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Ten (OK, twelve) things about breaking your collarbone

Up until this year I’ve been lucky enough never to have broken a single bone in my body. I probably haven’t been trying hard enough which suits me fine, if you’re injured you can’t ride for a start. But this year, as most of you know I collided heavily with a tree and the tree won quite easily, leaving me with a broken collarbone.

Matt's broken collarbone X-ray

What can you expect if you’re unlucky enough to experience the same? Here’s a list of the main points.

  1. Breaking a bone hurts, a lot. In my limited experience, not as bad as suffering for an entire weekend with a raging tooth abcess but close. The thing is, although it’s the sort of pain that makes you want to be very good and sit still if it would just stop hurting, when you do sit still it does stop hurting. Until you move of course. But for me, tooth pain is worse because it won’t stop, ever.
  2. Like tooth pain, when it stops hurting it’s difficult to remember how bad it was, which is probably a good thing. Until you move.
  3. The first week or so is the worst if you are following the traditional ‘strap it up and wait for nature to mend it’ course. The bone starts making new stuff pretty quickly but after a couple of days the sensation of the two ends sticking and then pulling apart as you move still makes me feel nauseous if I think about it.
  4. There is a wide range of estimates of how long it takes to heal. I’ve heard of people being back at work the next day (frankly that’s in the borderline insane category) to up to eight or ten weeks. For me, I had five and a half weeks in a sling followed by another couple of weeks to get mobility back enough to drive a car. And it was a simple (but clean) break. My advice is listen to your body first, then doctors. There are no shortcuts.
  5. Painkillers are a boon and a curse. Put it this way, codeine based painkillers are known for effective pain relief, followed by ummm, constipation. Calculate your dosage based on need.
  6. Most medical advice is offered on a ‘don’t do anything unless necessary (or we’re getting paid for it)’ basis. This gives rise to consultants suggesting pinning the bone whereas NHS doctors say ‘it’ll be fine, just wait’. If you think pinning is worthwhile, insist early on or it’s not worth it as the bone is healing straight away. For me, pinning would have saved time but not necessarily been the best option as it was a simple break and was always going to heal on its own. Pinning involves cutting muscles and invasive surgery, the wait and see approach is longer but does work. I’ve been lucky enough to get a full range of movement back albeit with the odd shoulder click.
  7. The medical system is obscure. Not because people don’t want to help (all the medical staff I met were great), but because they see this stuff so often they forget it’s a massive deal for you. My most upsetting moments were from being treated as a statistic or a ‘problem’ rather than a patient. Going private prevents this but even so, make a point of asking questions and pushing for answers.
  8. If you break your collarbone and have it strapped for any period of time (the most common treatment), expect the Armpit of Doom. It will happen. A combination of hot material from the sling itself, an immobile shoulder and a difficulty in washing can only lead to one result. It’s unpleasant, especially in high summer and has lead me to boggle at the thought of where all that dead skin normally goes. That’s enough for me to say but do your best to stay clean.
  9. The value of a good physiotherapist cannot be over estimated. I’ve been to a few over the years but the one that worked on me after I was out of the sling was the best I’ve had. After that length of time immobile you lose strength dramatically but also flexibility to the point where my elbow wouldn’t straighten and I couldn’t get my arm above my head or behind my back. The physio sorted all that and now I’m fine. And armpit massages (cf. the Armpit of Doom) are odd, painful and embarrassing in equal measure.
  10. Fitness. If you are injured, you will lose fitness. There’s nothing you can do about this but don’t be tempted to ‘get back on the horse’ too soon. It may be tempting but the consequences of another injury are both more time off the bike and potentially far worse damage to deal with long term. Wait until the physio says it’s OK to start training and do exactly what they say. When you do get back to riding, the first ride or so will be fine, after which the extended layoff will really sap your strength. Remember you’re still healing from a big injury. For me, I’ve ended up with a couple of colds and general tiredness for quite a while now and pushing harder doesn’t help. As I’ve said, listen to your body and play the long game.
  11. Be prepared for depression. Not necessarily the ‘whole world’s against me’ kind (although it might be) but longer term flatness and lack of enthusiasm. For me, not riding the whole summer, missing out on outdoor air and sunshine plus general tiredness and the knowledge that your mates are still riding has taken it’s toll, leaving me ill, unfit and fed up. Again, play the long game, beating it requires keeping a clear idea in your head of where you want to be and not being distracted by relatively small hurdles that get in the way. Don’t allow yourself to do stuff you don’t want but don’t let other easy excuses get in your way. Things like poor weather, wife has got used to you being around on Sundays, bike’s not quite right excuses don’t wash. Just do it.
  12. MTB Mojo—this is the hardest part of your recovery. Personally I’m not there yet. There are times when you start riding again that you find yourself just plain scared of hurting yourself again. Once you know what it involves you don’t want to experience it again. Besides, the definition of an idiot is someone who doesn’t learn from past mistakes. This is a tough one, you can’t just pick up where you left off but of course you know deep down that you can do it because you’ve done it before. For me, returning to riding in the autumn when everything is/was covered in slippery leaves and mud made it worse and there have been times when I’ve just wanted take up Tiddlywinks instead. You can’t force things and in my case I can’t shake the thought that my injury was stupendously close to a full on high–speed head–first disaster, in which case I might not be worrying about riding again at all. I’ve been really lucky and in those circumstances it’s best not to tweak the nose of danger again too soon. I know it will return but I’ll let it come to me rather than going looking for it.

