broke shoulder

I was in a hurry to get to the gate for my flight to Tuscon. In the summer of 2016, I was flying to an important meeting where I was going to have the chance to interview a former Surgeon General.

The traffic from Marin to SFO was obnoxious and the TSA line very slow. I was wearing a heavy backpack. Optimistic about getting some work done on the plane, I had filled it with medical journals and my laptop. I was also pulling my wheelie.

I was walking my usual fast pace when the ball of my left foot struck the floor first—it had been happening a lot lately—and I stumbled. As I tried to get my balance, the backpack slid up towards my head and propelled me forward and down—hard.

I took the brunt of the fall on my right shoulder, but the worst pain was in the middle of my upper arm. I couldn’t use it to help me get up off the floor.

After the fall

A kind passerby got down on the floor next to me and said, with confidence, “I am certified in first aid. Can I help?” Grateful, I directed her to take my left arm and gently pull me into a sitting position.

By now, I am the center of attention, surrounded by airport police, passengers, and a United Airlines representative who told me, in no uncertain terms, that I would not be getting on my flight to Tucson (I actually asked him to please take me to the gate in a wheelchair). Although he kindly booked me on a later flight, just in case the injury turned out to be something minor, he had already called for an ambulance.

So that was how I ended up as a patient in the ER I used to work in. The emergency physician on duty was one of the few people I still knew at Kaiser South San Francisco. He sewed up a small laceration in my right eyebrow and arranged for the x-ray. The radiologist, an old friend from my running days, gave me the bad news. I had a displaced fracture of the greater tuberosity of the humerus plus a non-displaced surgical neck fracture. I was definitely not going to Tucson.

broke my shoulder
My Xrays showed a proximal humerus 2-part fracture. I am definitely not going to Tucson.

Why a fall is not just a fall

There are so many interesting and important questions raised by my fall that I want to share with you because I learned that a fall is not just a fall and a broken shoulder is not just a broken shoulder. Bear with me as I take you through some of my thinking.

First of all, there’s the question: Why did I fall? The folks at the airport and the clinicians in the ER asked all the right questions to make sure it wasn’t something that needed an urgent evaluation. Did I have chest pain, dizziness, palpitations? No. Did I trip on something—an uneven tile or an object on the floor? No.

I am very clear about why I fell. I tripped over my own left foot. Once I explained that people lost interest in why I fell and concentrated on the result of my fall—the proximal humeral fractures. But, we will come back to the why later on because it is one of the most important questions that can be asked about a fall.

Managing the pain of a broken shoulder

The next question was what did I need for pain? I opted for 1 gram of IV acetaminophen. It worked like a charm and left my head clear so I could sort out the other issues. One of the most urgent was notifying my client that I would not be at their meeting in Tucson the next morning. I also had to figure out the best way to get home without having my husband schlepp an hour to retrieve me.

An obviously important issue to address: What’s the treatment? You can’t put a shoulder in a cast. I was given a sling and a follow-up appointment in Orthopedics for a week hence. I opted for NSAIDs for pain because I don’t like the nausea and foggy head that accompany opioids. It turns out that was all I needed.

The discharge from the ER was amazing. My friend, the ER doc, gave me a white and blue pocket folder filled with all the information I would need until I could see the bone doc. It included several sheets of paper that described upper extremity fractures. It also outlined the home care and follow-up instructions and explained when to seek urgent medical advice.

It also provided instructions on how to take the pain medication together with a note telling me that I could pick up my prescription at any pharmacy. It was already entered into the system-wide EHR. (Eat your hearts out, all you people getting care outside of an integrated delivery system).

I tucked the paper copies of my X-rays in the folder and paid my $5 (no kidding) copay. And then I said my thank yous to the staff who had treated me so kindly and professionally.

I took a Lyft home, whining to the driver about how I was missing a great meeting in Tucson. Even more important, I complained, I was going to miss the upcoming family trip rafting the Middle Fork of the Salmon that I had been looking forward to for months.

Follow-up for the broken shoulder

broken shoulder
My bruised arm looked like something from another world. Who knew a trip and fall could end up looking like this?

I got plugged into Kaiser’s orthopedic department and had regular x-rays to ensure healing was going ok. Of course, I spent hours on PubMed and other sites on the internet trying to determine what was the best treatment for my particular fractures.

My fellow internists won’t be surprised to hear that the Orthopedic literature is a mess. Most of the papers I read insisted surgery was the treatment of choice, but I was being treated conservatively with a sling and physical therapy (PT).

So, I made an appointment with the shoulder specialist at my Kaiser medical center to review the literature—yes, you can do that. He described several studies—one from the UK that I had already read—that found that outcomes were the same for people treated with surgery and those treated with a sling. This was the case even if there was displacement of the greater tuberosity like I had. Further, he pointed out, the top of my humeral head had a good shape and there was plenty of room between it and the acromion so impingement syndrome was unlikely.

I was lucky. Even before I started PT, my shoulder range of motion started to improve. With PT, I am about 80% of the way to normal shoulder function (Hooray!).

A deep dive into falls and fractures

Because there is so much more to the falls and fracture story, I have decided to divide it up into different posts. Here are some of the issues related that I will be exploring over the next several months:

  1. The humerus is a big bone. Why did mine break after a simple fall from a standing position? Had my long-standing osteopenia progressed to osteoporosis? If I have osteoporosis, what is the best treatment? And, what are its side effects?
  2. Why did I trip? Did I have foot drop or some other gait abnormality? Or was it just a problem with my shoes, my clumsiness, or my inattention? Equally important, what can I do to prevent falling in the future—a huge source of morbidity for women (and men) “of a certain age.”
  3. How can I get back full and normal function of my right arm? Believe it or not, I was so good at holding it still by my side that I had to consciously remember to use it once it was freed from the sling.
  4. How do I overcome my newly acquired fear of falling and mental images of falling when I go up and down stairs or walk with my big old black lab? Is this a form of PTSD? What’s the best way to renormalize my disturbed sleep?

I want to explore all of these aspects of falling with you because I think all too often clinicians, friends, and family members,—and even patients—think that a fall is just a fall. But in many cases, as I have learned, a fall may be so much more.

Related content: Do You Know Your Risk of Fragility Fractures?

If you would like to add to this list of issues to explore, please pass them along either as a comment on this post or as an email to info@thedoctorweighsin.com.


I originally posted this on July 24, 2016, shortly after my fracture. I am republishing it today because I am participating in OpenIdeo’s Healthy Bone Challenge.

I am hoping to hear more from readers about their experiences with osteoporotic fractures:

  • Were you asked about osteoporosis? Were you offered screening for the condition?
  • Were you evaluated for underlying or contributing reasons for the fall (e.g., balance problems, vision problems, safety issues in the home?
  • Did you experience significant emotional sequelae were present after the fall/fracture? Did any of your health professionals ask about or offer help with these symptoms? 
  • Would you fine a program, such as the one described in the Challenge description helpful? Would you use it?

You can leave your responses in the comment section below. Or, if you prefer you can leave responses on the OpenIdeo site (link above). Or, send me an email via info@thedoctorweighsin.com

86 COMMENTS

  1. A few tips and questions. I’m in 8th week of broken shoulder. No surgery. Healing going well. My physiotherapist suggested keeping dry washcloth, changing frequently, in armpit when in sling. Helps with rash. Same under breasts at night, just a light cotton under cloth/shirt. I didn’t wear button down — found it easier to use baggy tshirts, hang arm down to get into it, then pull rest over head and second arm. Using all natural baby wipes helps for frequent cleaning of sensitive parts if shower too difficult.

    It will get better, but seems like forever. Even at 8 weeks, still painful (mostly from PT exercises, but still frustrating). And hand and wrist still a bit numb. Arm still a bit swollen, although the horrid bruising almost gone.

    My question is, do some of you still have numbness even after such a long time, 8 weeks? Seems like should be gone by now?

    • And, Dr. Salber, thanks again for this post, and I realize I just moaned a bit instead of giving you some answers. Here are some answers:

      Were you asked about osteoporosis? Were you offered screening for the condition? NO to both.(And I am age 62, and have osteopenia, frankly, didn’t even think of that as a factor when it happened. It was a hard fall, from dog pulling at a leash, but perhaps without osteopenia, injury would have been less.)

