Clavicle Injury

[Taiger]

Ok, so i'm hoping that someone on here will be able to give me some advice or maybe suggest something i haven't already heard.
I'm 25yrs old and have always been extremely active. Playing both basketball and soccer at a competitive, college level. I'm sure that as a goal keeper for soccer that i have many related injuries. Scar tissue, muscle and joint problems, etc; as it is very much an "impact" sport when you're in net....im sure that some of these past impacts have affected me, and maybe my injury is something from repetive use. although i have not participated in these sports for almost 3 years now.
I lift weights at home and have been for many years, I have never had any shoulder, or clavicle related injuries. Approximately 6 weeks ago, I was lifting weights and felt like i maybe hurt a muscle in my peck and could feel it was really tight, so i booked a massage appt. When i was there the massage therapist tried a tecnique i've never seen before.
With me laying down face up on the massage table, she stood behind my head and placed both her hands on my clavicle bone, she then proceeded to push in, with alot of force, not once but 3 times. Each time she did, it was enough for me to completely expell my breath, to the point of having no air left. This tecnique was painful and im still not too sure what it is she was trying to do.
That night after my massage, i was having a lot of pain in the area she "treated", and later on that evening a couple of friends pointed out some brusing on my clavicle/collarbone. Since the day I had that massage I have been unable to use my left arm.
I saw a doctor a few days later and he took xrays. He claims he sees two fractures on the xrays, which seems likely as there are two very noticble lumps on my collarbone which have been there since i saw the doctor the first time. each of them where the dr thinks he saw the fractures on the xrays. However, upon reviewing my xrays, a radiologist said there are no fractures. So a bone scan was ordered. It too came back normal. My doctor spoke to an orthopaedic surgeon regarding my results, and was told that if nothing came back on the bone scan then there's nothing there and i need to start doing physio.
I have been in a sling for approximately 6 weeks now, the pain im feeling in my clavicle, still as intense as it was on day 1. tylenol 3's aren't enough for pain, neither is icing. both only provide very temporary relief.
At this point it causes me a great deal of pain just trying to do the littlest things, sitting up from a laying position, putting shirts on, tying my shoes. basically any movement that requires me to use my left arm, even just for balance, hurts.
I know my own body, and the pain im feeling, so to be told that there is nothing wrong is very frustrating. And because of where I live and because we have free healthcare, getting the best and most accurate diagnosis doesn't always happen. Not only that, but because my injury is not considered "critical" i would be waitlisted approximately 3-4 months to see an orthopaedic surgeon, and up to 9 months to have an mri done.
I don't trust that doing physio is going to help, being as there is still something going on in there that hasn't been found or fixed. however, i can't and don't want to continue to immobilize my arm if it doesn't need to be or if it is only doing more damage.
Any advice, i'm so frustrated!

[Canuck Physio]

Originally Posted by Taiger

Ok, so i'm hoping that someone on here will be able to give me some advice or maybe suggest something i haven't already heard.
I'm 25yrs old and have always been extremely active. Playing both basketball and soccer at a competitive, college level. I'm sure that as a goal keeper for soccer that i have many related injuries. Scar tissue, muscle and joint problems, etc; as it is very much an "impact" sport when you're in net....im sure that some of these past impacts have affected me, and maybe my injury is something from repetive use. although i have not participated in these sports for almost 3 years now.
...
I lift weights at home and have been for many years, I have never had any shoulder, or clavicle related injuries. Approximately 6 weeks ago, I was lifting weights and felt like i maybe hurt a muscle in my peck and could feel it was really tight, so i booked a massage appt. When i was there the massage therapist tried a tecnique i've never seen before.
What exercise were you doing specifically? Was it a real injury, spasm, or just a strange feeling of tightness?
With me laying down face up on the massage table, she stood behind my head and placed both her hands on my clavicle bone, she then proceeded to push in, with alot of force, not once but 3 times. Each time she did, it was enough for me to completely expell my breath, to the point of having no air left. This tecnique was painful and im still not too sure what it is she was trying to do.
A few things here: Can you describe exactly where the hands placed the most pressure?
Additionally in the future, if there is any technique you are unaware of or feel uncomfortable with then you have the right to ask what will be happening, what to expect, and if you wish to opt out of receiving that specific treatment. It seems like the application of that technique was unfounded in that situation, especially for a muscular problem that you came in with
That night after my massage, i was having a lot of pain in the area she "treated", and later on that evening a couple of friends pointed out some brusing on my clavicle/collarbone. Since the day I had that massage I have been unable to use my left arm.
Are there any bumps there, is the skin okay?
I saw a doctor a few days later and he took xrays. He claims he sees two fractures on the xrays, which seems likely as there are two very noticble lumps on my collarbone which have been there since i saw the doctor the first time. each of them where the dr thinks he saw the fractures on the xrays. However, upon reviewing my xrays, a radiologist said there are no fractures. So a bone scan was ordered. It too came back normal. My doctor spoke to an orthopaedic surgeon regarding my results, and was told that if nothing came back on the bone scan then there's nothing there and i need to start doing physio.
The results of these investigations are interesting, however, I wonder if they have actually looked at the bump itself. It is very much possible that you could have damaged ligaments during that treatment session, but without knowing where it is difficult to say. It is also possible as a result of the treatment there is underlying bruising, or compartmentalised swelling that is contributing to the pain. But without an idea of where/what is going on it is difficult to say.
I have been in a sling for approximately 6 weeks now, the pain im feeling in my clavicle, still as intense as it was on day 1. tylenol 3's aren't enough for pain, neither is icing. both only provide very temporary relief.
Are you in the sling all day? Are there times when you feel better/worse? Are you unable to use that arm because it is weak, or you simply can not move it due to pain. How about that problem with the pec? Does that remain? Are you taking the arm out of the sling and moving it about to maintain activity?
At this point it causes me a great deal of pain just trying to do the littlest things, sitting up from a laying position, putting shirts on, tying my shoes. basically any movement that requires me to use my left arm, even just for balance, hurts.
So you are able to use that left arm for simple activities, but are limited by pain
I know my own body, and the pain im feeling, so to be told that there is nothing wrong is very frustrating.
Have you seen a physio, whom have you seen thus far apart from the massage therapist
And because of where I live and because we have free healthcare, getting the best and most accurate diagnosis doesn't always happen. Not only that, but because my injury is not considered "critical" i would be waitlisted approximately 3-4 months to see an orthopaedic surgeon, and up to 9 months to have an mri done.
That is a lot of lay time in which you could be getting treatment for the associated problems at hand, if not the problem itself
I don't trust that doing physio is going to help, being as there is still something going on in there that hasn't been found or fixed. however, i can't and don't want to continue to immobilize my arm if it doesn't need to be or if it is only doing more damage.
Physiotherapy can help, because the one thing you are doing right now is keeping your arm immobilized, the human body is not designed to stay still. In the meantime the arm is losing muscle, becoming weaker, stiffer, and shortening as well. There are a great deal of changes that you could possibly want to prevent. Additionally Physio''s are highly qualified to make assessment of physical injuries. And at the very least can add to the assessment findings.
Any advice, i'm so frustrated!

