Very often shoulder injuries are difficult to treat, all the more so in the case of a broken collarbone. The time patients need to recover can vary greatly. As a rough guideline, broken collarbones take 6-8 weeks to heal, sometimes longer and, unfortunately, sometimes they may not heal at all. This does not factor in periods of rehabilitation, meaning overall recovery time can be from 12-16 weeks or more. However, it is not all doom and gloom.
Once the break has healed, physiotherapy can be a very effective means of helping you to return to optimal health. In this post, we have the first-hand account of Jason, a patient at The Putney Clinic of Physical Therapy, who broke his collarbone in May 2017. After a protracted period of rehabilitation, with several setbacks, he is finally well on the way to recovery.
HOW I BROKE MY COLLARBONE
I broke my left collarbone in May 2017 in somewhat bizarre circumstances. While in town celebrating a friend’s birthday, I somehow managed to trip over an outstretched leg, was sent flying and landed very heavily on my shoulder. I was able to get up straight away and, probably through embarrassment, I did not notice any pain initially. However, after about 10 minutes, the pain started to kick in. I did not go to A&E there and then, as I thought the damage was not too bad. I could move my arm albeit with pain.
The next morning, however, when I woke up, the pain was excruciating and I had great difficulty getting out of bed and getting dressed. So, I went to A&E and, after being x-rayed, I was told that I had broken my collarbone. To complicate matters, the break was right next to the shoulder joint, which meant that healing would be a complicated process. I was given a sling and co-codamol and sent home and given an appointment for the Trauma and Fracture Clinic two weeks later.
RECOVERING FROM A BROKEN COLLARBONE
From the outset, it was apparent that recovering from a broken collarbone was not going to be plain sailing. At the first follow-up appointment at the Trauma clinic, they discovered that the break had actually widened. Over the following 5 months, I had numerous appointments and there was still no sign of the bone healing. In fact, they discovered that a cyst was beginning to form in the break area and consultant traumatologist decided that the most appropriate solution would be to operate. In the meantime, I was referred for Physiotherapy. This helped me to keep active but did little to help with the injury.
Surgery (Distal Clavicle Excision) was performed just before Christmas 2017. It involved removing the section of the collarbone that was not healing. I was warned that it would not be a miracle cure and that I would require extensive physiotherapy to get my shoulder more or less back to normal. After the initial pain from surgery subsided and the wound had healed, I did notice that the pain I was experiencing before the surgery was no longer constant. Also, the pins and needles sensation I had been suffering had disappeared. However, my range of movement was still greatly impeded and the pain was very intense.
Approximately a month after surgery I resumed physiotherapy. This was a low point and a very disheartening time. I was unable to raise my arm upwards or sideways, bear any weight on the affected arm or even perform straightforward tasks such as opening doors. Essentially, I had to retrain my shoulder, which was not easy given that I had not been able to use my arm properly for 8 months. Not only this, but I had also acquired some bad habits during this time, both in terms of posture and movement (overcompensation and also through fear of not wanting to make the injury any worse).
ULTRASOUND GUIDED STEROID INJECTION
As I was still experiencing a lot of pain when moving my left arm and shoulder, I was referred for an ultrasound guided steroid injection. The ultrasound scan discovered that I had some calcification in the tendons, as well as ossification in the bursa. It took several days for injection to take effect, but it helped immensely. After about 10 days, I was able to move my arm again with very little pain.
After assessing how I was moving, my physiotherapist hit on a plan of action. There had been significant muscle wastage through lack of use. As a result of this, I had acquired “winging” of the shoulder when I attempted to move it, which I was completely oblivious to. However, my physiotherapist took videos of my shoulder movements to highlight what I was doing wrong. This was of great help as it helped me to start getting back into sync with my own body. The first step was retraining my shoulder to revert back to its natural position. It was like finding the biting point when starting up a car engine. It was a struggle at first, but with practice it became easier. Now I am very aware when I am “winging” and know what to do in order to rectify it.
RETURN TO EXERCISE
The second step of my rehabilitation programme is to strengthen muscles in the shoulder area. This is done by means of weights (elastic bands) and mat-based exercises. The key is to build these up gradually in terms of difficulty and the number of repetitions. At the start, I had to do the exercises on alternate days in order to avoid fatigue, which set in remarkably quickly.
As the weeks have passed, I am now able to do much more and have recovered a nearly full range of movement. I have even been able to return to swimming, which has helped enormously not only with my shoulder but also with getting my creaking frame back into action. I am still not able to perform the front crawl, but my physiotherapist has given me exercises which should help me along the way. Setting short-term, and more importantly, attainable goals has definitely helped me along the road to recovery.
If you are suffering from a shoulder injury, why not make an appointment to see one of our team of Chartered Physiotherapists, who specialise in shoulder injuries. To make an appointment, book online or call us on 020 8789 3881.