      Were you evaluated for underlying or contributing reasons for the fall (e.g., balance problems, vision problems, safety issues in the home? No, because it was clearly from the dog running after a squirrel and me not letting go! But in terms of safety, I guess, yes, in the respect that I was asked if I felt safe in my environment and home (presumably trying to get a possible abuse.)

      Did you experience significant emotional sequelae were present after the fall/fracture? Did any of your health professionals ask about or offer help with these symptoms? I was concerned about falling due to not being fully balanced, no one asked me about if I had emotional issues from being afraid of falling. Interesting thing is now, 7 weeks on, I’m finding I’m a little more fearful. That’s because I no longer am wearing sling, am sort of getting back to “normal” and am afraid I’ll suddenly make a wrong move. Whereas before I was being super careful. So, one aspect of an after care program would be “two months on”, etc.

      Would you fine a program, such as the one described in the Challenge description helpful? Would you use it? In my case, I actually had a nasty fall in college – many moons ago. I only got a bad bruise, it was slipping on icy stairs (outside). But since then I’ve been a bit cautious. Also have a lot of stairs in my house, marble stairs, so am always “aware” of that potential. I do not know if I would use a program such as that proposed because I’m quite aware of it already, it’s not really much worse than before, and I am working hard to get into better shape to avoid falls. But I think it’s an excellent and neglected idea.

  2. I tripped over my own feet and broke my shoulder about 17 years ago. It was the day before Thanksgiving, & I was thankfully out of school (teaching) and on my way to pick up table decorations. I stepped from the parking lot up to the sidewalk in front of the store, in sensible shoes, my left foot hit ball first, I lost my balance and started to tumble forward toward the plate glass, threw my left arm out and fell sideways with my arm outstretched. Wow, what a hard fall. As I started to get up, I realized I could not use my left arm at all. People helped me up, my purse had scattered debris everywhere, & someone got me into the store. I felt half nauseated,& very rattled. People were bring my stuff from purse to me. (Two days later, my MasterCard company called me to alert me of two $800+ purchases the same afternoon I fell, were these mine? No! One of those nice people helping me had ripped me off.) The store wanted to call an ambulance, I refused. I asked for a glass of cold water, but brought me a cold compress. If I did not move my left arm/ shoulder AT ALL, I felt no pain, the minute it wiggled, it hurt a lot. I went to my car, and found that getting in and driving with just my right arm was doable. I went home, and somehow got myself out of a pullover into a button up shirt, knowing that I’d be xrayed. I got my ice water & a book, and headed to the closest hospital, but that ER was packed. Forget it. I drove to the one 15 minutes away, & it was dead quiet. The triage nurse, seeing my droopy left arm, took me right in. X rays were excruciating since they kept putting my arm in different positions. They told me that my shoulder was broken, & I’d need to see an ortho, & put me in a sling. I got through the next week very gingerly, but I returned to my job and taught my middle schoolers, thank goodness they aren’t grabby like little kids so I could count on them not to jostle me. Finally the appointment, in which the Dr. gave me a much better apparatus, that velcroed around the waist, and snugly tucked my arm in with two velcro bands for support. Six weeks to not move it at all. Then 3 months of 3 times a week physical therapy, and I got 95% mobility back, when I had started with 20%.
    As far as anyone asking me about osteopenia, which I do have, no.. they didn’t. I didn’t even know I had it until a couple years later. Asked about balance, dizziness, vision, safety in the home? No. I’m not sure what you mean by emotional sequelance, unless you are wondering if anyone helped me at work, or if any of the professionals wondered about my emotional well being. No, no one did, and I was okay. I didn’t have any fears of falling, but I did promise myself to be more careful. I felt that my fall was due to not paying attention, and to trying to put up my keys and cell phone at the same time as I was hurrying into the store. Later, my husband was horrified that I had not called him, not gone in the ambulance, had driven myself. But I felt capable. I never want attention when I’m hurt or sick and just hate the embarrassment of falling. And, I will admit… that I’ve fallen several times in the years since then. We moved across the country, and my new internist was very concerned about the falls I had while under his care. They were always when I was in a hurry, and I never broke any more bones, but I kept hitting my head and having huge bumps and then massive, slow healing bruises on my face. He wondered about spousal abuse (no) vision (no) balance (maybe) dizziness (no) drinking(no). He would examine my eyes and tap my knees and have me stand on one foot, walk across the room. He would sigh and sent me for a Cat scan, saying “I hate doing this again, but… we have to check for bleeding under your skull.” Never was any. I kept telling him, “my mind runs 100 mph. I’m always thinking about so many things even while I’m moving or doing tasks. I’m clumsy and awkward. I feel big in my space, even though I’m average size. I bump into things that are in my house that are always there. I don’t know what it is, I just need to pay better attention.” He is the one who diagnosed me with the bone thinning, which I still have but it’s not getting worse due to the extra Vitamin D he put me on, I guess.
    I started taking Zumba, and I think my balance improved. I didn’t have a fall for 3 years, but then I had a bad one. New house, slippery patio, at night, trying to get my cat back in the house from a cat fight, I stepped onto a stone flower bed and fell off of it onto the stone steps. I didn’t hit my head this time, but I had a wrist, arm, and leg injury… nothing required anything but just bandaging at home. Since then, five years ago, I have fallen one other time, this past summer, going up uneven concrete steps at a cabin, I fell forward and hit chin first. Again, big cut & bruising but no MD attention needed. I imagine I will fall again, but I am much more purposeful about anyplace I walk. I’m 67 & I’m not sitting around like a decrepit old lady. I hiked down into a canyon with my daughter and grandkids this past summer. As an additional note, my parents both fell and had some pretty nasty injuries as they aged. My mom passed at 93, my dad at 95. I started falling as early as my 20s, but never had a big injury until the shoulder.

  3. So interesting to read! I type this comment one-handedly from my non-dominant hand after suffering a comminuted fracture of my humerus myself. I was doing an obstacle course race and jumped (!) from a trampoline straight into a wooden wall. Originally, we thought it was simply dislocated (WOW relocating a shoulder hurts), but turns out I also broke my shoulder in two places. Good times.

    Anyway, so nice to hear others commiserating about the small things we took for granted, like washing our underarms. I have tried to explain to people that no, I am not in great pain, but it is very frustrating coming to work everyday after “sleeping” upright in the corner of my sectional (pretty sure I haven’t slept more than 2 hrs at a time in 18 days), only to have to dress in pants with elastic waistbands, baggy shirts, and slip on shoes. Not exactly fashionable! I appreciate the tip about the medicated powder btw, as the skin under my right arm has been so itchy. It has been even more challenging for me than others, I think, because I live alone…my biggest struggle has been figuring out what in the world to do with my hair on a daily basis!

    34 more days until I can drop the sling. Looking forward to a (slow) return to normal movement!

  4. Hi Yvonne, regarding the shaking, I experienced the same thing when returning my forearm to my side (imagine a bicep curl with no weights). It has gotten better and rarely happens now. My fall was 7 weeks ago.

    I have a question for the group. I’m wondering how long you felt pain? I fractured the head and neck of my shoulder (not a complete break) and the head of my shoulder is offset from the part it should fit into). I have a dull ache throughout the day and it’s worse at night when I try to get comfortable. My doctor won’t prescribe anything because I’m “outside the window for opioids”. I asked for a prescription of anything non-opioid and she told me to take ibuprofen, which I have been doing. Just curious how long everyone’s discomfort lasted? I have a pretty high tolerance for pain and it’s at a 4-5 during the day and close to a 7 at night.

    • Thanks for the reassurance about the shaking. Mine is getting less now but still bothers me from time to time. We are at about the same stage as I am eight weeks post fall now. I also get a dull ache in my arm during the day and at night but I find the more I exercise The better it’s getting. It hurts while I exercise but I think each day the pain is slightly less. I still have nerve pain in both my thighs which I’m sure is connected to my fall but nobody seems very interested in that and just says it will go away in time.I’m visiting a chiropractor and a reflexologist and I’m hoping it will improve because now it’s worse than my home at night. It’s no fun is it?

