Advanced Shoulder Post-Fracture Rehabilitation

Published: July 26, 2026Updated: October 6, 2026

A 18-week advanced program using hand exercisers, dumbbells, therapy putty, tennis balls, and bosu balls to aid in the recovery process.

Quick summary

Professional rehabilitation program designed for effective recovery and pain management.

Medically reviewed by WellAlly Editorial TeamLast reviewed October 6, 2026Editorial policy

Key facts at a glance

Body part: upper-limb · shoulder
Injury type: post-fracture
Level: advanced
Duration: 18
Sessions/week: 5
Minutes/session: 30
Evidence level: moderate
ICD-10: S42
Cost tier: moderate

Advanced Shoulder Post-Fracture Rehabilitation: Program Overview

This 18-week advanced program is designed for people recovering from a shoulder fracture who have been cleared by their clinician to begin a more demanding course of rehabilitation. The goal is to gradually rebuild shoulder strength, movement control, and confidence so you can return to everyday activities and higher-level demands safely. It combines progressive strengthening, hands-on mobilization, balance and position-sense training (proprioception), and sport-specific drills. Progress is guided by your clinician through regular reassessment.

Before You Start

Talk with your clinician before starting, and pause or stop if you feel sharp or worsening pain, sudden swelling, new numbness or tingling, unusual swelling or warmth in the arm, or pain with breathing. This program is not appropriate if you have active compartment syndrome concerns, ongoing acute inflammation, or a clot risk (DVT). Avoid heavy loading early on, keep your spine in a neutral position during exercises, and always finish with a cool-down. When in doubt, contact your care team.

Weekly Structure

Plan for five sessions per week, about 30 minutes each, over 18 weeks. You will use a hand exerciser, dumbbells, therapy putty, a tennis ball, and a BOSU ball. The plan moves gradually through early protection, then assisted and active motion, then strengthening, then control and sport-specific work. Each phase builds on the last, and your clinician decides when you are ready to advance based on the criteria and your outcome measures.

What a Typical Session Looks Like

Begin with a gentle warm-up: relaxed shoulder circles, scapular setting, and easy hand-exerciser or putty squeezes to wake up the arm. The main work follows your current phase, for example light dumbbell strengthening, tennis-ball wall drills, and BOSU-ball balance and control tasks. Finish with a cool-down of slow, easy range-of-motion movements, gentle stretching, and relaxed breathing. Keep effort comfortable, and follow your clinician's guidance on how hard to push.

Tracking Progress

Your clinician uses the phase progression criteria to decide when to move you forward, ensuring each milestone is met without excessive pain or strain. Outcome measures such as the Constant-Murley, ASES, UCLA, Simple Shoulder Test, pain scale, and goniometric range-of-motion checks are repeated to track change over time. These tools help confirm that progress is real and guide safe adjustments. Never advance phases on your own; let your clinician confirm readiness.

Recovery and Self-Care

Manage pain carefully; keep activity within a comfortable range and rest when needed. Cold or warmth may help as advised by your clinician. Watch for red flags such as severe or escalating pain, new swelling, redness or warmth in the arm, numbness, or pain with breathing, and seek care promptly. Avoid overloading the shoulder, maintain neutral spine posture, and always cool down after sessions. Sleep and general rest support recovery.

Recovery phases

Week 1Protection Phase

Glenohumeral joint maintained in sling with elbow at 90 degrees flexion,Active elbow, wrist, and hand exercises to prevent stiffness,Scapular setting exercises in neutral position,Pain controlled below 3/10 at rest,No active shoulder flexion or abduction beyond gravity-eliminated range, rotator cuff tendon protected from aggressive loading

→ Advance to: Early Passive Motion Phase

Week 2Protection Phase

Passive glenohumeral flexion to 45 degrees within pain limits,Passive external rotation to 0 degrees (neutral) with arm in scapular plane,Scapular protraction/retraction in prone at 30 degrees trunk inclination,AC joint unloaded during all exercises,Biceps tendon protected - no resisted elbow flexion,No shoulder abduction past 45 degrees

→ Advance to: Early Passive Motion Phase

Week 3Early Passive Motion Phase

Passive glenohumeral flexion to 75 degrees,Passive external rotation to 15 degrees at 45 degrees abduction,Passive abduction to 60 degrees in scapular plane,Glenoid labrum not stressed with aggressive motion,Subacromial space maintained during overhead movements, rotator cuff tendinous insertions protected from strain

→ Advance to: Early Passive Motion Phase

Week 4Early Passive Motion Phase

Passive flexion to 90 degrees,Passive external rotation to 30 degrees at 90 degrees abduction,Passive abduction to 90 degrees,Scapulothoracic rhythm assessed - no scapular winging,Biceps tendon allowed gentle passive stretching,AC joint pain-free with cross-body adduction

→ Advance to: Controlled Motion Phase

Week 5Controlled Motion Phase

Active-assisted flexion to 110 degrees,Active-assisted external rotation to 45 degrees at 90 degrees abduction,Glenohumeral translation within normal limits,Scapular stabilization with load progression, rotator cuff eccentric loading avoided,Biceps tendon progressive loading initiated

→ Advance to: Controlled Motion Phase

Week 6Controlled Motion Phase

Active flexion to 120 degrees,Active external rotation to 45 degrees at 90 degrees abduction,Active abduction to 110 degrees,Glenoid labrum stability assessed with load progression,Subacromial bursa not impinged,AC joint resilient to functional stresses

→ Advance to: Strengthening Phase

Week 7Controlled Motion Phase

Active range of motion flexion to 135 degrees,Active external rotation to 60 degrees at 90 degrees abduction,Full functional elbow flexion/extension,Scapular control throughout range, rotator cuff isometric exercises at submaximal effort,Biceps tendon resisted exercises initiated at low load

→ Advance to: Strengthening Phase

Week 8Strengthening Phase

Full active range of motion in all planes,Glenohumeral rotator cuff isotonic strengthening at 30% 1RM,Scapular stabilization - serratus anterior, rhomboids, trapezius,Labral stabilization with proprioceptive drills,AC joint assessment for stability under load,Biceps tendon loading progressed to 40% 1RM

→ Advance to: Strengthening Phase

Week 9Strengthening Phase

rotator cuff external rotators at 40% 1RM, rotator cuff internal rotators at 40% 1RM,Scapular strengthening - prone Y-T-W exercises,Glenohumeral proprioception drills in closed chain,Biceps curl progression at 50% 1RM,Shoulder horizontal adduction pain-free

→ Advance to: Strengthening Phase

Week 10Strengthening Phase

Supraspinatus empty can test without pain,Infraspinatus/teres minor external rotation at 50% 1RM,Subscapularis internal rotation at 50% 1RM,Scapular control with overhead activities,AC joint loaded through full range,Biceps tendon functional loading initiated

→ Advance to: Advanced Strengthening Phase

Week 11Advanced Strengthening Phase

rotator cuff strengthening at 60% 1RM,Eccentric rotator cuff loading introduced,Scapular stabilization with resistance bands,Plyometric drills for glenohumeral complex,Labral proprioceptive training with perturbation,Biceps tendon - wrist curl integration

→ Advance to: Advanced Strengthening Phase

Week 12Advanced Strengthening Phase

rotator cuff at 70% 1RM capacity,Functional shoulder external/internal rotation at 90/90 position,Scapulohumeral rhythm normalized throughout range,Glenohumeral joint stability under dynamic loading,AC joint stress testing pain-free,Biceps tendon - throwing progression initiated