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Collar bone fracture - cycling

Faced with the prospect of 7 weeks off work after breaking my collarbone and under a large amount of pain, I resigned myself to a good spell of time off doing sports massage and the bike. It is pain like I've never experienced before, but as a hardcore endurance cyclist pain is part of the game and I think our brains clock pain differently. I needed some advice and the best person to ask is someone who's broken their collarbones 5 times, thankfully I have a few ex-pro cyclists who were clients that would arm me with some good advice.

The NHS suggested a 50/50 option of pinning the collarbone or not pinning it, saying the outcome in a years time would be the same. I needed two things, to get back to work more quickly and to ensure the shoulder keep working at peak performance, as a sports massage therapist I put a large amount of load through my shoulder and it was imperative this would not cause me any long term problems. So I called a a pro-cyclist who I know was very detailed at looking into the small differences in how the body worked and optimised every little opportunity. His first question to me was "is there an overlap in the bone", to which I replied yes, my bone was overlapping by about 4cm. That meant my shoulder was sitting way closer to my ear than pre-accident.


Our pro-cyclist had first hand experience on both pinned and unpinned collarbones and has lived with them for some time, so he should know. His findings were that the unpinned shoulder that had an overlap of the bones cause him more long term biomechanical issues than the collarbone that had been pinned. Essentially he was saying that the muscles were working in a shortened position and this caused them problems. We see this in clinic with our desk-workers who sit in twisted, slumped positions all day. So it seemed like a no-brainer for me to get the collarbone pinned. Obviously this was my decision and as always you should consider all your options before undertaking any surgery.

The recovery times were also better when having the arm pinned, a month with pinning compared to almost 14 weeks without, so I'd not be able to put any load into the arm for more than 3 months if I didn't get it pinned. This was a key decision for me as I needed to return to work asap.


My pro-cyclist said he was back on the turbo two days after surgery and two weeks later he was back on the road, here I was thinking "this is not too bad an injury". How wrong could I have been, I think if it was just the collarbone on it's own I'd have been ok, but the pain from smacking into the back of a parked car must have done a little more damage than I was willing to accept and it took me a good few months to recover, however the decision to pin the collarbone was the best treatment decision, I was able to start moving around more, and I could sleep without the pain of a grinding shard of bone ripping into my shoulder every time I moved.


I made use of my soft tissues skills to rehab myself and started soft massage around the stitches as well as using kinesiotape over the wound dressing to lift a little tension out of the some of the tight skin. Once the stitches came out I started with fascial work on the scar and it is good to see that the tissue is completely mobile around the scar with no adhesions. The muscles took much longer to kick into action but with some good rehab exercises it's good to see that the body does restore itself, but I underestimated the level of pain, how long it would take to recover and sadly the long term psychological effect of having a car run you into the back of a parked car is something I am struggling to adjust to and I have massively had to adapt where I ride to let me brain settle down a bit. But I'm back riding and that's all that matters.

 

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