I am welcoming myself to the broken clavicle club 🙁 Questions inside

Do not wait for the NHS physio. Had nothing since a fractured pelvis and hip socket in January. Went private to a sports physio and was the one that was sure my pelvis was fractured after A&E missed it. I've been referred for NHS physio but have heard nothing. It's costing but I am back on the bike and walking OK without surgery (found too late to get a hip replacement).

I was in my early 50’s when I broke my collarbone ( for the second time), I was advised to wait for it to heal as the first had done ten years earlier. 18 months later it was plated after a non-union. The metalwork is still there 12 years later. I don’t have any horror stories, healed quickly, good physiotherapy was invaluable and I regained full strength and mobility and I had the odd crash afterwards with no further long term consequences. Causes me the occasional pain if I have been doing work that involves impact or repetitive pressure ( hammering, planing, etc.) 

edit: I think access to NHS physiotherapy varies locally. Ours is run from the community hospital and we can self-refer. I have had excellent  and prompt service each time I have needed access over the past 15 years including last year for my back issues.

Thanks both. I am coming to the conclusion that having it joined is going to be the better long term option. Don't really want to wait 18 months to find out it still needs plating. I do have a great physio that sorted out loads of other broken body parts so it's just a question of waiting to find out what NHS says, or get a 2nd opinion.

Does sound like I could get out of doing some DIY with the plate, so that's going in the benefits column!

Broke mine in velodrome crash 10+ years ago, in my early 40s. Broke in two places, loose bit had spun round. Spikey end was pushing up into the skin too.

Fracture clinic visit took place after about 5 day, was in surgery the next day to get it plated. About 11 screws in there as well.

I had 4 or 5 NHS physio appointments, all excellent and I was exact in doing the exercises.

Full recovery, plate is still in there. If I don't exercise the shoulder it can get weak but that's more related to the dislocation a few years before.

Obviously things may be very different for you, NHS is in less of a good state than it was. I'd certainly be discussing the options of a private approach to get the best result, rather than the most cost effective.

Bugger.

Nothing else to add.

But... Can I have your bike?

50+ and broke mine last July, I'm still on a waiting list to have an OP... The only part of my experience that has been any good was my NHS physio, though he concentrated on the frozen shoulder I developed. Worcester NHS are simply not interested in operating on me, even though my collarbone was in three pieces. As it wasn't callusing normally I was finally referred for surgery, the surgery team still didn't want to do it, so I'm now 5 month into waiting for an OP.... oh and I'm back riding (I started 8 months after breaking it)... not seen a doctor since January and had a txt yesterday asking if I thought I still needed treatment.

If I'd known how long it would drag on I'd have paid the money for private op, I was lucky to have a very understand partner to help. 

From the little bit I know clavicles are an interesting bone to break as there seems to be very little consensus on the best treatment.  conservative treatment or plating - both have up or down sides.  Collar and cuff is commonly used in the UK now but figure of 8 brace used to be and IMO gives better results

Healing without surgery is best in many ways if it takes - but it doesn't always and often will leave a slight deformity.  Plating carries risks that are not insignificant but sometimes is still the best option.

Posted by: reeksy

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Bugger.

Nothing else to add.

But... Can I have your bike?

Bike was fine sorry. Not sure when I'll next be riding it tho 🙁

@z1ppy that's terrible! three breaks and they didn't want to plate it? I expect I'll have same convo in Hereford tomorrow unless I hear back from Gloucestershire before. Nuffield closed today but will call them tomorrow. I think I'll do that while I'm sat in Hereford A&E for a few hours...

Don't have anything helpful to add, just popping in to commiserate with my broken elbow, getting screwed back together next week.

Looking forward to bike-free summer is great, isn't it 😢

Healing vibes 🙂 

Thanks, Same to you! Yeah as I got older I always said "don't ride stuff that means you'll miss a riding summer beccause how many of those do you have left?". Good advice I entirely failed to heed 😉

At age 42, I broke my left collarbone into 5 pieces on 16 Sep 19 during the Ex Enduro, 1 of the pieces punctured my left lung. The shoulder end of the bone had also 'tented' and was poking the skin. Had the collarbone plated and with 7 screws on 25 Sep 19, though not after having to convince Southmead Hospital that it needed doing. The bone poking the skin had got worse, no way it could have healed naturally like that.

