An Ode to My Collarbone: Real Advice In Case You Suffer This Common Cycling Injury

As I looked up at the pretty yellow aspen leaves fluttering against the blue Colorado sky, all I could think was, “F@&k, that was my collarbone.”

I didn’t intend on sky gazing on Monday. I was only on the ground looking up at the leaves because a deer took me out while I was descending The Chutes, a popular trail in Colorado Springs. He had been munching leaves off to the side of the trail and, upon noticing me, decided to jump toward me instead of the other way. In truth I don’t know if the deer hit me or if I hit him, but in the end he pranced away and I had the pleasure of riding a few miles of single track nursing a broken collarbone.

A broken collarbone is the second-most common cycling-related injury, second only to abrasions. In 40+ years of cycling I have broken my left collarbone twice and this time I broke my right one. I am not a doctor and would not presume to give medical advice, but here are some recommendations for dealing with the immediate aftermath of a broken collarbone.

Check yourself

Sometimes it will be clear you broke a bone. Other times all you will know is that something in your shoulder really hurts and it’s limiting the function of your arm. As painful as it is, force yourself to check yourself out beyond the focal point of that injury. Did you hit your head? Are you bleeding profusely from your knee? Do your other limbs work? Do you remember where you are? Remembering to perform a comprehensive body check is important because it’s possible the broken collarbone is not the worst of your problems.

Evaluate your options

If you’re riding with someone you will obviously have someone to help you get home or get help. And though riding with partners is the safest way to go, let’s admit it, a lot of us ride alone some or all of the time. If you’re by yourself and break your collarbone, consider yourself fortunate. Yes, fortunate. It might hurt, but if a broken collarbone is the worst of your injuries, you have a lot going for you. If you’re breathing and your legs still work, you may be able to walk or ride to a place where you can get help. In contrast, in 1986 I broke my femur in a back-country ski accident. I wasn’t alone, but I also couldn’t do much to help myself and even with a group of people it took more than 5 hours to get me out of there.

If you have any doubt about being able to help yourself, call 911. If you are far from home, in an unfamiliar place, or don’t have friends or family nearby, calling 911 or search-and-rescue is a good idea even if you think you can walk/ride your way to safety. If you are close to home and confident you don’t need help from a first-responder, at least call a friend or family member to let them know what happened. It’s important to do this before you start walking or riding again so someone knows where you are, what happened, and that you are planning on walking/riding to safety. That way, if your condition deteriorates that person can come get you and/or send help.

If you’re going to go, get moving

Your body has a remarkable ability to shield you from intense pain, but only for limited time. If you decide you are walking/riding your way to safety, take advantage of this time to get your stuff together and get moving down the road or trail. In my case, I had about 3 miles to ride on single track to get to my car. It was uncomfortable, but manageable. And keep in mind; some of this “fight-or-flight” response is based on the situation, not just time post injury. It was only once I was back to the relative safety of the car that the pain really started to intensify.

Go to the hospital and consult an orthopedist

When you get back to safety, go to the hospital to get checked out. But even if the emergency room doctors tell you it’s a simple break that will heal by being in a sling, make an appointment to see an orthopedic surgeon. Best case scenario, the ER docs were right and you wait it out. But as an athlete, the extra doctor appointment is worth it so you can make a plan to return to your active lifestyle at full strength.

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Don’t overdo it with painkillers

Depending on who you see in the ER or physician’s office, you may be offered heavy-duty opioid painkillers. Those medications are great for managing pain but have the potential for addiction, as evidenced by the current nationwide crisis of opioid addiction. This is only my opinion, but I would rather be uncomfortable in the short term than develop a long-term dependence on opioids. As an athlete you are accustomed to being uncomfortable. You actively seek discomfort in order to improve your performance. Broken bones heal and the pain is temporary; don’t overdo it with painkillers and risk creating an even bigger problem for yourself.

Looks like either the angel or devil on my shoulder left an imprint…

What about getting back to training? I’ll cover that coming up soon!

