Broken Collarbone / Clavicle Fracture – Recovery Time & Tips!

What is the recovery and healing time after a clavicle fracture (also call broken collarbone)?

This is one of the first questions that people ask themselves after breaking their collarbone, especially since it is a clavicle injury that often occurs in athletes. In fact, it is the fourth most common fracture during sports practices (Robertson 2017).

I answer all the questions that people who have just fractured their collarbone, or who are in the healing or recovery period, frequently ask. I base my answers on:

👩‍⚕️ my experience as a physical therapist since 2012

📚 in-depth research in international medical literature.

Do you have any more questions? You can leave them in the comments, and I will be happy to answer them🙂!

Broken, displaced, or cracked collarbone: what’s the difference?

The radio you are going to have will allow you to determine:

• the precise location of the fracture: types fo clavicle fracture:
  • fracture of the middle third = mid clavicle = in the center of the bone. It’s the most common site of clavicle fracture;
  • proximal or distal fracture (at the end of the collarbone) = of the external or internal third = lateral end of clavicle or medial clavicle fracture.
• whether the fracture is displaced or not. A displaced fracture means that the two bone fragments are spaced apart enough.

Other types of clavicles fractures are:

• comminuted clavicle fracture;
• hairline fracture collarbone;
• greenstick fracture of clavicle.

In everyday language, sometimes the terms “crack” or “fissure” are used. However, it is indeed a fracture, usually not displaced.

Non-displaced clavicle fracture generally recover faster and rarely require surgery. But even displaced clavicle fractures are fractures where one can recover relatively quickly and well, with or without surgery.

Regardless of the location and type of your clavicle fracture, rehabilitation and recovery will follow the same general guidelines.

Is it normal to have pain after a broken collarbone?

You may be one of the hundreds of people who type phrases like these into their search engine every month:

• broken collarbone pain after 4 weeks,
• shoulder pain after broken collarbone,
• bruised collarbone pain
• back pain after broken collarbone
• pain relief for broken collarbone.

Pain is common in the hours, days, and even weeks following your clavicle fracture. This should not be a cause for concern; it does not mean that you will have complications or a poor recovery, although it can be a source of anxiety.

Several things can be done to relieve your pain or prevent its onset:

• identify the most comfortable positions; adjust your sling optimally;
• apply cold to the painful area (if it does not provide relief at the moment, there is no need to continue applying it);
• maintain as much as possible your usual physical, intellectual, and leisure activities🚶‍♀️💻. This will shift your attention to something else. Physical activity is also a very good natural pain reliever because it allows the secretion of hormones that alleviate the sensation of pain.

In the hospital, you will also have likely been prescribed pain-relieving medications that can be purchased with or without a prescription.

The pain will subside and disappear over the course of days, at most weeks.

Some people wonder about the origin of their pain. For example, you may feel like you have muscle pain due to its location (in the back, at the level of the shoulder… away from the clavicle).

Determining the precise origin of pain following a clavicle fracture is difficult and uncertain, and is likely not to provide any more clues for resolving it.

Pain is common following a broken collarbone, especially in the first few days. It will decrease, even without doing anything in particular. However, you can still do certain things to relieve your pain.

What is the treatment after broken collarbone?

There are two main types of treatments for healing a clavicle fracture:

1. Conservative treatment: This involves limiting arm movements for a period of time before gradually resuming all activities. This is by far the most common treatment.
2. Surgical treatment: Depending on the type of fracture (significant displacement), surgery may be considered in the days following the fracture. Reduction may also be necessary, which involves manually realigning the bone segments under anesthesia.

Physical therapy rehabilitation is rarely necessary and is not prescribed systematically. It may be necessary for people who have difficulty recovering functional shoulder ranges of motion.

In other cases, physical therapists are mainly there to reassure and advise during the recovery period.

Why immobilize after a collarbone fracture?

Why immobilize after a clavicle fracture? To properly heal after a fracture, it is important to avoid too much movement of the broken bone for a few weeks. To limit movements of the clavicle, shoulder joint movements are also restricted.

This mainly helps to reduce pain and maximize the chances of a good recovery without complications. This is because the clavicle is not heavily involved in arm movements.

Immobilization is facilitated by the use of a brace or sling. This is known as orthopedic treatment.