As above regards

[Taiger]

Originally Posted by Canuck Physio

As above regards

Thanks so much for the quick reply. In response to your questions:

"What exercise were you doing specifically? Was it a real injury, spasm, or just a strange feeling of tightness?"
- I was doing a combination of different lifts. bench press, curls, etc. i noticed one day that it was kind of hurting and then the next day when i went to do weights it was really bugging me. it was tight, and burning. like a tight muscle.

" Can you describe exactly where the hands placed the most pressure?"
- She put her palms either directly on, or just below my clavicle and pressed down towards my toes. I have a few friends who are also RMT's and they were both very concerned what she would've done such a thing, especially in an area that is so sensitive and has important arteries running under it....

"Are there any bumps there, is the skin okay?"
- There are no bumps, if you mean like a rash or irritation. There are however still two very prominent bumps, hard like bone, right on my clavicle. both of which cause intense pain if touched.

"Are you in the sling all day? Are there times when you feel better/worse? Are you unable to use that arm because it is weak, or you simply can not move it due to pain. How about that problem with the pec? Does that remain? Are you taking the arm out of the sling and moving it about to maintain activity?"
- I am still in my sling for most of the day. I took it upon myself at the 5 week mark, to start taking the sling off throughout the day and trying to use the arm, as i figured it wasn't good to have my arm immobilized that long. I can clearly see the muscle loss that's taken place. There's no real time during the day that if feels better or worse. and it doesn't always hurt all the time. it can be very sporadic some days. I am able to move my arm, but not without alot of pain, so there probably would be some weakness. My pec still has some tightness to it, however its kind of been overshadowed by the pain of my clavicle. I'm trying to do as much with my arm as i can, but don't know what pain is good and what pain is bad. if i'm overusing it, or using it the wrong way, etc.

"So you are able to use that left arm for simple activities, but are limited by pain"
- yes, basically

"Have you seen a physio, whom have you seen thus far apart from the massage therapist"
- No, I have been under the impression, up until last week that i was healing a fractured clavicle, and therefore have not been referred to a physiotherapist as of yet, but i do have another doctor's appt. this week coming up and i'm sure that is what he's going to be doing

Thanks again so much for all your help. I really appreciate it.

[alophysio]

HI,

Your story sounds terrible. As a warning to anyone, whenever you get a massage, they should be rubbing your muscles...if you want other treatment, then see a physio! Your RMT friends are right to be worried about their colleague.

Secondly, thanks for the helpful posts - lots of info is helpful.

Next, you live in Canada but where?? The reason why is because Diane Lee and LJ Lee are in Vancouver - both are basically the world's experts on the thorax - literally wrote the textbook on treatment and rehab.

Another point, you have something wrong. You have said so yourself. When a doctor tells you there is nothing wrong, they are telling you that the test they used came back as normal. Just because they don't know what is wrong doesn't mean everything is ok. Persevere.

It sounds like your condition could be many things. It might be a sternoclavicular sprain. It might be a first rib injury. It might be a thoracic outlet problem.

When you go to see a physio, during the assessment, they will do things that makes it sore. They will also do things that makes it better. If they don't, depending on what is wrong of course, then find someone who can. Even if it is fractured, one can make it feel better by changing the tension on the bones.

By the way, the technique the massage therapist was probably trying to do was to stretch out your pec minor but in my experience, when you go that hard, people tense up, not relax. A gentle stretch should have been enough.

Also, I would be sending my medical bills to the massage therapist...