Chris Carmichael
CEO/Head Coach of CTS

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Comments 53

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  3. Hello Chirs
    Sorry to hear the news..but glad you are able to share and advise. Thank you, as always, for the welcomed tips of the trade. Also kudos for calling out the pitfalls of opioid painkillers something that I always preach to people. Hope you recover well and quickly

  4. Ouch! Get well soon. I found denial to be an important tool when I broke mine. I was late getting back to a family function in Denver when I failed to bunny hop a small concrete drainage near Cherry Creek. I refused to acknowledge that I might have broken something until I got back to my in-laws’.

  5. Hi Kidd!
    Sorry you hit the deck! Hate to see what happened to the deer!
    Your body continues to train and recover at an amazing rate, as it did when you were a professional athlete.
    You are not only body aware, but highly functional in crisis situations such as a Tour de France level crash, or a back county incident such as this.
    Kidd, I know you will stay on top of your pain and swelling. And I am so glad you had no intercostal involvement.
    Ribs out of the picture, you might be slightly more comfortable.
    I know you will be on your trainer soon!
    Love you, and looking forward to seeing you and the boys at the Fig Fondo in Nov!

  6. Get well soon!

    I don’t know if the name rings a bell…you autographed a pic for a friend of mine in 2012…I still have it. “You will be back stronger than ever!” I am still not riding but, I am stubborn….

  7. Sorry to hear about your Deer encounter and the subsequent broken collar bone,never fun stuff when that happens. Hope you are healing up well and get back to teaching and riding right away. I think eating lots of tofu, tempeh is the key:))
    Heal up soon,

  8. Great article, Chris, and looks nasty! I almost had a similar run-in with a deer earlier this year, but luckily, he paused as I zipped by. I’m betting your experience on the bike prepared you for this with an innate response that made a difference!

    Looking forward to reading your thoughts on getting back into training. I am coming off an incident this summer where a car hit me causing damage to both Shoulder Rotator Cuffs plus other ancillary injuries, but luckily, no broken bones. I’m off the bike for a period of time and back on Kickr while I deal with sequential surgeries.

    After reading all of the commentaries, its amazing to see so many cyclists dealing with such a large range of injuries, many quite serious, and all fighting their way back! Very inspiring as I plan my own comeback.

    Wishing you a quick and easy recovery, Chris!

  9. Praying you recover quickly. I broke my right collarbone the last Saturday of August while racing at the HotterN Hell 100. A cyclist went down in front of me I was drafting behind in the pelaton.

    I drove myself home to Emporia, KS 6 hours away and went to the ER. I just ditched the sling last week and am back training and even started swimming laps again.

    Get better!

  10. I have broken both collarbones – the first time compounded. I am a Veterinarian and couldn’t afford 6 weeks in a sling. Plated both times…back to work doing surgery in 3 days. The broken/cracked ribs were the main pain issue after the collarbone was stabilized. Plates are still in no real reason to remove them.

  11. Sorry to hear this. Heal well. You’ve made me more cautious. Don’t want to look like that! 🙂 Like “Red Asphalt” for bikers.

  12. Sorry to hear about your injury/hope you heal quickly!
    I can’t help but make a connection in my own life about aging and injuries when I read stories like this (I know the dumb deer has nothing to do with your age, Chris, but the choice to push it on single track alone is a distinct decision that seems to become more and more ‘real’ as I age).
    It really seems like the injuries have ‘picked up pace’ both in cycling and my other backcountry pursuits since I entered my 50’s. And it’s caused me to start wondering if/when/how I should be making adjustments to my athletic/adventure endeavors. Who writes about this topic out there? How have others traveled through this issue with both wisdom AND a refusal to give up on an adventurous lifestyle?

    1. Age is a mindset, and life is short. Be thankful that in our 50’s we can still do these things. I’d rather suffer a few broken bones than a heart attack. Ride on!

    2. Like Randy said….
      Be thankful for the opportunity in life to still be out there brutalizing your body. Mine has 58 years of full abuse and still reveling in it. Seventeen different broken bones, seven surgeries, countless months on crutches, many more months laying in place with busted back….wouldn’t change a thing! It’s the price of being a “mature” athlete. Another injury is just a badge of honor. Just imagine the alternative- maybe sores on your arse from sitting on the couch watching tv…..kill me now!

