Beginner Shoulder Post-Fracture Rehabilitation

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

A 14-week beginner program using foam rollers, and rowers 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: beginner
Duration: 14
Sessions/week: 5
Minutes/session: 45
Evidence level: moderate
ICD-10: S42
Cost tier: moderate

Program Overview This is a 14-week, beginner-level rehabilitation guide for someone recovering from a shoulder fracture. It combines guided therapeutic exercise, hands-on manual therapy, and supportive modalities under clinician supervision. The focus is gradual, safe return of shoulder movement and strength.

Who This Program Is For and Its Goal This program is for people who have had a shoulder fracture and are cleared by their clinician to begin structured rehabilitation. The goal is to protect healing tissue early, restore motion gradually, rebuild rotator cuff and scapular control, and progress toward functional movement patterns. It is a guide, not a substitute for individualized care.

Before You Start Please review this plan with your treating clinician or physical therapist before beginning. Your therapist should confirm your fracture is stable enough for the phases described and adjust anything to fit your specific injury, surgery, and assessment findings.

Safety Notes and When to Stop Do not start or continue if you have signs of acute inflammation, symptoms suggesting compartment syndrome (such as severe, worsening pain, tightness, or numbness), or limited range of motion that has not been assessed by a clinician. Stop and call your clinician if pain sharply increases, you develop new swelling, warmth, numbness, weakness, or if movement feels unstable. Avoid overloading the shoulder, always warm up first, and keep your spine in a neutral position during exercise.

Weekly Structure Plan for five sessions per week, about 45 minutes each, across 14 weeks. Expect a foam roller and a rower as your main equipment, used for warm-up, positioning, and controlled conditioning. Session content shifts in phases: early protection, then gentle assisted motion, then active movement and strengthening, and later functional patterns—each phase guided by your clinician's assessment.

How the 14-Week Plan Is Organized The plan moves through stages: a protection phase, an early passive motion phase, and then progressive active and functional work. Early weeks emphasize sling use, rest, and very gentle scapular setting only. As your clinician confirms you meet the stated progression criteria, you advance toward more motion, light rotator cuff and scapular stabilization work, and eventually occupation- or sport-specific patterns. Never skip ahead on your own.

What a Typical Session Looks Like Each session follows a simple rhythm: warm-up, main therapeutic work, then cool-down. Your therapist may add manual therapy, ultrasound, or electrical stimulation during sessions as appropriate. The main work focuses on rotator cuff and scapular stabilization and, in later phases, functional movement patterns matched to your daily needs.

Warm-Up, Main Work, and Cool-Down Begin with gentle foam-roller work for the upper back and light, pain-free movement to prepare the shoulder, keeping your spine neutral. The main work includes the exercises and any clinician-provided modalities for your current phase. Cool down with easy range-of-motion movement and relaxed breathing. Use the rower only when your clinician clears it, with light effort and controlled posture.

Tracking Progress Keep a simple log of pain, motion, and how exercises felt each session. Your clinician will use your progression criteria plus outcome measures—such as the Constant-Murley, ASES, UCLA, and SPADI scores, goniometric range of motion, and rotator cuff strength testing—to decide when you are ready to advance.

How Progression Criteria Are Used Your therapist compares your current pain, motion, stability, and strength against the phase criteria to decide when to move forward. Outcome measures provide an objective picture over time and help catch problems early. Progress is individual—meeting criteria in some areas but not others means staying in that phase a bit longer, which is normal and safe.

Recovery and Self-Care Recovery takes time, and rest is part of the program. Follow your sling and activity guidance, avoid overloading the shoulder, and keep other joints moving as advised. Good sleep, pacing, and sticking to your home program support healing. Ask your clinician about any activity you are unsure about.

Pain Management Cautions and Red Flags Use pain as your guide and keep within the limits your clinician sets; do not push through sharp or escalating pain. Contact your clinician promptly for severe or worsening pain, new swelling or warmth, numbness, marked weakness, fever, or a shoulder that feels unstable or gives way. Do not adjust medications without your prescriber's advice.

Recovery phases

Week 1Protection Phase

Pain at rest ≤2/10 on visual analog scale,Glenohumeral joint immobilized in sling with elbow at 90 degrees,No active glenohumeral or scapular motion permitted,Rotator cuff tendon pain with passive glenohumeral motion ≤3/10,AC joint stability maintained without displacement,Biceps tendon intact at bicipital groove with no tenderness

→ Advance to: Early Passive Motion Phase

Week 2Protection Phase

Pain at rest ≤2/10, pain with movement ≤4/10,Sling compliance documented,No shoulder warmth or swelling at glenohumeral or AC joints,Passive forward flexion to 45 degrees tolerated without labral symptoms,Passive external rotation to 0 degrees with arm at side tolerated,Scapular stabilization exercises with scapular retraction only

→ Advance to: Early Passive Motion Phase

Week 3Early Passive Motion Phase

Passive forward flexion to 60 degrees without pain,Passive external rotation to 15 degrees at 0 degrees abduction,Passive glenohumeral internal rotation to 45 degrees,No AC joint pain with cross-body adduction,Biceps tendon resisted flexion without pain at mid-range,Scapular kinematics normal with passive arm elevation

→ Advance to: Early Active-Assisted Motion Phase

Week 4Early Passive Motion Phase

Passive forward flexion to 75 degrees,Passive external rotation to 20 degrees at 0 degrees abduction,Passive glenohumeral abduction to 45 degrees,No labral click or catch with passive motion,Rotator cuff strength grade 2/5 with pain-free submaximal isometrics,AC joint tolerance to scapular protraction without pain

