Collarbone (clavicle) fracture rehabilitation: sling to full activity

The NHS describes initial treatment as an arm sling and painkillers, with surgery rarely needed for even severe breaks, and the page on clavicle fixation in this site covers the cases where it is offered. The sling takes the weight of the arm off the broken bone. It does not mean the shoulder should be kept still.

NHS guidance asks people to do the shoulder and arm exercises they have been given regularly. The reason is practical: a shoulder that has not moved for several weeks can become stiff and painful in its own right, which may then be mistaken for a problem with the bone.

NHS inform describes using a sling during the day, except for exercises and washing, over about the first three weeks, with a choice about night use. Shoulder exercises begin in this stage, and the guidance is to avoid lifting the elbow above shoulder height.

Gentle movement of the elbow, wrist and hand is usually encouraged from the start, and pendulum-style arm swings are a common first shoulder exercise, though the pages used here do not name specific exercises, so use the sheet from your fracture clinic.

NHS inform describes gradually stopping the sling in this stage, starting light activities and increasing movement while still avoiding heavy lifting. This is a transition, not a switch: many people wean off the sling in situations where the arm is unlikely to be knocked, such as at home, before going without it on a crowded commute.

If your hospital arranged a follow-up appointment, the NHS says it monitors healing before you are cleared to resume physical activity. Keep it, since this is where a decision to do more or to repeat imaging is made.

From about 6 weeks NHS inform describes resuming normal daily activities guided by pain levels and beginning overhead arm movements. Contact sport is avoided until at least 12 weeks after the injury.

The pages used here do not give separate dates for weight training, swimming or cycling. Because those put different loads through the shoulder girdle, ask your fracture clinic or physiotherapist and increase in small steps, watching whether pain settles within a few hours.

NHS inform lists a permanent lump forming at the fracture site, swelling that can persist for months, bruising that spreads down the arm and changes colour, and pain at rest that may be worse in cold weather. A lump is often the callus of bone healing and is not by itself a sign that something has gone wrong.

Smoking is described as significantly slowing healing and potentially preventing it, and diabetes may also slow it. Anti-inflammatory drugs such as ibuprofen may delay healing, according to NHS inform, so it is worth checking with a pharmacist before using them regularly.

NHS inform advises checking with your insurer before driving and being able to perform an emergency stop and keep full control of the vehicle. It says no healthcare professional clearance is needed for work, and a phased return can be agreed with your employer.

Use NHS 111 for severe pain, swelling or inability to use the arm. Go to A&E if the shoulder changes shape, bone pokes through the skin, there is heavy bleeding, or you have difficulty breathing, chest pain or cough up blood, as the NHS advises. If the collarbone has not improved within about 6 weeks of following the guidance, NHS inform suggests seeing a healthcare professional.