  5. Hi, I just broke my shoulder 2 days ago. Doc says looks clean with no separation but getting MRI tomorrow to determine extent and treatment. I fell playing pickle ball. Sigh. Petty banged up and lots of pain. Just wanted to say hi and commiserate with you all!

  6. On a late evening in early August, I fell and suffered a non-displaced avulsion fracture of the greater tuberosity along with a black eye and a subconjunctival hemorrhage of one eye. Why did I fall? I don’t know. One minute I was standing and then next I was on the floor with my arm doubled under me and the left side of my face flat to the floor. I was diagnosed with osteoporosis earlier this year. An increase from the 4 years previous osteopenia. I was placed on Prolia therapy and had my first injection 5 months prior to the fall. I received expert treatment of the fracture in the ER and was referred to an orthopedic surgeon. No surgery needed. Will start PT in another week.
    A month after the fall, I saw a specialist for a chronic lung and systemic condition. She was visibly upset by the lack of ER attention to the why of the fall. No heart or head evaluation and no follow-up to check into possible factors.
    So now, here I am with a fear of falling and I am, as you say, reliving the fall & imaging how other falls might happen. I am also wondering whether or not I will be able to use my arm well enough to drive again. Driving is important as I live 30 minutes from medical care and sometimes need to take a family member to their medical appointments.

  7. Ohmygoodness! I am not the only person this has happened to! I tripped over uneven concrete and displaced mid-humerus and completely smashed my humerus head and broke my elbow in 2 places. I have had one surgery and am now plated and screwed together, but the head did not mend and it is in necrosis now. I have been ‘growing good bone’ as my doc states for just over a year now, he wanted all of the breaks to be completely healed before progressing. In the next couple of months I will have a total reverse shoulder replacement. I am looking forward to not hurting so much. I don’t complain, but golly… owie.

    I laughed so hard about the washing of the armpit. I use a medicated powder now too there because it is skin on skin so much. Where the bra is concerned I can place it out behind me, and gently grab both ends (one at a time) and hook in the front and then shimmy it around and get it on…. or most days, I just say the heck with it and go free. I bought an electric shaver to do my good armpit but hubby says I look like a contortionist. I am okay with that. My toughest challenge has been two-fold; 1. getting my britches up on the injured side 2. slicing anything. Life will go on. I will heal. I will be stronger.

    • Oh my goodness, what an ordeal. I’m so sorry. I hear ya on getting britches up, I’ve only worn elastic waisted or no waist items since this happened. Probably TMI but I only put on undies if I’m wearing a dress otherwise it’s too much work to pull up two items. This has been a very humbling experience, I’m fiercely independent so having to have someone do things for me is torture. Wishing you well on the surgery and subsequent healing.

  8. Hi Shannon, yes the armpit washing is a challenge, but your range of motion will improve. I still have to lean forward in the shower, dangle my bad arm forward and use a washcloth to clean myself. In the beginning I could only move m arm about 2 inches from my side. Now it’s only slightly better at about 3 inches (I think I’m being generous with that!). As for the bras, try front closure ones – they are doable by yourself! I was wearing my husband’s button down dress shirts, but they’re long sleeved and really hot, especially in Tucson. I bought some men’s (couldn’t find ladies shirts large enough to accommodate my arm in a sling) short sleeved button down shirts, but am now able to wear slightly oversized ladies cotton T-shirt’s.

    • Hi Jennifer, I hope your follow up appointment went well. I made a decision about four days into this journey that pain was going to be my new best friend and I needed to come to terms with that…and take joy in the small victories. I look forward to a bit more ability to move the arm from the body and know that it will come with time. I bought a sleeveless button up shirt today and it was very easy for me to get on, I live in Albuquerque so it’s still quite warm, I’m optimistic that ROM will be better before winter settles in (if not I’m prepared to drape with a sweater over the sleeveless shirt with sling underneath. I really like the idea of the app Dr. Salber is considering development of. I’ve not gotten much guidance from the medical folks I’ve been in contact with, only tip I got was sleep in a recliner and make sure that I remove the sling and move the elbow joint (that was stressed by two different PAs I’ve seen). I asked for do’s and don’ts and was pretty much told just keep doing what your doing, as healing was seen on the two week follow-up x-rays. I wish you well on your healing journey.

    • https://thedoctorweighsin.com/wp-content/uploads/Yvonne-Image.jpg

      This is a link to a photo that has been kindly uploaded for me. Its of my arm a few days after I got my greater tuberosity fracture. I find this forum incredibly interesting. I’m from the UK and haven’t found a forum of people who have done similar things to me. I find that my progress matches a lot of what contributors on here I’ve been saying. I broke my right shoulder and I’m right-handed so it’s been very difficult to do everything with my left. I have also suffered insomnia and a fear of falling again. I guess that’s pretty normal as nobody wants to do the same thing again. I was asked to join a study at my hospital which is looking at why elderly people fall. I think they are trying to understand what happens and why although of course it isn’t only elderly people who fall. I must admit I resent being called geriatric but I guess at 77 I am. I am determined to get movement back and I’m doing my exercises regularly. It’s encouraging to hear that this has helped others. I was also worried as to whether my shoulder was being kept still enough with just the small sling I was given But it seems that I haven’t done any further damage and my last x-ray showed that things are healing nicely. I shall keep reading posts on here with great interest

      • Oh my goodness Yvonne, that bruising is spectacular. I was fortunate to have very minimal bruising, with the exception of where they blew some veins trying to get the IV placed at the ER. As you did, I also broke my dominant arm so pretty much everything is a challenge but I’ve become very creative. I wish you well on your healing journey.

        • Avatar It doesn’t happen all the time but when it does I have to physically stop it. I have been told it’s due to weak muscles but wondered if anyone else had the same problem?

          I can’t see how to start a new post on here so I’m continuing with a reply. Does anyone else have the problem of their arm shaking? I am getting more movement back in my arm now and I’m following my exercises as prescribed by my therapist but I suffer from my arm shaking. It doesn’t happen all the time but when it does I have to physically stop it. I have been told it’s due to weak muscles but wondered if anyone else had the same problem?

          • Yes I do but I’m only 4 weeks in, they say it’s the muscle with me which I find really odd when my muscles used to use 8kg weights at the gym. How does the muscle go from that to this so quickly ?

  9. Hi everyone. I stupidly fell over my dishwasher 20th July 2017. My job meant that I would not be home until at least 21.00 hrs. I relaxed and got chatting to a friend. Went to bed around 11.30 pm. Was chatting to a pal and and was bringing a glass of water to bed. Forgot that I’d left the dishwasher door open and tripped over it in the dark. I hit the kitchen wall and landed on the kitchen floor just missing the table.
    Family heard my screams. Brought into hospital midnight. Was given painkillers. Eventually a CT scan which showed up a dislocated and badly smashed up top of humerus.
    Had surgery and 3 pins inserted after 36 hours in pain.
    A year later pins removed and a clean out done in the hope I might have more movement. No difference. MRI scan Nov’19 showed avascular necrosis. July ’19
    discharged from hospital physio as I’ve plateaued. No change in 3 months.
    Who would have thought a silly fall would have such a profound affect on my life.

  10. Hi Shannon, I agree that this forum is a godsend after something like this happens. I found great comfort in the comments people posted. It’s been 4 weeks and 3 days since my fall and I can tell you it will get better. I have my second follow up ortho appointment today and I’m really hoping there’s been no shift and surgery is not needed. I can relate to your sleeping woes. I don’t have a recliner so I’ve been getting spotty sleep on my back in bed. A huge victory for me has been the ability to wear a non-button down shirt (previously all I could get on were oversized, men’s short sleeved button down shirts – not flattering at all)! I am close to your age 47) and my break is to the humeral head and neck, so raising my arm over my head is impossible. I guess I just want you to know that you’re not alone and you will get through it, even though it might not seem that way. Take care.

