Collarbones, those bastards. Although relatively low on the severity scale, a break will put you on the sidelines in a hurry (unless you're Austin Forkner). Search the VitalMX, VitalMTB, Pinkbike, Thumpertalk or any other forum of your choice and you've got threads upon threads of collarbone stories. Any injury diagnosis is intimidating. Just like the Yelp effect, people with bad experiences are usually the ones that speak up. So I thought I'd give a more upbeat review of my recent collarbone experience. Be warned, this is very long-winded but hopefully it'll give some of those anxious about such an injury a little sigh of relief.
About a month and a half ago, while getting some moto seat-time before the Harleywood Kenda Full Gas Sprint Enduro outside of Bristol, VA, I took a digger while out on my hometown trails. I swapped out on a high speed fire road, went OTB and, long story short, broke my right clavicle. I had broken my left clavicle in high school football practice so I knew pretty quickly that I had broke the other one.
To be honest, neither of my collarbone breaks were that bad of an experience in the moment. It took me three days after my first break to even go see a doctor. This time around, I took the time to snap a pic after I sat up (for the 'gram, Bro), picked the bike up and rode it out of the hills to the house. Either I'm getting old or I just knew this one was a much worse break because I decided to go to the ER right after getting the bike loaded up.
An X-ray and a confirmation from the Nurse Practitioner later, I was on my way back to Mom's house for the night. The next morning I loaded up my duffel bag and hit the road, two hours back to my place. They gave me a few painkillers at the ER but I opted for an Ibuprofen (for now) and drove on back by myself.
I was off to work the next morning with the plan of getting an appointment with an Orthopedic Specialist to see if the break required surgery. I work in construction management so, other than some discomfort, it wasn't too big of an issue to work with. A huge thank you to the Owner of the company I work for, who immediately called a contact of his and got me in to see an Orthopedist within a couple of hours. After another X-ray I was given the news that I was very apprehensive to hear. The break was severe enough for the Doctor to schedule an Open Reduction and Internal Fixation (ORIF) Surgery - plate and screws - the next day.
Now come the nerves. I had never been under the knife before so of course I did all of the research I could. Thankfully, by this point, I had enough sense to only read information from Medical Journals and not just random info off of Google. Although I was bummed to be off my bikes for 3 months or so, I wasn't really intimidated by the surgery, just ready to get it over with. To be completely honest, I was more terrified of receiving the medical bills after the surgery than going through the surgery itself - a very real fear that I am currently having to deal with, even having insurance - but that's a different subject.
The day of surgery was, again, filled with more anxiety over the impending bills (pitiful, I know) and less anxiety over the fact that I was about to have surgery. Going under was exactly like everyone says: They tell you to count backwards but I only remember a couple of numbers. And just like that I was coming to in post-op and it was time to be discharged. Thanks to it being 2018, I don't remember experiencing any pain after coming to.
I was starving after being without food for over 24 hours at this point. Naturally, after one has a medical procedure, we left the hospital and drove directly across the road to the steakhouse. Probably not exactly recommended but I didn't have any issues.
The Doc sent me home with a Breg Polar Care Cube with instructions to keep it on constantly for the first 72 hours. The Breg is basically a pump that circulates icy water through a pad that you wear on your shoulder. It's a pain in the ass to keep the water iced down (thanks Mom!) but this thing is a lifesaver! I highly recommend you ask your doctor if they can provide one for you post-op. I can't imagine how much worse it would have been to be constantly swapping out ice packs, much less how much more uncomfortable ice packs would have been anyway.
I was prescribed painkillers after surgery and through fear of pain and utter discomfort I definitely utilized them. Sleep was definitely uncomfortable but not horrific, thanks to the meds. The next morning, we were up to make the two hour drive back home (the cruel irony), this time I was a passenger. A stop for some burgoo, a swing by my old project site to give some quick direction (punch list... can't get away from it), and a stop at Walmart for a Chromecast (gotta have that Red Bull TV app) later and I was home, feet propped up and Breg machine pumpin'.
