Since every injury is different, it's important to work closely with your physician and physical therapist to design a clavicle fracture rehabilitation program that is specific to your injury, fitness level and lifestyle. In general, all rehab exercise programs are designed to help the athlete regain full range of motion and full strength to return to sports safely and quickly.
Here are some general guidelines and basic rehabilitation exercises for an uncomplicated clavicle fracture.
Clavicle Fracture Rehab - General Guidelines
- No arm raising. Don't raise the injured arm above 70 degrees in any direction for four weeks postinjury.
- No lifting. Do not lift more than 5 pounds with the fractured arm for six weeks postinjury.
- Use ice. Ice the injured shoulder for 15 minutes three times per day as needed to help reduce pain, swelling and inflammation.
- Use a sling. Keep your injured arm in a sling for 3 to 4 weeks postinjury to help support the clavicle as it heals.
- Watch your body mechanics. While using a sling, it's important to maintain proper bone and muscle alignment to avoid future problems. Try to focus on good shoulder position. Don't shrug, slouch or let your shoulders round while in the sling.
- See your doctor. Keep your doctor's appointments, and see your physical therapist during your rehab.
Clavicle Fracture - Standard Rehab Exercise Program
- Week 1
- Work with your doctor and physical therapist to design a custom rehab program. In general, this includes:
- Standard Daily Exercise Routine
- Pendulum exercise. In this exercise, you bend forward at the waist and let your injured arm hang down toward the ground. Make small circles with your hand and let momentum move your arm around effortlessly. Try to make clockwise and counterclockwise circles.
- Grip Strength Exercise. Squeeze a small ball (a racquetball works well) with gentle but even pressure several times per day.
Isometric or Static Exercises. During isometric exercises, you contract your muscles without movement. There are several forms of isometrics you may do during your rehab, including the following:
Isometric Triceps Exercises. The triceps brachii is the muscle on the back of the upper arm primarily responsible for extending the elbow.
- Rest your injured arm on a table or counter top with your elbow at 90 degrees.
- Make a fist and press in to the tabletop with your entire forearm, from fist to elbow.
- Your arm will not move, but your triceps muscle will contract.
- Rotator Cuff Exercises. The muscles that make up the rotator cuff are often damaged or torn during shoulder injuries. Isometric internal and external rotation exercises are often prescribed to rebuild strength in the rotator cuff.
- Isometric Triceps Exercises. The triceps brachii is the muscle on the back of the upper arm primarily responsible for extending the elbow.
- Isometric Shoulder Exercises. You may also be instructed to do isometric shoulder exercises that include abduction, adduction, extension and flexion, with your arm at your side.
- During this week, your physical therapist may also work on any soft tissue injuries you may have sustained, including muscle tears, pulls or strains.
- If you feel up to it, you can continue to maintain your overall fitness by using cross training and cardiovascular exercise, such as walking, stair climbing and stationary cycling, during your rehabilitation program.
- Weeks 2 to 4
- Your physical therapist will continue treating your soft tissue injuries and identify structural imbalances caused by our clavicle fracture.
- You will begin passive wall crawl or easy pulley exercises twice a day to build shoulder range of motion. To do the wall crawl, simply walk your fingers up a wall as high as you can without too much discomfort in the shoulder. Each day, do a bit more.
- You will begin building elbow range of motion with easy pivots and bending and straightening the elbow and wrist.
- Weeks 4 to 8
- If you are healing well, you'll start increasing your range of motion exercises and begin strengthening exercises.
- Rotator cuff range of motion exercises continue, but now you may add some light resistance with bands or weights. Let pain be your guide regarding how much exercise to do. You should, however, avoid shoulder elevation, rotation or excessive movement.
- You may begin easy shoulder range-of-motion exercises that your physical therapist prescribes.
- Weeks 8 to 12
- During this phase of rehab, you will work toward full range of motion in all directions.
- Your strengthening exercise program will continue to progress, but you should avoid heavy lifting. Focus on rebuilding muscle endurance, with light weights and higher repetitions.
- Weeks 12 to 16
- If your physical therapist indicates you are ready, you'll start a more aggressive strengthening program. Stop activity if you feel pain, instability or "catches" in joint movements.
- Increase the intensity of strength-training exercises.
- Begin sports specific skill drills and exercises.
- Return to specific sports training and competition only when you are cleared for activity and your functional testing shows that your injured side is as strong and flexible as the uninjured side.
The American Academy of Orthopaedic Surgeons, Broken Collarbone, Patient Information, Shoulder Surgery Exercise Guide, 2007.