    • Jennifer, thanks for your reply and encouragement. I’m so sorry you don’t have a recliner, it was one of the first things the PA discussed with me was sleeping in a reclined position. I’m 2.5 weeks out from injury and I had very serious doubts leaving the doctors office after initial consultation but after the first full week, things became more manageable. I can’t move my upper arm more than maybe 1/2″ away from my body but have managed to put on sleeveless shirts, it’s a bit of an ordeal but as long as I go slow I eventually get it figured out. I’ve not worn a bra since the day I went to urgent care, not sure why I was so worried about it…as soon as I went back to x-ray I had to remove it. LOL I had no button up shirts and all of my husbands are long sleeved dress shirts for work. But here is the one thing that I’m still struggling with (other than sleep), washing my armpit on the fractured side. I’ve been dangling my arm and leaning slightly so gravity will pull the arm away from my body, then taking a washcloth and doing my best to scrub, then rinse with a hand held wand. I only had stick deodorant (until today) but I did figure out that I could dry the pit with a folded paper towel, then use an other one and wipe the deodorant on it and much like the washing dangle my arm and wipe the deodorant on. Who would have know it could take so much energy just do shower and get dressed.

  11. Wow, this has been the most helpful and encouraging I’ve read since I stumbled over some landscape rocks in the back yard 17 days ago. To make a long story short I waited over 12 hours before going to urgent care, even though it was the worst pain in my entire life, all 49 years! Turns out I have a 3-part fracture of the greater tuberous and surgical neck (minimally displaced). At this point the pain is tolerable with no meds, for the last week or more. I am obsessed about how I could have done such a thing and freaked out about doing it again. We have a two week trip to Cabo that we were supposed to leave on tomorrow but were able to push by a week. The PA says I can heal just as well in Mexico as I can in New Mexico. I’m worried about sleep, I’ve been in the recliner since this happened and I don’t think our resort room will have a recliner. But I’m devising a plan for a pillow wall to keep me from rolling. It’s already something that scares me just in the recliner, I woke myself up the other night with the sensation that I was rolling over. I got NO sleep after that. Since then I’ve been getting around 5 hours a night (off and on) and that’s not me. I really appreciated this article, it’s so nice to hear first hand from a doctor thats been through it.

  12. Hey Jennifer, hang in there! It is now 7 weeks since my fall. My arm still looks a little brownish, from the bruising or fake tan I put on it😉. My arm looked worse than Patricia’s. I wish I had iced it but the Irish nurse said it would not help. While you are going through this it seems it will never be over, but it will! I was able to sleep with the help of pain meds on the sectional couch. I am thinking that sleeping meds should also be prescribed. It sounds like insomnia is a common problem. So I am finally feeling better, sling is gone. I went to an art museum yesterday and walked around with some discomfort so I took Tylenol and felt better. I also had hip and pubis bone hairline fractures so walking was difficult in the beginning. My fear of falling is passing as well. I am doing PT at home and office visits, it’s really important if you want your full range of motion back. You are a lot younger that me so I think you will heal a lot faster. Wish I had the app when I was first injured. I went through all the emotions and thoughts you are having again I will say you will get better!

    • Cathy, THANK YOU for taking the time to reach out to me. Knowing you and others felt the same way I do now and triumphed over it is a great comfort and a reassurance that it will get better 🙂. I continue to meditate and find the pain an interesting distraction. I’m thinking of taking an Advil pm before bed to help me sleep. My most pain free moments are when I’m up and my arm can hang in the sling. The nighttime is the worst! I have so many questions for my ortho doc next week. I can’t thank you enough for sharing your experience. It feels better knowing I’m not alone.

  13. I’m at the very early stages of recovering from a “comminuted impacted fracture of
    the anatomic head of the humerus with ossific fragments within the soft tissue lateral to the humeral head, the lesser tuberosity also appears to be 1.7 cm displaced, glenoid fossa appears to be involved as well” (this is from my ER record). I fell on 8/18/19 and wasn’t given much information when leaving the ER. I have a cuff and collar and wear it at all times except when in the shower. I meet with my ortho doc on 9/4/19. I’m concerned about the swelling and bruising and am wondering what I should be doing to help alleviate both. Pain is manageable during the day but sleeping is a challenge. Mostly I’m feeling fearful and insecure if my bruising is normal (it looks very similar to the photo in the article). Any encouragement or guidance would be appreciated.

    • As you saw, my bruising was spectacular. And, I was swollen. It can take quite a long time to resolve because all that mess has to be cleaned up by macrophages, a type of white blood cell. Don’t worry the bruising and swelling commonly occur after fractures – even small ones like broken toes. There are things to do reduce swelling (such as elevating the extremity) but this SHOULD NOT BE DONE because you are in a sling or other device to immobilize the arm. Don’t worry. It will resolve over time. Yes, sleeping is hard during the early days after this type of fracture. It is simply hard to get comfortable. Insomnia can also occur as a part of the emotional reaction to the fall/fracture. Other emotional responses are fear of falling, feeling frail, anxiety, and instability. These too will resolve with time and some effort on your part. After some experimentation, I found that the best thing for my emotional reactions, including insomnia, was attending meditation sessions at a local Zen center. I wish you the best for a smooth recovery. There are lots of folks who have written here about their experiences. Please to come back over here any time you need support.

    • I have a greater tuberosity fracture which happened on the 12th of August. Yesterday my consultant through my sling away and told me to try to use my arm as normal as possible. I have been doing simple pendulum exercises for the last two weeks and start my physical therapy tomorrow. My arm aches dreadfully today without the support of the sling. My bruising was incredible and I was just about to go on holiday to Italy. I live in the UK so it wasn’t so far and my family was with me. We stayed with very good friends so I had lots of help. I just want to get back to driving my car but at the moment can’t see that happening very soon. This forum is very helpful. I’d love to add a photo of my bruising as it might help others to realize that in a few weeks it can disappear But I can’t see how to add a photo. Can anyone tell me how to do that? I’m 77 by the way and usually very active. This is the first bone I’ve ever broken And I did it falling over my back step into my kitchen-the steps only been there for the last 50 years.

  14. I have read through the beyond the cast challenge. It is very comprehensive. Kaiser would be wise to have a program like this. I also read all the comments. I found the question about data on future falls being caused by Fear of Falling or PTSD ( sounds more ominous), interesting. It makes sense that FOF would cause future falls by creating a fear of walking thus never getting muscle mass back. I wonder if there is data out there.

  15. Thank you for this! At the ends of May 2019, I fell to my knees with my hand stuck in a door handle. Anterior dislocation and displaced greater tuberosity fracture. The doc in ER managed a closed reduction, which included moving the fracture into place. I had to have the arm immobilized for 7 weeks to make sure the fractured bone remained in place. When I was finally allowed to “move” my arm, it felt like this dead weight that wasn’t a part of my body.
    I have been having physio and going to a pool to help mobilize my arm. Function is slowly coming back, but still can’t do much with it. The one thing that really bothers me is the fatigue that results from the pain and limited mobility. Not to mention the swelling!
    It has been such a disabling injury and it is hard not to get frustrated and sad, especially knowing how long it will be until I’m normal again.
    When it first happened, I behaved much like you. I an fiercely independent and relatively young at 45. There was something wrong, but it couldn’t be that bad – so I drove myself to the hospital.
    Little did I know….
    I keep doing everything physio tells me and hope it will be like nothing ever happened by this time next year.

    • I am so sorry about your fall and dislocation shoulder. I’m impressed that the Emergency Physician was able to do a closed reduction. The one thing I can say about my own recovery is that being fanatically diligent about doing your range of motion exercises at home for a prolonged period of time is key to getting back your mobility. I did them for well over a year with excellent results. Good luck and let us know how it goes.

  16. Thank you for the reassurance about travel. I definitely do not want to give it up. We are starting to make plans for our next trip, to Southeast Asia. My husband says we will keep going as long as we can. What did they do for your neuro work up? I too worked for Kaiser and while I was there “hall wall medicine” was practiced a lot. It’s a little more difficult now to get referrals. Does anyone not have trouble with range of motion after these fractures? Thank you again

    • Neuro w/u:

      A neurology consult with detailed neuro exam, nerve conduction study and EMG – all normal.

      Re ROM. The key is physical therapy that focuses on teaching you a home program, not just in office PT. I did my ROM exercises faithfully for well over a year and now have an almost full ROM. I have no functional limitations.