  13. Hi Chris – Have to say that over the 37 years of riding and racing I’ve hit the floor my share, too. Absolutely agree on the inventory step immediately post-crash. Even in a race where your urge is to get up and go right now, stop and make sure you are 100% (if only scraped up).
    As to the pain killers, sometimes you have to use the stronger products. Years back I had stacked it to the tune of six broken ribs, cracked scapula, busted humeral head in the left arm, AND a collapsed lung. After a six day stay at the hospital I rode the couch for another 5 weeks before I started PT and riding a little. During this period I was on an opioid and tried to stop too soon without discussion with my doctor. Besides still being wrecked I was literally sick as a dog, too. When I shared this with my doctor he said he appreciated my desire to not take the painkiller but that the taper is there for a reason; I had bad case of withdrawal. Lesson learned-I’m no doctor so don’t try to be one. Know your body but follow your doctors advice.
    Heal fast,
    Bruce Lee

    1. Thanks for sharing your comments. I struggle right now with stopping oxycodone- I think I’m close but yeah I’ve fought the whole way along. I’m 7 weeks into my cycling accident now, where I fractured 7 ribs, CRUSHED my collar bone, punctured a lung, concussion and various scraps and bruises. Btw not a scratch on my legs for which I was and continue to be grateful. No broken limbs – also a huge plus as Chris mentioned. But the pain on my right torso and shoulder/arm from the recovery period has kept me in a whirlwind because I have disliked being on a drug. My surgeons (yes, all plated up inside) constantly assured me to listen to my body and continue the drug until my body didn’t require the pain killer anymore. Incidentally, I’m down to 5mg every 6 Hours, alternating with ibuprofen (so every 3 hours I get some relief). In my husband’s earlier crash this year, fracturing 8 ribs, he stopped the drug within one month and has continued ibuprofen as needed. My lung capacity, a worry when taking oxy, is worked out with taking daily walks and having stairs I go up and down throughout the day. If a body remains in pain, it will slow the healing process. It’s important to consult with your surgeons/ doctor then “listen to your body”. And relax. You will see better days again.

      1. Cathy,
        Thanks for your detailed response here of your injuries and recovery, and the mention of oxycodone.
        On Friday the 13th this year, I was riding down a steep hill that curves to the right with a blind spot. A baby fawn jumped in front of me from my left. We got tangled up and I went flying. Broke my helmet, 8 broken ribs, broken collar bone, and a collapsed lung. All injuries to my right side. Thankfully I’m a Southpaw. The EMT guy in the ambulance asked me if I knew where I was? Not a clue I said. Told me they were taking me to JHU trauma center in Baltimore. Tube inserted to release gas and fluid in my chest. 5 days of pain in the hospital. Oxycodone, Ibuprofen, acetaminophen and Gabapentin to take the edge off. Now home and bored to tears. Down to one oxycodene at night. Helps for sleeping. I ride every day, at least150 miles a week for the last 25 years. Gonna suck for the next couple of weeks, but I know soon I’ll be on my bike again. I turn 60 this Sunday.
        Chris, my shoulder looks similar to yours, but I also have a huge nasty yellow bruise and what looks like gun shot bruises at and below my arm pit.
        Anyways, thanks for the article and follow up comments. It helps while I recuperate.

  14. My concern is that if I’m out on the bike alone, have an issue requiring EMS, what am I going to do with my equipment/bike, or worse, what is someone else going to do with it….

  15. Just had surgery to plate mine. Distal fracture. Hit a rock at speed on descent. Back on the Kickr. Be awhile before I’m back outside on my road bike.

  16. I could write a similar coloumn for trail runners and broken ankles. Two days ago I just snapped my left ankle at the end of a wonderful desert trail run. This is my fourth broken ankle. 2 on each side. I have a similar process of evaluating the circumstances. The first is determining if the ankle can bare weight or not. Then I figure out how I am going to get back to a safe place. Usually I am able to use the adrenaline to motivate me to push through he pain and limp back to my truck. But 2 years ago I had to be plucked off a mountain top by a helicopter rescue team. People always ask why I keep going out and putting myself in situations where I could injure myself again. It’s hard to convey to them why but anyone reading your newsletter already knows that I really don’t have a choice. It’s what keeps me happy. Hope you have a speedy recovery and can be back out in time for ski season!

