Broken collarbone rehab protocol
- DO NOT elevate surgical arm above 90 degrees in any plane for the first 4 weeks post-op.
- DO NOT lift any objects over 5 pounds with the surgical arm for the first 6 weeks.
- AVOID REPEATED reaching for the first 6 weeks.
- recommend regular icing routine for the first 2 weeks; please consult Post-Op Icing handout for full details
- An arm sling is used for 4 weeks post-op.
- Maintain good upright shoulder girdle posture at all times and especially during sling use.
- Intermittent X-ray to monitor healing as needed
- M.D./nurse follow-up visits at Day 2, Day 14, Month 1, Month 3 and Year 1 post-op.
Week 1
- MD/nurse. visit day 2 post-op to change dressing.
- Exercises (3x per day):
- Pendulum exercises,
- squeeze ball,
- triceps with Theraband,
- isometric rotator cuff external and internal rotations with arm at side
- isometric shoulder abduction, adduction, extension and flexion with arm at side. -Soft tissue treatments for associated shoulder and neck musculature for comfort
- cardiovascular training such as well arm cycling, biking for Active Recovery
Weeks 2 - 4
- Soft tissue treatments for associated shoulder and neck musculature for comfort.
- Gentle pulley for shoulder ROM 2x/day in limited ROM <90*
- elbow pivots PNF, wrist PNF
- isometric scapular PNF, mid-range
Weeks 4 - 8
- M.D. visit at Week 4 post-op and will usually be progressed to a more aggressive ROM and strength program.
- At Week 4: start mid-range of motion (ROM) rotator cuff external and internal rotations active and light resistance exercises (through 75% of ROM as patient’s symptoms permit) without shoulder elevation and avoiding extreme end ROM.
- Strive for progressive gains to active 90 degrees of shoulder flexion and abduction.
Weeks 8 - 12
- Seek full shoulder Active ROM in all planes
- Increase manual mobilizations of soft tissue as well as glenohumeral and scapulothoracic joints for ROM.
- No repeated heavy resisted exercises or lifting until 3 months.
Weeks 12 and beyond
- Start a more aggressive strengthening program as tolerated.
- Increase the intensity of strength and functional training for gradual return to activities and sports.
- Return to specific sports is determined by the physical therapist through functional testing specific to the patient’s demands
- completion of Sports Test I for initial return to sports and progressive sport-specific training
NOTE: All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process.