So there’s my thoughts. Basically, the injury hurts and the sensation of muscles shortening, withering and cramping up through inactivity can be extremely uncomfortable, but your body will heal.

You can have it pinned or wait for nature and there’s pros and cons with either option which depending on the opinion and employer of who you’re talking to you won’t get. But basically people do want to help, so keep pushing for answers.

Watch out for the Armpit of Doom and accept that it takes time to recover from a big break. I never realised how much blood there is in bones for example which leads to bruising and swelling which can take weeks to dissipate.

Finally, let mountain biking come to you once you’ve recovered, don’t try and prove a point to yourself (or worse, others) but don’t use feeble excuses to stay away either.

For me, after six months, I think I’m starting to enjoy it again…

Now, over to you…

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15 comments on Ten (OK, twelve) things about breaking your collarbone

  1. mike61 says:

    Matt, totally agree.

    I was out for a while with mtb induced broken ribs March–May of this year and both myself and buddies don’t think my fitness is yet back to normal.

    Point 12 is very true. Confidence returns but it is a frustrating wait.

  2. Matt says:

    Cheers Mike, it’s frustrating losing fitness you’ve worked hard to gain. Although you think you’ve still got it, it’s only after a couple of weeks you realise how far you have to go.

    Confidence is a long way behind but I was glad at how I rode BKB on Sunday’s year end ride so I hope I’m heading in the right direction.

  3. zeeyaa says:

    All what Matt has said is what I’m going through now. I broke my collarbone 3 weeks ago in car accident… its definetly not fun for the first 2 weeks…

  4. Jamie says:

    When I busted my arm I did a lot of time on the turbo. It’s difficult to get any exercise when you are busted up like that but even though a stationary bike is boring the exercise makes you feel better.

    My break looked like yours on the xray but it didn’t hurt as much and I was healed up in text book time, 6 weeks to drive a car, 12 weeks to ride a bike again.

  5. DaveH says:

    Great and very thorough blog post – and thanks for the comment on mine about my broken collarbone too in similar circumstances.

    Ironically the surgeon I first spoke to – a day after I broke mine – when I was still in a bit of a state and a good deal of pain – talked about how they might pin it. That made me optimistic – because having seen the x-ray I thought that there was no way it would heal itself in a decent way.

