Intermediate Shoulder Post-Fracture Rehabilitation

Program Overview This is a 19-week, four-sessions-per-week, 45-minute-per-session intermediate rehabilitation program for a shoulder after a fracture. It uses ankle weights, a stationary bike, and a barbell alongside other therapeutic tools, with moderate-level supporting evidence. The plan moves through carefully staged phases, beginning with protection and pain control and advancing only when you meet clear, clinician-checked milestones. Your treating clinician supervises and adjusts this program.

Who This Program Is For and Its Goal This program is for people recovering from a shoulder fracture who have completed early protection and are ready for intermediate-level rehabilitation. The goal is to gradually restore comfortable shoulder motion, rebuild strength in the rotator cuff and shoulder blade muscles, improve stability and control, and return you toward everyday function. Progress is guided by how you feel and by measured milestones, not by rushing.

Before You Start Before beginning, have your clinician confirm your fracture is healed enough and clear you for this stage. Do not start if you have limited range of motion that has not yet been assessed, signs of compartment syndrome (severe, worsening pain, swelling, or tightness), or a wound that has reopened. These conditions require medical review first. Your clinician will also check which equipment and modalities are appropriate for you.

Safety Notes, Contraindications, and When to Stop Follow your clinician's guidance on all movements and modalities. Stop an exercise if pain increases, and always cool down afterward. Seek urgent care for severe or worsening pain, new numbness or tingling, marked swelling, a wound that opens or drains, or a cold, pale, or tight limb. Do not push through sharp pain or perform resisted rotator cuff work until you are cleared. Report any new symptoms to your clinician promptly. Ultrasound and TENS should be applied only as directed by a trained professional.

Weekly Structure You will complete four sessions each week, about 45 minutes each, for 19 weeks. Early weeks focus on gentle motion and pain control, using tools like shoulder pulleys, then gradually add resistance bands, light weights, ankle weights, and eventually barbell work for the shoulder and upper body as tolerated. The stationary bike supports general warm-up and circulation. Your clinician will tell you when to advance between phases based on the progression criteria.

How the 19-Week Plan Is Organized The plan is divided into progressive phases. The first phase emphasizes protection and pain control, with gentle passive and active-assisted motion and isometric work introduced only when cleared. Later phases build strength and control using bands, light weights, and ankle weights, then add more challenging stability work with tools like a stability board or BOSU if appropriate. The barbell is reserved for later strengthening once your clinician confirms readiness. Each phase has specific milestones that must be met before moving on.

What a Typical Session Looks Like Each session follows a warm-up, main work, and cool-down pattern. Warm-up may include easy stationary bike pedaling and gentle shoulder pendulum or pulley movements. Main work combines range-of-motion exercises, progressive strengthening with bands, light weights, or ankle weights, and stability or proprioceptive drills as assigned. Cool-down includes gentle stretching and relaxed motion to help you settle. Your clinician tailors each element to your current phase and tolerance.

Warm-Up, Main Work, and Cool-Down Begin with light stationary bike pedaling and easy shoulder circles or pulley-assisted motion to warm the tissues. The main portion includes your assigned range-of-motion work, strengthening with resistance bands, light weights, or ankle weights, and stability drills using a stability board or BOSU when appropriate. Barbell work is added only when cleared. Finish with a cool-down of gentle stretching and slow breathing. Keep effort comfortable and stop if pain increases. Therapeutic ultrasound or TENS, if prescribed, is applied per your clinician's instructions.

Tracking Progress Your clinician will track your recovery using standardized measures, including the ASES, Constant-Murley Score, Simple Shoulder Test, and SPADI questionnaires, plus range-of-motion measurements with a goniometer and manual muscle testing of the rotator cuff and shoulder blade muscles. Keep a simple log of your sessions, pain levels, and any symptoms. Sharing this with your clinician helps guide safe progression and shows your improvement over time.

How Progression Criteria Are Used You advance between phases only when you meet the specific milestones your clinician checks, such as comfortable passive elevation to set angles, low pain with daily activities, improved sleep, and tolerance of gentle strengthening without increased pain. These criteria are assessed, not self-determined, so your clinician confirms each step. Outcome measures like the ASES and SPADI complement these checks by tracking function and pain over the 19 weeks and flagging any need to slow down.

Recovery and Self-Care Recovery happens between sessions too. Get adequate rest, sleep in a comfortable position your clinician recommends, and avoid prolonged positions that strain the shoulder. Stay generally active with light movement as tolerated. Apply ice or heat only as advised. Keep follow-up appointments, and tell your clinician about any changes in pain, swelling, sleep, or function. Patience and consistency matter more than pushing hard.

Pain Management Cautions and Red Flags Use pain as your guide: stop if pain increases during exercise, and cool down afterward. Do not use this program to self-manage severe pain or to mask warning signs. Contact your clinician for worsening pain, new weakness or numbness, increased swelling, fever, a wound that reopens or drains, or a limb that feels cold, pale, or unusually tight. These may signal a problem needing prompt medical attention.