An Eric Heiden Excerpt On Broken Collarbones

From: http://www.espn.com/olympics/cycling/news/story?id=4008306

USA Cycling physician Eric Heiden, the quintuple speedskating Olympic gold medalist who is now an orthopedic surgeon in Salt Lake City, said modern treatment of broken collarbones has reduced average healing time from six weeks to four.

Broken collarbones can mend on their own without surgical intervention, but Heiden, who also competed in elite cycling and started the 1986 Tour de France, said the current "treatment of choice" for cyclists with the injury is to insert a titanium plate that is 3/4 inch wide, 1/8 inch thick and can range from 2 1/2 to 6 inches long to "bridge" the fracture, held in place with screws.

The plate is specially molded to fit the collarbone, which has a unique curve, Heiden said. It's an outpatient procedure, and the plate generally is left in place rather than removed after healing.
"Then, it's just a matter of treating the soreness," he said.

With the plate stabilizing the fracture, riders can generally start training on a stationary bike in a week, Heiden said.

"In six weeks, there shouldn't be any residual problems from the collarbone," Heiden said.

Boston Update - Choices

Following a great trail ride in Chelsea last Saturday and my visit to the ER, I went to the see  orthopedic surgeon Dr. James Moravek today.  I explained my athletic goals for the year:  the Boston Marathon in April, Ironman Traverse City in August.  He listen and then here is what he showed me:

The doctor counted the pieces of bone that had once been my clavicle.  There are, he said, at least 4 pieces.  He went on to talk about the choices:

1. Let the break heal naturally.  The doctor said this was a choice because it would heal up. There would be a "bump" under the skin where the bones healed and fused together.  

2. Surgically repair the break.  In this surgery, the skin is cut and the collarbone is repositioned back to where it should be and then held in position with screws and a plate. The plate and screws do not typically get removed, but sometimes patients find the plate bothersome under the skin. If this is the case, the plate and screws can be removed after the fracture has healed, usually at least 6 months after the break. This operation is performed in the operating room under general anesthesia. The surgery will take about 60 minutes. Usually, this operation is outpatient surgery.

I listened, a little confused actually because the two avenues were being presented as choices.  I had assumed that treatment plan had already been determined while at the ER on Saturday:  the break was to heal naturally.

I listened some more as doc recited the research that had been done about natural healing of the clavicle versus the surgical option.  It was a mixed set of research.  In some collarbone breaks, it sounded like having the surgery made more sense while in other situations, natural healing made the most sense.

Finally, I found a moment of silence and said, "I hear you saying it is as choice to have this surgically repaired."  I listened to his clarifying response:  "We don't just treat the ailment seen on the x-ray; we treat the patient.  Every patient might have a different need. Some patients need surgery so they can get back to work in two weeks rather than three months."

Choices.  I like choices.

I thought for a second and said, "Let's do the surgery."  The doc responded that is exactly what I'd do if I were you.   Surgery is next Tuesday.  I'm hoping the surgical treatment plan will likely get me back to running about two weeks after surgery.  Fingers crossed.

As an aside, some of you know part of what I'm thinking about / remembering:

1. Tyler Hamilton winning a stage of the Tour de France in 2003 while riding with a broken collarbone taped into place.  

2. Lance Armstrong falling during the 2009 Vuelta a Castilla y Leon and fracturing his collarbone.  He went on to have the same surgery I'm having and then riding the Giro d'Italia and Tour de France.

                   

Boston challenge #1

 I've had a bit of a setback today. While riding my mountain bike in Chelsea, I fell and broke my collarbone. Just left ER. No surgery I don't think.   At this point the pain is pretty bad. Hopefully the medicine the doctor prescribed will help with that. Not sure how long I will need to sit on the sidelines… 

 No either injuries that I'm noticing at this point. My head feels fine, my back is good, legs feel great.  

Nike Odyssey React 9.5

First run in the new Odysseys. Great. Will be great if these can be Boston shoes!

First thoughts of Heartbreak Hill today. :-)

Size 10 Epic React = Good

I like the Nike Epic React for comfort and styling but my normal size 9.5 is making the toes on my left foot bleed. The toe box is, I guessed, just a little too snug like several others have reported.

I decided to try a size 10 with the hope that the comfort would still be there but without the bleeding. Today was my first run on the bluish size 10s and the result was good! No blood and still comfort.

Boston 2019 training - and maybe losing some of the current gut - starts in about a week. Hopefully the size 10 Epic React will be a staple during the training.

Next up in my shoe reports I will review the Nike Odyssey React, size 9.5. Stay tuned and keep tri'ing.