Clavicle problem

[echosystm]

(Summarised version follows!)

Hi,

Background: 21 years old, lifting weights at the gym for 3 years, this is my first injury.

This is a very frustrating situation, hopefully someone can give me some much needed advice!

Around the 18th of Jan I was at the gym one day doing bench dips. The link below shows this exercise:

Weighted Bench Dip

Normally, I would do this exercise with 1 20kg plate (plus maybe the occasional 10kg plate) on my lap to 8 reps. This was always very easy. On this particular day, I was aiming for 6 reps, so I put 2 plates on. When I started, I knew instantly this was quite heavy, but thought I would see how I would go. I managed to get to my 6th rep, but that was pretty much my physical limit. On the last rep I told my training partner to quickly remove the weights as I obviously couldn't do any more. At this point, I felt alot of stress in my right clavicle and felt a pop somewhere along it. I cannot be 100% sure where the pop was, as I do not remember. Even though I felt the pop, I managed to hold my weight there for a second until my partner removed the weight, so it is not like my shoulder gave way completely. My training partner said I was going quite low. This is probably an important thing to point out!

I stood up, really freaked out about the pop. There was no pain immediately. Infact, I was contemplating finishing my sets, but the pop just had me so scared I didn't dare do it. The sternoclavicular join on my right side began to feel a bit sore maybe 5-10 minutes after. I immediately went home, by which stage the pain had set in a bit more.

I went to the doctor ASAP and he said "see how it goes over the weekend". When I woke up the next morning, the pain was worse, but bareable. It was a dull ache when the joint was not moving, but if I tried to put on a t-shirt, raise my arm past 90 degrees, reach across to my left shoulder, or any such movements, then I would get a reasonably painful pinch in the sternoclavicular area.

A few days later I went to a physio. He did some pushing up/down on the clavicle and concluded that the joint was quite stable. However, then I asked how long I should take off before returning to the gym and he said I should be ok to start again immediately...

WTF? There is absolutely no way I was in any state to be going back to the gym.

At this point, I began to lose confidence in his advice. He then told me to do lateral raise and rotator exercises (immediately) to "rehabilitate" it... I could be wrong, but such exercises seem almost entirely worthless for a problem at the sternoclavicular joint. I pretty much discarded all of this advice and took 2 weeks rest. I returned to the gym after 2 weeks, doing half weights (very light) to 15 reps. I did this for 2 weeks, with my weights increasing on the second week to the point where I could feel the "burn" if I did the 15 reps slow enough. During this time, I would only feel pain in the SC joint while putting on t-shirts and similar movements. I would feel a bit of very mild soreness the day after gym too. As a guide to pain, towards the end of this 2 week weights period, when I stretched my quadricep out one day using that arm, that movement was a bit painful too.

After this 2 week return to the gym, I went overseas for 25 days and obviously did no real physical activity, beyond lifting my luggage. I didn't really have any pain in the SC joint, except occasionally when I would put on a very tight t-shirt.

I arrived back home and went straight back into the gym. 3 weeks have passed and I have been doing quite light weights - doing reps slow enough that I would get the "burn" around 12 reps. Over this last weekend, I did a little bit of VERY light digging outside. I actually only dug for maybe 20-30 minutes, the load was very light (thin trench shovel) and I avoided moving my right arm as much as possible! However, I have occasionally been feeling a bit of a pinch around my collarbone the day after (yesterday) and today.

Current condition:
When I imitate a shoulder press movement (no weight) with my right arm, I hear two clicks in my shoulder (AC joint maybe?) as I approach the top.
When I move my shoulder forwards and backwards, I get a click somewhere around my shoulder blade.
When I roll my left (uninjured) shoulder, my sternoclavicular joint pops in and out quite forcefully around the top of the movement. By forcefully, I mean it sucks in very quick, and darts out very fast. I assume this is due to the tendons providing a greater resistance against it. Doing the same thing on my right shoulder (injured) results in the joint going in and out, but not as much and far less forcefully. It also feels like it has a slight grind to it.
When I do close grip bench press or tricep pressdown, I feel a popping feeling in my tricep, just above and around the elbow. This goes away somewhat after a few sets, but can be a bit painful doing heavy sets - perhaps a damaged tricep from the dips?

In hindsight, I should have given my arm much more rest. The pain was not bad unless I was putting on a t-shirt etc, but I have heard some absolutely horrible stories about sternoclavicular joints and am very worried. What I would like to know now is:

1. How much would this have affected the recovery of the joint? Should I take a few months off from now?
2. Is there any point in seeing another physio/orthopedic doctor to get it assessed? Am I better off seeing a physio OR ortho?
3. Are there any supplements which I should take for a few months to try and help it recouperate?
4. Should I just quit weightlifting altogether? Will this joint ever heal, close to what it was before?

I really do not want to be one of those guys that has their clavicle popping out all the time because of a dumb decision they made 5-10 years ago!

Sorry for the massive post, but I really need your input!

Thanks.

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[echosystm]

Short version:

- Felt a SCARY pop around the clavicle doing heavy bench dips at the gym.
- Only mildly sore @ sternoclavicular joint while not being moved, but a painful pinch while putting on t-shirts, lifting arm up high or using that arm to do a quadtricep stretch.
- Visited a physio, who said the joint was quite stable and could return to activity basically immediately. Physio advice very questionable, based on the pain & popping feeling.
- Rested for 2 weeks, regardless of physios advice, but feel that 2 weeks was not long enough.
- Returned to gym for 2 weeks, lifting half-weights to higher reps. No major pain, just a bit of dull soreness the day after. The pinching during extreme movements (putting on t-shirts, quad stretches, etc.) was still there though.
- Overseas for 25 days.
- Returned to gym for 3 weeks, slightly heavier weights.
- Did some light shoveling over the weekend.
- Feeling a bit of pinching occasionally.
- Various odd pops and clicks as noted in the "current condition" area of the preceeding post.
- Would like questions at the end of the first post answered!

[Canuck Physio]

Hello fellow fitness buff,

Will have a read through and respond later, eh.

Later

[echosystm]

Extra info:

When I pull my beck back really far (my neck, not just bending my head backwards), I can feel my right clavicle joint go out a little bit. the left one does not do this.

[physio.smith]

I would seek a second physio opinion!

You can disrupt either or both ends of the clavicle with the activity you described.

AC joint end...there is not a lot holding the end of the clavicle in place, often the ligament that holds this end down can be overstretched or torn, causing popping, clicking grinding etc.. There are a few things that can help..getting a good physio to ensure the joint is in the correct position, assessing the joint through movt. to see if it remains stable. Sometimes specific control exercises are needed to control excessive movt., taping can help. Local inflammation in this area can be problematic and makes the joint a lot more tender and irritable.

SC joint end...again not a lot holding it in position, there are a couple of tests that your physio should be able to do to assess stability through movt. In your case this does sound like this may be a problem. If disrupted there are techniques to help relocate...these work better early on in treatment as the ligaments need to heal in the right position.

You really sound like you need to see a sports specialist therapist, one with an interest in shoulders, ask around. Shoulders are difficult to settle at times and often time is the main factor...that and being aware of what aggrevates and what helps.

I had a similar injury mainly affecting my AC jt from an impact injury...it did take a long time, a lot of hard work and patience to settle. (many various diagnosis from collegues...non of which were really wrong...they can just be difficult to manage)

Maybe Canuck will be of help.

Good luck and do seek another opinion.