[bah17]

Broke my collarbone quite badly 8 weeks ago coming off at speed, so I had a fixing plate put in but soonest they could do was 13 days later (a painful wait). Now at 6 weeks after the operation the xray showed no sign of the bones joining up again (yet). So I have to wait and see in another 6 weeks time. Turbo training attractions are starting to fade….

 I’m in my 50’s if that relevant.

Grateful to hear has anybody any experience of their clavicle bones taking a long long time to reunite or even not at all (in which case what can you do?).

BTW, helmet written off but did its job. Dread to think if it hadnt been on.

Topic

[bah17]

IanEdward wrote:

I had my latest follow up last week, effectively @ 14 weeks.

I was feeling pretty good, the remaining symptoms of the break (a feeling of something loose at the back of the fracture and sharp pains occasionally radiating from the same location) had more or less gone, I think due to some simple theraband/0.5kg dumbell exercises I was doing.

The consultant came in (finally, a consultant! I’d been fobbed off with trainees the previous two occasions…) and stated quite bluntly that he saw no real healing at the fracture. He once again put surgery on the table but by this point I was anxious to AVOID surgery as am now back on the bike etc. He pointed out that surgery would involve another 4 weeks in a sling due to cutting through muscle etc.

He also admitted that the NHS is frankly poor at predicting who would heal properly and who wouldn’t, seems like 80% will heal fine and 20% won’t, I’m obviously in the 20%. I kind of wish we had identified this at the 4 week follow up as I could still have justified getting it plated then…

We left it at ‘see how it goes’. He said surgery would be justified by symptoms, i.e. if I was in pain etc. The absence of any healing on X-Ray didn’t mean much as it could be a fibrous non-union etc.

My next follow up (6 weeks time) is after my first CX race of the season, so that could (metaphorically, I hope) be make or break time!

Hi Ian,

I think I read that jockeys who have this trauma maybe even more often than cyclists cope fine with fibrous non-union that doesnt show up on the xray, so if you could get back to sufficent pain-free mobility you wouldnt have to have a plate. Also, if you’re over 50 like me I  think thats one factor for slower healing.

 

Fingers crossed for your CX race – without a plate in at least you dont have the worry of nasty complications if you did fracture it again. This risk has so far stopped me resuming any serious cycling until I can get the plate out early next year, so I’m mostly running instead.

[IanEdward]

I had my latest follow up

I had my latest follow up last week, effectively @ 14 weeks.

I was feeling pretty good, the remaining symptoms of the break (a feeling of something loose at the back of the fracture and sharp pains occasionally radiating from the same location) had more or less gone, I think due to some simple theraband/0.5kg dumbell exercises I was doing.

The consultant came in (finally, a consultant! I’d been fobbed off with trainees the previous two occasions…) and stated quite bluntly that he saw no real healing at the fracture. He once again put surgery on the table but by this point I was anxious to AVOID surgery as am now back on the bike etc. He pointed out that surgery would involve another 4 weeks in a sling due to cutting through muscle etc.

He also admitted that the NHS is frankly poor at predicting who would heal properly and who wouldn’t, seems like 80% will heal fine and 20% won’t, I’m obviously in the 20%. I kind of wish we had identified this at the 4 week follow up as I could still have justified getting it plated then…

We left it at ‘see how it goes’. He said surgery would be justified by symptoms, i.e. if I was in pain etc. The absence of any healing on X-Ray didn’t mean much as it could be a fibrous non-union etc.

My next follow up (6 weeks time) is after my first CX race of the season, so that could (metaphorically, I hope) be make or break time!

[Fri]

I broke my collar bone about

I broke my collar bone about 18 years ago.  Because I lived in a remote part of the UK at the time, Shetland, and it was a friday night (yes there was some happy juice on the go) I went to A&E and they said radiology is close till Monday so come back for an X-Ray on monday morning.  I can tell you I was in pain, no painkillers and it was a bad fracture.  

On the Monday I was given tramadol which was good but the X-Ray showed the bone had snapped clean in two and overlapped.  I was told to come back in a week, then the rigmaroll started.  One doc said it needed pinning, the next said it didn’t.  Anyway 3 months later a surgeon saw me and was furious that nothing had been done for that long.  He said the bone had just started knitting back together and he didn’t want to rebreak it and pin it but he would not be surprised if I develop arthritis or some movement problems as I get older (I was 20 when I broke it).  

So yeah, if you are still following my story then yes, it can take a long time.  

[Atl1960]

Yes got some numbness around

Yes got some numbness around the plate. The most restricted movement is when i try  to put me arm behind my back – can only get half way. I also got told 12 months to remove plate, so still got to avoid coming the bike again!!!

