Collar Bone (Clavicle) Fractures: Understanding Your Injury and Why Early Physiotherapy Matters

A broken collar bone (clavicle) is one of the most common fractures, particularly following a fall onto the shoulder, a cycling accident, or sporting injury. Although most people make an excellent recovery, many are surprised by how stiff and weak the shoulder can become during the healing process.

The good news is that, with the right advice and appropriate rehabilitation, most people regain excellent function.

What is the collar bone?

The collar bone, or clavicle, is the long S-shaped bone that sits between your breastbone (sternum) and your shoulder blade (scapula).

It acts as a strut, holding your shoulder away from your chest and allowing your arm to move freely in almost every direction.

Without the clavicle:

• Your shoulder would sit closer to your body.

• Arm movement would be restricted.

• Lifting, reaching and carrying would become much more difficult.

The clavicle also helps transfer forces from your arm into your trunk whenever you push, pull or lift.

Understanding the shoulder

Many people think of the shoulder as a single joint, but it is actually one of the most complex joints in the body.

The main shoulder joint is formed where the ball at the top of your upper arm bone (humerus) meets the shallow socket on your shoulder blade (glenoid).

Unlike your hip, which has a deep socket providing excellent stability, the shoulder has a very shallow socket. This design gives us something remarkable...

Mobility.

The shoulder allows us to:

• Reach overhead

• Throw

• Swim

• Fasten a seatbelt

• Reach behind our back

• Perform activities in almost every direction

In fact, it is the most mobile joint in the human body. The trade-off is that it is not particularly stable.

How does the shoulder stay stable?

Instead of relying on bone, the shoulder depends largely on:

• Muscles

• Tendons

• Ligaments

• The joint capsule

Together these soft tissues keep the ball centred in the socket while allowing movement. The rotator cuff muscles are particularly important, constantly making tiny adjustments as you move your arm.

This reliance on soft tissues is one reason the shoulder becomes stiff so easily after injury.

The important role of the shoulder blade (scapula)

Your shoulder blade is just as important as the shoulder joint itself. Rather than being fixed, the scapula glides smoothly over the rib cage.

As you lift your arm:

• The upper arm moves.

• The shoulder blade rotates upwards.

• The collar bone rotates and elevates.

All three structures work together.

Physiotherapists often describe this as the shoulder complex, because every part depends on the others. If the shoulder blade becomes stiff or stops moving normally after injury, shoulder movement becomes much more difficult. This is why physiotherapy often includes exercises that improve scapular movement, not just shoulder movement.

Why does a broken collar bone make the shoulder stiff?

After a fracture, your body naturally tries to protect the injured area. Pain causes you to move less.

Your arm may be supported in a sling for several weeks. Although this protection is essential while the bone heals, it also means:

• The joint capsule begins to tighten.

• Muscles become weaker.

• The shoulder blade moves less.

• Connective tissues lose flexibility.

Unlike the hip, where the bones provide much of the stability, the shoulder relies heavily on healthy soft tissues. If these tissues aren't moved for several weeks, stiffness develops surprisingly quickly.

This is why early, gentle movement—when approved by your consultant or physiotherapist—is so important.

How do bones heal?

Bone healing is an incredible biological process. Most uncomplicated collar bone fractures heal over 6-12 weeks, although recovery varies depending on:

• Age

• Overall health

• Smoking

• Diabetes

• Nutrition

• The type of fracture

Healing generally occurs in three stages.

1. Inflammation (first few days)

Bleeding around the fracture forms a blood clot. Special cells begin cleaning the area and preparing for repair.

2. Soft callus (weeks 2-6)

The body produces a bridge of cartilage and soft bone across the fracture.

This provides increasing stability but isn't yet strong enough for heavy lifting.

3. Hard callus and remodelling (6 weeks onwards)

The soft callus gradually turns into strong bone.

Over the following months, the bone remodels and becomes stronger. Although many people feel much better after six weeks, the bone continues strengthening for several months afterwards.

Why physiotherapy matters

Once your consultant confirms that the fracture is healing appropriately, physiotherapy aims to restore:

• Shoulder movement

• Shoulder blade movement

• Strength

• Confidence

• Normal function

The earlier appropriate movement begins, the easier it is to prevent long-term stiffness.

Early exercises

Your exercises should always be guided by your consultant or physiotherapist, as every fracture is different. Early rehabilitation often includes gentle movements such as:

• Pendulum exercises

• Assisted shoulder elevation

• Table slides

• Wall slides

• Gentle shoulder blade exercises

• Gentle assisted external rotation

These exercises are designed to maintain movement without placing excessive stress through the healing bone. The exercises should be comfortable, and any increase in discomfort should settle within 24 hours.

Things to do

✔ Wear your sling as instructed.

✔ Keep your elbow, wrist and hand moving regularly to prevent stiffness.

✔ Follow your prescribed exercises consistently.

✔ Maintain good posture rather than allowing the shoulder to round forwards.

✔ Gradually return to normal daily activities as advised.

✔ Eat a healthy diet with adequate protein, calcium and vitamin D to support healing.

✔ Keep active by walking if appropriate.

Things to avoid

✖ Don't remove your sling earlier than advised.

✖ Don't lift heavy objects before your consultant says it is safe.

✖ Avoid sudden pulling, pushing or overhead lifting.

✖ Don't force stretches into pain.

✖ Don't stop moving completely—gentle movement is usually encouraged when appropriate.

✖ Avoid comparing your recovery to someone else's; every fracture heals at a different rate.

When should you seek medical advice?

Contact your healthcare professional if you notice:

• Increasing rather than improving pain.

• New numbness or tingling.

• Increasing swelling or redness.

• A wound that becomes hot or begins discharging.

• Sudden loss of shoulder movement after initial improvement.

• Shortness of breath or chest pain.

Final thoughts

Although a broken collar bone can feel like a significant setback, the vast majority of people recover very well.

Understanding how the shoulder works helps explain why gentle movement is so important. The shoulder's remarkable range of motion comes at the expense of stability, relying heavily on muscles, tendons and the shoulder blade working together. Following an injury, these soft tissues quickly become stiff if they are not moved appropriately.

With patience, a gradual rehabilitation programme and guidance from your healthcare team, most people return to their normal activities with excellent shoulder function.

Disclaimer

This article provides general information only and should not replace individual medical advice. Every fracture is different, and rehabilitation should always follow the guidance of your orthopaedic consultant or physiotherapist. If you have concerns about your recovery or experience increasing pain, numbness, swelling or any new symptoms, seek medical advice promptly

About Physio at Home

Physio at Home specialises in expert home visit physiotherapy across Mid Cornwall, providing high-quality assessment and rehabilitation in the comfort of your own home. Our service is particularly suited to people who are housebound, have reduced mobility, are recovering from surgery or illness, have neurological conditions, or simply find travelling to a clinic difficult.

Our HCPC-registered physiotherapists provide comprehensive home assessments, personalised treatment plans and tailored exercise programmes designed around your individual goals and your home environment. We can also assess how you move around your home and offer practical advice to help improve confidence, mobility and independence.

We cover Falmouth, Penryn, Truro, Helston, Redruth, Perranporth, Feock, St Agnes and many surrounding areas across Mid Cornwall.

Whether your goal is to reduce pain, improve mobility, regain confidence after illness or surgery, or remain independent at home, we're here to help.

If you'd like to find out more about our home visit physiotherapy service, we'd be delighted to hear from you. More information here https://www.physioathome.uk/