Broke mine in two places when I was knocked off my road bike, aged 51. The A&E doc consulted a senior colleague who explained that they prefer to let it heal naturally these days, but this was a particular kind of break they didn’t see very often (break near the ribs and one near the shoulder socket).
They plated it straight away. It took a good long time to heal completely. I have a protrusion where the plate is close to the surface, no big deal, but there’s a weird itching/parasthesia sensation which can really bug me sometimes. They’d warned about potential nerve damage.
Is posting the Nelson meme a bit much? I'll just go with "you're old enough to know better"
For now...
Ooo nerves, I forgot about that. I had no feeling in and around the surgery site for a couple of years. No big deal as it's an area that's not really used for much and lack of feeling doesn't really compromise anything. Oh, and I can't sleep on my front now as there's a bit of discomfort in that area but again, no big deal.
So I went to fracture clinic. Consultant and another doc. Absolutely zero interest in plating it as bone not pushing through skin. View was it would rejoin - I look at that xray and think "Really?". Anyway back in three weeks, if it's not healing they'll plate it.
Part of me thinks this is good- give it the chance to heal and if not have the op anyway. Part of me thinks that's 4 weeks in a sling followed by another 2 weeks post op and I'd defo then miss out on a trip to Ainsa early October. I'm going to sleep (well stay awake mostly) on it but think a 30 minute private consultation with a doc I've been recommended would at least give me some verification o or otherwise of what I've been told.
I can - I think.-feel the two bones rubbing against each other. So they're close but heck of an overlap! Also that's a HORRIBLE feeling!
Oh and I've had a sling update. Which is a lot better but going to be bloody hot.
Whatever, turbo starts tomorrow. Can't wait!
back in three weeks, if it's not healing they'll plate it.
I lost count of how many time I was told that.
Except it was a constant stream of four weeks waiting for me.
I can still remember the disappointment every four weeks walking home from the fracture clinic and being no closer to it healing.
I really hope you get a better outcome than I did.🤞
I broke my collar bone 30 years ago. It has given me pain and discomfort every day since. Do whatever you can to get it fixed as quickly and as fully as possible.
I did lots of stupid stuff as a teenager. Going otb whilst riding my bike recklessly is the only one I regret.
@singlespeedstu - they were - at least this time - clear as I made sure I got them to answer specifically that if it wasn't joining in 3 weeks, they would offer me an Op. We'll see if that holds. I feel a bit "fobbed off" even tho I asked lots of questions.
Your experience (and others I've spoken to) suggests getting a second non NHS opinion is going to give me some clarity on what options I should be pushing for. If I need to go private for the op I will, I just don't want it to be the only option.
Oops, bit late to edit, someone else can have my injury if they like 😉
I think you'll get fobbed off every time you go and even if it looks sightly better in 3 weeks (which suspiciously they'll see but you won't), you could get a repeat of my experience when it spontaneously pops a year later with little provocation due to a mal union.
Your body, time and money but I know what I would do if I had the insurance (or funds)...
Oh, and I don't know how yours is, but mine bloody hurt. I couldn't sleep, put a shirt on, tie my shoes etc etc. I was on Cocodamol for the pain which has the charming side effect of turning ya poo to concrete so you have that to deal with as well. Oh and second oh, you can't reach ya bum either for post poo duties...
healing without plating is best long term IMO. Its certainly worth while waiting to see.
Maybe but I might be the only person in this chat that has had one plated, one recovery naturally but then fail and one recovery naturally successfully. I'd pick the plating again for speed and efficacy of recovery and least pain overall. You do get more pain and buggeration in the short term but you're fixed up in no time. Long term (25 years), my experience is good. A sample of 1 I know but statistically relevant in MY experience 😆
I've been doing a lot of reading since I got back. Fair to say there's not a strong weight of opinion on most things collarbones- best way to set, best exercises to do in first 4 weeks, ways to avoid frozen shoulder, etc, etc.
I've been lucky pain wise- paracetamol has done the job and I'm only taking those before bed and when I get up. Sleeping is not great but I'm finding more ways to get a few hours in. Sling is tedious but that seems to be the one thing that's non negotiable (although how long you wear it etc seems more mutable)
No insurance but could go private if that's going to give me more years pain free/confidence in MTBing. Mulling over options but currently the 2nd opinion feels like the right way to go.
