Physical Therapy Exercises for Recovery From a Clavicle Fracture

A fractured clavicle, or fractured collarbone, generally occurs from a fall onto the shoulder or after enough pressure is placed on the bone that it breaks. The fracture may be partial or complete and often requires surgical repair or immobilization while it heals.

Every fracture is different. So it's important to work closely with your healthcare provider 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 someone regain full range of motion and then full strength.

This article offers guidelines for a clavicle fracture physical therapy treatment plan and the do's and don'ts to follow throughout it. It also outlines activities in a standard exercise program in the first week, from weeks two to four, four to eight, eight to 12, and 12 to 16.

Guidelines for Clavicle Fracture Rehab

The collarbone is one of the most commonly broken bones in the body. Follow these guidelines while healing from a clavicle fracture:

Do's

• Use ice: Ice the injured shoulder for 15 minutes three times per day or as needed to help reduce pain, swelling, and inflammation.
• Use a sling: Keep your injured arm in a sling for three to four weeks post-injury to help support the clavicle as it heals.
• See your healthcare provider: Keep your healthcare provider's appointments and see your physical therapist consistently.

Don'ts

• Don't raise the arm: Avoid this activity until your healthcare provider gives you the OK.
• Don't lift too much: Avoid lifting anything with the fractured arm until your healthcare provider approves.
• Don't shrug, slouch, or let your shoulders round while in the sling: It's important to watch your body mechanics and maintain proper bone and muscle alignment to avoid future problems. Try to focus on good shoulder position. Ask your provider to show you how.
  

Physical Therapy

You may be referred to physical therapy three to four weeks after your injury. Your physical therapist will take your history and do an assessment to determine specific ways they can help your rehabilitation.

The focus of your activities may include:

• Pain relief: You may continue to have pain for another two to four weeks. Your physical therapist can recommend using heat, ice, or transcutaneous electrical nerve stimulation (called TENS). This form of electrical nerve stimulation is aimed at reducing pain.
• Range of motion (ROM): Joint mobilization techniques can help restore joint mobility. Your therapist will teach you how to do these at home. Several exercises are used to help restore range of motion. Your healthcare provider may allow a therapist to perform passive ROM exercises for a stable fracture. If it's not stable, they may require complete immobilization for a period of time.
• Strength: Strengthening exercises will help restore the muscle and bone strength lost during immobilization.
• Scar tissue mobility: If you had surgery for your fracture, your physical therapist may use scar mobilization and massage techniques and teach you how to do self-massage at home.

Standard Rehab Exercise Program

This program is designed to improve the functional mobility of your shoulder and arm. Work with your healthcare provider and physical therapist to design a custom rehab program that is appropriate for your condition.

Week 1

Standard daily exercise routine: You will perform isometric or static exercises daily. During isometric exercises, you contract your muscles without movement. Here are the exercises you can expect to do:

• Pendulum exercise: In this exercise, 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 triceps exercises: The triceps brachii is the muscle on the back of the upper arm that is primarily responsible for extending the elbow. Rest your injured arm on a table with your elbow at a 90-degree angle. Make a fist and press it onto the table 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 shoulder exercises: You may also be instructed to do isometric shoulder exercises that include abduction, adduction, extension, and flexion. Abduction and adduction exercises strengthen muscles at the back of your shoulder and upper back. The latter two work the muscles, too, with extension focusing on moving your arms when they're behind you and flexion focusing on moving your arms from a resting stance to virtually any other position.

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 exercises, 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 your clavicle fracture. Here are some exercises they may suggest in addition to the standard daily plan:

• 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. Try to go a little higher each day.
• Start building elbow range of motion with easy pivots and bending and straightening the elbow and wrist.
  

Weeks 4 to 8

If you're 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. However, you should avoid shoulder elevation, rotation, and 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 a 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 using light weights and higher repetitions.

Weeks 12 to 16

If your physical therapist says you're ready, you'll start a more aggressive strengthening program. Stop if you feel pain, instability, or "catches" in joint movements.

• Increase the intensity of strength-training exercises.
• Begin sports-specific skill drills and exercises.

Take special care if you previously were active in sports training and/or competition. Your PT may not clear you for normal activity until testing shows that your injured side is as strong and flexible as the uninjured side.

Summary

Recovering from a clavicle fracture takes about four months. It may seem like a long time until you consider that the process is broken down into stages, with each lasting about four weeks after you reach week four. You'll have to follow a list of do's and don'ts as you proceed through a rehab program.

Throughout recovery, your focus will probably remain on pain relief, range of motion, strengthening, and scar tissue mobility. As you might expect, the challenges in your rehab program will generally intensify until you regain full strength.

Frequently Asked Questions

• The collarbone doesn’t fully form until age 23-25 or possibly older, so fractures before that are more likely.
• There is little muscle or ligament support in the collarbone.
• The middle third of the bone is relatively thin.
  

Yes. In fact, as long as you don’t need surgery, you should be able to start doing exercises for elbow motion soon after the injury. A physical therapist can guide you to the right exercises as you recover. Gentle shoulder exercises are necessary once your bone begins to heal. Gradually, you’ll add more strenuous activity.

A full recovery from a broken clavicle takes about four months. It could take longer if you have diabetes or smoke. It’s essential that you follow your treatment plan and do not perform activities such as lifting objects before you’re completely healed. Rushing things may mean having to start rehabilitation from the beginning all over again.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Wooster Community Hospital. Is Physical Therapy Right for You?
2. Johns Hopkins Medicine. Clavicle fractures.
3. Waldmann S, Benninger E, Meier C. Nonoperative treatment of midshaft clavicle fractures in adults. Open Orthop J. 2018;12:1-6. doi:10.2174/1874325001812010001
4. Massachusetts General Hospital. Clavicle Fracture (Broken Collarbone).
5. American Academy of Orthopaedic Surgeons. Rotator cuff and shoulder conditioning program.
6. Mulligan EP, Huang M, Dickson T, Khazzam M. The effect of axioscapular and rotator cuff exercise training sequence in patients with subacromial impingement syndrome: A randomized crossover trial. Int J Sports Phys Ther. 2016;11(1):94-107.
7. Orthobullets. Clavicle Fractures - Midshaft.
8. Hughes JL, Newton PO, Bastrom T, Fabricant PD, Pennock AT. The Clavicle Continues to Grow During Adolescence and Early Adulthood. HSS J. 2020;16(Suppl 2):372-377. doi:10.1007/s11420-020-09754-8
9. American Academy of Orthopaedic Surgeons. Clavicle fracture (broken collarbone).

• American Academy of Orthopaedic Surgeons. Clavicle fracture (broken collarbone).
• American Academy of Orthopaedic Surgeons. Rotator cuff and shoulder conditioning program.

By Elizabeth Quinn
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.