Physical Therapy Exercises for Recovery From a Clavicle Fracture

A fractured clavicle, or fractured collarbone, is a common sports injury that generally occurs from an impact to the shoulder of a fall on an outstretched arm. These fractures may be partial or complete and often require surgical repair or immobilization while they heal. 

Each fracture is unique. 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 an athlete regain full range of motion and then full strength to allow a return to sports safely and quickly.

Guidelines for Clavicle Fracture Rehab

Follow these do's and don'ts while healing from an uncomplicated clavicle fracture:

Do's and don'ts to rehab clavicle fracture.
Laura Porter / Verywell

Do's

Follow this advice on what to do:

  • 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 three to four weeks post-injury to help support the clavicle as it heals.
  • See your doctor. Keep your doctor's appointments and see your physical therapist during your rehab.

Don'ts

Heed these cautions on what not to do:

  • Don't raise the arm. Avoid this until cleared by your doctor.
  • Don't lift too much. Avoid lifting anything with the fractured arm until cleared by your doctor.
  • Don't shrug, slouch, or let your shoulders round while in the sling. While using a 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.

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 see the specific ways she can help your rehabilitation. These can include:

  • Pain: 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 (TENS).
  • Range of motion (ROM): Joint mobilization techniques can help restore joint mobility and your therapist will teach you how to do these at home. Several exercises are used to help restore range of motion. Your doctor 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 doctor 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:

  • 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 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 with your elbow at 90 degrees. Make a fist and press 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, 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 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 our 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. Each day, do a bit more.
  • Start 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. These can include:

  • 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 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 indicates you are ready, you'll start a more aggressive strengthening program. Stop activity if you feel pain, instability, or "catches" in joint movements. You may include the following:

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

Return to specific sports training and competition only when you're cleared for activity and your functional testing shows that your injured side is as strong and flexible as the uninjured side.

A Word From Verywell

Rehabilitation from a fracture takes time and dedication to your therapy program. To maintain overall fitness while recovering, opt for walking, stair climbing, or hands-free cycling. You may be anxious to return to playing sports, but it's best to wait until you are cleared by your medical team.

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Article Sources
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