[bah17]

Atl1960 wrote:

Stumbled onto this article and found remarkable similarities to my own situation. Same age / helmet broken in 6 places / 10 day painful wait for surgery. Needed plate plus 5 screws, with lots of bone fragments put back into place. Check up after 6 weeks showed no sign of healing, which i was told was to be expected. Was told that cycling was too risky asa fall could be catastrophic. 4 more weeks until i had my next check last week – same story.  Mobiliity of the armis still limited and painful with any extreme movement. 

Next check in 6 weeks!! That will add up to 18 weeks off the bike, which seems a long time, particularly after the summer weather.

Sorry to hear you’ve had similar experience to me, especially 10 days before getting it fixed. That were easily the most painful time I can remember. Fortunately  I did get the all clear to ride just under 15 weeks after the accident, albeit the xray showed there was still some increase in density needed where bone had bridged across the break before the doctor said it would be ready to have the plate out again. I’ve got an appointment early next year which will be c. 9 months post-op for an assessment on taking it out.

My 15 weeks off the road meant I missed all but one of my planned cycling events this year, plus the glorious weather, so I sympathise with your frustration. I only had my first physio session 8-9 weeks after the accident, by which time I had regained a decent amount of movement, but no strength.  Sounds like I was more fortunate than you as regards mobility as you are now about 11-12 weeks after accident. Do you have the loss of skin sensation too?

I know its not the same but I was allowed to get on a trainer as soon as I could support myself without pain, which was a week post-op. Its something to keep some sort of base fitness level going if you are keen.

 

Best of luck

 

 

 

[bah17]

Atl1960 wrote:

Stumbled onto this article and found remarkable similarities to my own situation. Same age / helmet broken in 6 places / 10 day painful wait for surgery. Needed plate plus 5 screws, with lots of bone fragments put back into place. Check up after 6 weeks showed no sign of healing, which i was told was to be expected. Was told that cycling was too risky asa fall could be catastrophic. 4 more weeks until i had my next check last week – same story.  Mobiliity of the armis still limited and painful with any extreme movement. 

Next check in 6 weeks!! That will add up to 18 weeks off the bike, which seems a long time, particularly after the summer weather.

Sorry to hear you’ve had similar experience to me, especially 10 days before getting it fixed. That were easily the most painful time I can remember. Fortunately  I did get the all clear to ride just under 15 weeks after the accident, albeit the xray showed there was still some increase in density needed where bone had bridged across the break before the doctor said it would be ready to have the plate out again. I’ve got an appointment early next year which will be c. 9 months post-op for an assessment on taking it out.

My 15 weeks off the road meant I missed all but one of my planned cycling events this year, plus the glorious weather, so I sympathise with your frustration. I only had my first physio session 8-9 weeks after the accident, by which time I had regained a decent amount of movement, but no strength.  Sounds like I was more fortunate than you as regards mobility as you are now about 11-12 weeks after accident. Do you have the loss of skin sensation too?

I know its not the same but I was allowed to get on a trainer as soon as I could support myself without pain, which was a week post-op. Its something to keep some sort of base fitness level going if you are keen.

 

Best of luck

 

 

 

[Atl1960]

Stumbled onto this article

Stumbled onto this article and found remarkable similarities to my own situation. Same age / helmet broken in 6 places / 10 day painful wait for surgery. Needed plate plus 5 screws, with lots of bone fragments put back into place. Check up after 6 weeks showed no sign of healing, which i was told was to be expected. Was told that cycling was too risky asa fall could be catastrophic. 4 more weeks until i had my next check last week – same story.  Mobiliity of the armis still limited and painful with any extreme movement. 

Next check in 6 weeks!! That will add up to 18 weeks off the bike, which seems a long time, particularly after the summer weather.

[Canyon48]

I can’t really help too much

I can’t really help too much as the situation I was in was dissimilar (I had open heart surgery when I was 17).

But… Ask your physio/doctor/surgeon first.

They should know exactly what your body can/can’t do and they should be able to direct you to sports rehab specialists if required.

[IanEdward]

Good news bah17!

Good news bah17!

Suspect you’ll be given lots of theraband exercises for the shoulder, I’ve been doing them on and off for a couple of years to treat an impingement issue I have. The good news is that if you do them dilligently I believe they help you hold a lower/more aero position with greater ease.

I’m at 8 weeks now, couldn’t convince hospital to put a plate in, although they did (finally) show me some evidence of new bone growth, so a 12 week heal isn’t out of the question. I can bear weight on the handlebars whilst on the turbo, so hopefully 1/2 hour commutes won’t be out of the question soon, as I’m going stir crazy spending 2hrs a day on a bus during a heatwave! 

