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My Broken Collar Bone - update 4

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  • Looks like its time for me to roll out to the left coast and start snatching Dino's Strava KOMs!!! (I can't help but to kick a man when he's down)

    But seriously, bummer on your shoulder but best wishes on your recovery. Listen to your body and don't rush it.
  • So Dino, how is it going? Right now is about the time you're walking around thinking "I can't believe I have pieces of my collarbone floating about in my shoulder but I'm not walking around screaming."
  • Hey Dino, sorry to hear about your crash. When I broke mine (May, 2011) I opted for the surgery. Mine had more separation, so it was a bit easier decision. I read a lot of stories by people who didn't get the surgery and ended up with non union healing, or having the surgery six months later because it never healed properly. When I told my doc that I am nowhere near done being active, and need full range of motion for some 2.4 mile swims in the coming years, she agreed. I got a plate and 9 screws, and felt better almost immediately. I was running 2 weeks later and raced a 70.3 three months after crashing. The plate is still in and I hardly ever notice it. The only thing I can't do is carry a backpack if the strap is over the plate.

    I'm very impressed that you convinced the ambulance crew to allow your bike to ride along! Good luck with your recovery. I'll be patiently awaiting your return to Strava.
  • Calling Dino!! Give us an update, please.
  • Hey peeps,

    Sorry for the blackout. The forums are just frustrating when you lose your voice (can't type without pain).

    Today is day 10 and must say I am really impressed with how quickly things seem to be coming together. On Saturday, day 7, I felt things simply were not improving, but today, I feeling I have come quite a ways. Pain is is just nagging and annoying, but manageable and my range of motion has dramatically increased. My wife is still washing me up in the shower (hooray) and today actually shaved my legs. sounds hotter than it was. my 5 year was shouting instructions and my 2 year old just laughed the whole time.

    At the same time, movement of bone in my shoulder seems to have subsided and i definitely feel like I am on the mend. I even went out tonight for my Tri Club's weekly run to catch up with friends and have beers after they got their run in. I have never been so envious of a run before....

    To rewind to last week, I was really very miserable. Ever since the crash, I had really bad nausea and headaches. The thought was a mild concussion and it seemed to be aggravated by the pain meds. As a result, I suffered without meds until about Thursday when I just seemed to come out of it. I tend to get sea sick and I can only compare waking up on Thursday like the feeling when the boat docks. The symptoms just seemed to subside.

    On the surgery side, I saw three separate orthopedic guys on Tuesday of last week and all them recommended against surgery in favor if letting it hit heal. Three guys sounds like a lot, but my father really came through for me. He is chief medical officer at the local trauma center and was able to simply walk me through the building with my x-rays in hand and solicit their opinions.

    One doc, whom has treated me before many times over the years, said he would not do it. If I wanted surgery he said would need to go some where else. The others we're a bit less scrupulous and said that based on my insurance, they would be happy to operate, but if it were their shoulder or that of a loved one they would recommend a figure 8 splint and rest. They apparently could not guarantee a better outcome.

    The consensus advice was that my break was 1 long, clean oblique line where the bones where in contact across a wide surface area and there was no poking or protruding into the surrounding muscle. They felt it would heal nicely. Apparently, indications for surgery are multiple breaks, bone pieces not in contact with each other or are poking into the soft tissue.

    My hope is to try and get in the trainer at the end if the week, but if and only if, I can pull on my own bids and mount the bike on my own. We will see what happens. I follow up X-rays coming next week and should know if things are healing well.

    Stay tuned.....
  • Posted By Dino Sarti on 19 Dec 2012 01:37 AM

    Hey peeps,



    Sorry for the blackout. The forums are just frustrating when you lose your voice (can't type without pain).



    Today is day 10 and must say I am really impressed with how quickly things seem to be coming together. On Saturday, day 7, I felt things simply were not improving, but today, I feeling I have come quite a ways. Pain is is just nagging and annoying, but manageable and my range of motion has dramatically increased. My wife is still washing me up in the shower (hooray) and today actually shaved my legs. sounds hotter than it was. my 5 year was shouting instructions and my 2 year old just laughed the whole time.



    Glad things are going well.  Getting mocked by your kids is a rite of passage.  The eye rolling comes next, and then it seems they just ignore you. 

  • Glad to hear you're doing well, Dino, and good to hear from you.

