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BROKEN COLLAR BONE
The collarbone also known as the clavicle is the bone over the top of the chest between the breastbone (Sternum) and shoulder blade (Scapula).
You can easily identify the collarbone (clavicle) because all other bones are protected with muscles while the collarbone is only with skin.
Hence the reason that fractures and brakes are common when falling or from impact.
A common injury that cyclist or triathletes get from falling off their bikes
Expect a collarbone fracture to heal correctly by constantly using a shoulder sling; if this does not help surgery may be needed although very few need an operation.
Different types of collarbone injuries
The two most common collar bone injuries are from falling on an out stretched hand or onto the side of the shoulder
There are 3 types of fracture injury to the collarbone
Middle Third – The middle part of the clavicle is the most common fracture to happen.
The Distal Third The end of the clavicle connected to the shoulder.
The medial Third – The end of the clavicle connected to the Sternum
Symptoms of a serious injury to the collarbone
Shoulder pain that does not get better in the hours after the accident.
Bruising in the damaged area.
Difficulty or impossible to move the arm
Swelling of the collar bone area
The fracture can sometimes bee seen or felt by pressing the skin
Correct diagnosis
X-ray or MRI scan will identify if the bone is broken or fractured.
Extra things to consider
It is rare but blood vessels and nerves close to the collar bone can be damaged. Ask for this quick test to be done.
Treatment required
Use Ice to reduce pain swelling & inflammation
Make sure you have the correct type of sling fitted and you wear it for as long as possible. Most common sling is a figure of 8 that supports the shoulder and holds the arm in place while keeping the shoulder blades back.
Not wearing a sling is the common reason for the collarbone to not heal as it should.
Avoid rounded shoulders in the first 2 weeks during your recuperation.
Very few cases require surgery when the fracture has separated.
The quickest way is to don’t rush back so it heals correctly.
Recovery time
The bone should heal in 4-6 weeks.
Pain should have gone in 10-16 days
Expect full recovery in 12 weeks
Age related recovery is a big factor and the fitness of the person.
The young heal quickly and fit athletes appear to recover quicker than arm chair athletes.
Expect to be able to exercise gently within 10 weeks and back to full recovery within 16 weeks
Strength may take longer to get back to where you were before.
Anything that causes pain then stop. Avoid throwing or holding objects no matter how light away from the body
Rehab
No arm raises
Don’t lift weights even a 1 kilo dumb bell.
Use an ice cube 3-4 times a day on the painful area. You can’t damage the area as the ice cube melts in a few minutes.
Mistakes to avoid
Make sure you monitor good upright shoulder back position.
Never Shrug slouch or have round shoulders when wearing your sling.
After effects
The bone may repair thicker causing a bump which may never go away.
On going treatment
See a physical therapist regularly to improve mobility.
Pain
This will help you decide how to progress. If it hurts or you experience any discomfort stop you are still not ready to progress.
What to do when
The Pendulum exercise – This is a great non-weight bearing rehab exercise. Bend forward at the waist and let both arms hang down.
Complete small circles clock wise and anti clockwise with your hands letting the weight of your hands move pain free comparing the injured to good side.
Static contracting without moving is another good rehabilitation exercise.
Rest injured arm on a table at 90 degrees and press into the table with lightly clenched fists. You must start the pressure from hand to elbow.
Progress to the gentle tricep muscle contraction hold for 2-4 seconds then repeat 3-6 times.
Once again stop if you experience pain and refrain from this exercise for at least 3 days if you have any pain in the collarbone area.
Repeat 4-5 times a week
The Grip is another strength exercise. Use a squash ball and squeeze GENLTY twice a day.
Stop if the collarbone is painful or don’t do it if you experience pain afterwards.
I have heard of speedy success during the recovery squeeze with the other hand.
Lastly the Rotator cuff may also be injured. Shoulder hugs @ 50% of what are normally able to do need to be done once a day for 4-5 days a week.
Fitness during & after a collarbone injury.
Cross training – Walking up stairs & Stationary cycling is vital to keep active but remember good bolt up right back posture.
Fitness plan after a broken collar bone
2-3-4 weeks after accident
Don’t forget to ask your sports injury therapist for individual advice.
Usually soft tissue injury and muscle imbalances can occur with a broken or clavicle fracture.
Gradually increase elbow range up and down
Stand facing a wall simply walk your fingers up the wall as high as you can without pain or straining the shoulder.
Don’t expect improvement every day. It is common that some days you may not be able to go as high as previously. Try and progress every 2-4 days not every day.
3-4 weeks only if advised by your sports injury therapist when you can do easy (none or little resistance)
4-6-7-8 weeks after accident
Only start weight training at least a week after you ready to.
First time no weights just go thru the motions and establish full range of movements first for 3 sessions during the next 7-14 days. If you experience no problems then consider light weights.
Avoid you are still NOT ready for full range of motion yet and do not do shoulder lifting and avoid shoulder elevation.
Continue rotator cuff range of motions exercises – Ask your sports injury therapist what you are ready for.
8-12 weeks after the accident
Aim to get most of your previous range of movement in all directions in the 8-12 weeks. Progress every 7 days and don’t force those last few %.
Avoid lifting weights; the weight of your arm will be enough. First you must build up muscle endurance with more repetitions.
12-16 weeks after the accident
You can ask others check the internet, search on Google “Fitness plan after a collarbone accident” “Treatment after a collarbone break” but remember we are all different. I have known some cyclist/triathletes who have recovered in the first month quicker than others only to struggle in to progress back to 100% don’t rush or force it.
Always stop if you feel pain a snatching catching sensation or unsmooth joint movement.
You should be ready to start drills for your sport. Swimming try dry land mimic swimming several days before swimming. Have a plan to stop before you get fatigued, don’t have a predetermined time of 30 minutes be flexible.
Before increasing intensity you will first need to re-learn the movements then repeat 2 days later the same workout. The fatigue from the first session will be progression when repeated a few days later.
The reason why you need to hold back from resuming sport specific training is you still will not be flexible and strong on both sides which can cause over compensation on the strong side.
When to return to sport after your collarbone injury
How soon can I return to sport after my collarbone injury is the million dollar question?
Our injuries will all be different remember we are all different. Starting back too soon can set you back 2-6 weeks or worse the problem re-occurring for months or the rest of your life!
The worse thing that can happen taking too long to start back training is it may take a few extra weeks to become fully fit again. Consistent training is key not starting back too early then many no-activity days due to rushing back.
The fitter you were before the accident the greater your chances of a full recovery in less time.
Work very easy @ 50-65% effort in your chosen sport until the movement feels natural, then you will automatically go faster. Skills drills balance should continue for 2 weeks (or 4-5 sessions) in your sport before increasing the pace.
Safe return to sport tips after a broken collarbone
Absolutely no pain or swelling
At least 95% range of movement from injured side compared to uninjured side.
Have 90% of strength of injured side compared to uninjured side
Mistakes to avoid
“I feel ok” 100% range of movement can hide you may have an imbalance – a loss of strength on injured side. You will also lack flexibility and defiantly have lost some of the skill.
Keep a diary there may be a pattern of aches etc after 1-2 or 3 days after rehab treatment or exercise. Find out what works best for you.
Your own sports injury physician will be best to help you.
Dont rush back its not worth it.