Broken Shoulder Blade (Scapula Fracture): Recovery Time

Is it really possible to break the shoulder blade?

Some people who have just fractured their scapula (=shoulder blade) are very surprised; they didn’t think it was possible to break this bone.

It’s entirely understandable: scapula fractures are quite rare, accounting for less than 1% of all fractures.

In 80 to 95% of cases, when the scapula is broken, something else is broken too. This is because it takes a significant impact for the scapula to break.

Rest assured, though; they are still fairly well-studied. The graph below shows that there are over a hundred scientific publications dedicated to scapula fractures (which is more commonly referred to as scapula nowadays, but it’s not of great importance).

So, it is possible to break the scapula, even though it’s quite rare.

The scapula can fracture across its entire surface:

• On its body (in 45% of cases).
• Or at one of its prominences: acromion, coracoid, glenoid process.

Regardless of the precise location of the fracture, it doesn’t significantly alter the treatment.

Source: Libby 2023

How to know if you have a scapula fracture? (Symptoms)

Firstly, scapula fractures often occur in road accidents (70% of cases):

• Either between two motor vehicles.
• Or a pedestrian struck by a vehicle.

This can also happen following electric shocks or other traumas involving significant stress on the shoulder.

Additionally, in the aftermath of reverse shoulder replacement: a few weeks or several months after surgery, with a peak around nine months. This applies to around 4% of patients receiving a reverse shoulder prosthesis due to arthritis or a fracture (Limb 2021).

These fractures are not easily overlooked because, following a significant trauma, a CT scan or another imaging examination is often performed to observe the entire body.

Scapula fractures are therefore easily detected through X-rays, MRI, or CT scans.

The symptoms are quite typical:

• Very intense pain in the scapula or shoulder, which may radiate to the back and arm.
• Difficulty in using the arm.
• Edema, swelling, redness in the scapula area or around it.
• Visible deformity to the naked eye.

In 5 to 13% of cases, in addition to a scapula fracture, there is damage to the brachial plexus (a location where the nerves of the arm pass).

Source: Libby 2023

What is the treatment for a shoulder blade fracture?

Firstly, some good news: as the scapula is a difficult bone to break, fractures often occur without displacement (in 90% of cases).

This means that there is little space between the different broken bone segments. Therefore, they consolidate quite “easily” and quickly without the need for surgery!

So, most often, the treatment for a scapula fracture is conservative, orthopedic: no surgery.

How (and when) to immobilize the scapula?

Following your fracture, you will likely be prescribed either a body-hugging brace or a simple sling for your arm, which is less cumbersome, or a bandage for your scapula.

This allows immobilization of the shoulder and, therefore, the scapula.

The goal is twofold:

• +++ to relieve pain (which is often increased when you move your arm);
• encourage consolidation by limiting scapula movements.

But since scapula fractures are generally not greatly displaced, you will probably also be encouraged to resume mobilization quickly, depending on the pain.

What is the recommended duration of shoulder blade immobilization?

You will receive specific instructions from your medical and paramedical team regarding the recommended duration of immobilization in your case.

As a physical therapist, I have observed very different recommendations for the same type of fracture, depending on the medical teams:

• Some teams do not even prescribe a brace.
• Others prescribe one and advise removing it after just a few days, once the pain is bearable without the brace.
• Others recommend a stricter immobilization period of 3 weeks or sometimes 6 weeks, until a follow-up X-ray.

In any case, you can remove your brace to dress or wash. For sleeping, you can also keep it, which can limit abrupt movements at night that might wake you due to pain.

There are no studies comparing the progress of individuals with or without braces.

There is also a downside to braces: they can lead to stiffness in the shoulder, a complication of shoulder fractures (and therefore also scapula fractures).

Scientific publications on post-fracture outcomes (for any part of the body) are increasingly encouraging early mobility and a decrease in strict immobilization times.

You can discuss all of this with your physical therapist to find the right compromise for you.

Why is there sometimes surgery for a scapula fracture?

If there is a significant gap between the different bone fragments of your scapula, surgical intervention will likely be suggested.

The purpose of the operation is to reduce the fracture (properly realign the bone fragments) and stabilize the fracture (securely hold them together), usually by using plates or screws (internal fixation).

