Nonoperative management of proximal humerus fractures usually begins with maximal support - a sling and swath equivalent worn continuously. If the patient is uncomfortable, a sitting position may be preferred for sleeping.
A patient who is very comfortable, at the beginning of treatment or after some recovery, may need less immobilization, and even begin gentle use of the injured arm.
As soon as pain permits, pendulum exercises (as illustrated) should begin. Active hand and forearm use should also be encouraged.
Isometric exercises can begin as soon as tolerated for the shoulder girdle including scapular stabilizers, and the upper extremity.
X-rays should be checked to rule out secondary fracture displacement.