# proximal humerus fracture



## spence648 (Dec 17, 2014)

Hey guys, i joined this forum because ive seen multiple people with the same injury as i just had.. but no one has updated their post to tell how they recovered. I did not break mine on a bicycle but on a dirt bike.. ive raced mx my whole child hood from 8 to about 22.. im now 33 and picked it back up a couple of years ago. Well in November as the mx season is done here in Illinois i decided to do an enduro race with my buddy.. thinking to my self. This should be a nice safe day without any jumps and whoops. Lol as i came out of a section of timber was 3rd gear tapped across a grass section to the next trail. I hit a stump i could not see under the grass and the next thing i know im over the bars.. shoulder hurting bad as i got up. Get to the er see the xrays and doc said i need surgery to fix it. To say i was bummed is an understatement. Now im almost 5 weeks after surgery and still have limited movement. Im just wondering how the others recovered as its hard to see the light. This is a very slow healing process and i feel im getting very impatient lol.


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## mantrain (May 23, 2013)

so about how fast were you going when this happened?


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## spence648 (Dec 17, 2014)

Id say around 35mph or so.. i think is what happened is it just caught me so off guard i had my arms extended out by instinct and took full force.. if i could have tucked them in and rolled i pry would have walked away. It ended up in 4 fractures. The ball got split in half, broke at bottom of the ball, then the upper and lower socket each had a fracture. I have broke my legs 3 times, foot once, wrist once, but have never had an injury like this before. Dr told me surgery went great. He said hardware would not hurt my mobility at all. Only thing that would was scar tissue from the trama of injury and also the scar tissue of him going in there.


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## spence648 (Dec 17, 2014)

U know the funny thing is. As i was sitting in the hospital i was thinking to myself. Maybe its time to lay off the dirtbike. Maybe i could get a mt bike and start trail riding.. then i found this site while researching my injury.. you guys seem to get hurt just as bad as motocrossers lol.. injury never bothered me before but now i have a 2 yr old daughter and a pregnant wife. Makes me feel bad not being able to do simple tasks as dishes. Wich is why i think im getting so impatient. . Physical therapy is helping. Im still in passive movement. I was really stiff because i had to wait 2 weeks before i had surgery due to swelling.


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## mantrain (May 23, 2013)

Wow makes mtb risk pale in comparison.


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## hillcountryav (Jun 8, 2011)

I had the same injury, though not as extreme.







Very similar accident, though not at 35, more like 12 and into rocks. I think I broke the ball in four places and had a piece floating in the socket.







It's been two years and I really don't have full mobility, but all things considered it's not too bad. I will say that once the cold weather starts to hit I start to have some issues. The joint gets locked up almost like a dislocation and has to be worked out. 
My insurance ran out before I could finish my rehab, maybe that made a difference? 
Stick with the rehab a shoulder is a complicated joint and is connected to all of your upper body. It will take time. What ever you do don't tell your wife that you will give up mountain biking, she'll be pissed when you don't.


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## mtnbikej (Sep 6, 2001)

I had a similar break in 2011. 

Had the front wheel wash out/blow out on a fast DH probably doing 25....left arm went out to help break the fall. Got up and felt discomfort, but knew it was not my collarbone. 

Thought maybe it was jammed or dislocated. After a few days finally went to see the Ortho. X-ray showed a big chunk of bone chopped off the head of the humerus. Based on the location, we decided to immobilize the arm and see if the bone moved anymore. If after 2 weeks it moved, it would have to be repaired. Went back after one week to have it checked on....it moved so it would kit heal on it's own. 

2 weeks later had plate and 9 screws put in. During surgery it was discovered that I had a transverse hairline fracture of the humerus about 4" below the ball that didn't show up in the MRI. So the plate was a little longer than originally planned. 

