Intermediate Shoulder Post-Fracture Rehabilitation
A 20-week intermediate program using balance pads, weight vests, dumbbells, and pull-up bars to aid in the recovery process.
Professional rehabilitation program designed for effective recovery and pain management.
Key facts at a glance
- Body part
- upper-limb · shoulder
- Injury type
- post-fracture
- Level
- intermediate
- Duration
- 20
- Sessions/week
- 4
- Minutes/session
- 30
- Evidence level
- moderate
- ICD-10
- S42
- Cost tier
- moderate
Program Overview — Intermediate Shoulder Post-Fracture Rehabilitation (Program 2381)
This program is for people recovering from a shoulder fracture who have moved past early healing and are ready for a more active, structured plan over 20 weeks. The goal is to rebuild comfortable movement, strength, and shoulder control so you can return to everyday activities with confidence. You will work with equipment such as a balance pad, weight vest, dumbbells, and pull-up bar, and your clinician will adjust the plan to your specific fracture and needs.
Before You Start
Please begin only after your clinician has assessed your shoulder and cleared you for this level of activity. Do not force movement into ranges that have not been assessed, and stop if pain increases during or after exercise. Always warm up before and cool down after sessions. Seek medical advice promptly if you notice sudden severe pain, new swelling, numbness, or a feeling that the shoulder is unstable. These are general safety steps, not a diagnosis—your clinician knows your case best.
Weekly Structure
You will do about four sessions per week, roughly 30 minutes each, across 20 weeks. The plan moves through phases: protection, early motion, strengthening, and advanced strengthening. Early weeks focus on gentle movement and control; later weeks add more loading and functional tasks. Your clinician uses checkpoints—such as pain levels, movement range, and strength—to decide when you are ready to progress, so the pace fits your recovery rather than a fixed calendar date.
What a Typical Session Looks Like
Each session follows a warm-up, main work, and cool-down pattern. A warm-up might include gentle shoulder and arm movements, light band or dumbbell work, and posture setting. The main work uses your balance pad for stability, dumbbells and a weight vest for progressive strengthening, and the pull-up bar only when cleared and appropriate. Cool-down includes slow stretching and relaxed breathing. Your clinician may also include hands-on techniques, taping, ultrasound, electrical stimulation, or water-based exercise as part of your plan.
Tracking Progress
Your clinician will use phase checkpoints—like comfortable rest pain, improving range of motion, and pain-free strength—to guide when you advance. These checkpoints are clinical guides, not targets you need to hit on your own. Outcome measures such as the Constant-Murley Score, UCLA Shoulder Rating Scale, DASH, pain scales, range-of-motion measurements, and manual muscle testing help show change over time and shape your program. Share how your shoulder feels day to day, because your feedback matters as much as the numbers.
Recovery and Self-Care
Some mild soreness after activity can be normal, but pain that keeps increasing is a signal to ease off and tell your clinician. Do not push through sharp pain, and avoid heavy or overhead loading until you are cleared. Rest, good sleep, and pacing your activities support healing. Contact your clinician if you have new or worsening pain, swelling, weakness, numbness, or a sense that the shoulder gives way. Medication questions should go to your prescribing clinician.
Recovery phases
Pain at rest ≤2/10 on VAS scale,Minimal glenohumeral joint effusion present,Passive forward flexion to 90 degrees achievable without increased intracapsular pressure,Scapular stabilizers able to perform submaximal isometric contractions without exacerbation,Biceps tendon palpation reveals decreased tendon irritability,AC joint alignment maintained with minimal step-off
→ Advance to: Early Motion Phase
Passive glenohumeral external rotation to 30 degrees at 90 degrees abduction,Active-assisted forward flexion to 120 degrees with scapular control,Rotator cuff isometric contractions pain-free at neutral,Scapular protraction and retraction against gravity achievable,Labral repair protection: no painful clicks with passive range of motion,Biceps tendon resisted flexion without tendon subluxation pain
→ Advance to: Strengthening Phase
Active forward flexion to 145 degrees with proper scapulohumeral rhythm,Glenohumeral external rotation strength 4/5 at 90 degrees abduction,Internal rotation strength 4/5 in functional position,Scapular control during loaded arm movements (wall push-ups),No reproduction of AC joint pain with cross-body adduction,Biceps tendon resisted supination without anterior shoulder pain
→ Advance to: Advanced Strengthening Phase
Full active range of motion in all planes (flexion 180°, abduction 180°, external rotation 90°),Rotator cuff manual muscle testing 5/5 in all planes,Scapular elevation and depression against resistance symmetrical,Proprioceptive training: closed chain weight bearing tolerated,AC joint load tolerance: functional overhead activities without pain,Biceps tendon: resisted supination at 90 degrees elbow flexion 5/5
→ Advance to: Sport-Specific Phase
Throwing progression: interval program Phase II completed without pain,Rotator cuff endurance testing: 30 repetitions at 50% max without fatigue-related form breakdown,Scapular kinetic chain: plyometric push-ups without scapular dyskinesis,Glenohumeral translational glide: physiological mobility restored,Overhead athletes: 90% velocity compared to contralateral side,Contact athletes: shoulder pad fitting tolerance achieved
→ Advance to: Return to Activity Phase
Constant-Murley Score ≥85 points,UCLA Shoulder Rating Scale ≥32 points,DASH score <15 points,Isokinetic dynamometry: external/internal rotation ratio 66-76%,Sport-specific functional progression completed without regression,Patient-reported return to pre-injury activity level achieved
→ Advance to: Discharge/Maintenance
Return to activity milestones
Pain-free basic activities of daily living
Week 6Patient adherence to home exercise programme ≥ 5 days per week
Light functional activities and conditioning
Week 9Able to perform light overhead reaching for objects at eye level
Moderate activity and sport-specific conditioning
Week 12Grip strength ≥ 50% of unaffected side on dynamometry
Full return to sport, occupation, and recreation
Week 20Patient reports ≥ 30% improvement in upper limb functional score
Precautions
- cool-down-after
- warm-up-before
- stop-if-pain-increases
Contraindications
- limited-range-before-assessment
Pain management
- Cryotherapy (ice pack application 15-20 minutes post-exercise)
- Non-steroidal anti-inflammatory medication (prescribed as appropriate)
- Positional relieve: semi-reclined sleeping with abduction pillow
- Gentle soft tissue mobilization to posterior capsule and rotator cuff interval
- Transcutaneous electrical nerve stimulation (TENS) for acute pain episodes
Equipment & modalities
Frequently asked questions
How hard should I push during a session?
Why do I need an assessment before certain movements?
What if I miss sessions or progress slowly?
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
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