Intermediate Shoulder Post-Fracture Rehabilitation

Program Overview This is a 14-week, supervised intermediate rehabilitation program for people recovering from a shoulder fracture. It combines stretching, strengthening, joint mobilization, electrical stimulation for muscle re-education, and scapular control work. You will train four times per week for about 20 minutes per session using a weight vest, hand exerciser, and dumbbell. The program is built in four progressive phases, and your clinician decides when you advance based on how your shoulder responds. Evidence for this type of structured approach is moderate, so your therapist will tailor details to you.

Who This Program Is For and Its Goal This program suits people whose fracture has healed enough to begin active work and who can tolerate gentle movement without severe pain. The goal is to restore full, comfortable shoulder motion, rebuild rotator cuff and biceps strength, improve scapular control, and return you to everyday reaching and lifting without compensation. It is not a substitute for individual assessment; your clinician confirms you meet the entry criteria and adjusts the plan if your shoulder behaves differently than expected.

Before You Start Have your clinician confirm your fracture is stable, your AC joint is stable, and you have no active infection or severe pain. Review your home setup: clear space, a chair, a wall, and your weight vest, hand exerciser, and dumbbell within reach. Know your baseline pain and motion so you can compare later. Ask which exercises you should do independently and which need supervision, especially joint mobilization and electrical stimulation, which should be guided by a trained clinician.

Safety Notes and When to Stop Stop and contact your clinician if you develop severe or worsening pain, new swelling, redness, warmth, fever, or signs of infection near the shoulder or any skin electrode site. Also stop if you feel numbness, tingling, or sudden loss of movement. Avoid overloading: increase resistance gradually and never push through sharp pain. Keep your spine neutral during exercise rather than arching or twisting. Electrical stimulation and joint mobilization should only be used under clinician direction, and this guide does not replace their judgment.

Weekly Structure Plan for four sessions each week, roughly 20 minutes each. Sessions include warm-up, main strengthening and mobility work, and cool-down. The 14 weeks move through four phases, roughly: weeks 1-2 protection and pain control; weeks 3-5 early mobility; weeks 6-9 early strengthening; weeks 10-14 strengthening and conditioning. Your clinician confirms each phase transition; the week numbers are a guide, not a deadline. Equipment use grows gradually as you progress.

How the Plan Is Organized The plan builds in layers. Early on, the focus is calming pain, gentle motion, and light muscle activation, using the hand exerciser and electrical stimulation for re-education under supervision. As motion returns, you add joint mobilization and scapular work such as prone Y-T-W patterns. Later phases add dumbbell and weight-vest loading, wall push-ups, and weight-bearing proprioceptive training. Progression is based on meeting clinical criteria, not simply completing weeks, so some people move faster or slower.

What a Typical Session Looks Like Each session follows a warm-up, main work, cool-down pattern. Warm-up might include gentle pendulum swings, shoulder circles, and light hand-exerciser squeezes to wake up the muscles. Main work includes your assigned stretching, scapular stabilization (prone Y-T-W), dumbbell strengthening, and wall push-ups or weight-bearing drills, with joint mobilization and electrical stimulation as directed by your clinician. Cool-down uses slow stretching and relaxed breathing, keeping your spine neutral and your shoulder comfortable throughout.

Warm-Up, Main Work, Cool-Down Details Warm up for a few minutes with gentle range-of-motion drills and light hand-exerciser work. In the main section, perform your prescribed stretches, then scapular patterns and dumbbell exercises with controlled tempo, adding the weight vest only when cleared. Wall push-ups and weight-bearing build proprioception. Joint mobilization (posterior glenohumeral glide) and electrical stimulation are clinician-guided. Cool down with slow stretching and easy breathing. Keep movements smooth, avoid overloading, and maintain a neutral spine.

Tracking Progress Keep a simple log of pain before and after each session, what you did, and how it felt. Your clinician will periodically measure motion with goniometry, strength with manual muscle testing, scapular symmetry, and scores on the SPADI and ASES questionnaires, plus a pain visual analog scale. These measures show whether you are ready to advance and help catch setbacks early. Bring your log to appointments so your plan can be adjusted based on real data rather than guesswork.

How Progression Criteria Work Each phase has clinical benchmarks, such as pain at rest being low, reaching certain motion targets, pain-free isometric strength, and good scapular control. Your clinician checks these alongside outcome measures like SPADI, ASES, goniometry, and manual muscle testing before moving you forward. Meeting a target is a green light, not a race; if a measure stalls, the plan may stay in the current phase longer. Never self-advance to heavier loading without confirmation.

Recovery and Self-Care Rest between sessions and avoid stacking heavy shoulder work on consecutive days if you feel sore. Use ice or heat as your clinician advises, keep good posture, and protect sleep. Gentle movement often helps stiffness, but respect pain. Stay consistent with the hand exerciser and light motion on off days if approved. Report any change in symptoms promptly, and remember that recovery after fracture is gradual; steady, moderate effort usually beats aggressive pushes.

Pain Management Cautions and Red Flags Mild soreness that settles with rest is common; sharp, escalating, or night pain is not something to push through. Do not use this program to self-treat severe pain, and do not apply electrical stimulation without clinician guidance. Seek prompt care for fever, spreading redness, new weakness, numbness, or a shoulder that suddenly feels unstable. Avoid overloading and keep a neutral spine. If pain at rest climbs or swelling returns, pause and check in with your clinician before continuing.