2 weeks after surgery the staples came out. 
1 week after staple removal, I began passive physical therapy(the therapist manipulated my arm/shoulder around and began breaking up the scar tissue) and range of motion. 
2 weeks after passive therapy, began strength training. 
As soon as I began strength training I began riding my bike again. Flat easy trails. 
Did another 5 weeks of PT to regain ROM. 

Broke it in early August, surgery in late August, was 100% cleared by the Ortho until late January. 

3 years later I have pretty much regain 99.5% ROM. Regained 100% of strength. Other than the 7" scar, I wouldn't really know it had been broken. 

Did a pretty good OTB in a rock garden 4 days before the final X-ray with the Ortho....scared me at first, but was fine. 

I was told when I injured mine, that usually you break the bone or tear the rotator cuff...so fortunately there was no soft tissue damage.


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## spence648 (Dec 17, 2014)

that's what I like to hear are some facts on how you guys got through this and the final out come. That is very positive for me to hear you say your at 99.5% rom. I don't think I occurred any soft tissue damage from the crash but the surgeon said he did a lot of soft tissue work on me to get the bones back together. im doing physical therapy now but I have already been doing passive for 2 weeks now.. and I probably have atleast another 2 to 4 weeks to go on it. im doing everything the therapist has me doing. I hear you guys on the insurance too. I just got my deductible and out of pocket met just for it to restart in January.. so I guess I will have to meet it again for my therapy.. wich brings me to another thing id like to point out.. I have Aflac accidental and short term disability insurance.. its been a life saver.. they have asked zero questions and pays well. got a check for 3150$ just for my surgery... my health insurance deductible is 1000$ and my out of pocket is 2500$ so just that check almost paid my hospital bills.. The Aflac is well worth it for anyone looking for extra coverage. 


as u can see my ball was a mess!


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## pulpwoody (Jan 31, 2006)

Well, if you're gonna do it, do it right!!!

I'm currently recovering from a surgery in the same area. I had a Bankart Lesion/repair, which involves some screws to reassemble the glenoid, which is the bone structure on the opposite side of the humorous. Essentially, the golf tee that the humorous sits in.

For me, rehab has been a slow process. I had the surgery in August, and it went really well, about a month or so later, started ROM/physical therapy, and that was going really well, the PT's were really impressed with how quickly I was getting my ROM back, so that made me feel pretty good.

A couple of months ago, I reached my arm across my body, grabbed a small item, and then moved my arm back, and my tendon instantly hurt like hell. It was the first time anything like that happened since I started the recovery process and it scared me. After talking with my PT, he advised I take some time off of stretching and exercising. I took two weeks off, and that time set me back a couple of months in terms of flexibility. I'm still dealing with some swelling in that same tendon, so I have to be careful and mindful about my movements. It's part of a vicious circle: I need the tendon to do the exercises, but the muscles aren't strong enough to do the exercises, so the tendon gets swollen because it's being overworked, rinse and repeat. 

It's been a slow process for sure. The shoulder is the most complicated joint in the body, and unlike the hip, the shoulder relies completely on the tendons and muscles to keep your arm from falling off of your body, the joint doesn't lock together.

Now, I have nearly complete ROM and I'm still doing my PT every day. I'm cleared to ride my bike, but I know that I'm not ready to ride any advanced trails yet. 

My advice, be patient and don't rush the process, do EVERYTHING your PT tells you to do, when he tells you to do it. Go slow on the exercises. Be prepared for some setbacks. Keep your doctor and PT informed of any changes. DO NOT push through the pain, you aren't getting paid a penny to play through the pain, or to show up on "game day." For something like this, it's sooo important to listen to your body and your shoulder.


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## spence648 (Dec 17, 2014)

Thanks for the advice pulpwoody.. yeah my physical therapist all ready said to me she usually worries about her patients not doing there home exercises, ans she told me shes scared im going to overwork myself and do more damage lol.. im still fighting swelling too. If i lay around all day with ice the swelling goes down but muscles get super tight . And if i stretch all day muscles are looser but then the swelling flares up and limits movement. . It is a viscous cycle.


