Broken clavicle: Now what?


Lee,
Oh no! I broke my collarbone pumping and jumping… as I’m sure you know with this stuff, occasionally, sh!t happens. I’m not looking for sympathy, but I am looking for some tips on
training tips for once the healing process begins.

I’m planning on hitting the trainer as a lot of the riding I do involves climbing fitness as well as riding skill, but during the period where I can’t really be on a bike (trainer aside), do you have any advice/tips? Just leave well enough along? Spin on the trainer and work hard once I’m back on a bike? Or maybe think about pumping/jumping on skis once I’m that far along to transfer skills to the bike? I dunno… just brainstorming here. Ahah… maybe get on the trainer and watch the Earthed movies!

Good luck with the gums. Glad to hear you are listening to the doctor. A friend of mine from work didn’t listen to the doc after the same procedure and ended up splitting the healing wound at work while laughing… not pretty.

Hope all is well.
Brett





My own personal clavicle in October 2003. I still have a bump.

Hey Brett,

Dude — I’m sorry. Clavicles hurt. But it sounds like you have the right approach.

Ride your trainer. The circulation and overall health will accelerate your healing and keep you sane.

Watch the videos. Turn of your brain and just put yourself in the bodies of the great riders. What are they doing? What are they feeling? Visualizing great riding will improve your skills way more effectively than merely riding. This is one reason so many injured riders come back better than ever.

Use your legs. As you know, most of the love happens through the bottom bracket. Your weak/sore shoulder is a great excuse to really dial in your Attack Position and work through your pedals.

Rip your skis. Wait until your shoulder is safe, but skiing is great training for mountain biking. All of the pump action is identical. Rock your Pump Track Nation on a bump run … oh yeah, nothing but back sides!

Take it slow. Listen to your doctor. Re-engage your shoulder very gradually. I’ll never forget: When my right clavicle felt like it had fused, I grabbed a full can of Coke and — POP! — back to square one.

Also read: I just hurt my shoulder – what to do?

Heal!

— Lee


8 replies
  1. Tjaard says:

    Hey Brett,

    Good luck there. I’m in the same boat. BTW my sports med doctor had just read a new study on clivicles and as a result sent me to a surgeon. I got surgery because the newer studies are showing more cases where surgery is indicated as opposed to the old research. So perhaps go talk to a orthopedic surgeon to see what your case looks like in the light of CURRENT research. Plating it still requires time of but at least no bump and faster healing with less residual pain. Ofcourse it’s not for every fracture.

  2. leelikesbikes says:

    They told me not to plate mine. The doctor said the current studies showed no appreciable benefits of the plate.

    But my clavicle healed out of shape. My right arm hangs lower than the left, and the tendon of my anterior deltoid tracks weirdly over the hump. This leads to lots of irritation. It limits my pressing strength, and its gets really sore when I ride DH.

    So, yeah, a plate might be a good idea.

  3. Chris says:

    If you break your clavicle, get it pinned because one day, after the doctors re-break it for the third time because it isn’t healing correctly, they will go “Hmm, pehaps we should have pinned it. Yes, let’s pin it.”

    Most doctors treat sedentary people. Lie. Tell them you are a buding world class athlete and it MUST to be pinned or it is the end or your career. Anything. Get it pinned.

    Also, have good health insurance. Its part of mountain biking. The faster and/or bigger you go, the more you need. Lee, perhaps you should have a chapter on crashing. How to crash. When to jump off the back or off the front. How to force a low-side crash when a high-side is imminent etc. How to mentally deal with not being able to ride. How to STAY OFF YOUR BIKE until you are FULLY healed (the toughest of all).

    And don’t drink alcohol whenever you have an injury that is susceptible to swelling. Or ever.

  4. Colin says:

    Yes! Watch movies, lots of them!

