Clavicle fracture rehab protocol is a structured pathway designed to restore function, minimize stiffness, and rebuild strength after a collarbone injury. The clavicle connects the arm to the trunk, so an effective recovery plan must balance protection of the healing bone with progressive mobilization of the shoulder complex. This guide outlines the key phases, exercises, and considerations that typically make up a comprehensive rehabilitation strategy.
Understanding Clavicle Fractures and Healing Stages
Clavicle fractures often occur from a fall onto the shoulder or a direct impact, resulting in pain, swelling, and difficulty moving the arm. Healing follows a biological timeline that includes inflammation, soft callus formation, hard callus development, and bone remodeling. During rehab, clinicians align exercises with these stages to ensure tissue loads remain appropriate for each phase of repair.
Initial Protection and Pain Management
In the first days to weeks, the priority is protecting the fracture site and managing discomfort. A sling or figure-eight brace may be used, depending on fracture displacement and surgeon preference. Gentle wrist and elbow movements are encouraged to prevent stiffness in the joints above and below the injury, while avoiding loading through the shoulder.
Use ice therapy for 15 to 20 minutes several times a day to reduce swelling.
Follow prescribed pain medication guidelines and communicate with your healthcare team if symptoms change.
Perform controlled breathing and gentle trunk mobility exercises to support circulation and prevent compensatory patterns.
Early Passive and Active-Assisted Range of Motion
As pain decreases and radiographic signs of early healing appear, the protocol advances to gentle range of motion. Passive movements, where the unaffected arm or a therapist guides the injured side, help maintain joint mobility without stressing the clavicle. Active-assisted exercises, using the uninjured hand to assist the affected arm, encourage muscular activation within safe limits.
Begin pendulum or Codman exercises once cleared to move the shoulder.
Progress to supine shoulder flexion and external rotation with support, focusing on smooth, pain-free motion.
Monitor for increases in pain or swelling after sessions and adjust volume accordingly.
Strengthening and Neuromuscular Control
When full, pain-free passive range is achieved, the protocol introduces strengthening and neuromuscular control. Isometric contractions, scapular setting exercises, and light resistance bands lay the foundation for dynamic movements. Emphasis is placed on rotator cuff endurance, scapular stability, and proper alignment during all activities.
Functional Progression and Return to Activity
Functional progression bridges structured rehab to daily tasks and sport-specific demands. Drills focus on controlled reaching, pushing, pulling, and overhead patterns while monitoring scapular positioning. A gradual return to contact sports or heavy lifting follows objective criteria, including strength symmetry, pain-free mobility, and confidence during complex movements.
Common Challenges and Professional Guidance
Setbacks such as persistent stiffness, weakness, or occasional discomfort can occur, especially if progression is too aggressive. Regular communication with a physiotherapist or orthopedic provider ensures the protocol remains individualized. Imaging and functional tests guide adjustments, helping to balance biological healing with realistic functional goals.