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## pulpwoody (Jan 31, 2006)

spence648 said:


> Thanks for the advice pulpwoody.. yeah my physical therapist all ready said to me she usually worries about her patients not doing there home exercises, ans she told me shes scared im going to overwork myself and do more damage lol.. im still fighting swelling too. If i lay around all day with ice the swelling goes down but muscles get super tight . And if i stretch all day muscles are looser but then the swelling flares up and limits movement. . It is a viscous cycle.


As a last resort, Cortisone shot. I got one last week, helped tremendously. didn't totally eliminate the problem, but it got way better.


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## hillcountryav (Jun 8, 2011)

I too got a steroid shot last December and it helped a ton through the cold months when I have the most problems. I'm due for another.


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## spence648 (Dec 17, 2014)

Thats something ill definitely keep in mind for the future but right now its only been 5 weeks since my surgery. . My next dr appointment is on the 31st so we will see if i get released for active therapy or stick with the passive.. i still have very limited movement though in some positions. . I dont know how to explain it in words but one movement i have 7° out of 90... its where the ball turns in the socket if that makes sense


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## mtnbikej (Sep 6, 2001)

spence648 said:


> Thats something ill definitely keep in mind for the future but right now its only been 5 weeks since my surgery. . My next dr appointment is on the 31st so we will see if i get released for active therapy or stick with the passive.. i still have very limited movement though in some positions. . I dont know how to explain it in words but one movement i have 7° out of 90... its where the ball turns in the socket if that makes sense


I found that I had a breakthrough during PT when I was out on a ride and I was able to reach back and grab something out of my jersey pocket. I was concerned that motion would not come back.


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## spence648 (Dec 17, 2014)

I just came from my physical therapy and got my first measurements of my improvements. I see my surgeon tomorrow. It will be 7 weeks since surgery so hopefully he releases me for active therapy. just wanna keep this thread informed so hopefully it can help someone else with this injury as its a long road.. I really have no pain and I quit wearing my sling almost 2 weeks ago. As u can see im very stiff but slowly getting movement back.


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## pulpwoody (Jan 31, 2006)

I had an MRI today for a tendon that is not cooperating, so hopefully that turns out to be nothing. Take it slow.


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## mtnbikej (Sep 6, 2001)

Thought I would throw in my pics:


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## MiguelH (Jul 1, 2003)

I'm glad to see this post. I also suffered a proximal humerus fracture, on July 2. I have not been on a bike since the accident - and not sure I will return (though at times I miss riding). This is my first time I have been back to MTBR since the accident, and was surprised to see a post (and the other posts) on this type of fracture. 

All I can say is... recovery is a long road. I'm still in physical therapy, and I have been told it will be two more months of work (about 7-8 months total). I'm healing well, but this injury is something I will need to watch for the rest of my life. 

The advice I would give is not to rush the process, listen to doctors and do the physical therapy at home. Also, rely on others (friends, family) for the help you need while you recover. 

For those who have suffered a similar injury, I have some questions. How hard was it to get back on a bike? Any fear of aggravating the injury? 

And is this a common injury for cyclists?

Attached are my x-rays. Thanks - MH


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## mtnbikej (Sep 6, 2001)

MiguelH said:


> I'm glad to see this post. I also suffered a proximal humerus fracture, on July 2. I have not been on a bike since the accident - and not sure I will return (though at times I miss riding). This is my first time I have been back to MTBR since the accident, and was surprised to see a post (and the other posts) on this type of fracture.
> 
> All I can say is... recovery is a long road. I'm still in physical therapy, and I have been told it will be two more months of work (about 7-8 months total). I'm healing well, but this injury is something I will need to watch for the rest of my life.
> 
> ...


It is a sucky injury for sure. On the positive side, it can be overcome 100%.

