Collarbone: On the Mend (And On the Run!)

All has been going well, aside from a couple rough nights of sleep. After meeting with my Orthopedic Surgeon a couple weeks back we finally decided on what approach, healing or surgery, would be best. This conclusion came about for a variety of reasons, which I will summarize as best as I can:

*Very Important Note: This is my individual experience and is simply to give a little insight to my injury. Every single case is different, so this is my experience and really only applies to individuals who have a 50/50 shot at no surgery vs. surgery. Many cases are either definite surgery (shatter) or definite natural heal (fracture but little or no displacement). Mine was a fracture with enough displacement to make surgery a possibility, but not enough to require it. If you ever think something different from your surgeon TALK IT OUT, they are professionals for a reason. If it still doesn't seem right/smart to you then get a second opinion, being too sure cannot hurt especially when it is your body.

On to my experience:

I really wanted surgery. Four and 5 nights after the break I was miserable. I don't like medication or painkillers (tylenol/advil I'm okay with but I will take as little as absolutely possible). I couldn't sleep, was uncomfortable to a pretty maximal level (I have a pretty good tolerance with discomfort), and generally not loving this whole process. The 6th night I took Tylenol PM and I have never taken a sleep aid in my entire life, so I passed out for 12 hours and when I woke up I felt amazing, but my shoulder was another story - the Tylenol PM made me sleep through shifts and I didn't wake up when it hurt...so it hurt for three hours after I woke up. From there on out things got a lot better.

Natural Heal:
Pros:

• No surgery, anesthesia, or hardware (this is pretty huge, noting the inherent risks of going under and having hardware interfacing)
• Ability to resume activity is based almost solely on if it feels comfortable (aside from arm impact things like skiing and pumping the iron)
• Being able to say my body doesn't need metal to be complete

Cons:

• There is a small (10% or less) chance of non-union, which would require surgery at 6-8 weeks through healing...and then 6-8 weeks additional recovery from that
• You don't know when you'll be able to resume activities
• Some additional discomfort in very early healing stages (note: breaking bones is not supposed to be comfortable...you destroyed a naturally functioning part of your body, so don't expect it to feel 'only a little bit bad')
• Not being able to call yourself a "bionic man" (or woman)

Surgery:

Pros:

• Knowing an exact timeline and specifics of when activities are permitted
• Guaranteed recovery by a (very well) estimated date
• More comfort in early recovery

Cons:

• Surgery (cutting stuff open - infection; anesthesia - inherent risks; and foreign, albeit bio-compatible, objects in your body)
• Metal + bone usually leads to some magnitude of a thing called stress shielding, and removing the hardware can lead to problems - a portion of what I have come across has been leaving the metal in typically works out fine and taking it out can be problematic
• Even if it feels 'good' or 'comfortable' your surgeon dictates what you do, and you have no say to push things sooner

So, both have a very good side and another side that isn't that bad. What did I decide to go with? I was initially pretty convinced I wanted surgery, but I talked it out pretty seriously with my surgeon - I spoke with him a couple days after my first appointment on that Friday, and then again at the next appointment on Tuesday, which was to check in to see how the first (miserable) weekend was. At the appointment 1 week out from the break we decided to continue this approach, switch to the figure of 8 brace to place my shoulders in a better healing position and then take x-rays a week from that day (2 weeks out from the fracture). At the 2 week appointment, the bone appeared to be in the same or, if not, better position. And it seems as though the bone has started to regrow. I had been able to sleep better and got better acclimated to the figure of 8 brace.

How are things at week 3? They are going well and, as expected, I have bouts of moderate discomfort, but that is usually from being out and standing up/moving around for hours or getting a real good workout in (read: self-induced discomfort!). Aside from that, I'm doing more than I probably should...but if I hit a decent level of discomfort or any real pain, I back it off immediately. If this continues I call it off and rest my shoulder. I have been steadily cycling on the trainer (no hands thus far) and had been strictly walking until a little under a week ago. I ran Wednesday (1mile WU, 3x0.5mile, with 0.5mile walk for rest). I have run nearly every other day since then. Luckily I have a pretty smooth stride, otherwise the bouncing would be pretty painful. At jogging paces (10:00/mi) it was too bouncy to be worth running, at 8:00-9:00/mi it was better, but not optimally smooth. I was reminded extremely quickly that running faster = smoother, and played around with pace enough that 6:45/mi feels pretty much optimal as much faster and (with my complete lack of running training) it would require a legitimate arm swing.

I'm definitely looking forward to being close to cycling outside, which is probably 1 week. The real big thing is that I am running 23 miles on my 23rd birthday (January 26th). Without having done an actual run yet, I am 7 weeks out from the run and haven't run more than 10 miles in a week since the first week or August. I haven't run more than 5 miles in back to back weeks since my front wheel broke and I wasn't able to bike.......in June. I have written my training plan to get to the 23 miles, which sets my first actual run for Saturday: 4 miles. The next Saturday is 10 miles, and it just builds from there.

Thus far I'm glad I am going with the natural heal, and will continue to be quite happy as long as everything is clear in 3-5 weeks (which will be a total of 6-8 weeks from the break, the normal expected "full heal" time frame). As always, if you get any injury (especially traumatic injuries) go see a specialist and listen to him or her...you will not regret it.