This information will guide you through the next 6 weeks of your rehabilitation. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery.

 

Healing: This injury normally takes 6-12 weeks to heal, but soft tissue injuries can persist for up to 3 months.
   
Pain:

Take pain killers as prescribed.

You may find it easier to sleep propped up with pillows.

                                              

Using your arm:      

 

Use the sling for the first 3 weeks to allow the soft tissues to settle.

It is important to keep the shoulder moving to prevent stiffness but not to aggrevate the injury. Follow the rehabilitation plan outlined below.

Avoid lifting your arm above shoulder height.

   

Follow up:

 

 

You will see a Shoulder Specialist about 3 weeks after your injury. 

They will assess your shoulder and discuss the injury management and the next stage of your rehabilitation. They may do another x-ray to evaluate the position of the collar bone.

If you have not received this appointment please contact your hospital appointment line.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Area of your injury

If you are worried that you are unable to follow this rehabilitation plan, or have any questions, then please phone the Fracture Care Team for advice.

Or, if you are experiencing pain or symptoms, other than at the site of the original injury or surrounding area, please get in touch using the telephone or e-mail details at the top of this letter.

 

 

 

What to expect

  Weeks

  since injury

  Rehabilitation plan

  0-3

  Wear your sling during the day, except for exercises and personal hygiene.

    X   Do not wear your sling at night.

  Start the "Initial Exercises" below straight away.

    X  Do not lift your elbow above shoulder height as this may be painful.

  Appointment at upper limb clinic

  3-6

    X  Try not to use the sling.

  Begin normal light activities with the arm and shoulder.

  Increase movement as shown in the Stage 2 exercises.

    X  Avoid heavy lifting for the full 6 weeks.

  6 -12

  The injury should be largely healed.

  Resume normal day to day activities but be guided by any pain you experience.

  Carry out day to day activities.

  Heavy tasks may still cause some discomfort and swelling.

  Avoid contact sports until 12 weeks post injury.

  Start to lift your arm over-head.

 

Advice for a new injury

Cold packs: A cold pack (ice pack or frozen peas wrapped in a damp towel) can provide short term pain relief. Apply this to the sore area for up to 15 minutes, every few hours ensuring the ice is never in direct contact with the skin.                                                    

Rest: Try to rest your shoulder for the first 24-72 hours. However, it is important to maintain movement. Gently move your shoulder following the exercises shown. These should not cause too much pain. This will ensure your shoulder does not become stiff and it will help the healing process.


Exercises

If you have stiffness in your elbow or hand from wearing the sling, you may wish to perform these exercises first. However, once they become easy you can start with the posture and pendulum exercises.

 

Initial exercises to do 4-5 times a day:

Finger and wrist flexion and extension

Open and close your hand as shown 10-15 times.

Then move your wrist up and down 10-15 times.

 

After a few days, hold a soft ball/ball of socks. Squeeze the ball as hard as possible without pain.

Hold for 5 seconds and repeat 10 times.

 

 

Elbow Bend to Straighten

Bend and straighten your elbow so you feel a mild to moderate stretch. You can use your other arm to assist if necessary. Do not push into pain. 

Repeat 10-15 times provided there is no increase in symptoms.

Forearm Rotations

Put your elbow at your side. Bend it to 90 degrees. Slowly rotate your palm up and down until you feel a mild to moderate stretch. You can use your other arm to assist if necessary. Do not push into pain. 

Repeat 10-15 times provided there is no increase in symptoms.

 

Postural awareness

Bring your shoulders back and squeeze your shoulder blades together as shown in the picture. Do this with or without your sling on.

Hold the position for 20-30 seconds and repeat 5 times provided there is no increase in symptoms.

 

 

 

 

 

 

 

Shoulder pendulum exercises

Stand and lean forward supporting yourself with your other hand. Try to relax your injured arm and let it hang down.

  1. Swing your arm slowly and gently forwards and backwards.
  2. Swing your arm slowly and gently side to side.
  3. Swing your arm slowly and gently in circles clockwise.

Continue for approximately 1-2 minutes in total provided there is no increase in symptoms. Remember to try and relax your arm.

 

 

Stage 2 exercises

Start these exercises 3 weeks post injury and to do 4-5 times a day:

 

Active assisted Shoulder flexion

Use your other hand to lift your arm up in front of you as shown in the pictures.

Repeat 10 times provided there is no increase in symptoms.

 

 

 

 

 

 

 

 

Active assisted External rotation

Keep the elbow of your injured arm tucked into your side and your elbow bent. Hold onto a stick/umbrella/golf club or similar. Use your unaffected arm to push your injured hand outwards. Remember to keep your elbow tucked in. Push until you feel a stretch.

If you don’t have a stick you could simply hold the injured arm at the wrist and guide it outwards. 

Hold for 5 seconds and then return to the starting position. Repeat 10 times provided there is no increase in symptoms.

Stage 3 exercises

Start these exercises 6 weeks after your injury and to do 4-5 times a day.

When you have regained full range of movement in the stage 2 exercises without pain you can start to do these exercises without the support of your other hand. This is known as active range of movement. Then when you have regained full movement without helping with your other arm, you can build up your regular day to day activities.

Perform these exercises 10 times each. Only go as far as you can naturally, without doing any trick movements to try and get any further. The movement should increase over time and should not be forced.

 

Active Forward flexion:

With your thumb facing up, try to move your arm up, keeping it close beside your body.

 

 

 

 

 

 

 

 

 

Active Abduction

With your thumb facing up and outwards, try to move your arm in a big arc out to the side.

 


 

 

 

 

 

 

 

 

Active External Rotation

With your elbow by your side, rotate your forearm outwards, keeping your elbow at about 90 degrees in flexion.