broken clavicle...surgery or not?

[berygu]

Quote: Originally Posted by alienator .

Adhesive capsulitis can be very severe. I had an excellent case of it after shoulder injuries and had to have a bit over 6mm burnt off the inside of my shoulder capsule. The worst part was that PT had to start the next day after surgery.
I'm sorry to hear this ...i hope you are ok now.
In the stage that i am right now i won't make any surgery for the capsulitis, but i am not sure that i will be 100% like before only with PT...my therapist sais that i will be because i regain the rom, and the stiffness will pass in time.

 

[alienator]

I'm perfectly fine, thanks.

 

[willy81]

berygu, Calm down a little and stop pushing yourself, The first big step is done, you had the surgery and now you recover. Recovery time differs, so you need to give yourself time and don't rush it simply because you will have the opposite result. At 5 months post op you still feel your muscles sore, weak and atrophied. Regular PT and gym will not shorten your recovery time, you need to give it time, lifting heavy is wrong, to revive atrophied muscles you need to lift light weights (say 2 kg) and make 100 repetitions. this is how muscles awake. But before all that I would still give full priority to the fracture, your bone has not mend fully, it needs more time until the fracture site is complete and it will be shown by the xrays you are going to have in 6 months post op. I am 15 months post op and still my muscles are not the same as before, I believe it has to do with the plate/screws which are still inside. When I have them out I believe I will return to full normal function. The metal stuff intervenes which the normal function of the shoulder. So, what you need is time, rest and moderate exercise with light weights. Professional athletes have a much shorter recovery time because they use different treatments regarding their muscle recovery, they use electrostimulation from Day1.

 

[bsbs1876]

*****, I don't follow your advice I'm at 7 months post op and I am lifting fairly heavy weights. I feel like it's really helping my muscles build and recover quickly. Like I said my rom and strength are amazing. My only complaint is the sensitivity of the area with straps and whatnot. I'm also playing golf a lot. I swing right handed and it was my left shoulder that was repaired. So imagine the amount if stress on the left shoulder. It actually powers pretty much all of the swing. No problems there either. So based on my experience, and yes everyone is different so take this as just an opinion, I would have to say "man up". Throw an extra 5 lbs on your exercises every two to three weeks and watch your strength and confidence rise!

 

[bsbs1876]

Oh also this isn't just a routine I made up on my own. My surgeons advice at 3 months was "light weights start now, ~15 lbs then progress every 3-4 weeks" I think he had the right idea, but nowadays it seems like no two docs can agree on anything, heh

 

[berygu]

Quote: Originally Posted by willy81 .

berygu,

Calm down a little and stop pushing yourself,
The first big step is done, you had the surgery and now you recover.
Recovery time differs, so you need to give yourself time and don't rush it simply because you will have the opposite result.

At 5 months post op you still feel your muscles sore, weak and atrophied.
Regular PT and gym will not shorten your recovery time, you need to give it time,
lifting heavy is wrong, to revive atrophied muscles you need to lift light weights (say 2 kg) and make 100 repetitions. this is how muscles awake.

But before all that I would still give full priority to the fracture, your bone has not mend fully, it needs more time until the fracture site is complete and it will be shown by the xrays you are going to have in 6 months post op.

I am 15 months post op and still my muscles are not the same as before, I believe it has to do with the plate/screws which are still inside. When I have them out I believe I will return to full normal function. The metal stuff intervenes which the normal function of the shoulder.

So, what you need is time, rest and moderate exercise with light weights.

Professional athletes have a much shorter recovery time because they use different treatments regarding their muscle recovery, they use electrostimulation from Day1.

Hi *****,
Thanks a lot for the good advice. I will use light weights 2-4 kg maximum at least until i reach 6 months post op. You are right with the plate/screws...it doesn't feel natural with them inside me, i believe some of the stiffness and pain it's because of this. Maybe i will go swimming , who knows, maybe it will help with the stiffness.
I also have the numb skin around the cut, it feels strange to touch, but this doesn't bother me that much.

ps: i think electrostimulation is prohibited because of the metal plate.

 

[berygu]

Quote: Originally Posted by bsbs1876 .

Oh also this isn't just a routine I made up on my own. My surgeons advice at 3 months was "light weights start now, ~15 lbs then progress every 3-4 weeks"
I think he had the right idea, but nowadays it seems like no two docs can agree on anything, heh
I will take a visit to my doctor and ask him about the healing point that i am right now, and what weights should i use.

 

[bsbs1876]

I will take a visit to my doctor and ask  him about the healing point that i am right now, and what weights should i use.

Also for what it's worth I'm not a big guy. After recovering from surgery I was about 140 lbs. I have since increased to almost 170 through lifting and eating properly

 

[bsbs1876]

Berygu, have you and your doctor discussed hardware removal at all?

 

[berygu]

Quote: Originally Posted by bsbs1876 .
Berygu, have you and your doctor discussed hardware removal at all?

Yes, he said at 1 year after the surgery i can remove the hardware.
I went to another doctor to ask about removal, this one said at 6 months i can remove it...but i will listen to the doctor that operated me and wait 1 year, besides he is the one that put the plate in, so he has to get it out.

 

[bsbs1876]

Quote: Originally Posted by berygu .
Yes, he said at 1 year after the surgery i can remove the hardware.
I went to another doctor to ask about removal, this one said at 6 months i can remove it...but i will listen to the doctor that operated me and wait 1 year, besides he is the one that put the plate in, so he has to get it out.