→ Advance to: Early Active-Assisted Motion Phase

Week 5Early Active-Assisted Motion Phase

Active-assisted forward flexion to 90 degrees with pulleys or stick,Active-assisted external rotation to 30 degrees with arm at side,Active-assisted glenohumeral abduction to 60 degrees,No pain with active biceps curl at 0 degrees elbow flexion,Rotator cuff isometrics at 30 degrees abduction pain-free,Scapular control with active protraction and retraction

→ Advance to: Active Motion Phase

Week 6Early Active-Assisted Motion Phase

Active-assisted forward flexion to 110 degrees,Active-assisted external rotation to 40 degrees at 0 degrees abduction,Active-assisted horizontal adduction to 30 degrees,Rotator cuff isometrics at 45 degrees abduction pain-free,Biceps tendon resisted supination without pain,Scapular upward rotation pattern normal with arm elevation

→ Advance to: Active Motion Phase

Week 7Active Motion Phase

Active forward flexion to 120 degrees,Active external rotation to 45 degrees at 0 degrees abduction,Active glenohumeral abduction to 90 degrees,Rotator cuff manual muscle testing grade 3/5 in external rotation,Biceps tendon strength 3/5 with elbow flexion,Scapular control during active arm elevation without winging

→ Advance to: Controlled Motion Phase

Week 8Active Motion Phase

Active forward flexion to 135 degrees,Active external rotation to 50 degrees at 0 degrees abduction,Active internal rotation to T10 vertebral level,Rotator cuff manual muscle testing grade 3/5 in internal rotation,Biceps strength 3/5 with resisted supination,Glenohumeral joint play mobility within normal limits

→ Advance to: Controlled Motion Phase

Week 9Controlled Motion Phase

Active forward flexion to 150 degrees,Active external rotation to 60 degrees at 90 degrees abduction,Glenohumeral arthrokinematics smooth without catching,Rotator cuff strength grade 4/5 external and internal rotation,Biceps tendon load tolerance with functional activities,Scapulothoracic rhythm 2:1 with arm elevation

→ Advance to: Strengthening Phase

Week 10Controlled Motion Phase

Full active forward flexion range of motion,Full external rotation at 90 degrees abduction,AC joint pain-free with functional reaching above shoulder level,Rotator cuff external rotation strength 4/5 with resistance,Biceps strength 4/5 with functional resistance,Scapular stabilization with resisted rows

→ Advance to: Strengthening Phase

Week 11Strengthening Phase

Rotator cuff external rotation with resistance 4+/5,Rotator cuff internal rotation with resistance 4/5,Biceps curl with 50% body weight resistance without pain,Scapular strengthening with prone Y-T-W exercises grade 4/5,Glenohumeral proprioception near baseline,No labral symptoms with resisted push-up plus

→ Advance to: Advanced Strengthening Phase

Week 12Advanced Strengthening Phase

Rotator cuff external rotation at 90/90 position 4/5,Rotator cuff internal rotation at 90/90 position 4/5,Biceps strength 5/5 with functional activities,Scapular endurance within 80% of contralateral side,Proprioceptive training completion at functional level,AC joint asymptomatic with overhead activities

→ Advance to: Return to Function Phase

Week 13Return to Function Phase

Full shoulder range of motion equal to contralateral side,Rotator cuff strength 5/5 all directions,Biceps tendon tolerance to throwing progression,Scapular control during loaded elevation patterns,Functional assessment reaching behind back to T12,No pain with sport-specific or occupational shoulder movements

→ Advance to: Return to Function Phase

Week 14Return to Function Phase

Full pain-free active range of motion all planes,Rotator cuff strength 5/5 with dynamometry within 10% of contralateral,Biceps tendon load tolerance equal to contralateral side,Scapulothoracic rhythm normal during functional tasks,Patient-specific functional goals achieved,Cleared for unrestricted activity without shoulder symptoms

→ Advance to: Discharge

Return to activity milestones

Pain-free basic activities of daily living

Week 4

Pain does not radiate during upper limb tension test at Stage 2

Light functional activities and conditioning

Week 6

Transfers and mobility tasks completed without upper limb compensation

Moderate activity and sport-specific conditioning

Week 8

Patient adherence to home exercise programme ≥ 5 days per week

Full return to sport, occupation, and recreation

Week 14

Patient demonstrates correct hand therapy exercise technique

Precautions

avoid-overloading
warm-up-before
maintain-neutral-spine

Contraindications

acute-inflammation
compartment-syndrome
limited-range-before-assessment

Pain management

Cryotherapy with ice pack to glenohumeral and AC joint regions for 15-20 minutes post-exercise
Non-steroidal anti-inflammatory medication as prescribed for AC joint inflammation
Gentle soft tissue mobilization to rotator cuff and scapular musculature
Transcutaneous electrical nerve stimulation (TENS) for pain modulation
Positioning and ergonomic education to avoid impingement positions

Equipment & modalities

Therapeutic exercise focusing on rotator cuff and scapular stabilizationManual therapy including glenohumeral and scapulothoracic joint mobilizationsProprioceptive neuromuscular facilitation (PNF) patterns for shoulderModalities: ultrasound for tissue healing, electrical stimulation for muscle activationFunctional training with sport-specific or occupation-specific movement patternsfoam-rollerrower

Frequently asked questions

Can I skip ahead if I feel better?

No—advance only when your clinician confirms you meet the phase criteria, since feeling better does not always mean tissue is ready. Skipping ahead risks re-injury and setbacks.

How hard should I push during exercises?

Work at a gentle, controlled effort within the pain limits your clinician sets, avoiding sharp pain or overloading. When in doubt, do less and ask your therapist.

What if I miss sessions or have a flare-up?

Missing occasional sessions is okay—resume gently and tell your clinician. If you have a flare-up, ease back, avoid overloading, and contact your clinician before continuing or progressing.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed October 6, 2026. · Read our editorial policy