Rehabilitation protocol
Non-Operative Proximal Humerus Fracture Rehabilitation Protocol
The current rehabilitation used when a proximal humerus (upper arm, near the shoulder) fracture is treated without surgery. Early care protects the fracture, with guided passive motion introduced early, then motion and strength are gradually restored. Your care team will tailor it to you — always follow the individualized plan they give you.
Who this protocol is for
Applies to a proximal humerus (upper arm, near the shoulder) fracture treated WITHOUT surgery. It does NOT apply after surgical fixation or shoulder replacement for a proximal humerus fracture, or to a humeral shaft or clavicle fracture (each of which has its own protocol). If the fracture is treated surgically, is open, involves a nerve or blood-vessel injury, comes with other injuries, or a surgeon selects a different plan, follow that individualized plan instead. The treating physician's plan takes precedence, and patients should use only the protocol identified by their care team.
What this protocol covers
- Rehabilitation when a proximal humerus (near-shoulder) fracture is treated WITHOUT surgery.
- It does NOT apply after surgical fixation or shoulder replacement, or to a humeral shaft or clavicle fracture — each of those has its own protocol.
- A surgically treated, open, or complex fracture, a nerve or blood-vessel injury, or a different surgeon-selected plan follows that individualized plan instead.
- Your care team selects the protocol — use only the one you are given.
If your fracture is treated surgically or has other injuries
This protocol is for a proximal humerus fracture treated without surgery. If your fracture is treated with surgical fixation or a shoulder replacement, is open, involves a nerve or blood vessel, or comes with other injuries, that individualized plan is used instead — a non-operative protocol never applies after surgical fixation or replacement. Follow the plan your care team gives you.
How rehabilitation is generally structured
Rehabilitation after this procedure is usually organized into progressive phases. The phases below describe the general shape only — specific exercises, precautions, and timelines are individual and are set by your surgeon and physical therapist.
Early protected motion
The earliest period, focused on protecting and supporting the healing fracture and controlling pain, with gentle guided passive motion introduced early as your care team directs and the hand, wrist, and elbow kept moving.
Advancing motion
As pain settles and healing allows, progressing shoulder motion within the limits your care team sets and beginning gentle activation of the surrounding muscles.
Strengthening
Rebuilding shoulder and shoulder-blade strength and control as motion returns and healing continues.
Return to activity
A criteria-based return toward full activity and, when appropriate, sport — guided by restored motion and adequate strength, with physician clearance for higher-demand activity rather than a fixed calendar.
This overview describes the general structure of rehabilitation only. It does not replace the specific instructions of your own care team, whose guidance always takes precedence. Timelines and precautions are individual and are set for you at your appointments — and if you had surgery, your operative note takes precedence. Use only the protocol your care team selected for you.