Intermediate Shoulder Post-Fracture Rehab

Program Overview This is a 9-week, intermediate-level rehabilitation guide for people recovering from a shoulder fracture. It combines guided exercise, hands-on therapy, and water-based work to help you regain movement, strength, and confidence in your shoulder.

Who This Program Is For and Its Goal This program is for someone whose shoulder fracture is healing and who has been cleared by their clinician to begin intermediate rehabilitation. The goal is to safely restore shoulder motion, rebuild strength in the rotator cuff and shoulder-blade muscles, and return you to everyday use of your arm with less pain. Progress is gradual and guided by your therapist.

Before You Start Always begin only with your clinician's or therapist's approval, and have a physiotherapist supervise or review your plan. This program is not appropriate if you have severe muscle wasting or a compression-type condition affecting the arm, as these need specialist care. Warm up before every session and avoid overloading. Stop and call your clinician if you feel sharp or worsening pain, new swelling, numbness, weakness, or if your shoulder feels unstable.

Safety Notes and When to Stop Your therapist will check for problems like severe muscle thinning or dangerous pressure buildup in the limb before and during the program; if either is suspected, exercise pauses until reviewed. Warm up first, build load gradually, and never push into sharp pain. Stop and contact your clinician if pain keeps climbing, swelling increases, you feel tingling or numbness, or movement suddenly feels wrong. Moderate evidence supports this approach, but your own response always guides safety.

Weekly Structure Plan for five sessions per week, about 60 minutes each, across nine weeks. You'll use a tennis ball and a back brace as tools, alongside clinic-based treatments. Expect to move through phases: early protection and pain control, then gentle mobility, then controlled movement, then strengthening. Your therapist decides when each phase begins based on how you're doing, not just the calendar.

How the 9-Week Plan Is Organized Weeks one through three focus on calming pain and gently restoring movement. Weeks four through six build controlled motion and early strength. Weeks seven through nine emphasize strengthening and coordination. Sessions mix hands-on therapy, guided exercises, a tennis ball for grip and positioning work, a back brace for posture support, and, where available, water therapy to reduce load early on. Ultrasound may be used by your therapist to support tissue healing.

What a Typical Session Looks Like Most sessions follow a warm-up, main work, and cool-down pattern. Your warm-up might include gentle pendulum movements and easy shoulder-blade squeezes. The main work uses your therapist's hands-on techniques, progressive exercises with the tennis ball, and posture work with the back brace. Cool-down includes gentle stretching and relaxed breathing to settle the shoulder.

Warm-Up, Main Work, and Cool-Down Start with light, pain-free movement to warm the shoulder. Main work combines therapist-led joint and shoulder-blade mobilizations, ultrasound for tissue healing at the fracture site, and progressive resistance and coordination exercises, using the tennis ball for controlled holds and the back brace to support posture and avoid strain. Water therapy may be used early for easier movement. Cool down with gentle stretching and rest.

Tracking Progress Your therapist will measure your pain, movement range, and strength at set points and record them. You'll also complete simple questionnaires about how your shoulder affects daily life, such as the SPADI, Simple Shoulder Test, and UCLA and Constant-Murley scores. These show change over time and help guide decisions. Keep notes on pain and activities between visits to share.

How Progression Criteria Are Used Moving to the next phase depends on meeting specific goals, such as comfortable rest pain, improved movement range, and strength gains, not simply reaching a certain week. Your therapist checks these milestones with you and uses outcome measures to confirm progress. If a goal isn't met, the phase is extended safely. Nothing is rushed, and your comfort and control come first.

Recovery and Self-Care Rest between sessions and follow your therapist's guidance on using the back brace and sling as prescribed. Stay generally active, keep good posture, and do only the exercises you've been shown. Ice or other comfort measures may be suggested by your clinician. Sleep and nutrition support healing. Report any changes promptly so your plan can be adjusted.

Pain Management Cautions and Red Flags Don't push through sharp or rising pain, and avoid heavy or abrupt loading of the arm. Follow your clinician's advice on pain relief; this guide does not recommend medications. Seek urgent care for sudden severe pain, marked swelling, numbness, weakness, fever, or a shoulder that looks or feels deformed. These could signal a problem needing prompt review.