  17. Broke and ankle recently and the doctors asked me to stay away from Ibuprofen until the bone healed. Ibuprofen appears to slow down bone growth.

    1. Thank you, Patricia & Cynthia, I did not know that. My doctors are having me on a regular schedule of ibuprofen. Since just reading your comments, I googled this and seems to be common knowledge. Very frustrating since I’ve been questioning why my recovery is taking sooooo long. Doctors just say everyone is different. No caution from them about slow bone healing using ibuprofen has been given me. I will adjust. So I’m glad I caught your comments. Thanks!

  18. A few years ago I was riding on a country road being remolded for resurfacing. I hit a 2in lip at speed where the work had stopped. The bike also stopped and I went over the bars. I took inventory, regained my breath and checked my bike. All seemed OK. I got a couple of ibuprofen from a friend and proceeded to ride 15 miles home. My shoulder was sore but I had full range of motion. I figured I’d pop some more ibuprofen and get up sore as hell the next morning. Until I got home, took off my jersey and saw a non-standard bump on my right shoulder. I got to my doctor and found out my collar bone was broken with 3 ribs and a “slight” lung puncture. They sent me to a hospital emergency room. By the time I saw a doctor there my lung had deflated by 40% and had a couple more broken ribs. I needed a chest tube and a trip to a trauma center. I recovered without any surgery and was back on my bike (all be it on a trainer) in 6 weeks or so.
    The important thing here is that while whole time my pain level was 2 to 3 max AND my oxygen level never fell below 92% if I had tried to tough this out for a day or so I might have died. Pain level does not always indicate the level of trauma.

  19. Chris, all the best with your recovery. Hope you’re healed up well enough in time for the Fig Fondo in November.

  20. Shoulder point also is a good one. Uncommon fractures of the lateral clavicle occur where the ligaments that connect the scapula are destroyed. In that case do NOT get a “hook plate” to attach the scapula. It impinges on other shoulder structures. The better docs use cadaver ligaments. Wish I knew that 2 years ago.

  21. Sorry to hear but you had a crash but you are strong and will heal quickly. Separated shoulder, broken pelvis, hand and ribs here. I have been biking for 48 years so these are to be expected. However, 6 weeks ago I crashed and was knocked unconscious. I didn’t come around until I got to the hospital which was near by. Concussion and bruised ribs. Cat scan showed no brain issues but the ER Doc said the helmet saved my life. It was cracked badly on the left side. Crash was my own fault. Luckily a EMT saw me go down and stopped. He got my contact and medical info from my Road ID. There were other riders with me but if I had been alone the Road ID would have been vital. This crash was the scariest as I was knocked out face down on a busy road. I highly recommend the Road ID and of course a helmet whenever you get on a bike.

  22. Great reminder about deer this time of year. They are very active daytime use single track MTB trails more often than we do. Deer took me out last week on single track. Now we post home made deer warning signs in appropriate locations. A buck in rut could be a real nasty problem.

  23. Welcome to the 3X club! ’76, ’01, & ’10 (all left side). In my case there were some lingering questions as to whether the bone ever developed a solid repair after the first break. After the third, and it was apparent this one resulted in a complete non-union, I opted for surgical repair a year after the fall. This was a mistake, too much scarring & many bone fragments resulting in 5.5 hours of surgery and consequent bruising of the brachial plexus nerve, left me with almost no use of my left arm for some weeks after surgery. Now some six plus years later, I still have significant numbness in my left hand, and perhaps 80% of the strength I formerly had. In hindsight, I should have left well enough alone. The non-union was a bit disconcerting, but I was back in the gym doing shrugs with double bodyweight, and every other conceivable weight bearing exercise without pain. I think I was a bit mislead by the path that seemingly every pro rider takes after a clavicle fracture toward a surgical repair. My surgeon was highly experienced, but given that my three breaks over 34 years left quite a mess to repair with a plate & 12 screws, this was a bridge too far. Don’t opt for surgery if you do not absolutely have to! Seems pretty obvious looking back on it. Next life I’ll know better. Still riding my bike though, and oddly enough, it’s perhaps the only time I’m not particularly aware of the numbness in my left hand.

