Fractured collarbone - any suggestions?

Hi all,

I had a nasty low-speed crash 11 days ago, and ended up fracturing my collarbone, and significantly bruising my bicep, pectoral and the upper ribs. I’m currently wearing a sling, but am now often more comfortable (and in less pain) removing it and holding my arm in place on my own.

My orthopaedic surgeon does not recommend surgery, as it looks as though I’ll heal naturally. More X-rays will be done in four weeks to confirm. I’m currently doing light shoulder/elbow/forearm/wrist motion exercises to keep the shoulder loose, and am to start more serious physio exercises in 2.5 weeks.

While I’m definitely in less pain than 11 days ago, I regularly get intense “cramping” type pain in the trapezoid and muscles/soft tissues around the shoulder blade.

I’ll likely be off the road bike until the end of August, but want to get on my indoor trainer as soon as I can to get my legs moving more (walking more than 15 minutes tends to trigger those incapacitating shoulder blade cramps).

I think/hope that I’ll be able to start next pedalling indoor next week sometime.

Does anyone have any advice or suggestions to make my return on my (indoor) bike more comfortable for my sore left side? Sling or no sling? Should I try to try to rest my arm on “something “?

I have a Wahoo Kickr, Climb and an adjustable-height “training desk”.

(Oh, while my head and body to the brunt of the fall and I managed to shred my Castelli Perfetto jersey and crack my Oakley helmet, I’m happy to report that my road bike seems fine! :blush: The only apparent damage is scratched brake levers… Don’t ask how, as I lost 15s of my memory prior to the crash, and passed out about 45s right after it. I only have a 0.2s flash memory of my handlebar sharply jack-knifing to the left as I was riding over a speed bump at 15km/h).

Thanks all!

Rob

I am not a doctor, nor do I play one on TV. This is my experience, it may or may not apply to you. YMMV

Eight years ago, I broke my left collarbone, and destroyed my rotator cuff. I could barely move my left arm.

The doctor said it would heal naturally. As per medical advice, I was told the sling was for my comfort only. I only used it in public places to keep people from bumping into it.

I started doing everything with my left hand (I am right handed). I used pain as my guide. I moved my arm until just beyond the pain point. and then stopped. Within two weeks, much to the surprise of the doctor, I had full use of my rotator cuff.

On the third week, with medical approval, I started riding an indoor cycle, but I did not lean on the handle bars, and tried to avoid jostling the arm.

Three weeks later I was riding my bicycle again as the collarbone had healed. I was told I did not need physical therapy.

The most important lesson, confirmed with some doctors, is that by appropriately moving my arm, I got the blood flowing to my arm which aided in recovery. Not moving it risks scar tissue that could result in a frozen shoulder.

Everything depends on the nature of the fracture, and your natural healing abilities.

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Thank you for sharing your own experience, Heretic!

Regarding the the physio/movement/pain situation, it’s exactly what I’ve been doing. The orthopedist commended me on staring the arm swing/pendulum, self-massage and elbow bending exercises on my own, before meeting with her.

Did you have major cramping and pain around your shoulder blade? I’m sure this is due to improper shoulder position and normal support; I’m looking forward to doing additional exercises as soon as I’m physically capable.

While cycling indoors, did you let your arm hang down or use an sling?

Rob

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I had no cramping or pain around the shoulder blade even when I slept without the sling.

When I cycled indoors, I kept the arm in the sling. I did that primarily to make sure I did not grab the handlebars out of habit, as well as to minimize the arm movement.

The workouts I did on the indoor bicycle were of the maintenance variety, I did not try anything really intense.

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@RServranckx I broke my collarbone 10 or so years ago - I think a stick got caught in my MTB wheel and I went over the handlebars. My break was in two places.

At first they had me wearing a sling to pull my shoulders back so the healing would occur in the right position but due to the double break - a piece was just floating in the middle - I ended up having to wear a bone stimulator which is basically two wires you stuck to the front and back of the shoulder attached to a battery that sent electrical signals to help the bones connect again.

I recall that the pain didn’t last long and frankly I wasn’t limited by the fact that it was broken and had no trouble doing bench press or other shoulder exercises. I decided not to ride outdoors due to the potential for the broken bone to cause further damage if I fell again.

