A stiff shoulder after a broken upper arm is NORMAL. Almost everyone has it, and it’s usually the slowest part of recovery.
The bone usually heals in 6 to 12 weeks.
Movement loosens noticeably after the first 4 to 6 weeks, then keeps improving for up to a YEAR. Some people don’t get every last degree back, especially after a bad break, but most get enough to dress, wash their hair and reach a shelf.
Stiffness that is slowly improving is recovery. Stiffness that is getting worse, or pain that is climbing, needs a closer look.
This article is about breaks at the top of the upper arm bone, just below the shoulder joint.
Doctors call it a proximal humerus fracture. For elbow and wrist fractures, see our sister site handpainnomore.com. Your surgeon’s or fracture clinic’s plan comes first. Use their timings over the ones here.
Why the shoulder stiffens
- Bleeding into the joint: a break this close to the shoulder bleeds into the tissues around it. As that settles, it leaves scar tissue that tightens the joint lining
- Time in the sling: a shoulder that isn’t moved for weeks tightens up, even with no injury at all
- Muscle guarding: the muscles around the shoulder tense up to protect the break, and they stay tense for a while after it has healed
- The shape of the healed bone: some breaks heal in a slightly different position. That can block the last part of lifting, however much you stretch
- Surgery adds its own scar: a plate or a replacement means more tissue has been disturbed, though the early movement surgery allows can help
How long it takes to loosen
- Weeks 0 to 6: very stiff and sore. That’s expected, and it doesn’t mean anything is going wrong
- Weeks 6 to 12: the bone is healing and you’re allowed to do more. Movement often picks up quickly here
- Months 3 to 6: steady, slower gains. Reaching behind your back and overhead are usually last
- Months 6 to 12: still improving, just more slowly. The AAOS guide to shoulder fractures notes that pain, strength and movement often keep improving for up to 12 months after the injury
For the full healing timeline, with and without surgery, see broken shoulder recovery.
The bone heals in weeks. The stiffness is worked off over months.
Exercises by phase
Little + regularity wins.
A few minutes, several times a day, beats one long session. An ache while you exercise is fine if it settles soon afterward.
- Weeks 0 to 3, pendulums: lean forward with your good hand on a table, let the injured arm hang, and rock your body so the arm swings in small circles. The arm stays relaxed. Many clinics start this within the first week or two
- Weeks 0 to 3, shoulder blade and neck: gently draw your shoulder blades back and down, and turn and tilt your head. This eases the tension from the sling
- Weeks 3 to 6, table slides: sit at a table with a towel under your forearm and slide it forward, leaning your body with it. Your body does the work, not the shoulder
- Weeks 3 to 6, stick exercises: lying on your back, hold a stick in both hands and let the good arm lift the injured one forward. Then, with elbows tucked in, use the stick to turn the injured arm outward
- From about 6 weeks, lifting on your own: start lying down, then sitting, then standing. Wall walks with your fingers help you creep higher
- From about 6 weeks, reaching behind: slide the back of your hand up your back, or use a towel held in both hands
- Later, strengthening: light bands and weights. No heavy lifting, pushing or pulling for at least 8 to 10 weeks, or longer if your clinic says so
Many of the same movements are shown in frozen shoulder exercises. Check with your physio before adding them.
When it’s something more
- Frozen shoulder: the lining of the joint becomes inflamed and shrinks. Instead of slowly loosening, the shoulder gets STIFFER over weeks, with deep, constant pain and bad nights. Nobody can move the arm far, not even your physio. It can follow an injury, and it needs a different plan. See frozen shoulder
- The bone hasn’t joined: doctors call this a non-union. In a large group of these breaks treated in a sling, about 1 in 10 didn’t join. The risk is higher in smokers and with certain break patterns. Signs are pain and a clunk or sense of movement at the break after about 3 months, when it should be settling
- A nerve injury: the nerve that works the rounded shoulder muscle is often bruised in these breaks. Signs are a numb patch on the outside of the upper arm, and not being able to lift the arm out to the side even though someone else can lift it for you. It usually recovers on its own over several months, but it needs checking
- The ball of the joint losing its blood supply: uncommon, and mostly after severe breaks. Pain and stiffness get worse months after the bone seemed to have healed
- Loosened hardware after surgery: new pain, a catching feeling or a sudden loss of movement after a plate or screws
What helps
- Take pain relief before exercises in the early weeks, so you can actually do them. Check with your pharmacist what’s safe for you
- Warm the shoulder first: a warm shower or heat pack for 10 minutes can make the first few movements easier
- Don’t stay in the sling longer than you need to. Once your clinic says you can come out of it, the sling is for comfort, not protection
- Stop smoking if you smoke. It slows bone healing
- Be patient past 3 months. Still stiff at 3 months after a broken shoulder is common, not a failure
Go to the emergency department if
- Your arm or hand turns cold, pale or blue, or goes numb
- You fall again and the shoulder suddenly changes shape or becomes much more painful
- You have chest pain or sudden breathlessness
Call your surgeon or fracture clinic today if
- A surgical wound is red, hot, swollen or leaking, or you feel feverish
- Pain is getting steadily WORSE rather than easing
- You feel a new clunk or grinding at the break with sharp pain
Mention it at your next review if
- Your movement hasn’t changed for 6 to 8 weeks, or is going backward
- You have a numb patch on the outer upper arm, or can’t lift the arm out to the side
- Night pain is getting worse rather than better
- You still have a lot of pain at the break after about 3 months
Stiff and slowly loosening is the normal road. Stiff and getting worse is the one to report.