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Which bones can be affected?
The collarbone links the chest to the shoulder blade. The humerus is the upper arm bone; its upper end forms the rounded shoulder head. A proximal humerus fracture involves this upper part. The shoulder blade can also fracture, often in more substantial trauma.
Fractures vary considerably: a small undisplaced break, displaced fragments, joint involvement or associated injuries. This explains why two people wearing a sling can have different instructions. This adult guide does not replace examination or your personal treatment plan.
Understand the picture
Bones around the shoulder
Collarbone
Links the chest and shoulder blade.
Upper humerus
Forms the rounded head of the main joint.
Shoulder blade
Provides the socket and muscle attachments.
Chapter sources [1]
What signs may appear?
Pain, swelling, bruising and difficulty using the arm are common after an impact. A bump or deformity may be visible, but its absence does not rule out a fracture. Bruising can spread down the arm over time without indicating severity on its own.
Dislocation, tendon damage and fracture can coexist. Do not lift a weight to test whether the bone is broken. Explain the accident and any numbness or change in hand temperature to the clinician.
Why can a fracture happen?
A fall onto the shoulder or outstretched arm can transmit enough force to break bone. A more violent accident can cause several injuries. In some people, weaker bone can fracture after a relatively small fall.
After a low-trauma fracture, the doctor may assess bone health and future fall risk. This does not mean every fracture proves osteoporosis. Age, previous injuries, medicines and the circumstances guide useful investigations. Preventing another fall can be part of recovery alongside shoulder rehabilitation.
How is initial treatment chosen?
The clinician examines the shoulder, skin, nerves and circulation. X-rays locate the fracture and assess displacement; CT may clarify a complex break. Associated injuries are investigated according to the accident and examination.
Some fractures can be treated with a sling and follow-up. Others need fixation or another operation. Fracture pattern, stability, health and activity needs guide the decision. Surgery is neither compulsory for every fracture nor excluded simply because the pain is bearable.
When is it an emergency?
Deformity, inability to use the arm or substantial pain after an accident needs prompt assessment. An open wound with visible bone, tightly stretched skin, significant bleeding, a cold or numb hand, or breathing difficulty are urgent signs.
Call 112 in Luxembourg for a serious injury or if you cannot reach care safely. Support the arm without forcing its position. Do not touch exposed bone or try to straighten the deformity. Do not drive yourself with the injury.
What is the sling for?
A sling may protect the area and reduce painful movement for a defined period. Its use varies with the fracture and treatment. Ask when to wear it, how to adjust it and when it may be removed for washing or permitted exercises.
Too little protection may expose the fracture or repair to unsuitable forces; unnecessarily prolonged immobilisation can contribute to stiffness. Follow personal instructions instead of an online timetable. Tell the team about pressure marks, increasing discomfort or numbness caused by the sling.
In everyday life
Returning to a daily task
Protect
Understand sling use and prohibited loads.
Move
Practise only the movements currently allowed.
Rebuild
Add strength and task demands when cleared.
How can home life be organised?
Keep essential objects at accessible heights. Avoid carrying, pushing or pulling with the injured arm unless cleared. Arrange help with heavy tasks and activities that risk another fall. Clothes that open easily can simplify dressing.
A supported position may make sleeping more comfortable; follow instructions about wearing the sling at night. Use only medicines advised for you and report troublesome effects. Clearly worsening pain, new loss of sensation or an abnormal wound after surgery needs contact with the team.
When do exercises begin?
Timing depends on fracture stability and treatment. The team may allow certain hand, wrist or elbow movements while restricting the shoulder. A pendulum exercise is not automatically safe for every fracture just because it looks gentle.
Rehabilitation usually progresses from permitted movement towards strength and task practice as healing allows. Ask separately about active movement, assisted movement, resistance and weight-bearing. These impose different demands. The general exercises on this site are not a fracture protocol.
How long does recovery take?
Bone healing takes several weeks, while comfortable movement, strength and heavier activity may take months. A healed X-ray does not automatically mean the shoulder is ready for every task. Stiffness and weakness can need continued rehabilitation.
Follow-up helps assess healing and adapt restrictions. A collarbone bump can remain without automatically indicating poor recovery. Persistent disability, increasing pain or failure to progress should be reviewed rather than accepted indefinitely or treated by forcing movement.
How is return to normal activity planned?
Describe your actual demands: dressing, carrying shopping, overhead work or sport. Light activities close to the body usually differ from heavy loads, falls or contact. Progression depends on the clinician’s assessment, healing and functional control.
Driving requires safe vehicle control and rapid reactions, compatible with medical instructions and medicines. Discuss return with your team; no general date is personal clearance. After a low-trauma fracture, include any bone-health and fall-prevention advice in the longer-term plan.
Your questions
Can I move the arm if the pain is mild?
Pain alone does not establish fracture stability. Follow the movement and loading instructions provided after assessment.
Is a pendulum always allowed?
No. Even gentle movement must fit the fracture or surgical protocol. Ask before using the general exercise sheet.
Does healed bone mean full recovery?
Not necessarily. Mobility, strength and confidence may need more rehabilitation after bone healing.
Does a minor fall fracture mean osteoporosis?
Not automatically. It can justify a bone-health and fall-risk assessment, guided by your medical history.
Chapter sources [3]
Sources and references
- [1] AAOS OrthoInfo · Shoulder trauma: fractures and dislocations
- [2] NHS · Broken collarbone
- [3] NHS · Osteoporosis
- [4] CGDIS Luxembourg · 112
- [5] NHS · Shoulder pain
- [6] NHS Inform · Exercises for shoulder problems
- [7] NHS · Heart attack
Text updated on
Medical review: awaiting Hasib Selimovic.