I had no problem getting back on the bike...then again, quitting was never an option.

Once it heals, the bone is good to go....if not stronger than before, especially with the hardware.

The only scary thing is the 1st time you crash on it.....but once you realize you are not injured, then it just keeps getting easier and easier.


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## MiguelH (Jul 1, 2003)

I appreciate the response. It is a sucky injury. But good to know someone with the same type of fracture is back on a bike.


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## Old Ray (Sep 5, 2010)

All's I can say for shoulder injuries an surgical repair, is re-hab it to the highest degree you can, and then, never stop the maintenance rehab. Once you do stop, it's just a matter of time before something bad happens.


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## pulpwoody (Jan 31, 2006)

Yup, I had my first big ride yesterday. My legs are destroyed today!

Before I got back on my MTB and rode dirt, I put in lots of miles on my commuter, just to make sure that I had the basic range of motion covered and I was comfortable turning, going up and down curbs, kinda like starting over. It really helped me get ready for the MTB, helped my legs and lungs too. 

The ride I did yesterday was very technical, so there's some places where I got off and walked, no shame in that. I simply didn't feel confident enough to tackle some spots. We'll see how everything shakes out, but I can see myself not being as aggressive a rider as I used to be. I'm not getting paid to ride like a maniac!!!

Take is slow and work back up to it, but there's the old story about falling off the horse; once you fall off, you need to get back on as quickly as possible, otherwise you'll never get back on. I think for all of us on this thread, stopping was never an option. Best of luck and be patient.


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## MiguelH (Jul 1, 2003)

Again, all good advice. Thanks. Makes sense to start on a commuter/road bike before hitting the trail.


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## spence648 (Dec 17, 2014)

that's cool to hear the thread helped you MiguelH.. that's what I wanted to do because I found myself having a hard time staying positive. Im recovering very well.. my range of motion is almost back.. my external rotation is lacking but I will get it.. Im now lifting light weight for physical therapy and it feels good to lift. I don't know how yours is but my shoulder really has no more pain and gets looser and stronger daily, I still have swelling and extra fluid in it wich I believe is whats stopping my movement to return to full function.

this is a long recovery and I don't ride a mountain bike but I ride a dirtbike. I would be lying if I said I was not nervous to get back on. but at the same time its not going to stop me. its something I love to do and life wouldn't be the same without it to me.. but I am going to take it smart and make sure im healthy and in shape before I get on. ive been jogging on the treadmill a lot to help me get there before I can actually start doing work outs again. I looked at this injury as a freak accident.. ive raced mx my whole life and never had an injury like this. next time im definitely gonna try to keep a mental note of not putting my hands out to break the fall if I go over the bars. gonna try to just tuck them in and roll onto my side. lol 

for what its worth I also liked to watch videos on you tube of the pros returning from injury.. a lot of these mx pros go thru hell with broken backs, shattered legs, etc wich people don't see.. and a lot of them return stronger!!


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## spence648 (Dec 17, 2014)

here is my x ray at my last doc visit on dec 31st. my next apt is feb 11th. and he said if my x rays looked good he would release me!!
And physical therapy is huge!! do not slack on it and get a good therapist.. luckily I really like mine. she went on vacation for a week and I got a different person that week.. lets just say if I had to work with the other lady I would have found a different place to do physical therapy. it made me realize some are way better than others


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## spence648 (Dec 17, 2014)

Last day of pt was today.. ( well thats assuming dr releases me on wed wich im sure he will) i had a total of 27 sessions. I measured in normal range in all motions! Ive been doing modified pushups for about 2 weeks now. Im now up to 10 regular pushups.. i know that doesn't sound like much but its huge breakthrough for me... i can post a pic of my final measurement page if anyones interested.. 