Mid-September start to the CX season looks unlikely though, especially since at this rate the courses will still be dry, hard and fast!

[bah17]

IanEdward wrote:

How’s everyone doing with their various broken bits?

I’m about 7 weeks in now, healing seemed to be going OK, but in the last two weeks or so it seems to have taken a step backwards, there is a new and very sharp pain occuring at the back of the collarbone, right at the top of the shoulder blade. If I poke around where the pain is I can definitely feel something ‘loose’ that sort of slides back and forth. Feels like it is at the edge of where the break occurred.

Worried I might have been using the arm too much, trying to help wife out with the baby and a couple of days driving to meetings that I couldn’t practically use public transport for.

Have another follow up on Tuesday, if X-Ray doesn’t show good bone growth I think I’ll be (respectfully) demanding surgery. I wouldn’t mind a slow healing process if I KNEW it was healing properly, currently it doesn’t feel like it’s healing properly.
 

UPdate – I have just had my follow up xray 12 weeks after having a plate put in. None of the following is medical advice, just my experience in case it helps others who are frustrated at being off the road bike for what seems like forever.

Good news is I’ve been signed off, i.e. I can go ahead ride and do everything else normally. The fracture is still visible on the xray but as I understand it as the bone density increases as it continues to heal this shadow on the xray should disappear. I asked about having the plate out and was told leave it until 12m after operation, by which time the plate should be completely redundant.  The doctor was clear that it was purely optional to have it removed (not sure if that is code for the NHS may not do it) but he did confirm that if I did fracture it again with the plate in, it would be 100% certain to need an operation (whereas most fractures are left to self-heal). A second operation would be more complex and therefore riskier than the first time round. Current thinking is I will have it taken out assuming xray beforehand is “normal”.

I’ve been out for my first ride in almost 14 weeks which was fortunately both incident and shoulder pain free. The doctor also said that further physio now that I have pretty much full mobility back wasnt actually necessary, although the phyiso was keen to get me back to give me some weight bearing exercises to get my strengh back, and I have a session pre-booked for a few days time..

[IanEdward]

How’s everyone doing with

How’s everyone doing with their various broken bits?

I’m about 7 weeks in now, healing seemed to be going OK, but in the last two weeks or so it seems to have taken a step backwards, there is a new and very sharp pain occuring at the back of the collarbone, right at the top of the shoulder blade. If I poke around where the pain is I can definitely feel something ‘loose’ that sort of slides back and forth. Feels like it is at the edge of where the break occurred.

Worried I might have been using the arm too much, trying to help wife out with the baby and a couple of days driving to meetings that I couldn’t practically use public transport for.

Have another follow up on Tuesday, if X-Ray doesn’t show good bone growth I think I’ll be (respectfully) demanding surgery. I wouldn’t mind a slow healing process if I KNEW it was healing properly, currently it doesn’t feel like it’s healing properly.
 

[Georgeraleigh]

bah17 wrote:

IanEdward wrote:

This is all depressingly relevant, I’m almost four weeks into my healing after breaking my clavicle near the shoulder when I hit a speedbump I hadn’t seen (in my defence it was unmarked, unsigned and in the shade of a tree).

Mine has never been very uncomfortable and I’ve retained a lot of function in the affected arm, but my most recent X-Ray barely looked any different from the 1 week X-RAy, and the consultant mentioned there wasn’t as much callous formation as he would have liked to see.

The first consultant I saw was quite blase about offering surgery, and my physio (deals with a lot of rugby players) seemed to think it would be worthwhile. I’m now of the same mind as I didn’t like the look of how the bones were overlapping, and I would rather everything healed with good alignment. Waiting to hear back from them today.

 

On the plus side I’m two sessions in on my cheap turbo trainer, one session with just my headphones for company, and one with a GCN video. They’ve both been brutal workouts and I can’t help but thinking I could come out of my broken collarbone fitter than when I went in!

In weighing up whether to have a plate in or not hopefully it was brought to your attention that nerves most likely will have to be cut to get the plate in. For me, this gave loss of normal sensation across my whole pec area from top of arm to middle of chest. It is slowly improving but may not normalise ever. Just one downside to consider.

Blimey Ian thats exactly how i did mine along with the scapula and 2 ribs. Hoping to mine plated in a couple of weeks I’ve been waiting 3 weeks now. Being 53 I’m hoping for a good result. I’ve got pretty good movement now but some pain.

