Clavicle fracture rehabilitation is crucial for restoring shoulder function and strength. It involves a structured program of immobilization, exercises, and gradual mobilization to ensure proper healing and return to daily activities.

Overview of Clavicle Fractures and the Importance of Rehabilitation

A clavicle fracture, or broken collarbone, is a common injury often caused by falls or direct blows to the shoulder. It can significantly impact daily activities and shoulder function. Rehabilitation plays a vital role in restoring strength, mobility, and proper alignment. Without proper care, complications like limited range of motion or chronic pain may arise. A structured rehabilitation program, including exercises and immobilization, helps prevent stiffness and promotes healing. Early mobilization and progressive strengthening are key to regaining full shoulder function. Rehabilitation also addresses scapular stability, reducing the risk of long-term issues. A well-designed program ensures a safe return to normal activities and sports, making it essential for optimal recovery.

Phase 1: Immediate Post-Injury (0-4 weeks)

Phase 1 focuses on immobilization and pain management. A sling is used to immobilize the arm, and early elbow, wrist, and hand exercises are recommended to maintain mobility. Active shoulder movements are avoided during this period.

Immobilization and Sling Use

Immobilization is critical during the initial healing phase of a clavicle fracture. A sling is worn 24/7 to support the shoulder and collarbone, except during hygiene or gentle exercises. Proper sling use ensures the fracture remains aligned, promoting proper healing. Patients should avoid active shoulder movements to prevent displacement. The sling helps reduce pain and inflammation while protecting the fracture site. It is essential to follow the healthcare provider’s instructions regarding sling use to optimize recovery. Immobilization typically lasts 4 weeks, after which gradual mobilization begins. Adherence to this protocol is vital for achieving full shoulder function and strength.

Early Elbow, Wrist, and Hand Exercises

Early exercises for the elbow, wrist, and hand are essential to maintain mobility and prevent stiffness during immobilization. While wearing the sling, patients can perform wrist extensions, fist clenches, and elbow flexions. These exercises should be done 4-5 times daily, with 10 repetitions each. Gentle movements help preserve joint motion without stressing the clavicle. Elbow exercises include flexion, extension, and rotations, while wrist exercises involve flexion, extension, and radial-ulnar deviations. Hand exercises, such as finger bends and spreads, improve dexterity. Pain should not exceed 4/10 during these exercises. These activities ensure the arm remains functional while the clavicle heals, preparing for more advanced rehabilitation phases.

Phase 2: Early Mobilization (4-6 weeks)

This phase introduces passive range of motion (PROM) exercises, focusing on gentle shoulder movements, with limitations on flexion, external rotation, and extension to protect the healing clavicle.

Passive Range of Motion (PROM) exercises are introduced during the early mobilization phase (4-6 weeks post-injury) to gently restore shoulder joint mobility without active muscle engagement. These exercises are performed by a therapist or caregiver, focusing on controlled movements within pain-free limits, typically limiting shoulder flexion to 90 degrees and external rotation to 45 degrees. PROM helps prevent stiffness and promotes healing by maintaining joint lubrication and soft tissue flexibility. Pain during these exercises should not exceed 4/10 on the pain scale. Consistency is key, with exercises performed 4-5 times daily to ensure gradual progress. This phase lays the foundation for active movements in later stages, ensuring a smooth transition to strengthening exercises. Adherence to these guidelines is crucial for optimal recovery.

Limitations on Shoulder Flexion and External Rotation

During the early mobilization phase (4-6 weeks post-injury), specific limitations are placed on shoulder movements to protect the healing fracture. Shoulder flexion is typically restricted to 90 degrees, and external rotation is limited to 45 degrees to avoid displacing the fracture. Patients are advised to avoid lifting weights, even as light as a coffee cup, and to keep the elbow supported during exercises. These restrictions are critical to ensure proper alignment and healing of the clavicle. Adhering to these guidelines helps prevent complications and promotes a stable recovery. Consistency in following these limitations is essential for achieving optimal outcomes in the rehabilitation process.

Phase 3: Strengthening and Range of Motion (6-8 weeks)

Phase 3 focuses on progressing to active shoulder movements, including flexion, external rotation, and scapular stabilization exercises. Isometric exercises are introduced to enhance strength and mobility gradually.

Progressing to Active Shoulder Movements

During Phase 3, patients transition to active shoulder movements to improve strength and mobility. Gentle abduction and external rotation exercises are introduced, along with isometric exercises for scapular stability. Resistance bands or light weights may be incorporated to enhance strength. Pain should not exceed 4/10 during these exercises. Patients are encouraged to perform these movements 4-5 times daily, with 10 repetitions each. Active flexion and rotational exercises are progressively increased to restore full range of motion. This phase is critical for rebuilding shoulder function and preparing for more advanced activities. It is essential to follow a structured program tailored to the individual’s healing progress and strength level, ensuring a safe and effective recovery.

Isometric Exercises for Scapular Stability

Isometric exercises are essential for maintaining scapular stability during clavicle fracture recovery. These exercises, such as wall slides and shoulder blade squeezes, are performed without moving the shoulder joint. Patients are instructed to hold each position for 5-10 seconds and repeat 10-15 times. These exercises strengthen the muscles around the scapula, improving posture and reducing the risk of complications. They are typically done while wearing a sling to protect the fracture. Isometric exercises are low-risk and can be started early in the rehabilitation process to prevent muscle atrophy. Progressing gradually ensures proper healing and prepares the shoulder for more active movements in later phases.

Phase 4: Advanced Strengthening (8-12 weeks)

Phase 4 focuses on advanced strengthening (8-12 weeks) with resistance exercises using bands or light weights, progressing to functional activities to restore strength and prepare for daily movements.

Resistance Exercises for Shoulder Strength

Resistance exercises are introduced to enhance shoulder strength, focusing on movements like overhead presses and lateral raises. These exercises are performed with light weights or resistance bands, gradually increasing intensity. Wand exercises, such as horizontal abduction and adduction, are also incorporated to target the deltoids and scapular stabilizers. Patients are advised to perform 3 sets of 10-15 repetitions, ensuring pain levels remain below 4/10. Progression includes increasing resistance or adding functional movements like diagonal patterns. These exercises aim to restore muscular balance, improve joint stability, and prepare the shoulder for daily activities and sports. Proper form and controlled movements are emphasized to avoid re-injury while maximizing strength gains.