    I still think they made a bad call – mine’s a mess and although I can ride a bike I still feel like my movement’s impaired enough to never swim properly and lifting things above my head will be a long hard road.

    Pinning does have its own implications but I think that the current health system relies too much on surgeon / consultant motivation. What possible motivation could there be for a consultant to want to cut into me? As you point out, it represents problems of its own.

    I still can’t help but feel that I’d have been pinned if I’d somehow explained how important exercise is to me (to the overweight consultant!).

    Good to hear your tale of recovery though… hope our cycling paths cross one day.

  6. matty clark says:

    Hi thanks for taking the time to explain your ordeal i myself have broken the end of my collar bone when in affan on penheed final section about 4 weeks ago went to hospital in wales and they said it wasn’t bren so drove to work for a week and went to see a consultant in portsmouth who re-xrayed it and said it was broken. Iam trying to figure out when i can drive legally as its still 4 weeks till i see the consoltant.

  7. Andy C says:

    The issue of driving with a serious injury is more of an insurance problem. You will need to contact your insurance company, explain where you are in the treatment and what you can do, and get some confirmation in writing if they say you are ok to drive.

    I’ve just fractured my metacarpal (see “Andy’s hurt his hand”) and am in a plastic semi cast which prevents me gripping a wheel at the moment. As soon as this is removed I will be on to the insurance company, but it’s down to them if they say you are covered or not, and sadly I have yet to find any insurance company that likes to take a risk without a huge premium.

  8. Angela says:

    hi matt!!
    i realise this is a little old but i am so grateful to have found this blog! :)

    i have also fractured my right collarbone from driving into a tree.. it sounds funny but its not really in real life haha

    im just wondering when was there signs of healing shown on your xrays? with me its been 4 weeks and theres no patchment of the bones yet.
    my xray looks alot like yours. now the specialist ( 2 different ones) are suggesting that i get the surgery.
    my general doctor says to wait.
    if you could tell me when yours started to heal in the xray it will help me heapssss

    thankyou and i agree with all the above. lol thankfully it is winter here. theres no smelly armpits haha!
    Angela

  9. paul901 says:

    Angela, each break seems to be different and the system is notorious for ambiguity. I think part of it is the uncertain nature of clavicle breaks and that 90% will heal without surgery but it takes several weeks to know. The medical world prefer not to elect for surgery straight away and monitor you instead unless it’s a bad break which they don’t believe will heal. In total it takes the body about 21 weeks apparently.

    In the case of my partner hers did not heal, our consultancy advice gave us too little information and after a month she was in the same amount of pain and had neck soreness presumed to be from trapped nerves. She was not getting the kind of natural recovery and trapezium support that some others are lucky enough to get. So we paid £200 for a private consultancy and could have paid £5000 for private surgery but were not happy to do so. 2cm of movement seemed to be the magic number and at the time of the accident it was less but by about 2 months it was 1.9cm. So her instincts were right the X-rays said so (we took screen prints on our camera phone each time) and at the point the hospital said it was borderline. She was adamant to the hospital team that she was in pain, that as a Mother she needed to be able to pick up her child, as a painter she needed full arm movement above the head and in general wanted full arm rotation swimming freestyle etc. She got upset in front of them and at that point they sought permission from the boss and then agreed to operate, thankfully it happened within the next month.

    She described the operation as a relief as the neck pain disappeared, the shoulder was supported, the shortening corrected and movement began to return properly. Yes, she had a scar she didn’t like, the clavicle line bulged a bit with the plate under the skin and she also had an area of skin surface with no feeling but she was glad she had taken the surgery. The plate continued to bother her and after another 3 months she had it removed and that was more relief.

    So, just another perspective as there doesn’t seem to be a universal answer. If you’re not happy with progress don’t let it go, persevere with what you think is right for you and hang in there through the misery of it if yours is a bad break!