Once i'd got the op OK'd the hospital were great, after the op I (luckily) had NHS physio straight away. I was totally focussed on doing the exercises and had 4 sessions, the physio was very happy with my progress and could do nothing more for me. On the 1st referral post op the bone was not knitting as good as the doc would have like so I tweaked my diet (plant based) which seemed to sort it, i've been plant based ever since.

I do Pilates and that had a massive positive effect on my recovery, I saw significant gains each week from doing it. I continued to self recover through pilates, shoulder strength and mobility and good diet, on 5 Jan 2020 I did my first MTB ride since the break.

I made a full recovery, plate and screws still in place. The numbness over the bone from the incision took ages to heal. The only downside is the collarbone is not the same shape as pre break, if I carry a heavy rucksack i can feel it on the bone. Aside from that I don't notice it.

OP, it sounds like plating and screws is your best option. From my experience, once the op is done it's on you to do your best to recover - mobility, healthy diet and strength training. At 56 this is totally possible I think.

Sorry to hear about the break OP. 

I am 53 and broke my right collarbone in Oct of last year. Previously I had broken my left collarbone back in 2010. I have been ok with recovery, both breaks have healed with no need for  operations. I had fracture clinic 5 days after the latest crash at which I was told it should heal naturally with a further review after 3 weeks.

I was on the turbo trainer after 7 days, running outside after 4 weeks but I didn't return to riding outside until 10 weeks after the crash. 

7 months post crash I have had no issues with the healing and recovery. So sometimes letting the breaks heal without op goes as planned 😊

Again thanks all- plenty to think about. Trying to be positive this gives me a real prod to modify my diet which is something I've been trying to do with limited success! I just rejoined the gym (great timing!) for Pilates and strength classes and I'd probably add something around specific exercises to strengthen broken bits.

My biggest concern right now is getting the "let it heal" prognosis and then having to get it fixed anyway at a later date. We've a week in Ainsa booked for early October and I REALLY want to be back fit and strong for that. No spring chicken but I'm not in bad shape and with some focus/dedication I think I can really use this to get me in the best shape I can be. 

Alex, two breaks three pieces tbf... as TJ says they simply want CB's to heal naturally now, as it doesn't cost them any money, and for simple fractures that probably works in no time. I was simply told at my first appointment they wouldn't plate, another I would die if I had the op (5 times in the same appointment), finally when referred for surgery, the surgery team are like "lets wait", I insisted (it's patient led treatment, LOL), since I've been on a waiting list for 5 months with no contact. I was/am hardly dying, and I do hope ppl in more desperate situations are getting the life saving treatment they need, but for non urgent cases (I know two other ppl in treatment by Worcester) you are just abandoned onto waiting lists & now it seem they want me to discharge myself by TXT without even checking up on me.

My advise, make sure you keep the shoulder mobile (Shoulder Pendulums), even when in the sling, as you don't want the frozen shoulder I picked up. 

Broke mine at Mayhem when I was about 50 (don't remember the exact year). By October it was still clearly separated, and the NHS were still saying we should just wait and see. At a checkup I collared a passing surgeon who said there was no way that was ever going to rejoin, but it was an option just to leave it separated. I had it plated a week later, and then the plate removed just over a year after that- his excuse was that I was reasonably likely to break it again and it would be less messy if there was no metalwork in there when I did.  

Cycology used to do a great "Clavicle Club" t-shirt, you could kill time looking to see if they are still available. 

Feeling a bit down ? 🙁

Then swing your arms in the air like you just don't care 😀

Oh no wait ...

No experience with shoulders but have just been through the NHs/private decision for a knee. From my experience I would seek out a surgeon who is a specialist in sports injuries.

