Proximal Humerus Fracture Rehabilitation Protocols

16 Proximal Humerus Fracture rehabilitation protocols from 14 institutions, published 2014–2024. Weight-bearing progressions vary by institution — compare them in the table below before selecting a protocol.

Compare by institution

Institution	Weight-Bearing	Key Restrictions
Dr. Grant Garcia MD (Proliance Surgeons) — / Greater…	Sling per MD; monitor per MD instructions; wean per clinical progression	Fracture stability is variable — check specifications and precautions from MD; greater tuberosity avulsion…
Dr. Grant S. Garrigues MD (Rush University Medical Center)…	Sling with abduction pillow at all times except exercises (3-5x/day), showering, and…	Intraoperative safe zones established by surgeon (two programs): 140/40 Program (FF 140 + ER 40) or 130/30…
Dr. Katherine J. Coyner MD (UConn Musculoskeletal Institute)…	Sling at all times x 2 wks including nighttime; may D/C at wk 4 if comfortable; inpatient…	No ER >40 deg x 6 wks; no active IR x 6 wks; no cross-body adduction x 6 wks; no lifting/pushing/pulling >5…
Dr. Michael C. Fu MD (Hospital for Special Surgery) — ORIF	NWB (arm) initially; progressive loading after radiographic healing confirmed	Sling with abduction pillow; safe zone: max 130 FF, max 30 ER for 6 wks; if concomitant biceps tenodesis: no…
Dr. Michael C. Fu MD (Hospital for Special Surgery)…	NWB (arm) initially; progressive loading after fracture healing confirmed	Unstable: 4 wks full immobilization; Stable: 2-4 wks; no active motion until cleared; pain <3/10 at all…
Ellis & Badenhausen Orthopaedics (Louisville, KY) — Humeral…	Sling full time x 2 wks; outside home only wks 2-6; D/C at wk 6; sleep arm out of sling…	No aggressive or forced PROM until X-rays show full union; no IR behind back or horizontal adduction; no…
iOrtho — Proximal Humeral Fracture ORIF	Sling x3 weeks (off 4x/day); wean at wk 4	No ABD >90 deg wks 1-4; shoulder ER 0-40 deg wks 1-4; no lifting >1lb wks 1-4; no lifting >2lbs until wk 6…
Mammoth Orthopedic Institute / Sierra Park PT — Non-Operative	Sling at all times x 3 wks (or per MD); D/C sling at wk 3 if MD cleared; bike and…	No PT x 3 wks unless otherwise specified by MD; no cuff strengthening Phase I; ROM and WB limitations per MD…
Mammoth Orthopedic Institute / Sierra Park PT — ORIF	Sling at all times or per MD; no AROM, lifting, pushing, pulling x 6 wks; D/C sling per…	No AROM/lifting/pushing/pulling x 6 wks; no ER >40 deg or excessive extension x 6 wks; no supporting body…
Massachusetts General Hospital — ORIF	Sling at least 3 wks (remove 4x/day for exercises and ADLs); wean at wk 4; no driving…	No ABD >90 deg Phase I; ER 0-40 deg Phase I; no lifting >1 lb Phase I; no lifting >2 lbs before 6 wks; no…
Ortho Illinois / Crystal Lake Orthopaedics — Non-Operative…	Sling at all times except exercises Phase I; wean per tolerance	Non-displaced defined as <1 cm displacement and <45 deg angulation; no extension or IR until 6 wks; no…
Orthopedic & Sports Medicine Specialists (OSMS)…	Sling worn at all times except to exercise Week 1; sling weaning implied through Phase II…	No shoulder extension or IR until wk6 post-injury (non-displaced defined as <1cm displacement and <45 deg…
Sutter Health / Palo Alto Medical Foundation — ORIF	N/A (upper extremity)	Sling with abduction pillow wks 1-6 (remove for exercises/showering); transition away from sling wks 6-12; no…
The Iowa Clinic Orthopaedics — Proximal Humerus / Greater…	Sling worn only as desired (not mandated for daytime); gentle passive pendulums…	No active shoulder motion x 4 wks; gentle passive shoulder motion all planes without restrictions from day 1…
University of Colorado / Denver Shoulder Surgeon…	Sling at all times except exercises and bathing (including at night); sleeping in…	No cuff strengthening wks 2-8; no cross-body adduction Phase 2; no IR behind back Phase 2 (only IR in…
University of Virginia Orthopaedic Surgery — ORIF…	Minimal UE WB (1-2 lbs) weeks 2-6; WBAT weeks 6-12 unless instructed otherwise by…	Sling for comfort weeks 2-6; discontinue sling at 6 weeks; Aspirin 325 mg daily (discontinue at 6-12 weeks)…