    1. i agree with 3 time,,,i’ve had 2, one in 5 pieces,,i am a veterinary orthopedic surgeon,,when i had my consult,,the dr was all about lets get you scheduled,,and on xray,it looked real bad,,but in between sentences i kept hearing red flags about the surgery,,i went home,,spent 3 hours googling results from this fracture,,and opted not to fix it,,recovery was great,,i am 100 percent,,and had non of the post op restrictions and rehab,,with my life ect,,i could not see going thru 6 weeks in a sling,,now,,i am not saying never cut these,,yet most bikers with multiple fractured collar bones will say that,,me included

  24. One thing I would add to the return to being an athlete comment…consult a good sports PT ( when okayed by orthopedic of course ) There will be soft tissue injury as well. Proper mechanics of the shoulder will need to be relearned.

  25. Chris,
    Thank you for sharing your story. Hope you are not in too much pain.
    Wishing you a speedy recovery!!!
    Be Well,
    NJ, USA

  26. I’ve never broken a bone but bruised myself really good last fall after a faceplant in the trail. It just happened that was the first weekend my backyard sauna was fully functional. It all cleared out in 3 days, scabs fell of and the black eye completely cleared. I’ve never experienced such quick healing. Thank you for the articles Chris. Get well.

  27. Hey Chris, I got creamed by a deer descending Gold Camp on May 4th, could have been a relative of your buck.
    They found me out cold in the middle of the road. No road rash! Figured I steer wrestled that doe before she flipped my head into the pavement, no deer hair on me or the bike but I’m sticking to my story.
    Heal Strong!

  28. Best wishes for quick recovery!!!

    I broke my collarbone into 5 pieces and had it affixed with a plate. Should I have the plate removed or leave in place? Arguments for leaving it and taking it out?

    1. Broke my collarbone some 20years ago my orthopedist recommended natural healing with a sling. I felt it never healed properly and bothered me, a year later the same doctor still did not want to plate it and recommended I live with it. Went to another orthopedist and he recommended “Lets fix it.” Well I have had the plate and screws in there for some 20 years and rideing Mt. bikes and road bikes daily, no problems.

    2. If it bothers you take it out. If not leave it in. My plate caused both a weird catching sensation and discomfort when I carried anything over that shoulder. Both gone after plate removal

  29. Advice from a physician cyclist who has broken his collarbone. Skip the ER, go straight to the orthopedist. I went to the ER, $750 ambulance ride, and $3000. ER bill later was told “you broke your collarbone, here’s a sling, go see an orthopedist”….DUH!

  30. Thank you for the solid advice. I hope you heal well and soon. Do you have any thoughts about continuing to ride with osteopenia or osteoporosis. Is there an age or stage that the risk benefits just don’t favor continuing to ride? I know some riders go to low to the ground recumbent bikes. That saying that there are only two kinds of riders-those who have fallen and those who will fall sounds bad ass when you are young but less appealing as recovery times get longer and falls more often lead to breaks. Do you think you will always press on and just not worry about it?

  31. Thanks for this information that hopefully will not be needed. I currently have a boxers fracture and just had the splint removed today. I am sure I will find your “getting back” article motivational. Sure you will be back soon!

  32. Ouch! Speedy recovery Chris! Another great article and solid reminder. I tend to ride by myself both road and off road. Strava Beacon, Road ID, Garmin Live Track and the emergency information screen on your mobile phone are also useful aids in the event you are riding alone and an incident renders you unconscious…..past crashes have left me with a wife who worries, so I leave a route map on my desk when I go out riding now. If I’m not where I should be she has a good idea of where I might be….

  33. Can be broken shoulder too. Went down not that hard and thought it was just a hard bang and bruising but two or three days later got an x-ray and I had a broken shoulder

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