| Phase | Rehabilitation | Precautions |
| Day 0 | Sling 4–6 weeks; hand/elbow/wrist ROM; gentle pendulums; scar care begins after 48 h. | Sling for 6 weeks (remove only for exercises). No overhead or cross-body motion above shoulder height for 8 weeks. |
| 0–2 weeks | Elbow/wrist mobilisation; gentle shoulder shrug/retractions; active-assisted flexion/abd to ~60°. | No weight through arm; no heavy lifting. |
| 2–4 weeks | Increase assisted flexion/abd (supine table slides); start gentle ER in neutral. Continue scapular exercises. | Maintain sling use except exercises; watch for pin or plate irritation. |
| 4–6 weeks | Wean sling at 4 weeks; progress to full active ROM (flexion, abd to 90°); isometric cuff/deltoid. | Avoid lifting heavier than ~2 kg. Continue no provocative positions. |
| 6–12 weeks | Advance strengthening (cuff, deltoid, scapular stabilisers); introduce cross-body add and behind-back motions after 8 weeks. | Light functional use; avoid heavy load >12 weeks. |
| 12+ weeks | Full return to activities; ensure fracture union. Strength close to normal. |
Key Points: Protect fixation – sling for 6 weeks. No cross-body adduction or extremes of motion for 8 weeks. Monitor healing with surgeon.
Return: Sedentary ~2–4 weeks; heavy manual ~12 weeks after radiographic union. Contact sports ~6+ months.