Clavicle (Collarbone) FractureCollarbone Fracture (Clavicle Fracture)
Clavicle (Collarbone) Fracture — Overview
Clavicle fractures account for ~10% of all fractures, with 80% occurring in the middle third (Allman Group I) where the sternocleidomastoid pulls the medial fragment superiorly and the weight of the arm/pectoralis major pulls the lateral fragment inferiorly and medially.
A clavicle fracture (collarbone fracture) is a break in the S-shaped strut bone connecting your breastbone to your shoulder blade, most often caused by falling onto the side of your shoulder.
Primary Causes & Biomechanics
Key Points You Should Know
- •Direct fall onto the lateral shoulder point or fall onto an outstretched hand transmitting axial compression along the S-shaped clavicle
- •Muscle pull shortening the shoulder girdle and causing scapular protraction/anterior tilt
- •Risk of supraclavicular nerve irritation, non-union/malunion, or thoracic outlet compression
- •Postural Shoulder Blade Alignment: Gently drawing your shoulder blades back keeps the collarbone fragments aligned at proper length.
- •90-Degree Rule in Early Weeks: Avoid raising your elbow above shoulder height during the first 3–4 weeks while the bone bridges.
- •Protecting the Skin: Watch the skin directly over the fracture bump so it is never tightly pinched or blanched.
Assessment Methods
1. Goniometric ROM & Postural / Kinematic Analysis
Shoulder girdle elevation/depression/protraction/retraction and glenohumeral ROM (limiting elevation to <90° during early conservative healing).
2. Special Clinical Provocation & Neurological/Functional Tests
Palpation of fracture callus, skin tenting assessment, distal neurovascular (brachial plexus & subclavian vessels) check, and scapular dyskinesis evaluation.
3. Standardized Clinical Outcome Scales & Imaging Criteria
DASH Score, Constant-Murley Score, and AP / 45° cephalic tilt clavicular radiographs.
1. Range of Motion & Posture Check
Your physiotherapist gently evaluates how comfortably and smoothly your clavicle (middle third, distal third, or proximal third — Allman Group I–III) and acromioclavicular/sternoclavicular joints moves and checks your overall posture.
2. Muscle Strength & Functional Movement Check
Your muscle balance, walking or reaching comfort, and specific gentle movement tests are evaluated without triggering sharp pain.
3. Typical Symptoms & Daily Impact Review
Localized tenderness, swelling, crepitus, and a visible/palpable step-off over the midshaft clavicle with the affected shoulder drooping downward and forward.
Treatment Options & Phase-Based Protocol
✨ Enriched GIF Exercise & Precaution GuidePhase 1: Acute Symptom Modulation, Tissue Protection & Early Activation
- •Phase 1 Clinical Focus & Tissue Protection: Immobilization & Alignment Phase (Weeks 0–3): Arm sling (or figure-of-eight brace), gentle isometric scapular retraction (drawing shoulder blades back to counter pectoral shortening), and active elbow/wrist/hand ROM.
- •Pain, Edema & Neuromuscular Modulation: Targeted physical modalities, relative load management, and early protected mobility of the clavicle (middle third, distal third, or proximal third — Allman Group I–III) and acromioclavicular/sternoclavicular joints without provoking mechanical or inflammatory irritation.
- •Proximal & Distal Kinetic Chain Maintenance: Maintain active mobility and circulation in adjacent joints while protecting the primary healing structures in Clavicle Fracture.
Phase 2: Progressive Mobility, Motor Control & Targeted Strengthening
- •Phase 2 Progressive Mobilization & Motor Control: Controlled Mobilization Phase (Weeks 3–6): Codman's pendulum exercises and supine wand-assisted flexion up to 90°; avoid horizontal adduction (cross-body reach) and overhead >90° elevation until clinical/radiographic union.
- •Biomechanical Alignment & Co-Contraction: Restore balanced agonist-antagonist force couples, joint centration, and multi-planar neuromuscular control across the clavicle (middle third, distal third, or proximal third — Allman Group I–III) and acromioclavicular/sternoclavicular joints.
- •Myofascial Extensibility & Endurance: Address secondary compensatory tightness and build local muscular endurance within safe, symptom-free biomechanical parameters.
Phase 3: Functional Integration, Proprioception & Long-Term Prevention
- •Phase 3 Functional Integration & Long-Term Prevention: Full ROM & Strengthening Phase (Week 6–12): Full overhead elevation, rotator cuff and periscapular (middle/lower trapezius, serratus anterior) strengthening, and closed-chain wall stabilization.
- •Proprioceptive Balance & Dynamic Loading: Progress to task-specific closed-chain, balance, and functional movement patterns tailored to daily life, occupational, or athletic demands.
- •Self-Management & Relapse Prophylaxis: Establish lifelong ergonomic habits, home exercise maintenance, and early warning-sign awareness to prevent recurrence.
Step 1: Calming Pain, Protecting the Area & Gentle Starter Motion
- •Postural Shoulder Blade Alignment: Gently drawing your shoulder blades back keeps the collarbone fragments aligned at proper length.
