Intermediate Shoulder Post-Fracture Rehabilitation

Program Overview This is a 23-week, twice-weekly shoulder rehabilitation program for people recovering from a shoulder fracture who are ready for intermediate-level work. Each session lasts about 60 minutes and uses a barbell, kettlebell, and ankle brace, alongside hands-on and guided techniques your clinician may provide. The plan moves through four phases: protection and pain control, early range of motion, progressive strengthening, and advanced strengthening. It is designed to rebuild movement, strength, and confidence gradually, with your rehabilitation professional checking progress at each phase.

Who This Program Is For and Its Goal This program suits adults recovering from a shoulder fracture who have completed initial healing and are cleared for supervised intermediate rehabilitation. The goal is to restore comfortable shoulder movement, rebuild rotator cuff and shoulder-blade (scapular) strength, and return you to everyday activities with less pain and better function. It is not for people with severe osteoporosis, who need a tailored, more protective approach. Your clinician will confirm this plan fits your specific fracture and stage of healing.

Before You Start Speak with your doctor or physical therapist before beginning, and confirm your fracture has healed enough for this level of activity. Because severe osteoporosis is listed as a contraindication, this program is not appropriate if you have it—ask your care team about a safer alternative. Have your equipment checked and set up a clear space. Plan how you will get to sessions and arrange support for any heavy lifting at home during the early weeks.

Safety Notes and When to Stop Follow your clinician's guidance on how much to load and how far to push. Avoid overloading the shoulder and keep your spine in a neutral, comfortable position during exercises. Stop and contact your clinician promptly if you notice sharp or worsening pain, sudden swelling, new numbness or tingling, a feeling of instability or "giving way," or if the shoulder looks deformed. These signs may mean something needs reassessment. Never push through pain that feels different from normal muscle tiredness.

Weekly Structure You will attend two supervised sessions per week for 23 weeks, each about 60 minutes. The plan is organized into four phases that build on each other: Phase 1 (around week 1) focuses on protection and pain control; Phase 2 (around week 5) adds early range of motion; Phase 3 (around week 9) moves into progressive strengthening; and Phase 4 (around week 15) advances to more demanding strength and control work. In plain terms, you start gently, regain movement, then steadily build strength and function.

How the 23 Weeks Are Organized Across 23 weeks and two sessions weekly, your clinician blends hands-on techniques, guided exercises, and progressive resistance using therabands and free weights. Early sessions emphasize gentle movement and pain control, possibly with aquatic therapy for supported motion. Middle weeks build range of motion and basic strength. Later weeks use the barbell and kettlebell for controlled strengthening and shoulder-blade control. The ankle brace may be used for supported positioning or balance work as directed. Progression is based on meeting specific milestones, not just the calendar.

What a Typical Session Looks Like Each session follows a predictable pattern: a warm-up to prepare the shoulder and body, a main block of targeted exercises and any hands-on techniques, then a cool-down to settle things down. Your clinician adjusts the mix based on your phase and how you respond. Expect a mix of range-of-motion work, shoulder-blade control drills, and graded strengthening. The goal is steady, tolerable effort—not exhaustion—so you can recover well between sessions.

Warm-Up, Main Work, and Cool-Down Warm up with gentle arm circles, shoulder-blade squeezes, and light band work to loosen the shoulder. The main work includes guided range-of-motion and stabilization exercises, progressive resistance using theraband, barbell, and kettlebell as appropriate, and any clinician-provided techniques such as joint mobilization or ultrasound. The ankle brace may support positioning during certain drills. Cool down with slow, easy stretches and relaxed breathing. Keep movements controlled, maintain a neutral spine, and let your clinician guide loads and difficulty.

Tracking Progress Your clinician will track how you are doing using standardized shoulder scores (such as the Constant-Murley, ASES, and SPADI), range-of-motion measurements, strength testing, and a functional scale based on activities that matter to you. These measures, combined with how you feel day to day, show whether you are ready to move to the next phase. Keep a simple log of pain, activities, and any exercises that felt easier or harder, and share it at your sessions.

How Progression Criteria Are Used You move to the next phase when you meet the milestones set for your current phase—things like comfortable rest pain, improved movement, better strength grades, and stable shoulder-blade control. These criteria guide your clinician, who combines them with outcome measures and your own goals to decide timing. Progress is individual, so do not rush phases. The outcome measures help confirm that gains are real and functional, not just numbers on a chart.

Recovery and Self-Care Recovery happens between sessions too. Get enough sleep, stay hydrated, and eat well to support healing. Do any home exercises your clinician assigns, but avoid adding extra loading on your own. Use rest and positioning to manage soreness, and keep the shoulder moving gently as advised. Pace your daily activities and ask for help with heavy tasks. Report any changes in symptoms early so your plan can be adjusted safely.

Pain Management Cautions and Red Flags Some mild soreness after exercise can be normal, but avoid pushing into sharp pain or overloading the shoulder. Do not take or change medications without your clinician's advice. Rest when needed and keep your spine neutral during activity. Seek urgent care for severe pain, sudden weakness, visible deformity, chest pain, or breathing problems, and contact your clinician for new or worsening shoulder symptoms, numbness, or instability.