      After my wrist fracture an immobilization I requested a PT referral even though it was suggested that it wasn’t needed. I asked the PT to focus not just wrist ROM (not really too limited by the fracture), but building up the strength of the small muscles in the hands and fingers.

      We loved SEA visiting all of the countries over the course of several visits. Don’t miss Laos (Luang Probang) and the far north and far south of Vietnam.

  17. Six weeks ago I was on a walking tour in Galway Ireland and suddenly found my self on the ground. I think I slipped on the wet cobblestones, but I am not completely sure. I have fallen in the past and always knew what I tripped on. There never was any discussion about why I may have fallen. Fractured surgical head of humerus, mildly displaced. I am 72 and have had osteoporosis for years but also had fear of the treatment side effects. With my fall I had pain in my hip/thigh after a ct scan and mri it was discovered that I had hairline fractures in my hip as well. My care became focused on the thigh pain and my rt arm was left in the Irish immobilizer. Providers just kept saying it was fine. I think someone should have told me to take it off and move my elbow because when it was weaned off my elbow was moderately frozen. I am doing PT now and getting my full range of motion back. Insomnia, I would take norco at night with Ativan and sleep thru the night on the sectional couch. I am interested in FOF, my fall was the 42nd day of a 43 day Europe trip. My husband and I love traveling and have been doing long vacations the past few years. My 36 year old son said we were pushing ourselves too much. I think I was in better shape after walking so much for 42 days. Last night we walked a few blocks downtown, every crack in the side walk was magnified in my mind. I definitely have fear of falling. Also fear of future fractures. I took Reclast 3 days ago and had horrible flu like symptoms afterwards, feeling better now. I am glad to hear the fear of falling will pass. Thank you for your interest in this subject I wish I had found your site sooner.

    • Hi Cathy, I am so sorry about your fractures, but I am glad that you are on the mend now. My adult son said to me a few years ago, why don’t you slow down, quit working, maybe just putter in the garden. Instead, my husband and I amped it up. Last year we had the busiest travel year of our long life of travel – despite having osteoporosis and two fragility fractures (saw Sri Lanka in December wearing a splint for a wrist fracture – definitely doable. Travel is good medicine!

  18. Very informative article especially as it extends into the aftermath of a fall. Thank you. My fall brought on feelings of fragility, inbalance and the FOF. I did not break or fracture any bones when I fell, the fall was due to my right knee not supporting me and needing replacement. I suffered from the knee due to bone-on-bone and arthritis. It was when I fell on two separate occasions that I decided to take my ortho’s advice and have the knee replaced. I thought for sure that once the knee healed I would regain my balance, return to my original gait with no more limping or clumsiness. The surgery wasn’t the success I had hoped for. I still limp slightly – still have some knee pain and an internal clicking every time I bend the knee. The worst consequence is the fear of falling – I go down all stair or curbs planting my foot parallel to the curb. Same thing going up. I did PT and water walking for a while but when forced to stop when another major medical issue put me in the hospital. I am hoping now to resume water walking and some gym workouts soon. My fear of falling was never addressed by with my surgeon or PT during my recoup time. I have that fear today and don’t know as I will ever overcome it. It would seem that information on this possible post-surgery circumstance would be part of an “early pre-surgery” warning” Treating the whole body during any major surgery (or rehabilitation) should be the norm, not the exception.I am a 72 YO female who while not a workout fanatic, but very active. I do travel, love to walk, visit museums, sightseeing and love the outdoors.

  19. Thank you for your article. As a fellow fast walker, I tripped while heading off with my rucksack for a 2-day work trip.
    Greater Tuberosity fracture. Back at work and using sling for protection on public transport, but about to start going out without it.
    I am very active,and several people have asked ‘But how did that happen?’ Now I can say it can happen to the best of us. Thanks to you and your respondents.
    Now doing PT and reassured that I’m not the only one who found it hard to move my arm away from my body.

  20. Pat, thank you so very much for your blog, advice, and encouragement! Tomorrow will be three weeks since I fell, hard, face first while running (literally) to catch the FedEx man at my front door so he’d set a very heavy boxes inside instead of on the porch in the rain. The toe of a sturdy rubber soled German slipper caught firmly on the hardwood and down I went as I reached out for the front door handle. My left shoulder and upper arm, right wrist and forearm took my full weight at a run. I’m 71 and have never broken anything: what an eye-opener! The shoulder pain was excruciating, a wave of nausea came over me, I somehow realized I was alone and needed to try to open the door and ask the delivery man to stay a few minutes. He was a true angel, took off his shoes and said he’d stay as long as I needed him. He took my right forearm and helped me to a sit, when asked, then in a few minutes he mostly lifted me to the nearby couch, got water and naproxen, my glasses and cell phone. He even left his phone number and name, said he’d be in my area all afternoon! Next day I called his supervisor, who has entered him in a national award program for exemplary customer service. So happy for him! I called 911 since I couldn’t move w/o waves of incredible pain in my left shoulder. The hospital took X-rays and put on a firm, wrapped splint. It was a proximal humeral head fracture with three white lines radiating from the neck area, not displaced. Two days later at the ortho, they took off the splint, put on a sling and emphasized it was only for comfort and I did not have to wear it. It wasn’t comfortable after a while so after a couple days, I went without it during the day. The tramadol gave me nausea, so I used naproxen, double dose. Not sure it helped much, though. Lots of zinging pain in the shoulder if any muscles in my body happened to flinch. I’m concerned that I was not told to keep it immobile, as everyone else has been told. At three weeks it still hurts to try to use the left arm for anything. I’ve moved wrist, elbow regularly just in the course of the day, fingers typing. Not sure why ortho didn’t give me the wrist and neck sling support I’ve read is the best for healing. I chose this ortho due to his excellent reputation in our Solano Co. area. Tomorrow I’ll see on the X-ray how it’s healing. A little worried it should be hurting less by now. Thank you again for this wonderful resource you’ve provided!

    • What a story. So glad the UPS man stepped up to the plate. He deserves that award. I learned when I was looking for answers about treatment for my shoulder fracture that treatment recommendations are all over the place.

      Many orthos recommend surgery but my ortho who was willing to spend quite a bit of time with me addressing my concerns. He pointed out that the best studies show that most (but not all) times surgery is not needed. The ortho literature was not that impressive with many just being small studies not well designed. There was one large study from the UK that supported what he said.

      I haven’t heard of people being treated without a sling, but it wouldn’t surprise me at all if the outcomes were the same with and without a sling. It’s primary function may well be comfort.

      I did have a second fracture last year. This time my right wrist (tripped over my big black lab in the dark). Ortho wanted to cast it, but I was going to Sri Lanka for a month a few days later. So I said, just give me a velcro splint instead. I didn’t want to have to deal with showering with a cast when I was in the developing world. When I returned to the states after 4 weeks, the fracture had healed nicely.

      It makes you wonder how much of routine fracture care is science and how much is just the way its always done.

      BTW, I am wondering, did you experience any fear of falling, insomnia, reliving the fall or other types of symptoms after your fall?

      Pat

      • As far as insomnia, I think it was a combination of things that made sleeping not easy. For four nights I stayed on the couch, sitting scrunched on my right side with pillows around me for the first two, then laying mostly down on right side on pile of pillows at head and shoulders. I was terrified to bump shoulder and severe pain with any movement. Night five I made a small space for the right side of my body in bed with a fat pillow behind me, two firm ones under head/rt. shoulder, one to rest left wrist on by my stomach. This allowed several consecutive hours of sleep once shoulder pain subsided. My neck and back hurt constantly from the unusual positions and weight of the sling (wore it to bed 2+ weeks). Still not sleeping a full night, but stay in bed and try to go back to sleep when I wake in the night.

        The fear of falling is strange. Yes, it almost seems I’m less steady due to placing each foot carefully as I go down the few low, wide steps on my deck I’ve zipped up and down w/o thought for 20 years! It feels unnatural, which I think makes one less steady on their feet. I’m a fast walker, tend to run just to feel the good feel of moving vigorously when getting up to tend laundry of go to the kitchen. I walk rapidly on the sidewalk. This is going to be my biggest challenge, I think: changing lifelong behavior to try to ensure I don’t fall again.