Your plan sounds solid - stay active on the trainer and work the joint.

@Heretic Interesting story of your break - I am not sure I healed in 3 months, much less the three weeks it took you but I definitely agree that working the area using pain as a guide worked for me as well.

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It was six weeks from the break until I could ride again.

I got my front wheel caught in some trolley tracks.

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I fractured my right collarbone and shoulder blade in December 2020 on a road ride. My rear wheel slipped in wet leaves and I went down hard on my right side - no time to clip out or anything. Right shoulder took the brunt of the fall but I also hit my knee and hip. My helmet probably saved my life. I was in a sling for 8 weeks and rode one handed for that time. I did almost all the Inspiration Videos. I found that one handed was really hard to do longer than an hour. I’m back to normal now but it was 3 months off of riding outside. Good luck!

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Surgery…

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Why? Faster more predictable healing result and back on the bike WAY sooner (but I’m just an anchorman)

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@ronburgundy Agreed it is faster and I do have a friend that went that route and had hardware implanted. But it is not without risk. I was referred to a trauma surgeon in Boston and he advised against surgery even with the double break.

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Thanks Janis! I’m also looking into “easy pedalling” videos… I plan to finish watching the few inspirational videos, and doing those like Open, recovery, etc…

Rob

Every intervention carries risk. There is a non-negligible risk of infection with hardware implements, and no piece of hardware is as good as natural bone. Hence, everybody has to weigh the risks and advantages in every individual case. It is extremely difficult to generalize.

In my particular case, I have been told that you can no longer see on an X-ray that I had a collarbone break.

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TLDR: get a second opinion from a sports medicine specialist. Surgery might be a better option. The most important part is the physical therapy and rehab!!! Do it. All of it. And let your therapist and/or doctor clear you to get back on the trainer… then the road.

Sooooooo…. For my two cents. For what it’s worth. I am not a doctor, either. But I am both a paramedic and a recent shoulder injury “survivor.” 10 years in the Army, jumping out of planes, heavy ass backpacks, and lots of push-ups… then becoming a firefighter/paramedic served to be the perfect breeding ground for the formation of bone spurs on the distal end of my right collarbone (and probably Ku left). After ten years of constantly increasing pain, I decided to get a second opinion (from 3 years ago when the doc said I wouldn’t need surgery because it “won’t get any worse but it won’t get better” [his actual words]).

There was no connective tissue involvement (labrum, ligaments, rotator, etc) so my new doctor recommended surgery, 100%. He cited that surgery will pretty much fix me. Something no surgeon can guarantee if too much connective tissue is involved.

Your injury is much more complex, though. My 50,000 ft view of your situation and looking at your film is get a second opinion. Preferably a sports medicine surgeon specialist. I was out of the sling in 10 days, and pretty much pain free in 3 weeks with almost full range of motion at one month. Physical therapy has been the most beneficial part of my recovery. Hands down. Take it seriously. And don’t get back on the bike until the doctor and/or PT clears you, period.

I wish you a speedy recovery.

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@RServranckx all the best whichever avenue you decide. Should you not go the surgical route, be VERY religious in wearing the figure-8. You don’t want to have to fix this down the road. Best Wishes!

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@RServranckx Btw Google ‘Tom Pidcock’ just for fun

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I broke mine a few months before a big multi-day bike tour. Direct impact and break so this did need surgery. I found running by comparison too painful, but riding (all sitting) with the one arm resting on top of the bars was fine. Some minor aches/pains but it really taught me about stillness and relaxing my upper body that some of the videos call for. Think of it like a direct feedback loop if you are not being still and relaxed as you are told to do :slight_smile:

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Ah, yes, I’m aware of the Pidcock situation….
He’s lucky to have the financial and medical resources of INEOS Grenadier at his disposal.
That said, I’m lucky to have found a good orthopaedic surgeon who is very aware of how to treat cyclists for whom cycling is not just a hobby, but a way of life! :hugs:

Thanks melibokus!
I’m not sufficiently flexible to comfortably rest my elbows on my handlebar, so I’ll need to figure you what to do…

…is there any other way??

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Hoping for a fast recovery for you!

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