After the operation, immobilization is often recommended for at least a few days, following the same procedures as the treatment for a scapula fracture without surgery.

Surgery remains rare: less than 1% of scapula fractures (Libby 2023).

Is physical therapy and rehabilitation necessary when you have a shoulder blade fracture?

It is quite common to undergo physical therapy for a scapula fracture, especially since there are often other issues.

There are two main phases in rehabilitation to support your recovery from a scapula fracture.

Phase 1: Healing period.

Your scapula is not yet fully consolidated.

Your physiotherapist can provide advice to alleviate your pain and maintain the mobility of your shoulder (and your overall physical condition).

This phase lasts at least a few weeks.

Phase 2: Recovery period.

Your scapula is consolidated or on a good path.

The goal is to regain 100% of your pre-injury mobility and strength. You’ll resume all your previous activities, including those that put more strain on your arms (such as carrying things, crawling, combat sports, or racket sports).

More demanding shoulder exercises are typically started at least 1.5 months after the fracture, gradually and carefully.

Your doctor or surgeon may prescribe physical therapy sessions if you feel the need for guidance during these phases.

How long does it take to recover from a scapula fracture?

Firstly, another piece of good news: scapula fractures are known to heale well and recover without complications in 86% of cases (Libby 2023).

Here are the recovery durations that I have observed (as there are no empirical data in the studies I found).

Stage	Healing Time (Typical Delays)
Much less pain	Few days to a few weeks
Bone consolidation completed or well underway	6 weeks to 3 months
Reduction of shoulder and back swelling, bruises disappear	Few days to a few weeks
No more need for immobilization, brace	Few days to a few weeks
Gradual resumption of arm use for eating, dressing	Few days
Able to drive again	Few weeks
Begin carrying weight (bags, dumbbells) with the fractured arm	2 to 5 months
Resume all pre-injury physical and sports activities	3 to 8 months

Pain: Is it normal after a broken shoulder blade?

It is common to experience pain in the days following the fracture and even in the weeks that follow. The pain may fluctuate, meaning it can decrease and then increase without any particular reason. It can be present at rest, during movement, at night, or during the day.

Pain does not necessarily indicate a complication or that the healing process is not underway.

Several measures can be taken to alleviate or limit pain:

• Find more comfortable positions, especially with the help of cushions.
• Spend a bit more time with the brace, or with the elbow bent and the forearm on the belly.
• Apply cold to the painful area.
• Take pain-relieving medications.

It is normal to experience pain for a few days or even a few weeks after the fracture. Pain can be relieved by various means. This is not a sign of severity, even though it can be bothersome.

What is the duration of sick leave for a scapula fracture?

There is no set sick leave duration based on the type of fracture. It depends a lot on your professional activity, your overall health, and the practices of the doctors you encounter.

Health Insurance system provides guidelines for sick leave duration purely for informational purposes, but it does not issue them for scapula fractures (probably because they are infrequent).

In general, you will likely need several weeks of sick leave if your job is physical or requires the use of your fractured arm. It may be several months if you have other more significant injuries.

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Here’s what I wanted to tell you about this! I wish you a very good recovery! Do you have any comments or questions? Your comments are welcome 🙂 !

If you feel the need to learn more about the recovery period after this type of fracture, I wrote this guide in eBook format:

…

You may also like:

• How to Sleep with a Broken Shoulder?
• Can you drive with a brace on your arm?

 📚 SOURCES

Libby C, Frane N, Bentley TP. Scapula Fracture. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537312/

Limb D. Scapula fractures: a review. EFORT Open Rev. 2021 Jun 28;6(6):518-525. doi: 10.1302/2058-5241.6.210010. PMID: 34267942; PMCID: PMC8246106.

Mahjoub S, May F, Zaraa M, Mahjoubi Y, Abdelkefi M, Mbarek M. Acute traumatic quadrilateral space syndrome following scapula fracture. J Clin Orthop Trauma. 2019 May-Jun;10(3):518-521. doi: 10.1016/j.jcot.2018.05.016. Epub 2018 May 24. Erratum in: J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1175. PMID: 31061581; PMCID: PMC6492218.