The next few days were spent in the recliner watching Netflix, Amazon purchases of anything Teton Gravity Research, and Red Bull TV. Again, thanks Mom! At this point I was taking one painkiller at night and one in the morning with the Breg on basically around the clock. By Saturday, however, I decided to not take the painkiller in the morning and only use one at night for sleep; little ice during the day.
Tuesday: Surgery. Wednesday-Friday Night: 1 painkiller in the morning, 1 at night. Saturday: 1 at night.
On Saturday we decided to get out of the house and drove into town; no issues. On Sunday I was brought back to my place because I needed to be back at work on Monday. I definitely could have taken more time off but I felt like I could just as easily prop my arm up on the center console as I could a pillow on the couch. I was still taking only one painkiller in the evening but I decided not to chance it and took an Ibuprofen before work. This proved to be sufficient. By Tuesday I was off the prescription meds altogether, opting for an OTC Tylenol PM at night and an Ibuprofen before work. Note: This was not a recommendation I was given by a medical professional. I just have an aversion to prescription pain medicine and wanted to take as little as I could handle. Again: Not a recommendation, just a personal judgment call and a useful illustration for those worried about the severity of pain after a collarbone surgery.
The following are my unedited notes that I typed up on my phone between Days 8 and 15:
Started noticing sharper pains at the 1 week mark, up until then it was dull pain with mostly pressure
Probably too lax on the sling, really afraid I’ve been moving it around too much, hopefully the follow up in 6 more days reveals some good news, afraid of malunion
At one week mark I went to OTC Tylenol at night and ibuprofen before work
Surgery on a Tuesday, recliner the rest of that week, stopped prescription meds during the day that Saturday, lots of ice packs still
Sleeping in a bed still sucks, probably screwed up by shifting around so much and sleeping on my other side but I just was completely unable to sleep on my back, only lasted 2 nights in bed and moved back to the couch
At about 10 days I started getting tingling sensations, assuming from the incision healing.
Day 10: decided to have a beer with dinner (it’s Friday) after reading beer contains silicon which is good for bone health [isn't the Internet lovely?]. Got paranoid, felt like I derailed my entire recovery which of course has been the perfect example of what to do after a broken bone... I use my sling like I’m supposed to (except not), don’t twist, lift, reach behind at all (always)...
Also day 10, walked around work without the sling. Didn’t really notice any soreness
Day 12: odd side note: Austin Forkner broke his collarbone at the Supercross the same day I broke mine. He made an Instagram post today that he “should be back on the bike this week.” ...I haven’t even seen my doctor for a follow up since surgery. How is that possible..? Hope, I hope.
Day 13 woke up extremely stiff. Muscular pain all around the shoulder. Previously the pain was just a dull ache but today is an odd sensation of intense soreness. Almost like a soreness a day or two after a super hard work out, but that is only a semi-close comparison, definitely something I’ve never felt before. Still a general “loose” feel.
Day 13 also touched around the shoulder for the first day in a few days. No longer (for lack of better term) ‘dead’ feeling. Tingling like a numbness instead of just nothingness.
The last couple of days (this is still notes from day 13) I’ve noticed a big difference in the feeling at the incision. Some pain, ‘normal’ pain one would expect from a deep cut healing. Hoping this is a good sign.
Days 14, 15 (as of 15) it’s been really stiff in the mornings. Not necessarily any more pain, just super stiff. Also some general “tightness”, assuming of the muscle but not sure, around the break. Some soreness in the evenings when driving home right around where it’s “tight”, assuming again at the break site but not sure if this soreness is of the muscle or the bone.