  10. Angela says:

    hi Paul
    thank you for your input.. im wondering how she felt after the surgery?? was she in pain, could she sleep properly in bed?
    the thing with me is.. the pain seems to be subsiding but its not joined yet :( its been 4.5 weeks almost.. i am just scared to go surgery… but hearing about your partner and how relieved she was i guess its not as frightening as i thought it would be.
    best wishes and thankyou again !

  11. paul901 says:

    Hi Angela, my good lady says that whilst she naturally felt nervous about surgery and knew she would have post-op pain for a few days these were less important than getting it sorted. Her father had serious cycling accidents in their native Colombia and said to her to get it done right from the start. Generally available information said don’t let it heal badly, you don’t want the tissue fusion if it’s not aligning properly. If I recall correctly, Amanda said surgery was the best thing for her too when she broke hers.

    Good luck with it, maybe Amanda will see this and post too.

  12. Angela says:

    hi Paul
    thank u so much again and to your lovely partner :)
    i have made an appointment for surgery next week… daunting but somewhat exciting as i know it will heal properly hehe

    thanks also Amanda!!

    best wishes

  13. David baker says:

    Hi everyone, I have read all your comments fascinated by how accurate they are.

    I am currently in week two post braking my RH clavicle as a result of riding recklessly down hill in the recent British snow. In my defence it was difficult in the flat light to see the ramp the kids had made which sent me over the handle bars.

    Having broken my clavicle before (childish motorcycle accident quite some time ago) I never get up from a tumble without the thought of a possible break! This one was particularly hard and fast so at first I was pleased only to have one brake!

    Because of the previous brake my collarbone broke in the 1st 1/3 medial, which means it broke at the sternum end. This I have found out is quite rare and leaves the medical proffessionals with a dilemma of how best to traet.
    My fist consultant with the fracture clinic after A&E just looked at the X-ray and diagnose natural healing even though through the pain of self examination I had expressed my alarm as to how high the sturnum join seems to be and the pressure it was applying to my neck/ wind pipe. I had no pain to breath in fact from my previous brake I was relatively pain free except from that nauseating feeling of bone on bone movement.

    Everyone I have spoken too has said expect a lump, I’ve had a lump for the passed 20 years from the last brake but I’m not happy about its direction and its likley hood of restricting movement in the future! I ride MTB/road and motorcycle, I also swim and run and was looking fwd to a year of triathlons. All of which I will need full range of movement in shoulder and the neck.

    Well that’s me, but my question is this, with only just over a weeks healing (going well) should I insist on seeing the consultant again early to talk about possible long term effects of just leaving it to heal naturally? Should I push for surgery if its even possible now I’ve started to heal? I’m not afraid of surgery if the outcome is that I can resume my sports.

    Dave

    • Matt says:

      Wow, that’s a tough call!

      First off, bad luck breaking your collarbone, we’ve all been messing about in the snow recently and had our share of tumbles, fortunately without incident. If you have competitive plans it really is especially frustrating.

      I’m no medical expert but I’d say if you have concerns you really need to pursue them with your medical contacts, either through private health or the NHS.

      The problem is always to balance the risk of intervention versus the risk of doing nothing. It’s very hard for anyone, even professionals, to come to a firm decision over this – there’s so many variables – but as many different opinions as possible would help.

      I was lucky, in the end I have a full range of movement back, albeit with clicks in certain directions, after allowing it to heal naturally. Other friends have not been as lucky, requiring further surgery from injuries much closer to the shoulder joint.

      Good luck David, hope it works out OK and sorry I can’t help more really.

    • Dandy says:

      Bad luck, Dave. I would echo Matt’s comment. Medics often dismiss the need for full movement of joints by the general public, not expecting them to want to take part in the types of activities that readers of this forum often enjoy!

      I guess like many of us that you’re not the youngest guy on the block, which again colours the medics’ judgement further. Go and seek a second opinion immediately, and explain (if you haven’t already) that you need guaranteed full movement for the triathlons you regularly enjoy.

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