Yes, I think 1 year is the norm. My doctor says 9 months to a year.
Do you think this is something that you will elect to have? Lots of people choose to keep their hardware in for life.
I think I will have mine removed. It feels clunky to me.
Not looking forward to having the scar opened again and waiting for the holes to fill in though.

 

[berygu]

Quote: Originally Posted by bsbs1876 .


Yes, I think 1 year is the norm. My doctor says 9 months to a year.
Do you think this is something that you will elect to have? Lots of people choose to keep their hardware in for life.
I think I will have mine removed. It feels clunky to me.
Not looking forward to having the scar opened again and waiting for the holes to fill in though.

There where risks with the first op (infection, nerv damage, hardware failure...), there will be risks even with the second op, but i want to have the plate out, as much as i wanted the plate in.
I hope all goes well.
I don't know right now how much time it will take to have the holes fill, and how weak will the clavicle be after i remove the plate. I hope this doesn't mean i will have to take it all over again with the sling (dessault bandage) and lots of rehab after.

 

[bsbs1876]

Quote: Originally Posted by berygu .
There where risks with the first op (infection, nerv damage, hardware failure...), there will be risks even with the second op, but i want to have the plate out, as much as i wanted the plate in.
I hope all goes well.
I don't know right now how much time it will take to have the holes fill, and how weak will the clavicle be after i remove the plate. I hope this doesn't mean i will have to take it all over again with the sling (dessault bandage) and lots of rehab after.


You will need to wear the sling for a bit after the hardware is removed, but not for as long. You should be able to use the same PT but start earlier. So make sure you are making note of the exercises that you are being taught now. The recovery will be much easier because nothing is being broken or moved around. Though it is still quite invasive, it is much less invasive than the original operation.

The clavicle will be weak for 4-6 weeks. My doctor sends guys back to riding motorcycles at 6 weeks after removal and he has not had a single re-fracture as long as they adhere to this advice.

I will be going in to have mine removed in the new year. I plan to get back to walking/riding a stationary bike fairly quick to stay active. I will leave the weights alone for 6 weeks and let everything heal up but then I am going to go right back to light weights and get myself back to where I am. I want to aim to lose as little fitness as possible while still being cautious.

 

[berygu]

Bsbs,
I showed you the xray of a friend of mine who fractured the clavicle in the same month as me, but his doctor never told him to wear a sling, he left his arm free.Indeed he has full rom and no pain , no stiffness from what he is telling me , but his xray lookes like this. I am not a doctor ,but to me the plate looks a little bent and the fracture still not to healed.

 

[bsbs1876]

Quote: Originally Posted by berygu .
Bsbs,
I showed you the xray of a friend of mine who fractured the clavicle in the same month as me, but his doctor never told him to wear a sling, he left his arm free.Indeed he has full rom and no pain , no stiffness from what he is telling me , but his xray lookes like this. I am not a doctor ,but to me the plate looks a little bent and the fracture still not to healed.




When was that x ray taken? It does look a bit messy in there.... My doctor didn't use the horizontal lag screws. At least if he did he didn't leave them in there. I have 10 screws that all go vertical down into the bone - 4 on the left and 6 on the right (when looking at x ray).

 

[berygu]

Quote: Originally Posted by bsbs1876 .

The clavicle will be weak for 4-6 weeks. My doctor sends guys back to riding motorcycles at 6 weeks after removal and he has not had a single re-fracture as long as they adhere to this advice.

if 6 weeks it's all that takes to be sure you won't have a re-fracture then it's ok , but this time i will move a little the hand in this 6 weeks to not have to suffer again with the stiffness and problems with ROM.
I will watch this thread to see how you are doing after the removal, and hope all goes well.

 

[berygu]

Quote: Originally Posted by bsbs1876 .

When was that x ray taken? It does look a bit messy in there.... My doctor didn't use the horizontal lag screws. At least if he did he didn't leave them in there. I have 10 screws that all go vertical down into the bone - 4 on the left and 6 on the right (when looking at x ray).

on 23 august

 

[willy81]

bsbs, I still believe relative light weights (2-4kg) AND many repetitions have much better results to revive atrophied muscles. You can lift heavy, I do and I have done 2 months post op but the result was not what I expected. Tendons need small weight/many repetitions to reactivate. berygu, I believe you need to wait 12 months minimum before you have the hardware removed. All surgeries have a certain degree of risk which is kept to a minimum if they are performed by an experienced Doctor and his/her team. For sure I will have mine removed when I can. berygu, how did you break your clavicle? I guess in a sport accident, but what kind and how/ I just want to figure out if your muscle problems are due to the surgery or the severe impact during the accident. I had a severe impact and part of my muscle problems are still due to the impact.

 

[bsbs1876]

You're right, *****, low weight high reps is great for waking the muscles up so to speak. I did this for 2 months when I first began at the gym.
You can continue with a routine like this if you want to tone yourself and train for endurance, but my goals currently are for gaining muscle and strength. This is why I have been increasing my weight and lifting heavier each month.
Everyone has different goals of course!

 

[willy81]

bsbs, when the hardware is out it will be only a matter of a dew weeks to get your muscle mass back to normal or even increase it, I believe the hardware intervene with normal muscle development