I was seen at a local private hospital under an NHS waiting list initiative. The guy I saw claimed to be a knee specialist and when I saw him told me I would be only suitable for a procedure called micro fracture and would need a new knee in 2-5 years. I asked about specific procedures and he told me despite being 44 and being pretty fit that I was too old and wouldn’t be suitable. I explained I was a cyclist and earlier in the year had ridden 200miles non stop, go on mtb stage races etc and hoped to get back to this as well as just playing with my kids. he said no. 

I was given a date just 2 weeks later for the op. 

I am a scientist and have worked in the NHS for over 20 years and luckily have contacts to ask for a second unofficial opinion. I was told by people I trust that under no circumstances to have the procedure I was offered. I was recommended to go and see a specific orthopod who spends all of their time doing these specific types of surgeries and not just routine knee replacements on pensioners who want to potter around the garden. 

I paid for a private consult and it was night and day seeing the right person. He asked what my life is like, what I want to do after the op. We came uk with a plan and even suggested some other people who might be able to the op on the nhs. He said he could but it would be a 9-12 month wait. Worth noting that one of his proposed options was the procedure I was told a week earlier I was too old for!

We decided to pay and I had the op within a few days. When they got into the knee they found more problems but he was able to deal with them there and then. 

It was a 3 hour round trip across London for each appointment but I am confident it was the best option and perhaps more than other areas of medicine finding the right surgeon is critical. I share an office with a very experienced consultant and he constantly speaks to colleagues for advice on treatments etc. once the operation starts they really do have to plough on! 

I deal with a lot of private hospitals in my day to day and know you get people with no expertise taking money for for things they are really not qualified to deal with.

i would have the NHS appointment but also look for specialists and try and see them on the nhs or even a private consult before making the decision.

good luck.  

Posted by: alansd1980

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From my experience I would seek out a surgeon who is a specialist in sports injuries.

This. My first consultant was a hip replacement specialist with an excellent reputation…for hips. He recommended waiting. When it still hadn’t healed after 15 months I requested to see a shoulder specialist who I knew did a lot of sports injury work- jockeys and the like. He took a look at the original x-rays and said much the same as above’ that would never have healed’ and I had it plated. It would have been better to have done it at the time of the injury.

edit: the shoulder specialist I saw is still working but only privately now- I was on his NHS list when he worked at Worcester and Kidderminster hospitals. 

Sports expert a good shout. See who I can find NHS and/or private. Everything quite sore now.. was not taking any pain relief but just chugged down a couple of aspirin. Get the feeling it's going to be a long couple of months....

All is not lost. Broke mine in 2 places at age 50 (don't try to keep up with your son at Ft. William!) and it was pretty well joined at 6 weeks, on bike in 8 weeks (gently). A year later only reminder is a lumpy bit where you run your fingers over it. 

Edit adding - NHS Physio was good. My shoulder got pretty stiff and they were good at helping me get it freed up. Also they were most concerned about whether I smoked. It seemed no smoking meant a good chance of a simple recovery. 

That's a real pisser.

 Sorry to hear it.

Having been in your position I'd go with options 2 and 3.

I like z1ppy I got given the run around by the local hospital.

Unfortunately for me it was during lockdown and no one wanted to take me on for a private op.

Was off the bike for nine months, though did eventually get an op on the NHS.

Had frozen shoulder for around 12 months after the op and it still constantly hurts.

Doesn't stop me riding or doing anything now but always there aching.

Only really useful thing i can say is do everything you can to avoid frozen shoulder.

In many ways it was worse than the broken bone.

The mark in the middle of the bruise is where the bone stuck out after the crash.

I managed to move it so it went back in and i could ride back to the car then drive home in 3rd gear. 😂

ooh mine is nowhere near as bad as that! I mean I've got a lump but it's not gone full Alien! Nine months tho. Man my wife will probably bury me under a new patio. I'm not good at doing nothing!

Spoke to my Physio who also works at Hereford, and her advice was if it can heal naturally it will be as strong, if the separation is as big as you think, you need to get it plated asap. Both in her view have similar recovery times hence wanting to get moving with any surgery. 

Nuffield apparently don't do collarbones (I'll check tho). I looked at cost of some private hospitals and it's kind of "fix the dog" money. So NHS is still my first call if they can get it done quickly. I fully expect a "your call is important to us" kind of morning tomorrow.