[benborp]

I think I’ve had five collar

I think I’ve had five collar bone breaks. The two most complex were complete opposites in terms of treatment and outcome. The first of these proved to be a non-union that took an awful lot of effort on my part to have properly diagnosed. Through the three years that I was struggling with it I was able to maintain function, strength and mobility to the extent that I could hold down very physically demanding jobs and still perform backflips – but towards the end of that period I required intensive physio to keep functioning and counter the effects of the imbalances that the injury caused – periodically losing the vision in one eye was one of the more bizarre effects. Just prior to getting a referral for surgery my physio was of the opinion that further physio treatment was becoming pointless in terms of maintaining function. The pain was becoming disruptive too. Surgery was too late to save the bone so the lateral end of the collarbone was removed, the shoulder blade reshaped and an artificial ligament used to bridge the gap. I would say function and strength have continued to improve with physio work over the twelve years since. Mobility is an issue in that there is too much movement throughout the shoulder and muscles that now stabilise the shoulder cause problems with supporting my head. The replacement ligament has now exceeded its expected useful life. Hopefully physio will keep everything moderately balanced and the shoulder functioning a while longer.

The other significant break came later on the other side. I think the bone was in five pieces and I was given the choice of whether to have it plated or not. I opted for the plate, but due to the timing of the injury and spacing of the fracture clinics it was a while before surgery could be scheduled. During surgery it was found that the bones had fused quite strongly but with considerable overlap which would impair function and increase the imbalance I suffered with the injury on the other side. It was much better to have discovered this earlier rather than later. About a year later I had the metalwork removed as it was very prominent and could be very painful in the wrong circumstances. It was only after the plate was removed that I realised it had also been causing chronic pain. Nerve damage after both procedures was a minor discomfort. The whole experience was a minor inconvenience mainly because I stayed under the care of one surgical team.

The second of these two injuries was much less disruptive and much easier to deal with.

Physiotherapists were invaluable for navigating my way through the difficulties of the first break – surgical intervention was only about a quarter of the story. Unless I became resigned to a sedentary lifestyle non-union was a huge threat to my well-being.

If non-union is a risk for you I would recommend having a solid relationship with a physiotherapist monitoring your progress. Hopefully you are receiving good physio support post surgery. If that is not the case a private physio is a very good investment. The fact that you are already under the care of a surgeon should mean that you have much less to worry about – the surgeon is invested in you having a good outcome, if you encounter any difficulties you are already being supported by that apparatus and won’t waste valuable time looking for a referral or waiting months to join another surgeon’s list. The body may take its time healing and there isn’t a huge amount that you can do to change that but you do have people standing-by to intervene if there is no improvement. Just make sure you are not signed off from the fracture clinic unless you are satisfied that all is well.

 

[bah17]

IanEdward wrote:

Thanks, it wasn’t brought to my attention to be honest!

However, despite me talking myself round to it (didn’t like the prospect of future complications/misalignment of shoulder etc.) the consultant finally took a decision themselves and decided it wasn’t worth it for me and that healing naturally would be fine.

It almost feels like this has forced me to pull my socks up and get on with it, as I’m already feeling more improvement, can hold handlebars (on the turbo trainer) if I engage the right muscles in the shoulder to protect the collarbone. Obviously this isn’t a long term solution so I’ll continue with one handed turbo-training for another 3 or 4 weeks. Actually the turbo training is going so well I honestly think I’ll come out of the whole thing a bit fitter…

Anyway, hope you’re feeling improvements!

Thanks Ian, give it another month or two and I suspect you might be glad of not having a plate in. I’m now 8 weeks after surgery (10 after the break) and just starting running again but not riding outdoors. Pretty good movement, but very plausible physio (first seen start of this week) advised me not to rush into any strength work (muscles are visibly smaller than on the good side). Its just heavy lifting I can’t do in the house/garden but otherwise broadly back to normal (apart from the scar and some residual loss of skin sensation).  Just have to wait almost 4 weeks for next xray.

[alex1987]

I’ll admit to not having read

I’ll admit to not having read the whole thread so I can’t quite jump in as such, but here’s my experience.

My break was pretty clean and not displaced (ie, no plates/nails etc, just a sling). After 6 weeks I was given the green light but I obviously needed more since it (loudly!) cracked again by just moving the shoulder in one crisp movement taking a shot during a 5 a side.

Long story short, I guess the 6 weeks is a guideline but can easily take longer, and perhaps acting extra carefully after the green light might be worth it! If a plate has been put in place I can imagine it might be slightly worse than my case anyway, so not unreasonable.

Of course other things such diet, smoking (I was told smoking has a very direct inpact on bone healing, which led me to completely quit out of frustration after the second break!), calcium and vitamin D intake etc do have an impact, as well as general phisiology and genes.

[Author]

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