- Give me a break by ChrisO August 12, 2019ChrisO3402
Lance Armstrong had to wait 17 years for his first.
Cadel Evans managed it three times in one season.
Speak to any group of cyclists and it’s almost inevitable one of them will have broken their collarbone. Or as one study put it in the dry language of academia:
“there was a statistically significant association between cycling practice time and frequency of clavicle fractures”.
No shit Sherlock.
According to the research* if you’ve been riding more than 10 years or training more than 10 hours a week the chances are nearly one in four, although surprisingly there was no correlation to number of races.
So I guess at 52 I was doing pretty well to be a late joiner to the Collarbone Club.
A cycling holiday in the Basque region of Spain was cut short by a crash which I still can’t quite explain. A little mist, a corrugation in the tarmac, a moment’s inattention as I started a descent… who knows.
What I did know almost immediately was that this was a not a crash I was going to be riding away from, tube clenched between my teeth in the style of Fiorenzo Magni. All those classic TV images of pro cyclists looking like a wounded bird surrounded by wheels and broken carbon suddenly made sense. You just know.
Happily my bike was OK and I was with a supported tour group who were able to scoop me up and take me to the nearest hospital (the Basque word is ‘klabikula’ if you ever need it, thank me later).
Patched up to seek further advice on my return to the UK I had plenty of time to put together this handy guide based on research and personal experience for anyone thinking of breaking their own collarbone. (Disclaimer – proper medical advice is here.)
What is it?
They say the collarbone is designed to be broken. It’s like a suspension strut between the breastbone and shoulders and it anchors a lot of ligaments. It absorbs impact up to a point and for cyclists who fall on an outstretched arm the collarbone often tends to break first.
You’ll probably be able to feel the break, assuming nothing has broken the skin. And head to the hospital as soon as you can, unless you have to finish a stage of the Tour of course.
How is it treated?
You may be given a sling or an immobiliser, like a figure of eight that goes around your neck and shoulders. I was told that in the UK medical opinion is against these because they don’t help healing. My own experience was that the immobiliser was good in the early days to just take the weight of the arm. And a sling is a good visual cue for others not to engage in any shoulder-punching camaraderie just yet.
Like any bone it can be a simple break or a complicated one with possibly several pieces. I learned a new medical word ‘comminution’ which is a nice way to say splintering. Silver linings and all that.
Your doctor will discuss the options which boil down to surgery or just leaving it to heal but some basic questions will be:
- Is the bone reasonably aligned? It’s broken but how close together are the pieces and can they join up. You might be sent for a CT scan to give different angles from an X-ray.
- Is it going to be the same length? The chances of problems with the rotator cuff in your shoulder are increased by collarbone injuries and more so if the bone heals shorter.
Surgery will be more likely if the answer to those questions is no. In that case a metal plate and pins will be used to hold the bones in place while they repair themselves.
In terms of recovery time there isn’t a huge difference between healing and surgery, although it will probably reduce pain more quickly.
The other advantage of surgery is that you know it’s fixed. If the bones don’t heal naturally then in two or three months you’re going to have had a lot of pain and still need surgery to start again. This certainty is the main reason why pros often go for the surgical route.
On the other hand leaving it to heal means avoiding the general, although small, risks attached to any surgical procedure. It’s also quite common in people with lean builds like cyclists to want to remove the metal at a future date – that means another operation and another period of recovery while the bones are in a weakened state with holes left by screws.
In my own case the complicating factors were the splintering, sorry ‘comminution’, and also a hairline fracture running along the bone. This would have meant a quite large plate to extend past those areas so the body was left to do its work.
As I write this I’m only a little more than four weeks past the accident. I was on the trainer indoors in 10 days and did my first track session at four weeks to the day.
Unless the fracture is unstable or painful then it’s just a matter of doing what you can bear, quite literally. The main risk is another injury while the bone is still recovering so try not to crash, as my wife often helpfully suggests. Official NHS advice is not to return to any contact sport for 8 weeks.
What’s actually happening inside takes place in three stages.
- Inflammation – blood rushes to the area and a hematoma or blood clot is formed around the broken bones. This lasts for about a week.