@euan - that would be my preferred solution. I'm not good at hospitals. Always assume I'm coming out feet first!

I’ve fractured my right collarbone twice since I was 60. I’m still 60. All healed naturally and back to full fitness within 4 or 5 months. I have a batwing protrusion from my 2nd fracture. No skin break so NHS said no plating required. Their default is to leave to heal naturally in most cases. If it’s through the skin you have a better chance of an operation. 

Most pro cyclists get an operation quickly as plating it in most cases gives you a faster recovery. It does have its risks though especially if you fall again and mangle the plate and screws. A private consultation is definitely worth the outlay if you are not happy with the NHS self healing option. 

Posted by: Alex

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Man my wife will probably bury me under a new patio. I'm not good at doing nothing!

I have no idea how Mrsstu put up with me not being able to ride or do much at all for that length of time.

Quitting the booze to try and speed up the recovery was probably the wise thing to do in regards to my mental health too.

On a more positive note a mate has recently broken his too.

Early 50's and he's making a good recovery without surgery.

Well first well done for making it so long *without* breaking one...

I did mine almost exactly 2 years ago (aged 49). No op, back on a bike (cautiously!) after 5 weeks. I think I waited 8 before I hit the MTB again. It can go well...

The initial response from the minor injuries dept was pretty much "here's a sling, piss off, don't call us - we'll call you". First fracture clinic appointment was over a fortnight in. I had access to my other half's medical insurance so tried going private in parallel, but with hindsight that was actually slower and very much more disinterested. The NHS when I did actually see them were very good.

What DID work was hideously snake-oily. I've had good experience in the past using a guy called Brian Simpson in Ipswich who specialised in MX and MotoGP injuries using magnetic and infrared treatments. He's now retired but one of his ex-staff has setup at Mid-Suffolk Physiotherapists. I saw them 2 days after the crash and aside from the might do something/might not treatments, they gave me some very solid advice about how to manage life - posture, sleeping etc. My break was overlapping a bit - the advice was to stand up straight, and keep my forearm pointed fore/aft not held across my chest as this pulled the ends into line. Likewise to sleep on my back with my arm extended out to the side like I was signalling on a bike - again to pull the ends into line. When I saw the NHS 10 days or so later, they were very impressed with how the callous was forming after such a short time. Whether that's me being healthy and lucky or the treatment is your call. It cost me a couple of hundred quid all in, so not cheap but not silly expensive. Worth it for the advice alone - I came away feeling a lot more confident about what to do and not do.

The big thing - don't use the sling all the time. Frozen shoulder is apparently hideous and even spending a few hours a day out of it (and increasing) my traps, lats and rhomboids were in a right old mess after 5 weeks when I started physio.

I spent a lot of time walking - figured that getting decent blood flow around the body couldn't do much harm. Initially just in the local woods, but my alpine bike holiday in the 4th week turned into some big (and actually rather good) day hikes in the mountains.

Most of my points are covered above, but I was also told that Ibuprofen slows down bone regrowth so maybe try and avoid that?

Broke mine coming off my bike good and proper the day before Good Friday this year. (Along with three broken ribs and a punctured lung) Nine days in hospital to sort the lung out and an operation on the collarbone. Was back on the turbo within a week of being discharged doing very steady rides, more to make sure the lung was ok than anything else. The collerbone still gives me discomfort and is quite numb around the area but it’s still early days so I’m hoping it’ll improve. Four years ago I smashed my scapula on the same side crit racing that needed pinned and plated so with the amount of titanium in me I’m slowly turning into a Terminator. 
Although both operations were done on the NHS I was very lucky that the Doctor that looked at my scapula referred me to a private specialist sports surgeon at wrightington hospital that I later found out sorted out the shoulder injuries that the MotoGP guys get and he did a fantastic job. The aftercare was also excellent. 
The aftercare after this operation hasn’t been great tbh, I’ve had to go chasing appointments otherwise I wouldn’t have had a follow up appointment. 
If you have the opportunity to see a specialist sports surgeon/Doctor privately I’d be tempted to go done this route. 

