Glenohumeral rhythm w/ proximal humeral fx: what is the recommended approach?

• A. Physically do the movement and explain it to yourself (or your dog)
• B. Rest completely and avoid movement
• C. Begin heavy resistance training early
• D. Use only passive ROM without active explanation

Answer: (B)

Protection during the early healing phase is the priority. After a proximal humerus fracture, limiting movement helps keep the bone fragments in proper alignment and allows the repair to establish stability. This reduces the risk of displacement and malunion, which is crucial for restoring normal glenohumeral rhythm later on.

So the recommended approach is to rest the shoulder completely and avoid active movement initially, giving the fracture time to heal before gradual rehabilitation begins. As healing progresses, rehabilitation typically transitions from passive range of motion to active-assisted and then active ROM, with strengthening only once the bone and soft tissues have sufficient stability.

Movements that push for heavy resistance too soon can disrupt alignment and delay healing. Relying only on passive ROM without any gradual active engagement can lead to stiffness and poor long-term function. Mental rehearsal or self-talk doesn’t substitute for protecting the healing bone.