        That the fall happened so quickly was unusual for me, as when I trip I’m able to re-place my feet to catch myself. I do tons of heavy yard work, am at a good weight for my 5’7″ frame, and am more active than most of my high school friends on Facebook. But, I was just diagnosed with osteoporosis on the DEXA scan I’d been putting off having. Very frustrating for a 30+ year pescatarian/vegetarian eating a very healthy diet!

        What did your doctors say about driving? Medical advice I read said not for two months. My ortho was rather vague, but I drive a full sized pickup truck and don’t want to take chances. I live alone now, though, and it’s become terribly inconvenient. My in-town kids are already over committed with their careers and children’s activities. I’m always the one helping out to make things work, not the one needing help. One of the wonderful EMTs who came to get me actually volunteered when I worried about my granddaughter that his wife works at gd’s high school and he would ask her to tell my granddaughter I was at the hospital and wouldn’t be there for her that afternoon when she got out of school.

        One more question as far as the pain you experienced. How long would you say it continued to hurt to use the arm with the broken shoulder? Pain is exhausting.

        Chuckled at your comment that maybe ortho care for shoulder fractures (possibly other fractures as well) is done just because it’s always been done that way.

        Your decision on treatment for your wrist before Sri Lanka shows it is a bit of a guess for the docs to know just what each injury needs for treatment. I’m glad it healed well. BTW, what were you doing that broke the wrist?

        Kay

        • So a few things. The pain will go away. I can’t remember exactly how long it took for my shoulder pain. But I can tell you that now I am completely pain-free and have an almost normal range of motion. Be sure to ask your doctor for a PT referral. I saw a PT who only did shoulders. She gave me a home program that consisted of many different range-of-motion exercises. I did them faithfully for a bit more than a year. This, in my opinion, is THE most important thing that you can do to get back to normal.

          The fear of falling thing is weird. And doctors don’t tend to bring it up. I was just like you. Fast walker, going up and down stairs to my office and bedroom with complete ease. During the time I had the FoF, I felt like I was a little old lady – watching every step. It did finally fade away – but it took a fair amount of time – perhaps 12-24 months. My gait is now normal.

          There are a few things I did change in my life. I now wear real shoes instead of the slip-on sandals that contributed to my fall. I also take QiGong which helps with balance. Tai Chi is very good for this as well.

          I am very interested in this complication of falls and have submitted a research idea to IDEO. Take a look. Perhaps you might like to jump in on the conversation. Here’s a link: https://challenges.openideo.com/challenge/healthy-bones/ideas/identify-and-treat-ptsd-like-symptoms-after-the-first-fall-fracture?utm_campaign=healthy-bones_Challenge_ideas_FE&utm_source=contribution-commented&utm_medium=platform-email&utm_content=normal&utm_term=290076#c-b266980e7cc7ed228ea1dce7e463f906

          • I’m a very faithful exerciser too, Pat, so the PT is second nature for me. They have good connections for that here at North Bay or Sutter Health, where I usually go for medical care. About the driving, how long before your drove? Afraid of rebreaking the shoulder if I moved suddenly, etc.. I’ll look at that web site. Thanks!

  21. wow, just discovered this. Great information, only 2 weeks ago I fell of a horse during my lesson, he was bigger than my usual lesson horse. Felt myself falling, tried to tuck and roll, but knew as soon as i had landed something was wrong. Felt like my arm was asleep,taken to ED, given IV morphine. Fractured proximal humerus, and ribs. still very sore, arm in sling. Treating conservatively. So far so good, have had heaps xrays and CT scan.
    I work as a clinical nurse, off work for 10 weeks at least. Frustrating that I cannot ride, run, do all usual things. Shoulder aches heaps, but rib pain is worse I would say. And sleep, manage a few hours before I wake up in pain, both shoulder and back.
    Certainly an experience I dont want to repeat.

    • I forgot to add that I am 63, still very active – or was till this happened.
      I will get back to riding, running, gym but its going to take a while I am a work in progress.

    • I am sorry about your fall and fracture. It is such a shock when something like this happens. I hope you have a smooth recovery. BTW, the most important thing you can do to get back a full range of motion if really good PT (not just a pendulum swing) that you do fully and faithfully. I did mine for more than a year. Good luck!

      • Thank you. yes its 3 weeks tomorrow since accident. I have already linked with PT for assessment next week, and planning to do hydrotherapy, then later back to gym. I need to be able to ride again, as well as back at gym. Running, obedience and agility with my dog.
        I am determined this is going to happen, I know its a long haul. But as they say “üse it or lose it” so I aiming for 100% recovery and giving my self time to do this. :)

        • One of the best range of motion exercises that I did was to hold a long wrapping paper roll in both hands while lying face up on the ground. I then made an arc with my arms each time trying to get the paper roll closer and closer to the ground. I eventually could easily get it all the way down, but continued doing this for more than a year. easy to do at home.

  22. OMG! Thank you so much for addressing this! I’m 59 and 21/2 weeks ago I tripped on a kitchen rug and went down HARD! I have four fractures in my shoulder. The day after my fall I saw an ortho dr who took additional x-rays and said to continue to keep my left arm immobilized and it would heal on its own. A week and a half later he wanted more x-rays and is now referring me to a shoulder specialist for surgery. He told me it would be a decision between a total shoulder replacement or “putting humpty-dumpty back together again.” I don’t understand how it goes from immobilization and rest to a possible shoulder replacement! I’m self employed and haven’t been able to work since my fall. I’m looking at what I can start selling in my house to make ends meet and now I’m facing potential surgery with its lengthy recovery. I have been doing research online but I’m more confused than ever. I don’t even know what I don’t know. Also, I’m scared to death of falling again! I envision myself falling again, I nearly refuse to go up or down a stairway and when I do walk I keep my eyes glued to the ground. Will this go away? What should I ask the surgeon? HELP! I’m in full panic mode!

    • Hi Denise,

      I am so sorry about your broken shoulder. I am sure you are feeling like I did. What a shock? How did this happen? What does it mean? Will I ever get back to normal again?

      I am going to answer these questions based on my experience as someone who also tripped and broke a shoulder. I am not answering as a doctor. I am not qualified to address shoulder fractures and I do not give medical advice on this site.

      So here goes:

      I did a lot of googling after I broke my shoulder. It was disturbing to see the differences of opinion on how to treat different types of shoulder fractures, doctor to doctor, country to country.

      Basically, immobilization (sling) is a good first therapy until you see a specialist who will evaluate the details of your fracture and make recommendations. I thought I needed surgery until I read the medical literature and talked to a trusted orthopedic surgeon. He strongly recommended conservative therapy (immobilization and then PT) for me. My fracture was only 2 part with minimal displacement and no angulation.

      Your fracture sounds more complicated than mine – 4 part fracture. You don’t say anything about whether it is displaced, angulated, where the fractures are, etc. That is really not in my area of expertise to evaluate.

      But I am a big believer in getting as many expert opinions as it takes for you to be comfortable with the recommendations. However, this can be both expensive and confusing. You will have to decide how much advice you need before settling on a doctor that you trust.

      So, let’s talk about your fear of falling. This was the most surprising thing to me. I actually think I developed a mild PTSD and the fear of falling was just one symptom. The other was really bad insomnia.

      Let me reassure you, if you work at it both of these symptoms will go away.

      I spent weeks being afraid of going up and down stairs which was hard as both my bedroom and home office are up a flight of stairs. So I just accepted it as a reasonable defense mechanism on my part. I made it a point to watch my feet wherever I went, particularly up and down stairs.

      Things you can do to help yourself include
      -seeing a good PT for balance exercises,
      -taking balance classes (including Tai Chi or what I am doing now, QiGong).

      IT WILL TAKE TIME.

      Be patient and be good to yourself.

      You didn’t describe insomnia, but for me, it was a huge issue. I actually moved my bed into another room and cried at night when I couldn’t sleep. I tried melatonin – didn’t work. I went to a local meditation center – it helped a bit. I finally tried prescription sleeping pills which worked beautifully but were not a viable long-term solution. Little by little almost all of my symptoms (fear and insomnia) went away. Yours will too.

      I ended up tripping on my dog and fracturing my wrist a few months ago. It was interesting that although my fear of falling again reappeared – I think mainly because my wrist was in a splint instead of a cast because I was traveling. But that went away once I was out of the splint.

