shoulder

Better Know Your Clavicle

The clavicle is the medical term for your collarbone. On one end, the collarbone attaches to the top of your sternum (the “breastbone”). The other end attaches to a bone of the shoulder blade. The clavicle provides considerable support for the shoulder. In fact, the clavicle is the only direct bony attachment that your shoulder has to the rest of your skeleton. The clavicle attaches to the sternum and shoulder blade by ligaments (strong fibrous bands of tissue). It has very few muscles to help contribute to the support.

Injuries

Clavicle injuries usually happen because of a trauma such as a car accident. They can also happen when you fall on your shoulder or outstretched arm. The result is either a broken clavicle or a ligament tear.

When a clavicle gets inured, you will feel pain at your shoulder blade attachments or at your sternum. Your shoulder may also have what is known as a “drop off.” This means your shoulder is lower than the other shoulder and has a noticeable step off rather than a rounded appearance. The pain may increase as your shoulder is lifted, especially when lifting over your head.

This clavicle here is broken very badly.  Ouch!

Treatment

In either case, the first treatment is to brace and support the shoulder for a period of time to allow the fracture or the ligament injury to heal. In severe or complete fractures, a doctor will need to set your fracture. The amount of time of immobilization depends on your physician’s opinion and the degree of the injury. In severe injuries, you may need surgery.

After a period of immobilization, you’ll need a more active rehabilitation program. Avoid lifting objects with your injured-side arm. Also, you will need to avoid carrying items such as purses or backpacks. At first, modalities such as ice, ultrasound or anti-inflammatory procedures may be used to help decrease the pain and reduce inflammation. Gentle range-of-motion exercises are helpful, usually in the lower ranges, avoiding overhead activity. As your range improves and your pain is reduced, the exercise program transitions to a strength program with range-of-motion overhead exercises.

Decreasing your pain level is key.

Patience Is a Virtue

Clavicle injuries may be difficult and painful to rehabilitate, depending on the severity of the injury and ligaments injured. Ligaments can be slow to heal, so rehabilitation may be slow and relatively long. It is important to have patience and not become frustrated during this time. In most cases the outcome is good. Consult your doctor or health professional for the details of your injury.

Written by Travis Rohner PT

Weightlifter’s Shoulder is a term that describes painful wear and tear of one end of your collar bone. It’s an injury that happens due to overuse.  It causes small fractures that can be quite painful and effect your range of motion. In some instances, something called osteolysis or bone breakdown occurs.

It’s called Weightlifter’s Shoulder because weightlifters are commonly affected due to the repetitive motions and heavy weight put on the shoulder joint when lifting weights. However, they are not the only ones affected. Jackhammer operators, baseball and football players and even soldiers can develop this problem.

Symptoms

The symptoms of this condition include tenderness over the front of the shoulder. You may also have pain while doing bench presses or dips, or you may be unable to do a push up due to the pain.  If you’re experiencing these symptoms it is very important that you do not try and push through the pain.  This will only lead to further damage and a longer healing process.

(Not being able to do a pushup due to lack of exercise is not a symptom.)

What Causes this Condition?

Repetitive stress from training and lifting can be a cause. For example, when your elbows drop below or behind your body during bench press, excessive traction on the AC (acromioclavicular) joint occurs. As a result, your shoulders extend too far.  If the bone does not have a chance to heal prior to your next workout, your shoulder can become painful and suffer from reduced strength and range of motion.

How to Treat It

Treatment for weightlifter’s shoulder usually starts with physical therapy and no surgery. This may include rest and changes in weight-training activities. You have to avoid over-training so that your joint can heal.  We can also help with suggesting modifications and design strength training for your condition.

(Rest is very important)

For those who don’t improve with therapy alone, or have a lot of damage to the shoulder joint, an arthroscopic surgery may be recommended. During the surgery, the surgeon removes portions of the damaged end of the collarbone in a procedure known as “distal clavicle excision”.  It is usually an outpatient procedure.  Most patients are able to return home the same day.

Physical Therapy is often recommended after surgery to improve strength and restore range of motion. Fortunately, most patients suffer no loss of function in the shoulder after surgery and are able to resume normal activities following rehabilitation.

Written by Travis Rohner PT