Oh I can get a shirt on but I think a t-shirt might be a stretch.... shoe laces are fine, socks need careful thought 😉
You're very lucky. My first was like yours, largely pain free but manageable when not. As a rampant 19 year old, the biggest issue was the impact on, errrrm, 'girlfriend interaction' which is obviously a very big deal at that age 😬
My second was utterly diabolical and getting from laying down to upright hideous.
My third, post op was initially Morphine then Tramadol which is pretty heavy duty. IIRC Morphine is Heroin's legitimate cousin and I fully endorse its effects 😉 I dint feel much pain throughout just alarm at a grey arm the size of a very large marrow. That's what a DVT can do to ya. It was filling up but not draining back.
I got dumped onto my left shoulder coming down off the Ridgeway into Avebury some fifteen years back, or thereabouts so probably in my late 50’s or so. The impact of my shoulder against the side of my head made it ring, (although that’s probably because there’s nothing in it, but I digress). After a month or so of it being painful when picking things up, a visit to my doctor got the diagnosis that well, I’d done something, but I’m getting older, so what do I expect. Ten months later, I realised it was wasn’t hurting any more. I also realised, somewhat belatedly, that I’d actually broken my left collarbone when I noticed a lump halfway along it…
It would have been nice if he’d told me that’s what I’d done, though. 🤷🏼♂️
Bloody useless, my assigned doctor - I always ask for a different one now.
I've been doing a lot of reading since I got back. Fair to say there's not a strong weight of opinion on most things collarbones- best way to set, best exercises to do in first 4 weeks, ways to avoid frozen shoulder, etc, etc.
yup
Make an informed choice 🙂 Personally I think figure of 8 bandage is the best option but rarely used now. Exercise is good
@boblo - that sounds horrific. Maybe I should think of myself as lucky!
I've booked myself in at ruinous expense to see the "horse and bike" shoulder doc recommended by my Physio. If nothing else it'll give me confidence that the NHS are telling me the right thing and/or give me some strong rationale for being assertive on needing an op if it's not healing in 3 weeks. Do not want to get into Stu's spiral of "come back in 3 weeks"
Just doing some very gentle rotation exercises three times a day so far. Also going to ask my very expensive consultant for his recommendations when I see him next Friday.
@alex It does sound as if you're having a better time pain and freedom of movement wise which will inform your decision. I couldn't countenance any form of unwarranted movement during my second one, everything was a ****ity bastard even on superstrongs.
Not sure how much influence you'll have on the NHS bods even with ya fancy pants private second opinion. They tend to be utterly institutionalised and exercise very little flexibility unless the reasons are very, very compelling i.e. imminent death.
For you I think they'll probably see it as elective so unnecessary. I've had a couple of serious brushes with them in the past 5 years which have just reinforced this view. One was a broken neck - car v bike the other an infected PE a couple of years ago. Both experiences reinforced my view of their dogmatic sticking to minimal cost/max return regardless of patient's views against a backdrop of dysfunctional delivery. That's the NHS, great when it gets really, really serious (which they were overall as I'm still here despite them pre-warning my wife on the last one) but on anything frivolous like a collar bone - forget it.
Whichever way it goes - bon chance
@boblo - that's a depressing view of a hollowed out NHS. I could take the view they think it'll heal naturally and that's the best outcome or, as you say, they're not going to do anything unless there are no other options. If it comes to that and I'm stuck in that loop, at least I'll get an idea from the private fella what the cost would be. It's probably in the region of "a new bike". If that's the difference between riding pain free and with confidence of a good repair, I'd absolutely pay that.
Probably give me the hurry up on selling a couple of bikes as well!
Here's my Xray from a crash at rogate about 7 weeks ago...
Basically i shoulder-barged a tree, and the collar bone had no option but to snap!
I don't know a tonne about fractures TBH, but the fracture clinic surgeon seemed happy to let it heal by itself. Additionally, it's pretty pain free, and I had reasonable range of motion from, like, day 5! It appears it's 'best' to snap the SHOULDER end of the bone, as it's pretty much held in place by lots of ligaments.
I've had a follow up appointment adn it's starting to knit back together.
