Intermediate Rehabilitation for Post-Fracture Shoulder

Program Overview This is a 23-week, intermediate-level shoulder rehabilitation program for people recovering from a shoulder fracture. It is designed to be delivered twice a week in sessions of about 60 minutes, using a bosu ball and a barbell. Your clinician will guide you through protected healing first, then gradually build your motion, strength, and shoulder control. The program blends manual therapy, targeted exercises, and supportive modalities, with progress checked against clear milestones rather than fixed timelines.

Who This Program Is For and Its Goal This program suits people whose shoulder fracture is healing and who have been cleared to begin structured rehabilitation at an intermediate level. The goal is to restore comfortable shoulder movement, rebuild rotator cuff and shoulder-blade muscle strength, and return you to everyday function safely. It uses a step-by-step approach so your shoulder is protected early, then challenged gradually. Your clinician tailors every element to your assessment and your fracture's healing stage.

Before You Start Before starting, have your clinician confirm your fracture is healing as expected with imaging, because some techniques here are only appropriate once healing is confirmed. Do not push into movements or ranges that have not been assessed yet. Always warm up before activity and cool down afterward. Stop if pain increases, and report new or worsening symptoms rather than working through them.

Safety Notes and When to Call Your Clinician Your program notes limited range of motion before assessment, so avoid stretching or loading beyond what your clinician has cleared. Some treatments, such as ultrasound at the fracture site, are only used once healing is confirmed. Stop exercise and contact your clinician if pain rises and stays up, if you feel new sharp pain, numbness, or weakness, or if swelling returns. Never work through increasing pain; it is a signal to pause and check in.

Weekly Structure You will attend two sessions per week, each around 60 minutes, for 23 weeks. The bosu ball supports balance and shoulder-blade control work, and the barbell is used later for controlled strengthening. The plan moves through phases: first protection and gentle motion, then early protected movement, then progressive strengthening and function. Your clinician advances you when you meet specific milestones, not simply because weeks have passed.

How the Plan Is Organized The 23 weeks are grouped into phases. Early weeks focus on protecting the fracture, gentle motion, and pain control. Middle weeks add active-assisted movement, shoulder-blade control, and light resistance. Later weeks build strength and function with progressive loading. Each phase has clear criteria, such as comfortable rest pain and specific motion targets, that your clinician checks before moving you forward. Sessions stay consistent, but the content shifts as you progress.

What a Typical Session Looks Like A typical session includes a warm-up, main work, and a cool-down. Your clinician may also use manual therapy for joint stiffness, ultrasound once healing is confirmed, and electrical stimulation to help shoulder-blade muscles activate. Some sessions may include water-based motion work when appropriate. The main work changes by phase, from gentle motion to resisted strengthening. The cool-down helps settle your shoulder and is required after every session.

Warm-Up, Main Work, and Cool-Down Warm-up uses gentle motion and light activity to prepare your shoulder. Main work may include manual therapy, then exercises for the rotator cuff and shoulder-blade muscles, using the bosu ball for control work and the barbell for graded strengthening when cleared. Electrical stimulation may support muscle activation. Cool-down includes gentle motion and stretching to help you recover. Always complete the warm-up and cool-down as planned.

Tracking Progress Your clinician tracks progress using phase criteria and standardized measures, including the ASES score, Constant-Murley score, Simple Shoulder Test, goniometric range of motion, manual muscle testing, and a pain scale. These show how your motion, strength, and function change over time. Tracking helps your clinician decide when to advance or slow down. Report how your shoulder feels between sessions so the plan stays safe and effective.

How Progression Criteria Are Used Progression is milestone-based. For example, early phases require low rest pain, minimal swelling, and comfortable isometric contractions; later phases target specific passive motion ranges and active-assisted movement quality. Your clinician uses these criteria alongside outcome measures to decide when to advance. If a criterion is not met, the program stays or adjusts rather than pushing ahead. This protects healing and keeps progress steady.

Recovery and Self-Care Recovery happens between sessions too. Follow your clinician's guidance on rest, positioning, and activity limits. Do only the home exercises you are given, and avoid adding load or range on your own. Keep up warm-up and cool-down habits. Sleep, hydration, and pacing daily activities support healing. Tell your clinician about changes in pain, swelling, or function so your program can be adjusted promptly.

Pain Management Cautions and Red Flags Mild discomfort during exercise can be expected, but increasing pain is a signal to stop. Do not use this program to push through sharp pain, new weakness, numbness, or returning swelling. Follow your clinician's advice on rest and activity. Seek prompt review for severe or worsening pain, new deformity, fever, or inability to use the arm. Medication questions should go to your clinician or pharmacist, not be self-managed based on this guide.