35 y/o female here. Triathlete, avid mountaineer, marathoner and ultrarunner too. Just qualified for Boston at my last marathon December 2021. Got on my bike for a recovery ride post-marathon and crashed it resulting in gnarly road rash, broken ribs and a shattered clavicle. Ended up getting surgery (due to clavicle being displaced >2cm, shortened, comminuted etc) with plate and 8 screws put in, your traditional clavicle ORIF. Surgery was 12-21-2021, post-op imaging and appointment was 1-7-2022; next appointment 1-27-2022. Doc has refused to clear me from sling immobilization or to run etc. Right now I barely wear the slight except at work (I’m actually a physical therapist but I’m supervising a student so my student performs all the physical lifting of patients, etc).
I’m frustrated at my doc and his antiquated post-op protocol practice. I’m pretty candid with him regarding my sling use which is I primarily wear it at work and at the gym. I don’t wear my sling at home AT ALL or when I go for walks/hikes. He insists that if I continued to “swing my arm excessively” ie., by not wearing the sling immobilizer, I’m at risk of loosening the hardware thereby requiring follow-up revision surgery. (This is some bullocks if you ask me, but OK). The post-op protocols that I found online due typically indicate sling immobilization 4-6 weeks, but clearly the practice is not uniform, as I’ve read on this forum people are cleared to run/ride running 2-3 weeks post-op. There is even literature online showing elite pro athletes returning to sport within 8-10 weeks.
For those who’ve had clavicle ORIF surgeries, I would love to hear your stories about your rehab; when you progressed from immobilization, to active range, to resistance training, to swimming, to body weight push-ups, to deadlifts, to rock climbing (if you climb) etc. And if your doctor medically cleared you to do so and what those indications for clearance were (such as radiographs showing signs of union, or suture lines fully healed as is required for swimming, etc). At this point, I’m tempted to ditch my precautions altogether and just go for a jog. Running has always been my passion and my therapy, and right now I feel my mental health taking precedence to my physical health.
Broke my clavicle about 14 months ago. Plate and 10 screws.
Like you I was frustrated with the recovery period. I was in a sling way longer than I wanted to and felt I needed to be. It was awful, but I will say listen to your doc. I get your frustrated and want to run/bike etc. Running will take a while, the jarring up and down will bother your arm. Biking, well the weight will bother your arm. I took 6 months I would say before I didn’t notice the plate anymore.
Truth is now is the time to rest and recover. Looking back at it, I did enjoy the time off. I did other things, I went for long walks vs working out. Spent more time playing with my kids etc. Then truth be told, what are you losing? 6-10 weeks of your amateur weekend warrior glory? Pro athletes go back early because its their job and need to accept the risk, they need to race to put food on the table. Take your time, get the recovery done right.
Editing to add: If I recall, the additional time in the sling is to remind you its still healing. Not to pickup stuff, move it too much etc.
I cope with my mental health issues through physical exercise and the active release of endorphins and endocannabinoids. I don’t have kids or family near me. I wish it were as simple as spending more time with loved ones but I’m alone. Thanks though.
Mostly limited myself to easy indoor spinning until 8 weeks, then running on soft surfaces, and returned to the pool 2-3 months later when I had better range of motion. Probably could have pushed a little harder, but my break was at the end of the season so I didn’t feel a need to rush back.
I could feel every running step vibrating through my body up to the broken clavicle for 6-8 weeks after surgery. It wasn’t a good feeling. Tried running before cleared by PT and Dr. but the vibration of impact pit me back in my place.
The toughest part for the rehab was bringing my arm above my shoulder … was a slow process for me, but could have been the nature of my fracture and location of plate/screws.
I’ve had a hook plate with 7 screws on my clavicle for 7 years now. Going thru it, it seemed like it was taking forever being in a sling. In reality it was probably a month or two but when it came off I had no range of motion. It came back within 3-6 weeks but in the moment felt like it was taking forever. As triathletes we get extremely frustrated missing the next race. Just come to grips that Boston might not happen but there will be others. Your doctor knows best.
You might think that I’m saying that about Boston flippantly, but I’m in the same boat. I’ve been trying to qualify since 2010. Qualified in 2018 but missed the cut and this year is the first time I’ve been accepted into the race. At the same time, my wife and I are expecting our first child 5 weeks before Boston. My wife has told me that she wants me to go do the race, but I’ve come to realize that it might not happen this year and I’m ok with that. There will be other Boston’s.
I smashed mine into a lot of tiny, tiny bits crashing on a mountain descent. They kept 8 pieces, threw away my AC jt as well as the rest of the pieces. Plate + 10 screws with 3 or 4 of those screws just holding bone pieces together. And tied my clavicle to the coracoid process.
IIRC i wasn’t cleared to return for 16w and was in a sling for about 8 weeks post op. Not going to lie it didn’t feel good for ~ 4 weeks post op.
FWIW my ortho still introduces me to people as the most complex shoulder surgery he’s ever done. And I’m 7,8,9 yr post op.