- Repair – cartilage and tissue, known as a callus, is formed around the end of the broken bones and these gradually rejoin over 2-3 weeks. The callus transforms into a spongy bone structure.
- Remodelling – the spongy bone becomes classic hard bone with blood vessels inside as the fractures are rejoined. Sometimes a swelling or lump remains over the end.
Can I do anything?
There are some useful NHS and other guides to beginning basic mobility and stretching and physiotherapy will be helpful in terms of regaining strength.
Obviously the body has to work hard to repair the bones so good diet and rest are important. Some people report being very tired in the early weeks after a fracture and I had a few nights where I crawled into bed while it was still light outside.
With a healthy diet anyone should have enough nutrients. Supplements and natural remedies are a personal choice but general advice is to make sure you have plenty of protein and calcium. Vitamin D helps your body absorb calcium and Vitamin C helps produce collage, while iron and potassium (bananas) are also beneficial for blood and mineral absorption.
Apart from that it’s just a matter of time and recovery. Within 6-8 weeks the bones should be functionally re-formed and pain should have subsided, although the full healing process may continue for several years.
By that stage you may well have broken something else… happy riding.
*Nishimi AY, Belangero PS, Mesquita RS, Andreoli CV, Pochini AC, Ejnisman B. FREQUENCY AND RISK FACTORS OF CLAVICLE FRACTURES IN PROFESSIONAL CYCLISTS. Acta Ortop Bras. 2016;24(5):240–242.Continue reading →
- On the front August 12, 2019chuckp3410
I wish I could say that this is a regular view of my riding partners because I’m the strongest of the bunch. But alas, not. Usually just because I’m the only person who knows where we’re going.
BTW, that’s my new lid: Lazer Z1 Flanders special edition. If y’all are wondering about the jersey: it’s a previous model year Danny Shane.Continue reading →
- A Tidy Cockpit August 7, 2019Teocalli3377
I really hate a messy cockpit with GPS, lights etc spread over the handlebars. I like to have things aligned and centred if at all possible.
My latest incarnation on #1 comes after swapping out my old Garmin for a Wahoo.
Fitting a K-Edge mount means I have a mount with interchangeable puck.
That means that I can hang a Go Pro mount underneath.
So with a Headlight with a Go Pro style mount from the helmet fitting kit (and a bit of filing).
I can then hang the Headlight under the Wahoo.
Which I just realised gives me a bit of a Starship Enterprise look. Give me all you’ve got Scottie………….
- Clasica Ciclista San Sebastian July 29, 2019Teocalli3349
Photo – Clasica Ciclista San Sebastian
Well the La Grande Boucle is over and what an event it turned out to be vs the pre season expectation of the usual Tour fare.
Anyway, the OTRL season rolls on with the 39th Classic Ciclista San Sebastian. How much will the GT riders be on parade and how much will they still be going for it? How much will some of the GT contestants have hit the Burgers and Beer in the week after the Tour (and regret it on the first hill)?
With a hilly parlours it’s certainly going to stretch the legs of anyone over imbibing post Tour.
Time to make your choices. Teams and riders here or here.
Top 5 from 2018:
- van Avermaet
- Round Isle of Wight July 17, 2019Teocalli3321
Any UK folk fancy joining us on a round IoW ride Sept 7th (or 8th). Weather dependent on precise day. Option to meet in Portsmouth or ride down from Haslemere and train back from Portsmouth with possible option of a lift back to Haslemere depending on numbers.
Ride will be approx 56 Km / 35 miles to Portsmouth. Coffee and snack in Portsmouth before fast ferry to Ryde. Loop the island clockwise via the marked tourist route. Recovery Ale and Fish and Chips at Wooton before catching a late afternoon ferry back to Portsmouth for Imperial Ton for the day.
Pace will be leisurely!
Oh – and we will be going via the Cowes Chain Ferry not as above.
- La Course July 17, 2019Teocalli3314
Well, until ASO/UCI get round to (re)instating La Grande Boucle Feminin we have La Course.
