patients or at any time during or after you have needed our services.

To collect this feedback, we would contact you using the registered telephone number we hold in your care record. This feedback will be strictly anonymous and whilst we will share the feedback as part of the process, we will not share any details which may identify you.

We will never ask you any personal questions about your health during these telephone calls.

If you do not wish to speak to us, please say this when we call, we do not want you to feel pressured.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.