Distal Humerus ORIF Starter Exercise Guide

1. Elbow Range of Motion

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

How often: 2–3 sets of 10 each, daily.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tip: Keep the upper arm still — the movement is at the elbow and forearm.

2. Forearm Rotation

What it helps: Strengthens the muscles that rotate the forearm — the motion behind turning a key, a doorknob, or a screwdriver.

How often: 2–3 sets of 10–12 each way, most days.

1. Tuck the elbow at your side, bent 90°, holding a light weight or a hammer by the handle.
2. Slowly rotate the forearm to turn the palm up, then down, through comfortable range.
3. Keep the elbow pinned to your side.

Tip: Holding a hammer toward the head end adds gentle resistance — slide your grip to adjust.

3. Grip Strengthening

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

How often: 2–3 sets of 10–15, most days.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tip: Full squeeze, full relax — both matter.

4. Arm Nerve Glides

What it helps: Helps an irritated neck nerve glide freely down the arm, which can ease arm pain, tingling, or numbness. Gentle, repeated motion — never forced.

How often: 2–3 times sets of 10–15 slow glides, daily.

1. Sit or stand tall. Start with the affected arm out to the side, elbow bent, palm up.
2. Slowly straighten the elbow and ease the arm out while gently tilting your head AWAY — then return as you tilt the head back toward that side.
3. Move smoothly in and out of the range, like flossing — never holding at the end or pushing into symptoms.

Tip: Gentle is the rule — ease back the moment it provokes sharp or shooting arm symptoms.

5. Wrist Isometrics

What it helps: Loads the forearm tendons gently without movement — a comfortable way to keep them strong and often to ease tendon pain before they're ready for moving resistance.

How often: 1 sets of Hold 20–45 sec ×3–5, daily.

1. Rest the forearm on a table, hand off the edge. For extensors: make a light fist, push the back of the hand up against your other hand — no movement — and hold.
2. For flexors: push the palm down against your other hand and hold.
3. Use comfortable pressure; the wrist stays still.

Tip: No movement happens — you're holding against resistance.

6. Scapular Retraction

What it helps: Keeps the muscles that position the shoulder blade working while the shoulder joint itself is resting. Those muscles set the platform the whole shoulder moves on, and they weaken quickly in a sling, which makes the later recovery harder than it needs to be.

How often: 2–3 sets of hold 5s, 10 times, daily.

1. Sit or stand tall with your arms resting at your sides or supported in the sling.
2. Draw both shoulder blades gently back and down, as though squeezing them toward each other.
3. Keep the movement small and slow. Your arms should not move at all.
4. Hold briefly, then relax completely.

Tip: Small is correct. This is a squeeze between the shoulder blades, not a shrug and not an arm movement.

7. Gentle Neck Isometrics

What it helps: Strengthens the deep muscles that support and steady your neck without moving it — a safe, comfortable way to build the support that eases neck pain.

How often: 5 each direction sets of Hold 5–10 seconds, daily.

1. Sit tall with a gentle chin-tuck. Place your palm on your forehead.
2. Press your head lightly into your hand and your hand back into your head — a steady, comfortable push with NO movement of the neck.
3. Hold, relax, and repeat. Do the same with the hand on the back of the head, then each side.

Tip: Light pressure — about 20–30% effort. This is not a strength test.

8. Core Activation

What it helps: Switches on the deep core muscles that stabilize your pelvis and spine, giving your hips a solid platform to move from.

How often: 2-3 sets of 10, daily.

1. Lie or sit comfortably.
2. Gently draw your belly button toward your spine.
3. Hold a few seconds while breathing normally, then relax.

Tip: Avoid holding your breath.

Recovery reading

• Shoulder Replacement Recovery
• Reverse Shoulder Replacement Recovery
• Sleeping and the Sling After Shoulder Surgery
• Broken Shoulder Recovery
• All Shoulder & Elbow recovery guides