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Intermediate Shoulder Post-Fracture Rehabilitation

Published: July 26, 2026Updated: October 6, 2026

A 20-week intermediate program using balance pads, weight vests, dumbbells, and pull-up bars to aid in the recovery process.

Quick summary

Professional rehabilitation program designed for effective recovery and pain management.

Medically reviewed by WellAlly Editorial TeamLast reviewed October 6, 2026Editorial policy

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

Week 1Protection Phase

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

Week 4Early 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

Week 7Strengthening 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

Week 11Advanced 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

Week 15Sport-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

Week 18Return 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 6

Patient adherence to home exercise programme ≥ 5 days per week

Light functional activities and conditioning

Week 9

Able to perform light overhead reaching for objects at eye level

Moderate activity and sport-specific conditioning

Week 12

Grip strength ≥ 50% of unaffected side on dynamometry

Full return to sport, occupation, and recreation

Week 20

Patient 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

Equipment & modalities

Therapeutic ultrasound to promote bone healing at fracture siteElectrical stimulation for rotator cuff neuromuscular re-educationJoint mobilization: glenohumeral grades I-II for pain modulationScapular stabilization taping during functional activitiesAquatic therapy for progressive loading in reduced gravity environmentbalance-padweight-vestdumbbellpull-up-bar

Frequently asked questions

How hard should I push during a session?
Work at a level where you can control the movement and pain does not keep rising. If something feels sharp or wrong, stop and check with your clinician before continuing.
Why do I need an assessment before certain movements?
Your clinician needs to confirm your shoulder can safely handle specific ranges and loads. Skipping that step could slow healing or cause harm, so follow their guidance on what to try and when.
What if I miss sessions or progress slowly?
Recovery is not always a straight line, and missed sessions or slower progress are common. Tell your clinician so they can adjust the plan; the phases are guides, not deadlines you must meet alone.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

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

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