I stopped taking detailed, day-to-day notes after that but you get the idea. To sum things up: SLEEP SUCKS. Showering is a pain in the ass. Putting on a shirt is awful. Did I mention that trying to SLEEP SUCKS. If there's anything that I might have done differently up to this point it would be to keep taking the painkiller in the evening to see if that would help falling and staying asleep. There's just absolutely nothing you can do. I wish I had recommendations for anyone going through a collarbone injury but it's really just trial and error. If you normally sleep on your back then you're wayyy ahead of the game. If you're a side or stomach sleeper, like me, then you're screwed. Wash your hair with one hand and hope you have a closet full of button-up shirts because you can forget about getting a t-shirt on for quite some time.
There just is not any way to really hack daily tasks with one injured arm. I'm super glad that I wear slip-on boots and don't have to tie shoestrings. Also, for once, I'm happy I write with my left hand. Feeding a belt through belt loops is much easier before you put your pants on. Socks... well, good luck. Drying off, wiping, getting to your wallet. Sorry.
Be prepared for sleepless, uncomfortable nights. At the time of me posting this, I'm still unable to sleep on my right side or put my right arm under my head like I would normally do. At this point it's more of a nuisance than anything, although I have tried putting my arm under my head and that still comes with notable pain.
Day 16 was my first Post-Op Follow-Up. I was very nervous that all of the activity I had been doing had derailed my recovery. During the exam the PA asked me to raise my arm above my shoulder to see how far I could go, assuming not very far. She was blown away by the range of motion I had and relative lack of pain in doing so. The Doc tempered his enthusiasm but was still very pleased with my recovery. I was told not to raise my arm above my shoulder or lift any weight but otherwise turned loose to go about day-to-day activity (go back to work... sorry, Doc).
As far as a sling, I honestly had not been wearing it very much up to this point. I was told at the first follow-up that the sling is now only for discomfort but I had really only been wearing it when I was walking or standing, otherwise I just propped it up on something.
Between the first follow-up and the 4-week follow-up was pretty uneventful. It still sucks not being able to sleep on my right side but that's about the only real lingering gripe. The 4-week X-ray showed good bone growth. I was released to raise my arm above my head but still not to lift anything above my head (I didn't clarify whether I could lift otherwise, I'm just trying not to push it). Most importantly: I AM RELEASED TO RIDE MY BIKES!
One month after my collarbone surgery, I was told by my Orthopedic Surgeon that I can ride my mountain bike AND dirt bike! His only stipulation was not to not, "jump or do any kind of competition." I'm too chicken to do much of a jump anymore and too lazy to compete, so we're good. Although, and I'm not saying I'm Graham Jarvis or Aaron Gwin, but I'm not sure that Doc knows what kind of riding I do. I guess I'll just be reasonable and hope for the best.
Six weeks after surgery and I've already been on a handful of mountain bike rides with basically no more discomfort than day-to-day life. I won't wear my hydration pack yet in fear of the weight across my shoulder causing problems. I've ridden some pretty chunky trail here at Cave Run and have been relatively free of discomfort or soreness. Oddly enough, jarring through rocks, roots and rollers has not hurt at all but grabbing a handful of front brake has given me some very noticeable discomfort. I'm either having a buddy load the bike or I'm lifting it with my left arm, watching not to forget and lift the bike over my head. Hike-a-bikes haven't been an issue but I haven't ridden anything that required an over-the-shoulder hike.
I will say that, now at exactly 6 weeks, there is still day-to-day discomfort. I'm currently sitting here with a very dull ache but I haven't experienced any painful movements or anything that has particularly worried me. The Doc said in my last appointment that no matter how well the recovery seems to be going, there's no way around the 3-month healing time. A bone break just takes time. Add in the muscle damage that results from a bone that was considerably displaced and the collateral damage caused by having the bone surgically repaired, there's a whole lot of healing going on in there. I'm still very conscious when I reach across the cab of the truck or pull a tshirt over my head, and I will be for quite a while yet.
All things considered, I'm extremely happy with the progress I've made and the ability to mountain bike so soon. It's a bummer to go through but things could have been much, much worse. I was blessed to have someone there willing to take good care of me while I was recovering and help even after I was being an irritable ass. So don't forget to thank your loved ones when it's all said and done. They're the real heroes.