Most broken shoulders heal WITHOUT surgery. In a sling, with gentle exercises started early, the bone usually heals in about 6 to 12 weeks.
Even when the break is out of place, surgery often doesn’t give a better shoulder. In a large trial of adults, most in their 60s, a plate or a shoulder replacement did no better than a sling at two years, and still no better at five.
The shoulder keeps improving for up to a YEAR. Stiffness is the main thing to beat, and early movement is how you beat it. Your surgeon’s or fracture clinic’s plan comes first, and the ranges below are typical, not rules.
What a broken shoulder is
A broken shoulder usually means a break at the top of the upper arm bone, just below the ball of the shoulder joint.
Doctors call it a proximal humerus fracture.
It’s one of the most common breaks in people over 65, usually from a fall onto the arm or straight onto the shoulder. Women get it about twice as often as men, partly because thinning bones (osteoporosis) break more easily.
Sling or surgery?
- Sling: the standard for most breaks, including many that are somewhat out of place. Across all types of broken shoulder, about 8 in 10 people treated this way do well
- Plate and screws: holds the pieces in place. More often considered for younger, active people, or when the pieces are far apart
- Shoulder replacement: considered when the ball is broken into several pieces or is unlikely to survive. In older adults this is usually a reverse shoulder replacement. See reverse shoulder replacement
- Why many older adults do well without surgery: thinner bone holds screws less well, and an operation brings its own risks, such as infection or screws working loose. In the large trial, surgery didn’t reduce complications, and about the same number of people in each group needed a further operation
Most broken shoulders need a sling, early movement and time. Surgery is the exception.
Week by week without surgery
- Weeks 0 to 2: sling on most of the time, for comfort. Take it off to wash and dress. Bruising often spreads down the arm and onto the chest. That’s normal
- Weeks 2 to 3: gentle pendulum exercises, sometimes sooner. Lean forward with your good arm on a table, let the sore arm hang, and swing it in small circles. Starting within the first week or two is safe for most breaks
- Weeks 3 to 6: less time in the sling. Many people stop using it at about 3 weeks, though some are asked to wear it for up to 6. Assisted movement starts: your good arm or a stick helps lift the sore one. Light objects only
- Weeks 6 to 12: the bone is healing. Out of the sling, lifting the arm on its own, then light strengthening
- Months 3 to 12: strength and reach keep improving. Some aching and stiffness can hang on for up to a year
After surgery
- Plate and screws: a sling for comfort, usually for a few weeks. Gentle movement starts when your surgeon says so, often early, because the plate holds the bone
- Replacement: follow your surgeon’s program closely. The early limits protect the new joint
- Either way: the bone still takes weeks to heal, and the shoulder still takes months to recover. Surgery doesn’t skip the rehab
Stiffness: the main thing to beat
- Stiff is normal for weeks after a break. The joint has bled, and the muscles tighten to guard it
- Little and often: a few minutes of exercises several times a day beats one long session
- Some ache during exercise is fine if it settles soon afterward. Sharp pain that lingers means ease back a little
- Full range doesn’t come back for everyone, especially after a bad break. Most people get enough movement for daily life: dressing, washing their hair, reaching a shelf
- Still very stiff months later? See stiff shoulder after surgery
The American Academy of Orthopaedic Surgeons notes that after a shoulder injury, pain, strength and movement often keep improving for up to 12 months.
What helps
- Sleep propped up on pillows or in a recliner for the first weeks. Many people keep the sling on at night early on. See sleeping after shoulder surgery for set-ups that also work here
- Take pain relief regularly early on, so you can do your exercises. Check with your pharmacist what’s safe for you
- Ice for about 10 minutes a few times a day in the first weeks, with a cloth between the ice and your skin
- Ask about bone health. A broken shoulder after a simple fall can be a sign of osteoporosis. Treating it lowers the chance of the next break
When can I…
- Drive: not while you’re in the sling. Many people feel ready at around 6 to 8 weeks, once they can control the car in an emergency. Check with your insurer
- Go back to a desk job: often around 4 weeks
- Do manual work: up to about 12 weeks off
- Lift heavier things or reach overhead: after 6 weeks, building up gradually as the bone heals
Go to the emergency department if
- The arm turns cold, pale or blue, or goes numb
- Swelling suddenly gets much worse with severe pain
- You fall again and the shoulder suddenly changes shape or becomes much more painful
Call your surgeon or fracture clinic today if
- The wound is red, swollen, hot or leaking
- You have a fever or feel unwell
- Pain is getting WORSE after the first week or two instead of easing
Mention it at your next review if
- The shoulder is still very stiff several weeks after the sling comes off
- You have a numb patch on the outside of the upper arm, or can’t lift the arm out to the side at all
- You still have a lot of pain, or a clunk when you move, after about 3 months
The bone heals in weeks. The shoulder is won back over months, one small movement at a time.