      Bottom line: After your shoulder is treated (sling or surgery), work really hard at the recommended physical therapy. Aim for a full range of motion. Keep on doing the PT for month and months after you are pain-free. I did my range of motion exercises for almost a year.

      Work on your balance. Keep on moving (swimming great). Get enough sleep.

      You will get back to normal.

      • Thank you so much for your thorough, articulate and kind response. I actually gasped out loud and my heart started racing when I read you had tripped and broken your wrist. I wish you a speedy recoery!

  23. Thank you for your stories. I’m on week 4 of a broken humorous right at the ball. The pain seems to be getting worse, which makes my fear of falling overwhelming. I’m 52 and like many of you having terrible insomnia. Just reading your stories made me feel better.

    • You are welcome, Pamela. I am glad all of the stories have helped you feel better. Two thoughts offered as a person who has been there (not as medical advice): 1. Keep on walking, watch where you put your feet do balance exercises (yoga or Tai Chi) and take a deep breath, the fear of falling will fade over time. 2. The insomnia was harder for me to conquer. I tried meditation (helped a bit), melatonin, benadryl, sleep tapes, etc. But for me what really helped was a short course of a medium acting (~5 hours) prescription sleeping pill. It let me experience what it felt like to wake up fully refreshed after weeks and weeks of fitful sleep and long days of feeling horrible. I am not advocating sleeping pills for anyone else. They certainly have their side effects (dependence being one of the most serious), but they helped me over a rough patch.

  24. After caring for my sick husband for over 15 months, I had lost 40 pounds when he died. After 6 months of changing names on titles and other stressful tasks. I was headed to bed when I hit my toe on some object and was thrusted forward into the corner of a wall. I hit right side of face and shoulder and then totally spun around landing on hardwood floor. I hurt and was dazed. I just laid there trying to comprehend what happened. My right arm hurt but I could move fingers. I used my left arm to move my right arm over my chest. I searched around in near darkness and found a wide ribbon I had saved from Christmas. I used it to tie right arm to my neck. I was in food physical condition and scooted down hall to staircase and used rails to stand up. I called my daughter. It took her over an hour to get to me and I decided to just sleep. I thought may it was fractured but thought I would wait. Next day decided to go to ER. Yep, 3 fractures. A spiral fracture to upper humerous and fractures on both sides of humerus head. After 5 miserable weeks in sling I started using arm. No, I started to move it but I could hardly lift it. I had home therapy. BTW 80 years old and l live alone. I could lift 20 pounds and drag 30 pounds but now I couldn’t even reach a lightswitch. The worse part was not being able to cook decent meals. Now over a year and a half later I can do much more but I am always in pain. Sometimes a 2 level and sometimes an 8. Using a vacuum cleaner is torture. Even using a computer mouse is painful. So I am concerned that the pain will never stop. As for fear of falling, I was an ice skater and never feared falling and usually went with the fall. This made me fearful of falling. I was walking sort of fast when I fell. Now I walk slower. We use our arms to balance when we walk. So having an arm in sling changes our balance. While in sling we are less active and leg muscles get weaker as do other body muscles. I think PT should be a whole body activity. I had always done PT exercises for legs when I cared for my husband. I have resumed them. I also thing possibly being less mobile might do something to our inner ear balancing. My arm was black and blue from shoulder to my hand. My age and diabetes definitely had negative effect on my recovery.

  25. Thanks for your reply – 95% range of movement sounds like a great result. I’m definitely focusing on one day at a time & avoiding the worst case scenario/catastrophising, which would be terribly unhelpful. I’m expecting to begin physio in the next fortnight, so that’ll be a real positive step.
    Again, thanks for putting your story & analysis on the web.

  26. So interesting to come across this blog post. I fell a week ago running downhill on cobblestones, wearing hiking boots, something I’d done several times previously. Landed heavily on outstretched right (dominant) arm. Fractured humeral head, not displaced, in sling, expecting to begin physio in a fortnight assuming next xray is satisfactory. Painful & extremely inconvenient. I live with my parents in their 70s, dad v fit, mum quite advanced with Parkinson’s. So my inability to drive will impact seriously on all 3 of us. Dad & I usually share the care/ driving, so next few months is going to be tough.
    Also, I’m a keen outdoor hiker & gym fiend, at my best fitness level since childhood (I’m 46), so serious restrictions on my activity levels is already freaking me out. I can see my OCD has worsened considerably since the accident. I have a long history of depression & eating disorders too, so all those factors are cause for concern. But I do have some excellent longstanding friends, great neighbours & a close family, so I’m hoping to take this thing one day at a time.

    • Hi Kate, I am sorry to hear about your fall and fracture and definitely agree it is very inconvenient to have your arm in a sling. Once you are out of the sling, you will probably be recommended to have physical therapy to get back your range of motion – this is very important. I had a 2-part fracture of my humeral head/neck. I went to PT for a while and did all my home exercises, some of which I still do today – several years later. I have about 95% of my prior range of motion – a very good result. I also had a mild PTSD and terrible insomnia after the fall which is not uncommon. I went to our local zen center to get help meditating which helped with stress and with sleep. Glad to say, all’s back to normal now – except I do watch where I put my feet much more closely than I did before. Be patient with yourself. Recovery takes time. But I am confident that you will get there with the help of your health professionals, family, and friends. Best wishes.Pat

  27. It was interesting to read your report and I thought I’d explain what happened to me. 3 weeks ago I was out running with my husband when I tripped over a root sticking out of a concrete footpath unfortunately I fell forward on to my hands and have broken both shoulders the Dr’s felt sorry for me and have opperated on my right but left the other in a sling gradually I am regaining strength in both. I think I’m a bt of an experiment to see if the final outcome on both shoulders is the same!
    With regards
    Charlotte

  28. Hi Patricia, I appreciate you for sharing and I hope you are doing well.
    On November 28th 2015 while shopping at a local grocery store I fell into the the dairy case (cooler) and came within inches of hitting my face.
    It all happened because I am short and the chip dip was on the top rack and was not fronted so I knew that this was going to be challenging. I put my body as close to the rack as possible stood up on my tip toes and flung my right arm up to reach for the dip only to realize the rack was not locked in place! Everything happened so fast as I reached to the right to prevent my face from injury I grabbed the metal rack and felt something give way in my arm/shoulder. There was a man behind me trying to help, he grabbed my shirt combined with his help and me using every muscle in my right hand and arm saved me from a serious face plant. I felt my embarrassed afterwards and just wanted to leave the area. As I walked away my whole right arm, shoulder and hand felt like it was on fire. I did not know the extent of my injury for about 6 weeks. My doctor wanted to give it time to heal because he thought I had sprained my arm. I was in incredible pain for weeks, finally I had enough and went to see a two different surgeons. After a CT-scan I was diagnosed with a torn rotator cuff. The hand surgeon diagnosed me with carpal tunnel and trigger finger. After all the test were in I was scheduled for hand surgery to fix my problems. He made two incisions on my hand and the shoulder surgeon repaired my arm and shoulder. When the shoulder surgeon opened up my arm he found that I had ripped 80% of my bicep off the bone. It’s been a year since the surgery and my shoulder seems better after the cortisone shot. I wish I had not gone through with the hand surgery.
    Ten days after my shoulder surgery I had a mini stroke. Also I lost three teeth from the tubing they put in my mouth. When woke up from surgery my partial plate was already back in my mouth. I’ve had several surgeries and not once did they put my partial plate in my mouth. I always put it in myself when they bring it to me.
    Thank you for letting me share. I don’t know what to make of all this!

  29. Your photo of the bruising and the x-ray of the fracture look just like mine now. I don’t have your knowledge, so, I am going in for the surgery tomorrow morning. The displacement is well over 5mm and that was the magic number for me to say plate and pin it. My neck popped and has ached since the fall, but, I didn’t mention it, since my shoulder was my main concern. I wonder what the treatment was for your neck.
    My fall was from misjudging my steps coming off a ladder. I was too eager to get cleaned up after successfully repairing a garage door opener. Age 51 years & 51 weeks.
    Hope you had a full recovery.
    I’m not sure how the PT will go on my arm, I tore the bicep many years ago, so, range of motion was already impaired, some.

