12/24/25: Waiting, Healing, and a Little Anatomy (Why Not?)

Published: December 24, 2025

Waiting, Healing, and a Little Anatomy (Why Not?)

Christmas Eve, and the waiting continues.

My post-surgical follow-up isn’t for another six days, which leaves me in that familiar in-between phase: feeling better, but very much not healed. So what can I do in the meantime?

First, stay loyal to the acute healing protocol. That still means don’t use the arm. The medications are tapering, but pain meds and anti-inflammatories still have their place—and timing matters. Second, as my wife wisely puts it, “Don’t do anything stupid.” This is a vulnerable window. You start to feel human again long before tissues are ready, and that confidence can be dangerous.

Third, do what I can do to promote healing—smartly. Maximizing circulation is the goal. That means walking often (yes, still in the sling), and taking the arm out of the sling three to five times a day to move the fingers, wrist, and elbow. I’m also doing pendulums: sling off, arm fully relaxed, the opposite arm holding on for support while my body gently moves forward and back, side to side, diagonally, and in circles. The shoulder follows passively like a pendulum. It feels amazing after being imprisoned in a sling, gently distracts the joint, improves blood flow, and reminds muscles, tendons, ligaments, nerves, and bone what motion feels like—without stressing the repair. Three sessions a day, five minutes each. Fifteen minutes total of very intentional, very gentle movement.

And finally, rest. This might be the hardest part. My brain is ready to go, go, go—but healing isn’t. Sleep matters most in this phase, even though nights are still rough. Pain tends to spike, repositioning is limited, and comfort is elusive. Still, I do my best to get to bed at a reasonable hour and let the biology do its work.

My fracture was at the surgical neck of the proximal humerus, a structurally vulnerable region of the bone. I’m grateful to have had a skilled surgeon who restored the alignment as close to normal as possible. As a physical therapist and functional health practitioner, I know this early phase can feel tedious and repetitive. So why not lean into an anatomy refresher?

The anterior surgical neck of the humerus sits near several critical structures. Anteriorly, it’s covered by the deltoid, while medially the subscapularis crosses nearby as it inserts on the lesser tubercle. The axillary nerve wraps around the surgical neck just inferior to the humeral head, traveling with the posterior circumflex humeral artery and vein. Although these structures are technically more posterior, they’re highly relevant—and vulnerable—in fractures of this region. Anterior and medial branches of the anterior circumflex humeral artery also course close by, contributing to blood supply to the humeral head. Nerdy? Yes. Refreshing? Also yes.

Fortunately, my surgeon reports minimal associated damage—thanks in part to being healthy and strong going into this injury. So what will matter most down the road in rehab?

Ready for nerdy part two?

Rehabilitation after a proximal humerus ORIF hinges on restoring coordinated function of the rotator cuff and key proximal humeral muscles. The rotator cuff—supraspinatus, infraspinatus, teres minor, and subscapularis—provides dynamic stability to the shoulder, centering the humeral head during early passive and active-assisted motion. Supraspinatus plays a key role in controlled elevation, while subscapularis is critical for anterior stability, especially if it was split or mobilized during surgical exposure. Muscles attaching directly to the proximal humerus—deltoid, pectoralis major, latissimus dorsi, teres major, and the long head of the biceps—also deserve respect. These muscles generate the primary forces across the fracture site, and restoring their balance and timing is essential to protect the hardware and rebuild efficient shoulder mechanics.

I’m genuinely looking forward to that work.

But for now, it’s just… waiting.

And not being stupid.