- •Calm Protection & Gentle Start: During the initial stage of Collarbone Fracture, avoid painful overloading and perform the gentle, pain-free starter movements shown below to support circulation and comfort.
- •Respecting Your Body's Signals: Every movement should stay within a comfortable, non-painful zone—never force through sharp or radiating pain.
Step 2: Restoring Flexibility & Building Supporting Muscle Strength
- •90-Degree Rule in Early Weeks: Avoid raising your elbow above shoulder height during the first 3–4 weeks while the bone bridges.
- •Step-by-Step Flexibility & Support: As acute sensitivity settles, gradually build mobility and strengthen the supporting muscles around the joint at a steady, controlled pace.
- •Posture & Breathing Coordination: Keep your posture upright and breathe smoothly (never hold your breath!) during every repetition.
Step 3: Safe Daily Habits, Stamina & Preventing Recurrence
- •Protecting the Skin: Watch the skin directly over the fracture bump so it is never tightly pinched or blanched.
- •Confident Return to Daily Life: Integrate your stronger muscles and improved balance into walking, stairs, work, and recreational activities.
- •Preventing Future Flare-Ups: Continue your core protective habits and key maintenance exercises even after symptoms resolve.
Animated (GIF) Therapeutic Exercise Guide
Animated clinical exercise protocol with biomechanical angles, target muscle groups, and dosage parameters (Click image to enlarge)
Step-by-step animated exercise demonstrations you can safely perform at home (Click image to enlarge)
🔍 Enlarge1. Scapulothoracic Retraction & Depression (Middle/Lower Trapezius & Rhomboids)
1. Shoulder Blade Squeeze (Postural Alignment)
Adduction and depression of the scapulae via the middle/lower trapezius and rhomboids while inhibiting upper trapezius overactivity. Corrects anterior scapular tilt, widens the subacromial outlet, and unloads the anterior thoracic column. Specifically indicated in Clavicle Fracture rehabilitation to optimize clavicle (middle third, distal third, or proximal third — Allman Group I–III) and acromioclavicular/sternoclavicular joints biomechanics and neuromuscular control.
Sit or stand tall. Keep your shoulders relaxed away from your ears, gently draw your shoulder blades together and slightly downward toward your back pockets, hold for 5 seconds, and release. Perform smoothly within a comfortable, pain-free range to support your Collarbone Fracture recovery.
🔍 Enlarge2. Isolated Humeroulnar Active/Active-Assisted Flexion and Extension ROM
2. Full Elbow Bending and Straightening
Controlled full-arc elbow flexion and extension with the humerus stabilized in neutral alignment. Prevents anterior capsular contracture (extension loss) and restores biceps/triceps reciprocal excursion. Specifically indicated in Clavicle Fracture rehabilitation to optimize clavicle (middle third, distal third, or proximal third — Allman Group I–III) and acromioclavicular/sternoclavicular joints biomechanics and neuromuscular control.
Keep your upper arm comfortably close to your body. Slowly bend your elbow to bring your hand toward your shoulder, hold for 3 seconds, then slowly straighten your elbow as far as comfortable. Perform smoothly within a comfortable, pain-free range to support your Collarbone Fracture recovery.
🔍 Enlarge3. Supine Wand-Assisted (Cane) Active-Assisted Shoulder Elevation
3. Lying Cane/Stick-Assisted Two-Handed Arm Raise
In supine (scapula stabilized against the plinth and gravity eliminated in the final arc), the unaffected upper extremity guides a wand/stick to elevate the affected shoulder smoothly without deltoid-induced superior humeral shear. Specifically indicated in Clavicle Fracture rehabilitation to optimize clavicle (middle third, distal third, or proximal third — Allman Group I–III) and acromioclavicular/sternoclavicular joints biomechanics and neuromuscular control.
Lie on your back holding a light stick or cane with both hands. Use your healthy arm to gently guide both arms up overhead as far as comfortable, hold for 3 seconds, and slowly lower. Perform smoothly within a comfortable, pain-free range to support your Collarbone Fracture recovery.
🔍 Enlarge4. Closed-Chain Wall Ball Stabilization & Serratus Anterior Protraction
4. Wall Ball Circles & Shoulder Blade Control
Rhythmic stabilization and small circular perturbations with the hand pressing a soft ball against the wall at shoulder height. Stimulates glenohumeral joint mechanoreceptors, serratus anterior upward rotation, and rotator cuff co-contraction. Specifically indicated in Clavicle Fracture rehabilitation to optimize clavicle (middle third, distal third, or proximal third — Allman Group I–III) and acromioclavicular/sternoclavicular joints biomechanics and neuromuscular control.
Hold a small soft ball against the wall at chest or shoulder height with your elbow nearly straight. Gently press into the ball and trace small, controlled clockwise and counterclockwise circles. Perform smoothly within a comfortable, pain-free range to support your Collarbone Fracture recovery.
