Doctor, heal thyself
There is a saying in cycling about broken clavicles: "There are those that have, and those that will" (break their collarbone). Over the years, yours truly has had a shoulder separation, and broken clavicles on two separate occasions. For those of you that have had both broken a collar bone and separated a shoulder, you know that the clavicle typically heals in a matter of weeks and feels pretty good, while a separated shoulder hurts for months, and I'd take a broken clavicle over a separated shoulder any day of the week.
Which brings us to the Mississippi Crit last night. It was a fun, fast race with lots of primes. With two laps to go, a rider went down in turn 1, and two of us right behind him went down too. Fortunately everybody was basically OK, but my shoulder did not feel good. Having experienced the joys of both clavicle fractures and AC separations previously, this felt more like the latter. Thankfully, my go-to Chiropractic Physician Dr. Noel Snodgrass was willing to meet me at his office for some quick treatment. This is where we took this picture:
As you can see from the picture, something is wrong with my right shoulder. Directly after the crash I checked it out and it seemed OK. Dr. Mike Murry was also on the scene last night and did some poking and prodding of his own, and the consensus at the time was a separated shoulder, most likely grade 2.
Dr. Snodgrass did some assessment of his own, but it became increasingly difficult to tell anything because everything was so swollen. We did some cold laser and kinesio-tape, both of which have been tremendously helpful on prior clavicle injuries. With my last clavicle injury (fracture) in 2004 I did treatment with cold laser etc within 12h of the injury and was back on the bike in less than a week, swimming in 3 weeks, and did a triathlon 5 weeks out. So, by treating the injury less than 2h after it happened, I was hoping that we would make good progress in short order.
Dr. Snodgrass graciously allowed me to bring home his cold laser so I could continue treatment. I did one more treatment before bed and then got up 2x at night to do more treatment.
Results Speak for Themselves. The picture above shows my shoulder this morning around 11:30, 16h after the injury. The swelling is down markedly and is feeling pretty good. Mobility is definitely not happening, but we'll work on that later today.
So, the reason for writing the post is to talk about what can be done for this type of injury to speed the healing process. The standard treatment for something like this is PRICE (protect, rest, ice, compression, elevate). All of these things can help, but it is hard to compress or elevate a shoulder. There are several other things that I have been doing that seem to help with the injury, and I have seen similar results in my practice and with other athletes:
- Cold Laser, starting as soon as possible. Cold laser is an FDA approved treatment which speeds the healing process and has been shown especially effective for acute swelling. With an injury like this, much of the pain comes from the swelling itself, so bringing down the swelling goes a long way.
- Kinesio-Tape. This stuff has been around for a long time, but had its "coming out" party at the Beijing Olympics. Who can forget the beach volleyball players with taped shoulders? This stuff also helps with swelling and support. In Lance Armstrong's book, he talks about the "magic tape" they were using, it was kinesio tape (k-tape).
- Wobenzym. This is a combination proteolytic enzyme product. Proteolytic enzymes were the go-to anti-inflammatory before NSAIDS came on the scene. The good thing with proteolytic enzymes is they are natural and have no side effects.
- Arnica. I've used it for years. Products like Traumeel have had double-blind placebo controlled studies done that show that they decrease inflammation and pain better than NSAIDS. Another natural product.
- Ibuprofen. Works great for this type of thing.
- Hammer Nutrition Tissue Rejuvinator. Another combination product with proteolytic enzymes, glucosamine, chondroitin, MSM, Type II collagen, etc.
So, it might seem like a lot of work to do all this, but basically I am taking some medicine, doing cold laser every couple-few hours, and working on maintaining my shoulder ROM. There is some clicking in the shoulder currently, so maybe there is a fracture? I may get an x-ray tomorrow. My current best guess is a grade 2 AC separation, torn upper trapezius grade 1 and a non-displaced distal clavicle fracture. The good news is that I can still do everything I need to, including changing our baby's diaper :-). Not sure when I'll be back on the bike, but I'm thinking the Test of Endurance is off my calendar. Was really looking forward to that and had registered weeks ago. Ah well, next year.
Labels: racing, sports injuries