One thing i would like people to notice is my external rotation started at 7°. I could barely move it and at times felt i was stuck like this and had to live with it. But keeping positive and pushing through the therapy and excercises im now at 84° wich is considered normal. My advice to anyone else going through this type of injury is to not focus on negatives but to concentrate on staying motivated to get better. And to listen to and do everything your therapist tells you to. I really dont think i would have recovered or at least not as quickly without it.


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## pulpwoody (Jan 31, 2006)

That's great news. I got ally ROM back, but still not able to do a regular Push-up yet. I didn't know how much I would miss them! Being able to ride my bike has made recovery much easier. If I couldn't ride, I'd be going crazy. Remember that a shoulder injury can take up to a year before its 100%, so don't go get crazy and start building the addition to the house yet.


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## spence648 (Dec 17, 2014)

Yeah i was pretty happy with the news lol.. got released by the dr with no restrictions. He says im out of the woods for infection or blood flow problems and the bone is healed. Going to be weird to wake up early and go to work on monday! The reg pushups are definitely hard for me and causes a little discomfort. And doing 10 took all i had. Ive went back to just doing more modified ones to build more strength so i dont end up hurting something. Thanks again everyone


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## pulpwoody (Jan 31, 2006)

That's great new man! I rode a really technical trail for the first time since the surgery a couple of weeks ago. I was holding out on riding it, since it involves a lot of upper body, but everything worked out fine. For the first time in years, I didn't ride this trail like a bat out of hell. I took it at about 3/4 speed and it was a blast, actually more fun than going full out. Now, my biggest fear isn't if my shoulder can handle riding, it's crashing. Well, maybe not a 'fear,' but I'm far more aware of the consequences now, and taking the trail at 3/4 speed is just fine. 

I guess this thread turned into more of a "shoulder surgery" thread than anything else, but the rehabs are similar even if you tear a tendon or break a bone, and it takes a long time to get back to 100. 

I wish everyone continued success.


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## pulpwoody (Jan 31, 2006)

Well, after plenty of rehab, riding, being careful, I'm doing great. I'm on to full weight body push ups and full ROM exercises with real weight. I still have some pain when I stretch it out in the mornings, but hell, there's still three screws in there, right.

Stay patient, stay persistent and good luck to anyone recovering from something like this.


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## spence648 (Dec 17, 2014)

i kinda forgot about this thread. but i just wanted everyone to know i made a full recovery. shoulder feels great. i forget i even ever broke it. if i lost any range of motion its very minimal. i cant tell. i can reach behind my back just as far as i can with my left hand.. so if anyone else goes through this. stay strong push hard and it will pay off. thanks for the support from everyone on here


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## stepf (Mar 7, 2015)

Hey spence,

nice to hear you made a full recovery.

I too, broke my proximal humerus about a year ago (October '16). It was 4 major and many smaller pieces of bone. Because of my arm being swollen way too much, I had an emergency surgery in Italy (I'm from Germany), but had it fixed with a different kind of osteosynthesis. They put 4 K-Wires (It's more like very long nails) in there, which may or may not have been the right treatment. Upside was the minimal amount of metal in the bone, downside was stability. I had to keep my arm in a sling for 9 weeks, which my range of motion is still suffering from. Mobility still sucks big time for me.

Unfortunately my fracture wasn't healing properly because of blood circulation issues within the bone. After 9 months of not putting any stress on the shoulder I got humerus head necrosis (dying bone) because of those blood circulation problems.
In August 17' I had to have another surgery, in which the (this time German) doctors transplanted a piece of pelvis into my humerus head.
Now, 3 1/2 months later, I'm again not sure if everything will heal as expected. There is still a spot with a lack of blood circulation visible in the xrays. In December and January, I will have further checkups.

If everything works out "fine", I can start regaining range of motion and strength, but it will be a loooong journey one way or the other. 

I'm in very good hands here in Germany, but sometimes things just don't work out. I definitely learned how to be extremely patient and how to deal with bad news. Good thing is, I'm still positive and I'm still super excited for when I'm returning to mountainbiking at some point


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