Advanced Shoulder Rehabilitation Post Fracture

Advanced Shoulder Rehabilitation After Fracture: Program Overview This guide outlines a 14-week advanced shoulder rehabilitation program for people recovering from a shoulder fracture. It combines therapeutic exercise, manual therapy, proprioceptive training, electrical stimulation, and taping or bracing as needed to rebuild motion, strength, and shoulder stability. The plan is designed for supervised use with your rehabilitation clinician.

Who This Program Is For and Its Goal This program suits people past the early healing stage of a shoulder fracture who are ready for advanced work on the rotator cuff, labrum, AC joint, and biceps tendon. The goal is to restore full, pain-free shoulder motion and strength, improve scapular control, and return you to daily activities and higher-level function safely over 14 weeks.

Before You Start Begin only after your clinician has cleared you for advanced shoulder loading and confirmed the fracture is stable. Your therapist will tailor each phase to your presentation. This guide does not replace hands-on assessment, and your clinician decides when equipment, electrical stimulation, or taping is appropriate for you.

Safety Notes and When to Stop Do not exercise over an open or re-opened wound (wound dehiscence); keep the area protected and tell your clinician if it separates or drains. Avoid overloading the shoulder, keep your spine in a neutral position, and stop if pain increases. Stop and call your clinician for new or worsening pain, swelling, numbness, or weakness.

Weekly Structure You will complete four sessions per week, about 30 minutes each, across 14 weeks. Sessions use a hand exerciser and a foam roller, plus clinician-provided manual therapy, electrical stimulation, and taping as needed. The program moves through four broad phases—protection, early motion, progressive motion, and strengthening—advancing only when your clinician confirms you meet the listed criteria.

How the 14-Week Plan Is Organized The plan builds gradually. Early weeks emphasize pain control and gentle motion; middle weeks add active movement and scapular control; later weeks focus on strengthening the rotator cuff and scapular stabilizers. Phase changes happen when you meet criteria such as improved range of motion, pain-free isometric contractions, and adequate strength, so timing varies from person to person.

What a Typical Session Looks Like Each session follows a consistent pattern of warm-up, main work, and cool-down. Your clinician adjusts the mix within the 30 minutes based on your phase, symptoms, and goals. Expect gentle motion first, then targeted strengthening and control work, then a calming finish to help you recover before the next session.

Warm-Up, Main Work, and Cool-Down Warm up with gentle pendulum and active-assisted motion. Main work may include range-of-motion and rotator cuff strengthening using the hand exerciser, scapular stabilization, proprioceptive closed-chain work, and foam-roller mobility for the upper back. Cool down with light stretching and relaxed breathing. Manual therapy, electrical stimulation, and taping, if used, are applied by your clinician.

Tracking Progress Your clinician tracks range of motion with goniometry, strength with manual muscle testing, and function using the SPADI, ASES, Constant-Murley Score, and Patient-Specific Functional Scale. These measures, alongside your symptom reports, guide decisions about advancing phases and adjusting the program.

How Progression Criteria Are Used You move to the next phase only when you meet that phase's criteria—such as reaching target motion without increased pain, achieving pain-free isometric contractions, or demonstrating adequate strength—as confirmed by your clinician. Outcome measures are repeated over time to show change, guide adjustments, and confirm you are ready to progress safely.

Recovery and Self-Care Recovery happens between sessions. Rest the shoulder as needed, keep the wound area clean and protected, and follow your clinician's guidance on activity and any taping or bracing. Sleep and general activity support healing. Report any changes in symptoms promptly so your plan can be adjusted.

Pain Management and Red Flags Mild, brief discomfort during exercise can be acceptable, but stop if pain increases and tell your clinician. Do not push through sharp pain or overload the shoulder. Seek prompt care for worsening pain or swelling, wound separation, fever, new numbness or weakness, or a sudden loss of movement, and follow your clinician's advice on pain relief.