TBH, to see me, you wouldn't think i've anyhting wrong, which is lucky I guess.
My tip: avoid NSAIDS (ibuprofen/aspirin) - they inhibit bone healing.
Good luck - all of the ones above sound much worse than mine to be fair!
DrP
@alex first Google return suggests £10k - £14k current cost. Mine was £5k in 1999 so sounds plausible. A friend had one done (their default protocol) in Majorca a couple of years ago and his insurance paid €30k! I understand why you'd be reluctant to stump that up if you're more in DrP's position than mine.
@DrP - thanks, always good to see a non plated one healing. Did you just get a sling or was it strapped up? I've read quite a lot about slings causing misalignments on natural healing (but also that things like fig 8 slings don't help!) so I'd be interested in your experience
@boblo - ouch. Interestingly the company I was due to ride out with in Bulgaria tell me they have lots of "health tourism" and an op over there is about 3k Euro. I'm not sure I'd be that brave tho!
I was given a sling to wear for the first 2 weeks, and some simple physio exercises. I basically only wore the sling for about 8 days as had to keep working etc etc!
I think my break/recovery has been pretty good TBH - i'm less than 8 weeks down the line - have no pain during normal activities, and full range of motion.
I restarted swimming a few days ago.. I've been doing long road rides since (please don't read this Mr Surgeon man...) about week 3! I was on zwift the day after the injury!
I explained to the surgeon that mobility and strength are REALLY important to me - he seemed happy with the progress so far.
So i guess not all clavicle injuries are catastrophic, but like i say, a distal clavicle seems the 'better' part to snap!
DrP
I'm with @boblo with the NHS. Fantastic when it's very bad, not so good otherwise. Broke spine 9 years ago, rushed in, no A&E wait, straight through to Resus. I was apparently quite poorly first 48 hours - really low sats too due to the impact, but didn't know too much due to the shed loads of morphine. Eventually got out of hospital 7 weeks later, and that's where aftercare went to pot. Couple of NHS physio visits where they just talked at me. Went private, and they got me back to being able to go to work again.
More recent extensive pelvic fractures - absolute mess. Missed the break, only when I went back 6 weeks later armed with an email from my private physio, did they then do a CT scan after telling me nothing on the Xray, yet again. The look of shock and horror on the consultant's faces made me think I'd done something bad. Apparently I could have easily died. By then though, too late to do anything, so sent on my way. Three months later I saw a hip specialist. Letter says 'evidence of healing - WTF, I've been back on the bike and cycling to work, and have done 3 1/2 hours gravel. I'll be asking questions at my 6 month follow up. I've had no NHS physio,, so I've been back to the guy that found my fractured hip. Although now, due to extensive whizzing about on crutches, my rotator cuff is torn. Given all the crap that's happened, I've complained to my GP and hospital separately as my care has been non existent. Funny how my physio's referral for a shoulder ultrasound has been acted on immediately, given I was told to get lost when I discovered my hip may have been worse than I thought.
Thanks again- super helpful. I have just set up the electronic shifting on Zwift this morning so I can change gear one handed! I'll be back on it today and I expect most days until I can do some proper riding.
Good to hear such a positive outcome... don't want to get my hopes up but at least it's not all doom and gloom!
Shit! There's always someone worse off...😐
I've had a couple of NHS Physio referrals- they gave me photocopies of stuff to do and sent me away after 5 mins. No hands on. I went private.
Blimey grim tale that one 🙁
First Zwift done. Sat up with backup sling on so I don't get new one sweaty. That is blooming hard work. 20km quite enough thank you. Didn't realise how less efficient it is hands not on bars. Still good for my core 😉
Back on it tomorrow I think. Going to see if I can do 3-4 hours a week. Less than I'd ride but about all I can stand on the turbo.
Brief update: Had the shoulder taped by my physio today to try and improve alignment when healing. Received a telling off for my poor posture which apparently doesn't help. Her view is the collarbone is a bit shorter/forward due to the break but that's expected and if it does heal, it's purely cosmetic and won't affect strength of repair/range of movement etc. The entire error is a lovely shade of yellow!
Off to see the private specialist on Friday. I shall be armed with a list of many questions to get my how-blooming-much for half an hours worth.
