Intermediate Shoulder Rehab Post-Fracture

Program Overview This is a 16-week, intermediate-level shoulder rehabilitation guide for recovery after a shoulder fracture. It combines supervised therapeutic exercise with manual therapy, electrical stimulation, hydrotherapy, and proprioception training. Sessions run three times per week at about 20 minutes each, using an elliptical, stationary bike, ankle weights, and a TRX suspension trainer. The plan moves through four phases — protection, early motion, strengthening, and advanced strengthening — so you build control and confidence before adding load.

Who This Program Is For and Its Goal This program is for people recovering from a shoulder fracture who have been cleared by their clinician and are ready for intermediate-level rehabilitation. It targets the rotator cuff, labrum, acromioclavicular (AC) joint, and biceps tendon. The goal is to restore comfortable shoulder motion, rebuild strength and shoulder-blade control, and return you to everyday and recreational activities safely. Your clinician should supervise or review your progress, especially at phase transitions.

Before You Start Begin only after your fracture has been assessed and your clinician confirms it is safe to move the shoulder. Do not start if you have an open or re-opened wound, a recent or healing fracture that is not yet stable, or limited shoulder range that has not been assessed. Tell your therapist about any pain, swelling, or changes in your shoulder. Warm up before every session, never push through increasing pain, and cool down afterward.

Safety Notes and When to Stop Stop exercising and contact your clinician if you have sharp or rapidly worsening pain, new swelling, a feeling of the shoulder slipping or giving way, numbness or tingling in the arm or hand, a wound that opens or drains, or pain that persists well after the session. These may be signs the shoulder needs reassessment. Mild discomfort that eases with rest is common, but increasing pain is a signal to slow down. Always follow your care team's advice over this general guide.

Weekly Structure Plan for three sessions each week, about 20 minutes per session, across 16 weeks. Each session includes a warm-up, targeted shoulder and shoulder-blade work, and a cool-down. The elliptical and stationary bike support general warm-up and circulation, ankle weights add light resistance, and the TRX helps with supported and controlled movements. Expect the early weeks to focus on gentle motion and control, with strength and load building gradually later.

How the 16-Week Plan Is Organized The plan has four phases of about four weeks each. In the protection phase you focus on gentle, supported motion and quiet shoulder-blade setting. In early motion you work on increasing comfortable range and smooth movement. The strengthening phase builds rotator cuff and shoulder-blade strength. In advanced strengthening you add controlled load and overhead control. Your therapist decides when you are ready to move to the next phase based on how your shoulder responds.

What a Typical Session Looks Like A typical session follows a warm-up, main-work, cool-down pattern. You will likely start with a few minutes on the stationary bike or elliptical to warm the shoulder and body. The main work combines prescribed rotator cuff and shoulder-blade exercises, possibly with ankle weights or the TRX for support and control. Cool down with gentle motion and stretching. Your therapist may also provide manual therapy, electrical stimulation, hydrotherapy, or proprioception training as part of your supervised care.

Warm-Up, Main Work, and Cool-Down Warm up for a few minutes on the stationary bike or elliptical to raise blood flow and loosen the shoulder. Move into your main exercises: rotator cuff and shoulder-blade strengthening, position and control drills, and supported movements using the TRX or light ankle weights as directed. Cool down with slow, gentle range-of-motion and stretching. Keep the effort comfortable, and let your therapist adjust intensity and exercise choice based on your response.

Tracking Progress Track your pain before and after sessions, how far you can move your shoulder comfortably, and how strong and controlled movements feel. Your clinician will also use standardized measures such as the ASES score, Constant-Murley score, a pain scale, range-of-motion measurements, rotator cuff strength testing, and the SANE rating. These give a clear picture of progress over time and help guide decisions about advancing your program. Bring any concerns or changes to your therapist.

Using Progression Criteria and Outcome Measures Your therapist uses phase-specific checkpoints — such as comfortable range of motion, pain levels, strength grades, and absence of certain pain signs — to decide when you are ready for the next phase. Meeting these checkpoints is not automatic; your clinician confirms readiness. Outcome measures track your overall recovery and help identify areas that need more attention. Progression is based on safety and control, not just time in the program.

Recovery and Self-Care Rest between sessions and avoid overloading the shoulder on consecutive days if it feels tired or sore. Use gentle movement and ice or heat only as advised by your clinician. Keep the shoulder supported during sleep if that feels better. Stay consistent with your program, but let comfort guide effort. Good sleep, hydration, and general activity support healing. Report any new symptoms promptly.

Pain Management Cautions and Red Flags Do not take medication or change medication based on this guide; ask your clinician or pharmacist. Stop and seek advice for severe or worsening pain, sudden loss of movement, visible deformity, wound opening or drainage, fever, or numbness and tingling. These are red flags that need prompt assessment. Mild soreness that settles with rest is expected, but pushing through increasing pain is not recommended.