It’s tempting for On The Rivet to boycott the event until it is a stage race but I’m not sure yet that we are a major player on the horizon of ASO. Maybe we will be by next year………
Anyway, sorry for the short notice – my excuse is that I’ve been away on 3 holiday/riding trips with only a day between each so had kinda lost track of events. Thanks to DanCollins for the prompt.
Rider and route details can be found here. As the major players are pretty much all present it will hopefully be a cracker.Continue reading →
- Rob’s Ar1 July 9, 2019RobSandy3292
I had a hankering to take my race bike out for a spin last week. I haven’t raced this year due to work, life and health issues so I’d missed it. When I was prepping it I thought it looked good, so I took a quick snap.
What a beast, eh?Continue reading →
- Columbia, South Carolina, USA July 4, 2019Cycling Monk3290
My ride from last week.
Continue reading →
- Grand Depart 2019 (ish) June 30, 2019Teocalli3272
Just back from Brussels after riding a charity ride Prostate Cancer UK Grand Depart. Really well organised event with all sorts of abilities taking part. It was somewhat warm (British understatement there!).
Interesting to near follow the route but there are loads of road sections still being resurfaced. Makes you wonder why they leave such work so late, surely the riders would prefer not to be riding on fresh tarmac. Especially if it is likely to be hot and melting. The thought of a crash and road rash from fresh tarmac hardly bears thinking about.
Coming back into Brussels on the TdF route was a bit of a mare on a busy Saturday afternoon!
Oh and we cleared the Muur and Bosberg.
Rather “interesting” in exploring my current limits of endurance. I’m presuming it’s related to my ongoing treatment but the march of Father Time could also be contributing. That bugger seems to walk Hand in Hand with The Man with The Hammer…..
Continue reading →
- Puncture Repair – A Lost Art? June 27, 2019Teocalli3252
Call me ecological, old fashioned or plain tight fisted but I still repair my punctures. Is it just me, as I don’t seem to know anyone else who does? Some other folk must, otherwise shops would not sell repair kits.
Of the few folk I know who have tried, most seem to claim they can’t get a reliable patch running high pressures around 100 psi.
Here are my steps for a good patch.
- Thoroughly check the tyre for embedded flint/stone chips. If the tube will hold some air I find this it best done before removing the tube with some air in the tyre. On removing the tube also check inside the tyre for any projecting objects that would re-puncture the tube.
- Find the puncture, either by putting air in the tube and slowly rotating close to your ear/cheek. You will likely hear or feel the air from the puncture. If that does not work use a bowl of water. Make sure there is not more than one hole. Check back to the tyre at the puncture point and make sure the offending object is not still in the tyre.
- Clean the tube. Nothing excessive and if you need to use a bowl of water to find the puncture then drying the tyre will suffice. I use talc when I replace my tubes so that needs to be washed off the tube before patching.
- Ensure the tube is thoroughly dry and then scuff the area around the hole with the provided sandpaper of abrasive pad. This is key to getting a reliable patch.
- Apply adhesive in an area larger than the patch to be applied. Just needs to be a thin layer evenly spread.
- Allow adhesive to dry till it is on the dry side of tacky.
- Apply patch and press firmly.
- Remove film from patch. Fold the tyre across the patch and the film should split. This allows the film to be removed from the centre and avoids pulling up the edge of the patch.
- Apply talc around the excessive adhesive. I still have the little John Bull French Chalk puffer I used as a kid.
- Preferably allow to dry thoroughly before refitting.
- I like to put some talc in the tyre and rotate the wheel to coat the inside of the tyre prior to replacing a tube. This helps prevent the tube sticking to the inside of the tyre.
Incidentally, I have heard folk say you can’t repair latex tubes. I run latex on #1 and have had no issues successfully repairing them, see lead photo, that patch has done many miles. Note – if you run Tubs and send them for repair these will be Latex (if of a decent make) and so will be patched by the repairer.
I usually draw the limit at 6 repairs in a tube before ditching. In this day and age of manufactured waste and redundancy it does irk me when I can’t repair something. It might take a while but surely, sometimes, that’s the whole point of doing something properly.
As for ‘cyclists’ who abandon their punctured tubes by the roadside I just wonder what planet they are from.Continue reading →