Also Gloucester did get back to me with a review in three weeks as promised. Depending on how grumpy I'm feeling, I am not expecting an x-ray that shows a good outcome.
Did mine a few years back (late 40's then). Specialist (who claimed to look after WC Dhers!) said that unless I was competing at pro level best to just leave it as the op would just extend the recovery time for no real benefit.
That's what I did, it still floats around but there's no pain or mobility issues.
Update time: went to see a consultant at the Nuffield and his view was it'd heal as strong as it was but it could take up to 12 months 🙁 Probably closer to 8 as his view was I was doing everything right to aid recovery. The reason given was not the severity of the injury but the way I did it- ie lots of trauma=longer healing times. Apparently big difference between falling off a curb and planting yourself into some rock hard soil at some velocity.
Cost of private op is 9k ish. Recovery time would be 4-6 weeks. His view was also fracture clinic would just keep kicking it down the road as it's elective surgery (in line with some experiences in this thread). I've missed the 'first" window to have any op, next one would be after 8 weeks. So that's 6 weeks to make a decision I guess.
He was impressed with my range of movement. It's really not painful at all, just irritating. The idea of it taking up to a year to get better enough for me to ride the stuff I want to ride tho is pretty grim.
More updates if anyone is interested! Been to see (another) consultant today. NHS fracture clinic. Good conversation. Short version is I can ditch the sling, start doing easy exercise / stretching / pilates etc. And put my hand on the bars of the turbo. And lift arm about shoulder level so can now wear T-shirts 🙂 And drive (auto) if I feel comfortable holding the wheel. Shall go out for a test later on on quiet roads.
Was told no op until 12 weeks if it doesn't heal. He thinks it will without any major issues other than a lump. No obvious shortening or drooping. I'm pretty much on my own between now and then other than some NHS physio starting next week which I don't have massive expectation for.
Best of all can RIDE IN A MONTH if I feel okay. Not proper MTB but a bit of fireroad stuff. He was actively encouraging me to try and do everything I want to do (until it hurts and/or I don't feel comfortable) before the x-ray at 12 weeks. No x-ray today so who knows if it is healing properly but he gave me a proper working over(!) and could not feel any bone rubbing or whatever the medical term is.
Today is 3.5 weeks after the break, and I'm definitely in my most positive state of mind even tho 3 of my friends are off on a trip I was due to be on on Saturday. I am dreaming of making Ainsa in October tho 🙂 Until then sweaty turbo, long walks with the dogs, some Yoga and Pilates and maybe back in Gym in 4-6 weeks for some very light weights. Going to listen to the old withered frame tho and not try and go too quickly.
Wrote a thing. Note: has some swear words : https://www.pickled-hedgehog.com/tefab/
Bit late to the party on this one. Sounds like you are doing OK for now. I've had 3 clavicle breaks. The first was in many pieces and tenting. They however only plated it on the toss of a coin as part of a research study. Healed fine, full strength and mobility, still there. The second was 11 years later, other shoulder during the end of the first covid lockdown, again in many pieces though not quite as bad as first. Ortho's were obviously short of things to do so was sent straight in for surgery and another plate. Metalwork seems nicer, less pronounced. Didn't get any physio though, because well, covid and it still doesn't quite feel right, though I did have an existing injury on that shoulder. Both the earlier ones were biking but the third time was kayaking. I got washed over a shallow waterfall upside down and clipped a rock on the way over. The end of the clavicle with the first break, fractured right at the end of the plate. I could felt the bits moving but wasn't too bad, drove to minor injuries, minor fracture on xray and was sent home with a sling which I only needed for a couple of weeks. The bone has now healed around the end of the old plate, so thats never coming out! All done in Edinburgh for reference. Hope you heal up well.
Blimey, I don't want to break another one!
Just had first physio- mobility is a-ok no interventions needed, some pain in shoulder/forearm being managed with some simple, frequently repeated, exercises. Still feeling quite chipper after losing the sling and getting chunks of my independence back.
My birthday is 16th August. I have the 3 month x-ray on the 12th August. I'll hopefully have done a bit of very easy riding by then and if it shows as properly fused, I'll go for my first proper off road ride on my birthday. Which I expect will be on the nesh side of extremely tentative. It's good to have a target tho.