  30. Thank you so much for this. I’m 11 days out from a shoulder fx incurred while ice skating. The fear of morbidity is far harder to cope with than the pain (I’m 60.) It’s my dominant arm and I fear being unable to draw or to swim, since like you The injury is to the tuberolosity area. I will see the orthopod tomorrow so I will hope get more info then.

    I’m going down stairs with my feet parallel to the tread instead of at right angles. in other words, I am turned so that I face the rail. I don’t advance to the next stair until both feet are on the ‘current’ stair, i.e I play ‘catch up.” If I cone out of this with reasonable ability I’m not givingup cycling but I have thought carefully and I can’t risk ice skating again, even thogh I love it – too easy for ice to be damaged (which caused my stumble and fall) or to be knocked down by overexcited youngsters, etc. Risk assessment is hard – where is the ‘sweet spot” between paranoia and carelessness. The stress is very real and I struggle to get enough sleep. I find sleeping in recliner awkward as it puts a lot of stress on the back for example.

    Nancy your story sent chills down my spine. I wish you and the author the best.

    • Thanks for sharing your story. I think reactions like these are much more common than we have thought and are, I think, by and large, ignored by physicians. I know I didn’t pay much attention to these issues when I was in practice. I would love to hear from others, what is your experience with getting help with emotional issues after a significant health event?

      • Fell hiking in New Mexico 6 weeks ago. Fell on top of shoulder and crushed everything. Fear of falling is a real issue now. Out of sling, will have to have some surgery for impingement. Driving & using arm a bit, but the memory of the fall is a real nightmare. I won’t look at the X-rays. No one discussed anything about the fear. 3 days after my break I tripped on the concrete lip at the end of my garage where it meets the driveway. It was a miracle I didn’t fall. I came so close. Every night I dream about falling: off a bridge, off a mountain trail, off a ledge, out of a tree, off a bike, off a roof, off a cliff. I hate to go to bed.

        • I am sorry to hear about your fall and the fear of falling. The latter is quite common after falls. I had it. Every time I walked down the stairs from my office I could feel myself falling to the bottom. And whenever we went to the airport, I had to avoid the place where I fell.I also had terrible insomnia.It was a mild form of PTSD. It did eventually go away completely, and yours should too. One of the things I did that I think helped me was going group meditation once a week. I also saw a neurologist to be sure I didn’t have any gait issues that could have contributed to the fall, then I saw a PT who helped me both with shoulder mobility and balance. I also have a great massage therapist who has been working on my shoulder to keep it mobile. You will get better, it just takes time and a bit of work on your part. Let me know how it goes. Pat

  31. Absolutely believe in the fear fracture. Though I now almost 72, I can well remember being thrown from a horse and dragged by the stirrup until they could stop him… I was maybe 10? Fast forward to today, when my husband wants to put straps on the pedals of our recumbent bikes. All I can see ifps taking a fall and being unable to get my foot out of the strap. and I’m on a recumbent for fear of falling off a two wheeler.

  32. A year ago I had a fall off my bicycle at a young age of 59. Unfortunately fractured my pelvis bottom to top, and a femoral fracture, fortunately with little displacement.
    3 months in a wheel chair no weight bearing, after back to work and doing OK. Have been back out on my bike , but yes there is always that awareness of what another fall could do.

  33. Sorry we missed you here in Idaho. I hope you have since made your way to the South Fork.
    Several years ago, while on one of my horses, I took a fall. Broke my radius, ulna and the head of my humerus. I was in the Owyhee Mountains about 60 miles from the nearest hospital. Fortunately I was with a friend who is an ICU nurse ( I am also an RN). Getting down the mountainside with my friend leading both horses and holding onto my belt with one hand was painful, to say the least. I was unable to mount my horse as the movement caused my muscles to spasm and the humerus ends to grind. I knew if I got up there and passed out I would be in a real mess. It was my L arm broken and I needed to use it for balance while getting on my horse, couldn’t do it. All this on the side of a mountain trail.
    We managed to get to the horse trailer. She loaded the horses, I wedged myself in the truck seat so I could brace with my feet on the dash. By now every movement caused spasms in my deltoid and I got very light headed. Until we got to the paved road, I was in 8+ pain.
    Got to the ER, nauseated from pain. Don’t remember what meds I got but I sure did appreciate the pain relief. Demerol and Visteril I think. I was taken to the OR and a general anesthesia for the cast on the forearm. Woke up with a cast and a sling.
    I was 39 y.o. at the time and my deltoids were quite strong, the spasms were terrible for weeks. Ended up with my upper arm terribly swollen and bruised and a cast on my forearm. Arm in a sling for several weeks. Sternoclydomastoid (hope I spelled that right) very painful for weeks.
    I am 69 y.o. now, have about 90% ability to raise my L arm over my head.
    I imagined myself bullet proof up until this injury. When my arm had been in a sling and I had the cast on for about 2 1/2 weeks I couldn’t stand the inactivity and put my leg over my kid’s pony. I could make it up there with some difficulty and rode the 1/4 mile, bareback, to the mail box. That lovely pony made my day. His name was Buckshot and he was so patient and kind. He was humanely put down at age 31, several years later.
    I am still going at 69. I do have some PTSD, I think. It did not bother me for years, but now I have flashbacks of the injury. Now I have RA and Lupus and I know that I would be in a bad place if I were injured again. I still ride. I mostly drive a buggy, but injuries from those accidents are also terrible.
    Thanks for the discussion of the aftermath of these falls and fractures. Life is an interesting trail and an interesting trial.
    I live on a hay ranch in Owyhee County, Idaho. My friend, Margaret Cary comes to visit us here in the wilds of Idaho. Maybe you can come with her some time. Happy healing.
    and I am terrified of getting hurt again.

    • Hi Nancy, thank you for sharing your experience with a fall and fracture. I think fear of falling and PTSD are underreported and underappreciated. Hopefully we can change that by sharing our stories. Maggi has often told me how much fun she has visiting you on the hay ranch. Idaho is also underappreciated, but I selfishly hope it stays that way. Pat

    • Nancy, thank you for your post. As I read your post I found myself nodding in agreement as you were describing the pain and how you got help for your initial injury. I’m only 2 1/2 weeks out from a shattered shoulder but I’m scared witless of another fall! So glad to know there is life after this kind of injury because right now I find myself crying several times a day and struggling not to feel sorry for myself. Seems the only thing I can do well is eat and drink (neither one is an activity I need to do!). Thanks for posting.

  34. Thank you for sharing. As a middle-aged runner who falls occasionally on trails (but so far only ever with bruises and irritations), I fully get both why you need to figure out how it happened and how to overcome fear of it happening again.

    And thank you for your kind words about my employer’s SSF team.

    Wishing you a speedy recovery (and hope you get that rafting trip next summer)!

    • Thanks Murray. Please keep your bones strong so your falls only lead to bruises, not fractures!

      Re: the care at SSF. I didn’t have room to write about all of the great care I got including the Medical Assistant who wrapped me in warmed blankets so I wouldn’t get chilly as she irrigated my wound, the expert care of Emergency Physician Dr. Uli Chettipally and kindness of Dr. Sherry Reynolds the radiologist who read my x-rays. Care doesn’t get any better than what I had that night. Thank you Kaiser South San Francisco.

  35. Thank you for the wonderful essay, Pat. I’m curious to learn of your analysis of the precipitant for your fall. I concur that serious injury consequent to falling creates a type of PTSD–my tri-malleolar fx-dislocation in early middle-age certainly did.

    I’m glad to learn of your steady improvement/recovery. All good wishes for a rapid return to maximal function and activities. Regards./@sjdmd

    • Thanks, Steve. My recovery is going well. My range of motion back to about 90% and I am still in the early stages of PT. I would love to chat with you about your symptoms of PTSD post-fall. I suspect it may be a common, but perhaps unrecognized symptom. We all know that people with hip fractures often die soon after the event (within a year or two). I wonder, has anyone looked to see how much of that morbidity and mortality is related to self-restricted movement because of FOF (fear of falling) related to some variation of PTSD. Certainly an interesting and perhaps an important question – to me at least.

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