Excellent points about keeping moving the arm. When sitting watching tv I took the sling off and did gentle small movements of the arm. I also took the sling off when I slept and just put a pillow underneath the arm for support.

Is the break at the inner end? I ask because you landed on your back and that is kind of how I did mine.

Subject to doctor's advice, the keeping it moving thing might be easier and a good idea if the break nearer the sternum. I had 85% movement almost immediately.

The single best thing I've found for lots of injuries is to hammer it with heat/cold for twenty minute stints, on and off for as many times as you can over as long a period as you can*. Working from home is a big help with this.

*Once any swelling has stopped growing.

I’ve fractured my right collarbone twice since I was 60. I’m still 60.

My 12yo saw some humour in that! We both ride a lot, including racing (gravity events, such as those organised by Northern Downhill). This thread (particularly the numbers who have sought help privately) has me wondering whether it would be worth taking out a sport-specific insurance policy. 

Sorry if I've not read your posts properly, but a fracture can go into three or more pieces if it is comminuted. But in those cases the pieces are more fragments than sections, so pinning/plating may not be an option as the fragments may be too small to screw into.

Mine fragmented on the inner end and popped my SC joint. The healing was just left natural and the bits fused themselves back together, although I have a lump at the front quite near my throat - so I was told to look out for trouble swallowing/breathing. 😬

Thankfully there have been no longer term issues other than a twinge occasionally and the associated whack on the shoulder still makes itself known occasionally. It's nothing like the trouble my busted thumb still gives me.

Posted by: Oakwood

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Is the break at the inner end? I ask because you landed on your back and that is kind of how I did mine.

It's kind of in the middle but closer to the shoulder end. The break shows the shoulder end moving "up". So no shoulder drop but quite a big gap as I said.

Really useful to read through all those experiences. I will definitely be looking at anything that shortens recovery time and is the most sustainable. 

Posted by: Alex

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I will definitely be looking at anything that shortens recovery time and is the most sustainable. 

That could be contradictory.  Plating will at least allow you to use the arm more quickly but it will still not be strong for many weeks but a non surgical union will give the best long term results if it takes

I broke mine many years ago.

If I broke one now I would be very reluctant to have surgery unless essential

The reason there is no medical consensus on treatment of broken collar bones is that there is no good evidence for any particular choice in general.  Of course specifics may mean surgery is the best option

Broke mine this time last year. It wasn’t plated as the doctor said there was no need and would sort itself out. He was right it did fortunately so no surgery needed. Had my first physio at week 2 with some simple mobility exercises to stop my shoulder and elbow seizing up. Apparently seized elbows are common from being stuck in a sling all the time so I was encouraged to keep it moving. At week 6 checkup it had healed and had physio on fracture clinic as part of the appointment with follow ups and an open appointment option if I needed it. I took that up as I was concerned about range of motion so given some additional exercise that did the trick. Perhaps I was lucky or my local hospital good but it was all sorted as quickly as it could have been

Best mate did his, about 20 years ago.  Definitely absolutely and utterly see the xrays and question things.  He got told at 2 different places they'd leave it to self heal.  As engineers we thought the alignment via the  X-rays  looked shite. But 2 separate docs (1 in Wales, one in the East Mids) said the same - leave it.

12 months later... had to have the badly half healed thing re-broken, aligned properly, plated and a bone graft off his hip to fix it as it was too long since the original break for it to heal after just plating.  12 months of pain, several checks, more pain, got back riding (in pain and absolutely no gnar), before the real consultant did the final inspection for the sign off and went "oh, that's not right at all, it needs breaking and plating" - come back in 4 weeks and we'll do the job.  

Obvs that will probably expand over 3 years knowing the current waiting times and 14 years of cutbacks.

First appt in Hereford two weeks away 🙁 That's 14 days of what feels like wasted time. Chasing Gloucester later but expect similar. Short of turning up in A&E with an actual emergency that's as good as it's going to get.

Sent out a few enquiries to local private hospitals. See what eye watering quotes I get back from there. I am definitely considering getting a second opinion even if I don't have any (if recommended) op privately.

