Help! My collarbone is getting in the way!

[Scuby Dooby]

About 1 week ago I was in a motorcycle accident. I took a bit of a tumble down the road and landed REALLY hard on my left shoulder – dislocating / spraining my clavicle. It’s been a week and with physiotherapy for 3 straight days I can now just about lift my arm over my head and I’m no longer using a sling (except on the subway, the crowds here are pretty brutal and the sling keeps it from getting jostled). The pain and swelling are much better though not completely gone.

OK, now the REAL problem – I am scheduled for a dive trip to the Philippines on Friday with a good friend who I only see a couple of times a year. That gives me three more days of recovery before I’m due to be in the water. If I do dive I’m going to go really easy on my left side – no carrying gear (that’s what buddies are for right?) , I’ll jump in and put my gear on in water, get help climbing onto the boat, etc. Actually, the 2 things I anticipate will be most difficult are putting on my wetsuit and climbing the ladder into the boat. We dive from bancas in the Philippines, they are fairly small outriggers and the only way back in is to pull up onto the boat or climb a small ladder – no dive platforms available to say the least!

I asked both my GP and physiotherapist what they thought about my diving this weekend. Neither ruled it out, basically they said let’s see how far I get by Friday and if I do go that I ‘shouldn’t dive too deep’

Does anyone here have any other words of wisdom for me regarding diving after a nasty sprain / partial dislocation? Are there any concerns re DCI with a healing injury that I should be aware of? Etc.???

Many thanks for replies, especially the Docs!

 

[beche de mer]

Are there any concerns re DCI with a healing injury that I should be aware of? Etc.???

DCI is more likely to occur in injured tissues. The only DCI hit I ever got was in my left elbow - in which I had been experiencing tennis elbow for the previous 2 months.

Be super conservative with your dives and ascents. Maybe extend your safety stops.

I'm guessing that you have an acromio-clavicular dislocation. (Or partial dislocation.) If so, you'll have a prominent lump at the outer end of your collar bone. This injury will certainly be aggravated if you carry any weight with that arm. Climbing back into the boat could be a problem, but if you divest yourself of all your gear in the water, you should be OK with a bit of assistance. Just hope you don't have to swim any distance.

Have a great trip.

 

[clementyn]

hi,

don't know how much patient education your md and physio there have done with you, but here is my "for information purposes only - seek your own medical professional's official advice regarding your case/care" attempt ....

acromio-clavicular (acromion process of the shoulder blade and the distal/outside end of your collar bone) dislocations/sprains are usually grouped into one of three categories.

1) partial or full disruption of the acromioclavicular ligaments which help to stabilize the joint between your shoulderblade and collarbone - usually seen in the clinic with fairly good outcome given time, rest and followed up by appropriate rehab

2) partial or full disruption of the stronger coracoclavicular ligaments which stabilize the joint - without proper time, rest and rehab, patients sometimes continue to experience instability at the joint with time which may manifest in weakness or more rapid onset of fatigue of the shoulder complex with activity. can also see involvment at the sternoclavicular/costoclavicular joint (where the collar bone attaches to your breast bone and first rib).

3) full disruption of the ligaments above combined with avulsion (tearing away from the bone) of the anterior deltoid (major muscle of the shoulder complex) - these patients are often surgical repair candidates and will require more extensive periods of treatment, rest and rehab. can see involvment at the sternoclavicular/costoclavicular joint (where the collar bone attaches to your breast bone and first rib) here too.

if you were my patient (and you are not , my worry with an early return to more strenuous activity would be threefold, and i would want you to make your decision weighing the factors.

1) your md and physio may not be divers and may not fully comprehend the actual and potential demands diving would place on your newly injured shoulder. although you may be able to avoid stressing the joint with gear and suiting up with a little help, the senario in the water may be very different. even if you 'take it slow and easy' you never know when you or your buddy's life might depend on your ability to use that arm. if you get there and are still experiencing limited range of motion, pain with motion and/or noticing rapid fatigue of the muscles supporting the joint with activity, give serious thought to what you might need to do with that arm in an emergency.

2) sprains are partial to full tears in the conective tissue that holds your joints together. these tissues are fragile in their present state of healing and can become a chronic life-long problem with weakness and instability if not given the proper time and rehab to heal. ask your md frankly how fragile your shoulder is and get an idea for the limits he/she wants you to observe in planning you dives (specifically weight bearing, positions to avoid altogether and positions to avoid straining in).

3) as beche pointed out, there have been many threads with input from the scientists in the group discussing issues of injured/inflammed tissues and increased DCI risk.

it is my recurring nightmare before every big trip we plan that my hub or i will do something to impede our week of underwater bliss... i truly empathize. hope this helps you make a more informed decision and glad it was an accident you walked away from.

dive safe. - lorien.

ps. don't know what the legalese/releases are like on the boats in the phil. but you may want to print out an md waiver off of one of the agency websites to take with you...

 

[chrisch]

I don't know about the diving so this is just to cheer you up. A few years ago on my way to a friend's I was too enthusiastic on a bend with my old Z750 Kawa. As well as hurting the bike I broke my collar bone.
I rang my friend to say I couldn't make it so he came over to see me in his old VW camper van. As his journey came past the hospital he offer to collect me.
Now, my friend is a bit dumb at times so on the way home we ran out of gas..

So we ended up pushing the van to the gas station - me with a broken collar bone...

It has healed now and I am back diving.
Chris

 

[Scuby Dooby]

beche de mer, clementyn, (and even chrisch for the laugh),

Many thanks to all of you for the informative answers. I'm off for a last physiotherapy appointment this afternoon and flying out to the Phils tonight. Still not sure whether I'll dive or not, interested as to what the physio thinks of the idea at this time. Swelling is down and my range of motion seems to improve every day - I can just about lift my arm all the way above my head, thought it is a bit painful and weak still. Oh well, even a weekend at the beach is better than being here and going to work!

Thanks again, Joe