Q&A: Mending Bones

I was halfway round the first recce lap of the first cyclocross race of the season when my forks snapped… In addition to re-separating the collarbone I managed to break a rib and a knuckle. To try to speed up the healing I've paid for laser and magnetic treatment (on the collarbone) and a shoulder brace. Is there anything else I can do to speed up the recovery and get me back on the bike sooner?

Q: Back in the summer I crashed heavily in a road race. The end result was an ambulance ride, a three-piece collarbone and the loss of my favourite jersey. After 12 weeks I was cleared to ride again by orthopaedic surgeons; the bone hadn't fully healed, but I was in good shape with almost no pain. (I'd already been mountain biking in Glentress, but I forgot to tell them that!) Four days later I was halfway round the first recce lap of the first cyclocross race of the season when my forks snapped… In addition to re-separating the collarbone I managed to break a rib and a knuckle and lost another jersey and a gilet. To try to speed up the healing I've paid for laser and magnetic treatment (on the collarbone) and a shoulder brace. Is there anything else I can do to speed up the recovery and get me back on the bike sooner? My work colleagues have given me some stabilisers for the bike, so I should stay upright next time!

Dominic Castle

A: Dominic, your luck sounds atrocious, but the clavicle (collarbone) is one of the most common bones for cyclists to break. I broke mine a matter of weeks ago, so I feel your pain wholeheartedly! The reason a fracture here is so common is our tendency to fall directly onto the shoulder, transmitting the energy of the fall through what is a reasonably delicate bone. Falling on the outstretched hand can break it too, although your scaphoid bone or wrist are just as likely to go in this case.

As you know from your experiences, they're painful when healing because it's one area of the body where a broken bone can't be immobilised in plaster. The good news is that the clavicle is one of the fastest healing bones in the body, and an uncomplicated, standard single-break is well on the way to normality after four to six weeks. In spite of inevitable movement at the fracture site, nonunion (failure to heal) is rare, although you almost always end up with a funny-shaped, lumpy collarbone.

We all heal at different rates and speeding up your recovery should involve giving your bone the very best to work with. Pay attention to your diet, ensuring a balanced intake of fresh ingredients to provide your body with a plentiful and varied supply of nutrients. New cells have to come from somewhere, and there's truth in the phrase 'you are what you eat'! Calcium plays a greater role in fracture prevention than treatment, but there's no harm in ensuring at least 1500mg intake a day. I'm sure you don't, but smoking delays fracture healing and I would avoid alcohol too. There's a growing number of references in the research literature concerning the use of non-steroidal anti-inflammatory drugs (NSAIDS such as ibuprofen and diclofenac) and their potential to delay fracture healing, so avoid using these as painkillers and stick to paracetamol preparations instead. Thus far the jury's out on electromagnetic and laser therapy, although on balance there's more robust literature out there in favour of the former.

Getting back on the turbo trainer and exercising (in a sling if necessary) can be done in the early stages of healing, allowing you to maintain your fitness as well as adding an important psychological boost to your recovery.

On a final, positive note, it's worth mentioning that although a mended clavicle may not look perfect, it usually narrows the shoulder slightly, which of course confers a small aerodynamic advantage for time trialling. I keep reminding myself of this fact – but I definitely won't be in a hurry to break the other one to make sure! 

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