Bloody sore today. Sleeping was, well, staying awake mostly.

Sending healing vibes.

I did mine in mid October last year in Finale. Looked quite displaced in xrays.

The Italian doctor at the hospital in Pietre said that if I were Italian they'd have operated on it straight away, but they just put me in a figure 8 brace instead and told me go to hospital when I got back the UK.

Got back, was put in a sling and told to wait it out. It healed itself and I was back cycling by mid December, riding enduro style stuff again by Christmas. 

No problems since, so in my opinion, the course of action in my case was appropriate.

It does seem to be a contentious topic in orthopaedics.

I've broken mine 3 times... As Casey Stoner famously said; 'ambition exceeding ability...'.

I broke my right when I was 19, OTB avoiding a car that had overtaken then emergency stopped in front of me... Healed in a few weeks, no issues just a bump to mark the spot.

The left I first broke bodysurfing at high speed. It healed in a few weeks then...

Almost a year to the day later, I had a very minor lie down in some grass and it snapped again at the (presumably mal) union. I elected for plating as I was off on a multi month tour a few weeks later. I was referred by my GP, under the knife within 48hrs and back on the roadbike within a week. There was a DVT complication a few days after surgery but that's a general post surgery risk and not specifically a collar bone issue. I made the tour and have had zero issues since (25 years).

If it were me, I'd get a referral and have the plate. You should be up and running as soon as your motivation allows. During that tour, one of the Japanese MotoGP riders broke his in a race, had it plated and won the next race 7 days later... Hard as F.

For us (me),  anything that can accelerate recovery and put you back where you need to be rapidly is a GOOD thing. Yes I had a DVT which could have been messy but just resulted in a week of tummy jabs and a year of pills. The original injury healed perfectly and rapidly which was my aim. In 1999, it cost BUPA £5k.

Spent a lot of time listening to hold music today 😉 Still nothing closer than two weeks. Spoke to a couple of private providers- bit of a pain as they want to assess you before referring which is fair enough but as the "good" ones are 90 minutes away, I'm still holding out for a "quick" NHS appt. If that doesn't happen then I'll be asking the better half to ferry me to some posh private docs for a prod. Worse case I'll get a 2nd opinion and that's probably worth the cost/PITA of getting there.

Walked past my bike(s) as I attempted to do some one hand typing in the shed today. Made me sad 🙁  Also first time for about 20 years I don't care about the weather forecast!

Posted by: bjj.andy.w

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Broke mine coming off my bike good and proper the day before Good Friday this year. (Along with three broken ribs and a punctured lung)

The holy triumvirate! Mine was like that with the added complication that the initial A&E X-rays didn't show the ribs/lung.

I had my crash on Sunday then had a pre-existing appointment for a CAT scan follow-up from another investigation. They confirmed I could go ahead with the CAT scan even with the collar bone. Got a lift in and groaned a lot as I was scanned (everything hurt). 

I got a call a couple of days later - er, we're looking at your CAT scan. Did you know you've got broken ribs and a pneumothorax- can you get into A&E as soon as possible? All healed up without any intervention but a bit more exciting than I needed. Still, the polyps they were interested in looking at were all clear so that was a good thing.

Heal fast! The ribs hurt!

Well after having Glouc fracture clinic on speed dial the last day, finally got through and they booked me in for tomorrow. I shall spend between now and then rehearsing a speech on what I need the recovered bone to be able to do. Good to get some movement, I was not looking forward to waiting 2 weeks.

Not getting ahead of myself tho, I expect there will be a few more "hurry up and waits" before I have a level of confidence in recovery time/approach/what I need to do and when I can do it. Hope to be back on Turbo next week for example.

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.

Posted by: nickc

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Is posting the Nelson meme a bit much? I'll just go with "you're old enough to know better"

Still got both eyes 🙂 Old enough for sure. Wise enough to say "ohh new trail, I'll go look at that obstacle before committing"? Apparently not!

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!

Posted by: Alex

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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.

@alex that photo has your full name and hospital number displayed in it. 

you might want to edit it!

Ps- glad you got some potentially good news

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.

Posted by: Alex

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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!

@Alex

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/