I suspect post op sling use is dependent upon how complex your ORIF was. At least in your surgeon’s mind. More complex = longer sling use.
Since you’re smarter than the average individual in regards to rehab what would you tell your pt? If you’re doing well, and you need to be honest with yourself, treat yourself. IME from coaching for about 25y rehab is typically more conservative & slower than the athlete would like.
yet I know athletes who have had coaches push them to fast, too far, too soon and set them back by months.
It comes down to a risk management approach. Would you rather spend a bit more time in rehab with or without the sling or risk a setback? If you take an extra 2 weeks now in a sling you’re still weeks/months ahead of a setback.
Your accident and subsequent surgery sound just unreal. It does sound like the most complicated shoulder surgery in recent history tbh.
I appreciate your feedback and I agree with you regarding risk management. Working as a health care provider in the United States, we tend to subscribe to a patriarchal approach to health care overwrought with fear of liability. I would tell my patients to adhere to surgeon’s orders, but that’s because I need to follow the rules to protect my license; I can take more risk with my own body. What I struggle with most is the predicated notion that we all heal at more or less the same rate, which we don’t - healing depends on past medical history and any existing comorbidities such as DMII or HTN, prior use of steroids, smoking history, activity level, etc. I don’t think my doctor has taken efforts to understand this because he recommends 6 weeks in sling for all post-op clavicle ORIF pts. He wants to play it safe, and that’s fair - I totally get it. But that said, I’m willing to take some risks with my own body (taking small risks to preserve function and quality of life is not the same as doing something irresponsible and asinine). That’s why I’m curious to hear other people’s journeys and experiences.
I have a titanium plate and 10 screws. I texted my sports physician in the ER that I needed surgery and asked for his recommendation so I got a surgeon who was also an athlete. What I remember, is that I never stopped biking. I remember sitting on my bike on the trainer with the sling on and pounding out hard intervals. I also power walked steep hills right away with the sling on to maintain leg strength. I think my accident/surgery happened in June and I raced IM Cozumel in November fully functional. My swim speed probably wasn’t full strength but I remember pounding out hard 25’s leading into that race and setting PR’s and then the downhill swim there helped some, but still, I was fully swimming and in shape to swim 2.4 miles by then. I remember those first swims were PAINFUL just sitting on the deck trying to get my swim cap on took awhile
I smashed my clavicle into pieces years ago. No surgery, but used a figure 8 brace. It must have been well aligned, really don’t recall due to the concussion, but surgery never came up. Anyway, one armed volleyball, tennis, MTB on smooth trails ensued that week. Young and dumb. When I went back as a follow-up in a couple of weeks, healing was very fast, but he told me since I didn’t listen to his advice at all, I would have a large lump there forever. I do. As a fellow PT and athlete, I get your frustration. You are now healing from surgery though, and as you know that introduced a longer healing time. Can you ride a stationary bike or do other workouts without involving the arm so much? Sounds like you are almost there, and would guess that at your follow-up you are cleared to start moving again.
Pulverized mine March 20, 2021. It wasn’t a compound fracture, so it was deemed a “non-emergency”. Cracked sternum, cracker rib, contusion on hip (still have a knot).
I couldn’t get into surgery until March 26. Plate,10 screws, synthetic graphing material to replace the missing 1/2" in the middle (which they had to remove). So, overall, worse than some; not as bad as others.
My Doc was great. One-week follow up he said, “looks great. if you want to jog, no problem” However, he did say “DO NOT life your arm above the middle of your chest and DO NOT swing your arm across the middle of your chest.” This was for the same reason your Doc said - basically, you’ll pull the screws out because they’re not set.
For the sling, after the second follow up (two weeks after surgery) he said, “Wear it as you wish. If you don’t want to, don’t. But I recommend wearing it in public as a visual sign to other to be a little careful around you.”
Didn’t feel like doing anything until the Apr 10. Ran 4 EASY miles. Did this for several days. My rib hurt a lot more than the shoulder or other injuries.
Thanks for sharing. I feel like your doctor took a more functional and aggressive approach to post-op protocol, which pretty much describes how I’ve been feeling tbh. And yes, the rib fracture pain is way more irritating than the clavicle. Getting out of bed is STILL painful.
Thanks for sharing. I feel like your doctor took a more functional and aggressive approach to post-op protocol, which pretty much describes how I’ve been feeling tbh.
He was exactly what I wanted/needed. He was quick to mention I’d probably wouldn’t need PT, like most of his patients, because of the training. But added, he would gladly prescribe it if I started training and thought I needed it.
And yes, the rib fracture pain is way more irritating than the clavicle. Getting out of bed is STILL painful.
Really bad news for you - It’ll take what will seem like FOREVER! I know exactly what you’re talking about on getting out of bed. You’ll be able to swim/bike/run - but then getting out of bed will hurt. Drove me crazy. One or two STers told me it would take months before they became non-noticeable. I didn’t believe them… Boy was I wrong…
