A broken collarbone, or clavicle fracture, is a common injury that immediately restricts movement and requires careful management to heal properly. The clavicle is the bone connecting the sternum to the shoulder blade, serving a unique role as the only bony connection between the trunk and the upper limb. Because this bone is so involved in shoulder mechanics, any exercise program must be designed to protect the fracture site and prevent non-union. Before attempting any physical activity, even simple stretches, it is absolutely necessary to consult with a physician or physical therapist, as advice depends entirely on the specific location and severity of your fracture.
Understanding Immobilization and Initial Restrictions
The initial phase of recovery, typically the first one to three weeks, focuses entirely on immobilization to allow the bone ends to stabilize. A simple arm sling is the most common method of support, providing comfort and keeping the fractured segments still. The sling prevents the weight of the arm from pulling down on the shoulder, which would otherwise stress the clavicle and potentially displace the fracture.
Movement of the shoulder is strictly prohibited because the muscle forces acting on the clavicle can easily disrupt the forming soft callus, the initial matrix that bridges the broken bone. This prohibition means avoiding any lifting, reaching, or pushing motions with the injured arm. Even small, seemingly harmless movements like reaching for a cup or lifting a book can apply dangerous leverage to the healing bone.
Any motion that elevates the arm above 90 degrees, in any direction, is particularly dangerous in the first six weeks following injury or surgery. This overhead motion directly engages the muscles that pull on the collarbone, creating a shearing or distracting force at the fracture site. Prioritizing bone healing over maintaining full range of motion in the shoulder itself is crucial.
Maintaining Fitness Below the Fracture Site
While the shoulder is immobilized, you can focus on exercises that maintain cardiovascular fitness, core stability, and lower body strength without affecting the clavicle. Low-impact cardiovascular activities are highly recommended to promote blood flow and overall well-being. A stationary bicycle or a recumbent bike is an ideal choice, as these machines allow the injured arm to remain secured in the sling while the legs work.
For strength training, focus on compound movements for the lower body, such as squats and lunges, which do not require the use of the upper body for support or resistance. Bodyweight exercises can be performed without gripping weights or engaging the shoulder girdle. Non-rotational core work, such as forearm planks or supine bridges, can also be incorporated once cleared by a professional.
When performing daily tasks, it is important to consciously use the uninjured arm for lifting, carrying, and opening doors. The injured arm should be kept secure and essentially inactive, only performing movements like bending the elbow, wrist, and fingers to prevent joint stiffness in the hand and lower arm.
Gentle Early Range of Motion Exercises
Once a physician confirms initial healing stability, often after the first few weeks, gentle, passive range of motion exercises may be introduced. These early movements are designed to prevent shoulder stiffness and are performed without actively engaging the shoulder muscles. The most common of these are Pendulum Swings, also known as Codman exercises.
To perform a Pendulum Swing, you must lean forward so your torso is parallel to the ground, supporting your weight on the uninjured arm against a stable surface like a table. The injured arm should hang perpendicular to the floor, allowing gravity to create a traction force on the joint. You then use slight movements of your body, not your arm muscles, to initiate a gentle, passive swing in small circles, clockwise and counterclockwise.
It is also important to perform safe, active movements for the joints below the fracture site to prevent localized stiffness. This includes actively bending and straightening the elbow, and moving the wrist up, down, and side-to-side. You should also regularly make a full fist and then fully extend the fingers to maintain hand strength and dexterity, ensuring these movements do not cause any pain or tugging sensation at the shoulder.
Progression Milestones and Long-Term Movement Avoidance
The first major milestone is typically the removal of the sling, which often occurs around four weeks post-injury, but this must be confirmed by radiographic evidence of healing. Once out of the sling, therapy progresses to active range of motion, where you use your own muscles to lift and move the arm without assistance.
Light strengthening exercises may be introduced around six to eight weeks, focusing initially on isometric contractions and rotator cuff stabilization. Full weight-bearing activities are usually not permitted until eight to twelve weeks, and only after a doctor confirms the fracture has achieved solid bony union.
Specific movements must be strictly avoided during the early stages and often for several months to prevent re-injury or delayed healing. These include pushing, pulling, and carrying objects heavier than the approved limit. Contact sports, skiing, or any activity with a high risk of falling onto the shoulder must be avoided until full clearance, which may not occur until four to six months or even longer, depending on the fracture and the sport.