    If you're kids are making fun of you then they are not worried and that's a good indicator.

     

  • D, if you can't type without pain I'd be hard pressed to try a bike, what I'm saying I guess is take to healing like you take to training !
  • Dino - glad to hear you're doing better. Now just stay smart and don't rush it image

  • Dino- Broke mine in July along with a thumb and severe road rash. Did Ironman Canada 5 weeks later and Marine Corp Marathon 8 weeks after that. Don't be this guy! It is now 5 months later and I am just now getting to the point that I can wash my hair without pain. If you want to do IMCdA with any hops of doing well, take 8 weeks OFF now. and then hit it hard in February. Otherwise you'll have nagging pain all the way up to and after CdA. Trust me been there, done that.
  • Hey Gang,

    Here I sit on day 20. Frankly, it feels quite a bit longer. Looking back, I can't believe how far I have come, and I am trying not to be discouraged by how much farther I need to go to get back to where I was. My range of motion is getting better and I am finally starting to really be able to do a few things on my own. Getting dressed is becoming easier, showering is back to being a solo act and I feel like I can move around.

    The issue is strength coming back. It is still really hard to push or pull things and if I exceed my current range of motion limits, it stings quite a bit. Other than those little moments where I cringe, there really is no pain, just a lot of soreness. Movement of the bone has pretty much stopped, but it does seem to sort of pop a little once in a blue moon.

    I was able to get on the treadmill this AM for the first time and that was really encouraging. It was fun to catch a sweat and get a little taste of the endorphins I really missed from not working out. The bummer was that the best I could do was a "tempo" walk. I set the incline to level 4 and was able to do 3.4 miles in 60 minutes. Toward the
    end I felt pretty good and even thought I might break into a little jog, but figured I shouldn't push my luck. I feel like this hopefully signals the return of some type of daily exercise and gets me back on the bike trainer next week.

    Hopefully, follow up x-rays next week to see how things are mending....
  • Hi Dino - glad to hear you're easing back into the game.  Sounds smart to not push it.  Take care of yourself & continue exercise judgment as much as anything else and all will be good.  

     

  • My $.02, it'll be a while before you are able to get full ANYTHING back - strength, range of motion, balance, etc. Unless the bone is "secured", pushing anything will be impossible. You'll have to wait for it to heal otherwise.
  •  x2 on what Steve said.  I tried to rush it as well and feel like I added a couple of months to my recovery.

    I was told you really shouldn't try to do a lot of strengthening exercises until you had the vast majority of your range of motion back.  It took me forever to be able to wash my opposite shoulder without pain. 

    I actually found that as I started to come back jogging/running caused more pain do the jarring/arm hanging during the workout.  For me, riding my TT bike on the trainer in the aero position was the most comfortable thing for me to do.  I also wore the figure 8 for my first few rides outside on the bike.  I don't think it was really doing anything for me, but mentally it made me feel a little better.

    Good luck with the recovery.

     

  • Glad to see you making progress, Dino.  Sounds like a good decision to stop when you did and not push things too much too soon.  I know what you mean when it comes to every day challenges like getting dressed and showering.  It's like getting your life back when you are finally able to function independently.  Mentally, it's big win!  Keep at it and keep us posted!

  • Thanks for all the advice and encouragement. It means a lot to hear from people who have been there. I am doing any thing strength related and generally baby the left arm quite a bit. My rule of thumb has been "if it hurts, don't do it".

    Today I got on the trainer. Haha! What a wake up call! I wore the figure 8 sling and used my road bike. I basically sat up the entire time with my hands on my hips/thighs or holding hands behind my back to pull my shoulders back. The only issue was in the very beginning when I tried the move from the small ring to the big ring. I just knew the left arm wouldn't make that move. Right hand did the trick.

    The epic fail was the workout I choose. I use trainer road and thought I would give the 2x20' set a whirl based in my ore crash FTP. WOW. That was just silly. I literally exploded 10 minutes in. HR was through the roof! Wow. I have a long way to go. Good news was that I was pain free for the entire ride... image
  • So... I saw the doctor today. This was week 3.5 follow up The doc is an orthopedic guy I have seen for years about bumps and bruises. The news was encouraging.

