For cyclists, the collarbone was basically made to be broken. When we fall, we often extend the arm to break our fall. The force travels through the arm up to the shoulder. The collarbone is usually the weakest link in the chain and tends to break first.
My good mate and Osteopath Dr. Dominic Briscomb (First Place Osteopathy) has lots of experience with treating collarbone injuries. He’s been around the cycling scene all his life and has treated some of the biggest names in professional cycling. Here’s what he has to say about broken collarbones and treatment options.
The Broken Collarbone
by Dominic Briscomb
A broken clavicle is not difficult to diagnose. The typical scenario goes something like this:
You can’t lift your arm!
You may be able to feel something wrong with your collarbone. 95% of broken collarbones can be diagnosed by feel if you know what you are looking for, but you are going to need an X-ray anyway.
I am assuming you haven’t hit your head or injured your spine and your crash has been moved safe place (i.e. you are not lying in the middle of the road with traffic still passing).
You’ll need help.
If you think you might have broken your clavicle, go to hospital. That’s where medical experts tend to hang out.
Okay, let’s say you’ve made your way to the hospital. What happens next is up to you and the medical people. As you can imagine there are lots of ways to break your collarbone, from a simple break, to shattered. If it’s a simple break and you are okay with not riding for up to 8 weeks, it is simple; just let the bone knit back together then start riding again. This is the safest and cheapest option available.
The other option is that the clavicle is broken it in a couple of places. It could be poking thru the skin and the broken ends of the bones could be perilously close to the nerves and blood vessels that run underneath it. In this case surgery is a good idea. The doctors will want to screw a metal plate onto it for a couple reasons:
1) Hold it in the shape of a collarbone again and avoid injury to the neurovascular bundle near the injury.
2) To keep the collarbone the same length as it was before. Once you have broken your collarbone your chance of having rotator cuff problems later in life is increased. If your collarbone heals shorter than it was before, the extent of those problems will also be increased.
3) The other reason to have surgery is because you actually are a PRO, and missing 8 weeks of your season is a big deal. Surgery will have you back riding on the roads in 4 week, and even less time to get back on the trainer.
There are two significant complications that you need to avoid in this scenario. The first is infection. After surgery you’ll have a wound covered by a water proof dressing. Cyclists tend to get on their trainer as soon as the pain becomes managable, and therefore start to sweat around the wound site (and everwhere else). I assume this is worse on a trainer because there is no wind to evaporate away the sweat and it tends to pool around the bandage. Sometimes this makes a favorable environment for an infection. A post surgical infection can be a very serious complication, and it will really keep you off the bike.
If you broke your collarbone and you’re be chomping at the bit to get going again, remember sometimes more is not better. Wait for a while longer so the break can heal. For the majority of us, a few more days isn’t going to ruin your seaon.
Also, if you have a piece of metal bolted to your clavicle and you are unlucky enough to fall off again, then it is going to break around the bit of metal. This can make repairing it more complicated (and surely more painful!). That said, Cadel broke his three times in the same season, and look where he is now. It didn’t seem to slow him down.
Lance broke his collarbone after over 15yrs in the pro peleton. Surely some sort of record. Also, he said he was surprised how much it hurt ! “Two riders crashed in front of me and I was not able to avoid them,” Armstrong said to La Gazzetta dello Sport Luigi Perna. “It the first time in my career I fractured my collarbone and I can tell you it hurts a lot.”
“In 17 years as a pro I have been lucky to avoid one of the most common cycling injuries. The crash has put my upcoming calendar in jeopardy but the most important thing for me right now is to get back home and rest up and begin my rehab,” said Armstrong.
Words to live by !
As those who have done it will know, riding a trainer with a broken clavicle is actually quite hard. Local VIS cyclist Jono Lovelock broke his, and we rigged up a harness to reduce weight on his torso:
With thanks to:
Dr Andrew Garnham, Sports Physician
Alphington Sports Medicine Clinic