    When I broke my back (and luckily did no nerve damage), I watched all my downhill racing movies countless dozens of times. Although I don’t have a DH bike, some of those skills transfered to my all-mountain enduro riding (braaap!).
    By the time I was 2 weeks back into riding, I was faster than ever on the downs (my lungs/legs were still catching up, but now, 6 weeks back, they’re doing pretty damn close to 100%)
    But just watching those movies so much made me ride smoother and faster, drift better, and learn sweet cutties 🙂

    Good luck healing, and don’t worry because you’ll get back out there stronger/faster than ever.

  5. Brett says:

    Thanks for the comments guys. I was advised by the ER to just let it heal, but one look at the x-rays and I knew better. Turns out the effective length of my collarbone due to the displacement from the fracture would be about 1″ shorter then before the break. No good. Not to mention that a sharper edge is tenting the skin.

    I saw an orthopod and have surgery scheduled the day-after-tomorrow to pin the bone back into place using a titanium plate. Psyched to be another step closer to being the bionic man…

    BTW – here’s a good MedScape article touching briefly on a clavicle fracture study done to compare corrective surgery vs letting heal with a sling/figure-eight brace.
    http://www.medscape.com/viewarticle/540966

    (hopefully the HTML link embeds correctly – if not, you can fix it by removing the tag Lee)

    Brett

  6. Tjaard says:

    Lee, my surgeon said this was from very recent studies, and yours was a while back right? Also the case for or against surgery depends on each individual cae. For example mine was moved up a full inch and overlapping by a quarter. It’s hard for bone to grow back around an S bend and it wasa very big bump, even right after the break, so no way it would ever be level.

  7. scott says:

    my 2 cents worth,

    Much of what everyone has said has some truth to it.
    It used to be that almost no clavicle fractures were repaired and now there is a clear literature that some people will benefit from operative repair and internal stabilization.Most of the indications for surgery are obvious signs of threats to local tissue (i.e. the tenting of the skin described above is a clear indication), fractures in the most lateral quarter of the clavicle, older bone (that was my reason)or reall transverse fractures where there is little for the opposing bone frags to interact with.
    Most uncomplicated midshaft fractures will heal without any functional problems without surgery. The will all have some deformation. No matter how bad the overlap on the initial film, once those muscles get tired of trying to hold the shoulder inwardly rotated to unload the clavicle, the bone will drag out to close to normal length. that’s why slings are back in vogue and those damn figure of eight braces are not.
    I still have probs with stuff sliding over the top of my plate the same way you do with your fracture callus.
    The biggest problem with them is what was already mentioned. You get 3 weeks out, it feels good and stable, you overdue it and refracture it, and you start over, if you’re lucky. Otherwise you go the the O.R. for treatment of a non-union and now you have big problems. Be patient, wait for them to heal, be cautious when you first get going. And, welcome to the world of the most common fracture in the biking world.
    Scott (right clavicle courtesy of the 4X track @ Snowmass)

  8. fran says:

    This has all been very interesting to read…I’m the mother of a 14 yr old girl who is a “totally awesome snowboarder”. She’s actually an all-around athlete who gets confused for a boy on the slopes due to her style. BUT..she suffered a clean break of the clavicle 11 months ago, and it healed more slowly than normal according to the PA who saw her. I was kind of suspicious… but she was eventually cleared to go back to all she does (soccer, bball, snowboarding). Great. Except she fell off a rail last week and fractured it again. It’s awful! She was put in a sling and sent for a ct scan. We see an orthopedic surgeon in a week. I have no idea what is going to happen. I saw the x-ray and it looks like the overlap didn’t necessarily move this time, so perhaps it just…kind of… cracked. I was wondering how common it is to have a second fracture occur 11 months after the first one. Will it ever be strong? I’ve been keeping the thought “you may not be able to do the things you want to do” to myself until we see the doc, but I’m freaked – this kid knows what she wants, and works at it. She’s a jock. I guess it could be worse (it could) but I can’t imagine her being careful her whole life. I’ll check out that website – thanks!

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