    - bones is mending nicely. You can see new growth in the X-ray. The crack/break is no longer visible.
    - there has been very little movement or displacement meaning there should little cosmetic or usage impact
    - guidance was to stick to the trainer for another 3-4 weeks as a safety precaution while strength returns and mending continues

    I totally agree with the third point. I am in no shape to ride outside. The arm just doesn't have the strength and the position of leaning over and reaching while on the trainer to grab the bar with my left hand is tender, sore and weak. I bet in another week I could ride, but god forbid I hit a pothole, take a bad bump or someone cuts me off. That would be a big re-injury opportunity.

    I have been riding the trainer sitting up with my hands behind my back like wearing hand cuffs. This simulates the sling and keeps my shoulders back and chest out. The issue is it feels like riding a unicycle! The seat hurts and the FTP is totally different. I now need three FTPs - outside, inside and unicycle! Lol

    Docs recommendation was another couple weeks in the Figure 8 sling as a precaution and a bit of support until the bone growth matures. I have a follow up again in 3 weeks with him and hope to be good to go. Just for fun, I meeting with another of the three docs I saw the first week just to get his thinking on week 4 and how bone growth looks after another week.

    Feels like things are getting a bit better. I have given up any kind intervals and just look at HR while I try and build a little endurance. Yesterday was my third ride and actually got in 60 minutes. it was a steady HR Z3 ride. NP was 125. Lol. My pre-crash, outside FTP was 265. Today I rode the same steady 60 minutes but had an NP of 136. 11 watts in 1 day. I will take it, but I still have a long way to go.... Lol.
  • Keep it up Dino! Sounds like you've come a long way and are heading in the right direction. Too bad you couldn't have gotten your ortho to write you a script for once a week 'precautionary' shower help from your wife... You know, just as a rehabilitation thing...
  •  X2 Dino.  Good work! In a few weeks this will all be just an unpleasant memory and you will be as strong as evah! 

  • Glad to hear you are making progress.  It must feel good to be back in the saddle and doing something aerobic in nature even if it is with hands behind your back.  Keep making progress and you'll put yourself in great a great position to come back strong once everything is fully healed!

  • @John - lol. I am still trying to sell that....
  • Quick update:

    What broken bone?
    image

    Met with the Ortho Tuesday (different guy from last week) and got another x-ray. He was really impressed that the visible break is already gone, but reminded me that the mend is tender/soft and needs to be protected to keep healing. As a result, no running for two more weeks. That translates into six weeks from the crash. Until 22nd, it's trainer rides, trainer rides and more trainer ride....

  • Great progress, man!  Looks like you get a head start on your start bike focus plan!

  •  Dino,

       I have some knowledge of clavicular fractures as a physician (I'm a vascular surgeon) but unfortunately much more knowledge as a patient (broke my left clavicle twice).

    Among other injuries I had a bad comminuted fracture which prompted a quick recommendation for a plate by my orthopedic surgeon. Although I missed IM Kentucy I completed IMLP the following year and subsequently had my plate removed. The following year I unfortunately re-fractured my clavicle 13 weeks before IM Wisconsin and I was happy when my orthopedist agreed with my strong desire to get the plate back in so I could continue on my path to Madison which I completed without issue.

    Recommendations regarding clavicular fractures have changed over the years. When I was in medical school (32 years ago) the rule was " clavicle fractures will heal if both ends are in the same room" ie. figure of 8 splints work just fine.

    Management has shifted- particularly for very active individuals like yourself. In brief, plating the clavicle achieves much quicker pain relief with quicker return to previous activities and in most instances less chance of long term disability.

    Just be sure that LOCKING screws are used for the plate (I had my plate removed the first time because by the time I got to Lake Placid some of the screws were almost popping out of my skin). My current plate (with locking screws) is just fine.

    My opinion is that I would not hesitate to get a plate unless your orthopedist feels this is a very simple fracture with minimal displacement. In the long term you will be happier as your return to your "normal way of life" will be easier and quicker.

    One final point: no I am not accident prone- I've been at this game of triathlon for 25 years with no broken bones or major injuries until recent.

    Best of luck.

                                                    Dave

     

  • @Dino- an update on MY broken collar bone (7/21/12). My recovery was slowed due to continued activity (IM Canada, Marine Corp Marathon) but then took 8 weeks off completely. Started working out out again Dec 25, and noticed a severe drop in speed, endurance and comfort. Both in running and biking. Today was able to hit my fastest pace for 10 miles since April last year. So just give it the time it needs and you'll be back for IMCdA.
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