I'm also going to drive up to Staunton (in the Forest where I crashed) and walk the trail to piece together (hah) exactly what happened, and decide if I ever want to ride that trail again!
For anyone interested/just to provide closure for any future searches, I was discharged today from Hereford fracture clinic with a "that's a strong looking join, you can do any exercise you want"- build up steadily tho but that bone is now as good as any other in your withered and aged frame" 😉
It still looks "broken" but it's not. That's new bone in the gap. The gap has come down a lot as well. I can't really see it pulling my shoulder forward, I do have a quality lump tho.
It's not been plain sailing as I had a couple of weeks when it was really properly sore in the AC joint after I started physio. It's still sore after riding 3+ hours but it's improving every week. Maybe not as fast as I'd like but then I am a very impatient patient.
That x-ray is 13 weeks after the accident. I did have a off-road ride on my birthday on Aug 16. A very slow one 😉
Going to continue with the 30 mins physio I'm doing every day and get back in the gym and start to do some weights- again building up gently. Hopefully be able to increase the time on the bike as well and maybe ride some stuff I've not gone near for three months.
I did go back to where I crashed. Saw exactly what I did. Not desperate to go back and ride it again.
So glad I didn't have the op.
Really glad to hear you healed quickly, and you should get to go on your holiday. I was finally offered an operation at the end of July, a year and a week after my accident... They didn't seem to be interested in seeing me first (x-ray or anything), I had to decide if I needed the op, so I called their bluff and said great I'll go for it... they then got me in and x-rayed me and have decided I'm healed.
Admitted I'd been riding since April, so didn't really think I needed the op, but having not been seen by a doctor since January, I was appalled that I was asked to make the decision without any medical advice (I was about to cancel the op, when they finally said, maybe we should see you first).
I wish I'd had an op soon after the crash, but this is seemingly not a option, so I put up with 7-8 months before making the decision I needed to get out riding again.
Best of luck for anyone experiencing this in the future...
PS: It took me nearly 2 month of riding before I checked out my crash site & rode it again... I'm not sure why I crashed, as it's a straight line path down to a fire road.
@zippy - that's just not great is it. Just seems strange they offer you the Op with no context. How does it feel now? Do you think it's healed? Or would you have the Op if you were offered it again?
@z!ppy - that's just not great is it. Just seems strange they offer you the Op with no context. How does it feel now? Do you think it's healed? Or would you have the Op if you were offered it again?
Just seems strange they offer you the Op with no context.
When I finally got to see the consultant, from what he said, it seemed to me I was not on a waiting list, I was just put to one side and ignored until they decided I should be healed. Luckily for them I was... This followed on from them txt-ing me in march asking if I thought I still needed treatment...no medical advise, just do YOU think you need it?
I do feel fine now, occasionally that side feels weak trying a random arm movement (lifting my FF e-bike over gates is fun), but I didn't have much pain all through my experience, other than when doing the physio exercises for my frozen shoulder. The frozen shoulder was a complete barstard of an extra issue, then one day after months of the physio I realised I could lift it all the way up. I now have 95% of the range it did before and that 5% is more about ease of use, rather than restricted range...Do you physio kids! I experienced horrible pain while doing my exercises, but pushed on (whilst weeping) & it was worthwhile
I wanted the op early on and would have still had it up until around February, which was 7 months after the crash, but the thought of going back to a sling and potentially setting me back to square one, meant I really didn't want it after that (I sat on the waiting list just to see when/if they would see me)
That's very different to my experience. As I said earlier in the posts, I did want the option of the Op but it wasn't really offered. Maybe if I'd pushed really hard, they might have changed their mind. I was referred for Physio 3 weeks in which a few people suggested was very early but I'm glad to have to got started as the frozen shoulder thing was one of my biggest worries.
My actual biggest worry was it not healing and then needing the Op - a bit like what you had @z1ppy.
Looking back to where I was 3 months ago, I probably had a better experience than most who have posted on this thread. Even tho sometimes it didn't feel like it!
Oh last thing- if anyone wants a really good set of rehab exercises graded by difficulty let me know. I've built up a folder which started with "stabilisation" and ended with "strengthening". Mix them up for anything from 10-40 minutes.
I'll be carrying on with them as they've also improved my non broken, but not very good right shoulder.
