The good news is that broken shoulder blades heal WITHOUT surgery. Well over 9 in 10 scapula fractures are treated with a sling for comfort and early, gentle movement.
The bone usually knits in about 3 to 4 months.
People whose break didn’t need surgery are often back to normal activities somewhere around 6 to 8 weeks, although getting every last bit of shoulder movement back can take 6 months to a YEAR.
The bigger worry with a scapula fracture is usually not the shoulder blade itself. It takes a hard hit to break it, so the team will check your chest, lungs, ribs and spine first. Your fracture clinic’s plan comes first, and the ranges below are typical, not rules.
Why it’s checked so carefully
The shoulder blade is a thick, flat bone wrapped in muscle.
It’s well protected and hard to break, and scapula fractures make up less than 1 in 100 of all broken bones. Most come from car or motorbike crashes, falls from a height, or a heavy blow to the back of the shoulder.
- Other injuries are the rule, not the exception: about 8 or 9 in 10 people with a broken shoulder blade have another injury as well
- Ribs and lungs: broken ribs, bruised lungs and a collapsed lung are the most common partners. This is why you may have a chest scan even if your shoulder is what hurts
- Collarbone and upper arm: other bones around the shoulder often break at the same time
- Head, neck and spine: the same force can injure these, so they are checked too
- Nerves and blood vessels: the nerves to the arm run close by and are occasionally stretched or bruised
That’s why you may spend the first days on a trauma or chest ward, with the shoulder treated once the more urgent problems are under control.
Sling or surgery?
- Sling: the standard treatment for the great majority, including many breaks that look alarming on a scan. The thick muscles around the shoulder blade act like a natural splint and hold the pieces close together
- Surgery with plates and screws: considered when the break runs INTO the shoulder socket (the glenoid) and the joint surface is out of line, when the neck of the shoulder blade is badly tilted, or when the bony tip over the shoulder (the acromion) is pushed down into the joint
- The “floating shoulder”: when the shoulder blade and the collarbone are both broken, the shoulder can lose its support. Some of these need an operation on one or both bones
- What surgery means for recovery: it usually signals a more complex injury, so recovery tends to take longer
The American Academy of Orthopaedic Surgeons has a clear overview of scapula fractures and when surgery is used.
The shoulder blade heals well on its own. The shoulder next to it only stays loose if you keep it moving.
Week by week without surgery
- Week 0 to 1: sling for comfort. Keep the rest of the arm moving from day one. Many teams want gentle shoulder movement started within the first week
- Weeks 1 to 3: the sling comes off more as pain settles. Gentle exercises where the arm is supported or helped by your other hand, such as pendulum swings and table slides
- Weeks 3 to 6: sling usually gone. Movement builds toward shoulder height and above. Light daily tasks with the arm
- Weeks 6 to 12: strengthening begins once your team is happy with healing. Many people are back to most normal activities
- Months 3 to 12: the bone has usually healed. Keep stretching until the shoulder moves fully, which can take up to a year
Keep breathing exercises going if you also broke ribs. Deep breaths and a supported cough help keep the lungs clear.
What’s normal
- Bruising across the back and down the arm, sometimes spreading for a week or two
- Pain with deep breaths, especially if ribs were broken too
- Grinding or clicking near the shoulder blade as you start moving again
- A stiff shoulder once the sling is off. It loosens with daily work. See stiff shoulder after surgery
- Poor sleep for the first few weeks. Sleeping propped up often helps. See sleeping after shoulder surgery for setups that work here too
When can I…
- Drive: not in a sling or on strong painkillers. Once you can turn the wheel firmly and control the car in an emergency. Check with your insurer
- Go back to a desk job: often within a few weeks, once pain is controlled and any other injuries allow
- Lift heavy or work overhead: not until strengthening is under way, usually after 6 to 12 weeks
- Play contact sport: only once the bone has healed and strength is close to the other side. Your surgeon will guide this
If the collarbone broke as well, see broken collarbone recovery. If it was the top of the arm bone, see broken shoulder recovery.
Go to the emergency department if
- You get sudden shortness of breath, chest pain, or you cough up blood. A blood clot in the lung or a collapsed lung can show up days after the injury
- Your calf becomes swollen, red, warm or painful, especially if you’ve been lying in bed a lot. This can be a blood clot in the leg
- Your arm or hand turns cold, pale or blue
- You have new weakness or numbness in the arm that is getting worse
Call your fracture clinic today if
- A surgical wound is red, hot, swollen or leaking, or you have a fever
- Pain is suddenly much worse, or the shoulder changes shape
Mention it at your next review if
- The shoulder is getting stiffer week by week instead of looser
- You still can’t lift the arm to shoulder height at around 3 months
- Pain is still waking you most nights after 6 weeks
- The shoulder blade sticks out or “wings” when you push against a wall
The shoulder blade usually mends itself in a sling. Your job is to keep the shoulder moving while it does.