🔍 Enlarge5. Codman's Pendulum Glenohumeral Decompression Exercise
5. Bent-Over Gentle Arm Pendulum Swings
Trunk flexed forward 45°–60° with the sound hand supported on a table while the affected arm hangs completely relaxed like a plumb line. Momentum from gentle trunk sway creates passive glenohumeral distraction and synovial lubrication without rotator cuff firing. Specifically indicated in Clavicle Fracture rehabilitation to optimize clavicle (middle third, distal third, or proximal third — Allman Group I–III) and acromioclavicular/sternoclavicular joints biomechanics and neuromuscular control.
Lean forward supporting your healthy hand on a table and let your affected arm hang completely relaxed toward the floor. Gently sway your body to let the arm swing in small pain-free circles without using your shoulder muscles. Perform smoothly within a comfortable, pain-free range to support your Collarbone Fracture recovery.
🔍 Enlarge6. Towel-Supported Glenohumeral External Rotation (Infraspinatus & Teres Minor)
6. Outward Forearm Rotation with Rolled Towel Under Elbow
External rotation performed at 90° elbow flexion with a rolled towel placed between the elbow and trunk (20°–30° scaption). Enhances infraspinatus/teres minor recruitment while preventing superior humeral head migration and deltoid shear. Specifically indicated in Clavicle Fracture rehabilitation to optimize clavicle (middle third, distal third, or proximal third — Allman Group I–III) and acromioclavicular/sternoclavicular joints biomechanics and neuromuscular control.
Place a small rolled towel between your elbow and your side with your elbow bent at 90 degrees. Keeping your elbow pressed gently against the towel, rotate your forearm outward, hold for 3 seconds, and return slowly. Perform smoothly within a comfortable, pain-free range to support your Collarbone Fracture recovery.
Movements to Avoid & Strict Precautions
1. Raising the Arm Above Shoulder Height (>90°) in the First 3–4 Weeks
1. Lifting your elbow above shoulder level during the first 3–4 weeks
2. Cross-Body Reaching (Horizontal Adduction) & Sleeping on the Injured Side
2. Reaching across your chest to the opposite shoulder or sleeping on the fractured side
3. Carrying Heavy Backpacks or Bags Over the Healing Collarbone
3. Wearing backpack straps or carrying heavy bags on the healing shoulder
4. Weight-Bearing Push-Ups Before Complete Bony Consolidation
4. Doing push-ups or leaning body weight onto the arm before full bone union
Clavicle (Collarbone) Fracture — Video Guide
Click directly on any video to open and watch in a window, or review details via 📋 Summary & Options.
Condition Overview Video (1 Video)
Summary of pathophysiology, biomechanics, and clinical presentation
What the condition is, why it develops, and its basic mechanism
What Is a Collarbone (Clavicle) Fracture? How Is It Treated?
Clavicle fractures account for ~10% of all fractures, with 80% occurring in the middle third (Allman Group I) where the sternocleidomastoid pulls the medial fragment superiorly and the weight of the arm/pectoralis major pulls the lateral fragment inferiorly and medially.
A clavicle fracture (collarbone fracture) is a break in the S-shaped strut bone connecting your breastbone to your shoulder blade, most often caused by falling onto the side of your shoulder.
Treatment and Exercise Videos
Phase-based physiotherapy protocols, mobilization, and therapeutic exercises
Step-by-step recovery and safe home exercise applications
Early-Phase Exercises Following Shoulder and Clavicle Fractures
Phase 1: Acute Symptom Modulation, Tissue Protection & Early Activation: Phase 1 Clinical Focus & Tissue Protection: Immobilization & Alignment Phase (Weeks 0–3): Arm sling (or figure-of-eight brace), gentle isometric scapular retraction (drawing shoulder blades back to counter pectoral shortening), and active elbow/wrist/hand ROM.
Step 1: Calming Pain, Protecting the Area & Gentle Starter Motion: Postural Shoulder Blade Alignment: Gently drawing your shoulder blades back keeps the collarbone fragments aligned at proper length.
Rehabilitation Exercises Following Upper Extremity and Arm Fractures
Phase 2: Progressive Mobility, Motor Control & Targeted Strengthening: Phase 2 Progressive Mobilization & Motor Control: Controlled Mobilization Phase (Weeks 3–6): Codman's pendulum exercises and supine wand-assisted flexion up to 90°; avoid horizontal adduction (cross-body reach) and overhead >90° elevation until clinical/radiographic union.
Step 2: Restoring Flexibility & Building Supporting Muscle Strength: 90-Degree Rule in Early Weeks: Avoid raising your elbow above shoulder height during the first 3–4 weeks while the bone bridges.
Clinical Assessment, Goniometry & Special Test Videos
Displayed only in Healthcare Professional mode (hidden in Patient mode)
Shoulder Girdle Goniometric Measurement (Flexion, Abduction, Internal & External Rotation)
Goniometric ROM & Postural / Kinematic Analysis: Shoulder girdle elevation/depression/protraction/retraction and glenohumeral ROM (limiting elevation to <90° during early conservative healing).
Systematic Shoulder Girdle and Clavicle Physical Examination
Special Clinical Provocation & Neurological/Functional Tests: Palpation of fracture callus, skin tenting assessment, distal neurovascular (brachial plexus & subclavian vessels) check, and scapular dyskinesis evaluation.