Clavicle Fracture (Non-Operative)

UVA Orthopaedic Trauma

Clavicle Non-Operative Protocol

More information can be found about your injury at these websites:

● Orthopaedic Trauma Association:

https://ota.org/for-patients/find-info-body-part/3713

● American Academy of Orthopaedic Surgeons:

https://www.orthoinfo.org/en/diseases--conditions/clavicle-fracture-broken-collarb

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0-2 weeks post injury

Instructions

● Sling when awake and moving around

● Can come out of sling to stretch your elbow and wrist

● Position for comfort when sleeping

2-6 weeks post injury

Instructions

● Minimal weight bearing (1-2 lbs) with upper extremity

● You can use your hand for activities of daily living (feeding, hygiene, etc) as tolerated

based on your pain

● Wear a sling for comfort, you should come out of the sling several times a day to stretch

your elbow and wrist

● Begin to work on the shoulder exercise program as detailed below. This includes

pendulums, active assisted range of motion and passive range of motion of the shoulder

Exercise Program

● Regular exercises to restore motion and flexibility to your shoulder and a gradual return

to your everyday activities are important for your full recovery.

● You should exercise for 10 to 15 minutes, 2 or 3 times a day during your early recovery

period.

● Early in your recovery it is critical to use pain as your guide when exercising.

Doing too much, too soon may delay healing.

● Unless otherwise noted, these can be done 3 sessions per day, 10 repetitions per

session

Pendulum, Circular

● Bend forward 90 degrees at the waist,

placing your uninvolved hand on a table

for support.

● Rock body in a circular pattern to move

arm clockwise 10 times, then

counterclockwise 10 times. Keep your

arm relaxed during the exercise. The

circular movement should occur through

your shoulder joint.

Shoulder Forward Elevation (Assisted)

● This exercise can be done either lying

down (A) or sitting down (B).

● Clasp hands together and lift arms above

head. Keep your elbows as straight as

possible.

● Maintain the elevation for 10-20 seconds,

then slowly lower your arms.

● Slowly increase the elevation of your

arms as the days progress, using pain as

your guide.

Supported Shoulder Rotation (Assisted)

● Keep elbow in place and shoulder blades

down and together.

● Slide forearm back and forth, as shown.

● You can also perform this exercise using

a stick or cane to assist your arm

outwards (keeping your elbow at your

side).

6-12 weeks post injury

Instructions

● May begin to increase your weight bearing up to 10 pounds

● Discontinue sling

● Begin outpatient physical therapy and/or advance home exercise program

● Add active shoulder range of motion exercises and progressive strengthening

● Continue to work on the shoulder stretching exercises started 4 weeks ago.

Exercise Program

● Add active shoulder range of motion exercises and progressive strengthening

● Continue to use pain as your guide, each patient moves at a slightly different pace

● Unless otherwise noted, these can be done 3 sessions per day, 10 repetitions per

session

Walk Up Exercise (Active)

● With elbow straight, use fingers to

"crawl" up a wall or door frame as far

as possible. Hold for 10-20 seconds.

Shoulder Forward Elevation (Active)

● Raise arm upward to point to ceiling,

keeping elbows straight and leading

with your thumb, as shown. Hold for

10 seconds.

● Tip: Avoid hiking or bringing up your

shoulder blade. It may be beneficial to

watch yourself do this exercise in front

of a mirror.

Shoulder Abduction (Active)

● Raise arm out to side, with elbow

straight and palm downward. Do not

shrug your shoulder or tilt your trunk.

● Repeat only 3 times per session

● Note: This exercise may not be

recommended after certain surgeries.

Check with your surgeon or physical

therapist to ensure that it is

appropriate for you.

Shoulder Extension (Isometric)

● Stand with your back against the wall

and arms straight at your sides.

Keeping your elbows straight, push

your arms back into the wall. Hold for

5 seconds, and then relax.

Shoulder External Rotation (Isometric)

● Stand with the involved side of your

body against a wall. Bend your elbow

90 degrees. Push the back of your

hand slowly into the wall. Hold for 5

seconds, and then relax.

Shoulder Internal Rotation (Isometric)

● Stand at a corner of a wall or in a door

frame. Place your involved arm

against the wall around the corner,

bending your elbow 90 degrees. Push

the palm of your hand into the wall.

Hold for 5 seconds, and then relax.

Shoulder Adduction (Isometric)

● Place a small pillow between your

inner arm and the side of your chest,

as shown. With your arm, squeeze the

pillow against the side of your chest.

Hold for 5 seconds, and then relax.

Shoulder Abduction (Isometric)

● Resisting upward motion to the side,

slowly and gently push your arm

against the back of chair. Hold for 5

seconds, and then relax.

Shoulder Internal Rotation (Strengthening)

● Lie on your involved side. Keep your

elbow bent at 90 degrees. Holding a

light weight (< 5 lbs), raise hand

toward stomach. Slowly return.

Shoulder External Rotation (Strengthening)

● Lie on your uninvolved side. Keep

your elbow bent at 90 degrees.

Holding a light weight (< 5 lbs), raise

hand away from stomach. Slowly

return.