You may be advised to wear the sling for a few days or weeks, depending on your pain level and any necessary follow-up X-rays.

What sling is used for a collarbone fracture?

There is no consensus on the best type of sling, brace or splint to use. Two main types of splints exist:

• Figure-eight splints, also called clavicular rings, figure 8 ankle brace or Delbet rings;
• Arm slings, which are often easier to put on.

These splints can be purchased at any pharmacy or medical supply store, or online on Amazon for example. It is the same for the right or left clavicle.

Smaller sizes are available for children, even for babies (see on Amazon). They are no better or worse than other types of splints for adults.

How do you put on a figure-eight splint? It is best to ask the person providing it to show you and to put it on by yourself once in front of them to make sure you understand. There is also an explanatory leaflet provided with your sling or ring.

You can also find explanatory videos on Youtube. If you have difficulty putting on the figure-eight splint, use a simple arm sling instead.

In general, the splint is kept on for 2 to 4 weeks, depending on the pain. A radiograph is taken to confirm bone healing 2 to 6 weeks after the fracture.

There is no best sling for broken collarbone: no sling or splint is more effective than another. Prioritize comfort and ease of installation.

Should the sling be kept on at night?

Figure-eight splints or slings can be removed at night after borken collarbone. Do what is most comfortable for you, causing the least pain, discomfort, or apprehension.

The same reasoning applies to other types of splints.

After broken collarbone, you can remove sling at night.

When to know when to stop wearing the sling during the day?

The (para)medical team that diagnosed your fracture should have given you information about how long to wear the brace, sling or splint. Generally after broken collarbone, it is worn:

• until a follow-up X-ray, 2 to 6 weeks after the fracture;
• or until pain is reduced, based on your own assessment, with no minimum duration of use.

Some studies have looked at whether people recover better with a period of strict immobilization (for example, they were instructed to wear the brace for at least 2 weeks) compared to people who were not required to wear a brace at all after a clavicle fracture (they were instructed to wear it only in case of pain).

The studies are of low quality and conducted on a small number of people. Here are their conclusions:

• the incidence of non-union (delay or absence of consolidation) was roughly the same: 5 to 24% in non-strictly immobilized people, compared to 3 to 29% in others;
• residual pain occurred in 35 to 83% of non-strictly immobilized people, compared to 14 to 49% of strictly immobilized patients at least for a time.

The sling should be worn for a few days to a few weeks, depending on the evolution of pain or a follow-up X-ray.

When is surgery needed for a collarbone fracture?

If the clavicle fracture is displaced, surgical treatment may be considered. This involves consolidating the fracture site by placing appropriate material at the level of the bone (osteosynthesis, pin), to maximize the chances of proper bone healing.

The decision to operate depends on many parameters:

• the habits of the medical team that is treating you;
• your overall health, your age;
• the way you yourself perceive the benefits and potential risks of the different therapeutic options that are proposed to you.

This is what the research team that conducted an in-depth synthesis of the studies on the subject concluded:

There is low‐quality evidence that surgical treatment has no additional benefits in terms of function, pain and quality of life compared with conservative treatment, but may result in fewer treatment failures overall.

Very low‐quality evidence means that we are very uncertain of the findings of a slightly better cosmetic result after surgery and of no difference between surgical and conservative treatment in the risk of adverse events.

For both composite outcomes, there is a need to consider the balance of risks between the individual outcomes; for example, surgical adverse events, including wound infection or dehiscence and hardware irritation, against risk of adverse events that may be more commonly associated with conservative treatment such as symptomatic malunion and shoulder stiffness.

Treatment options must be chosen on an individual patient basis, after careful consideration of the relative benefits and harms of each intervention and of patient preferences.

Cochrane, 2019

If the context allows, you can discuss with the medical and surgical team the relevance of surgery in your case if it is proposed to you.

A study conducted in the United States shows that 68% of people presented with a scenario where they have a clavicle fracture following an accident prefer to make a shared decision with the medical team on whether or not to operate, rather than delegating the decision 100% to the medical team (Perez 2020).

This is even if they knew nothing about clavicle fractures before having one.

What are the complications of a collarbone fracture?

Clavicle fractures are injuries for which it is extremely rare to have long-term complications. Therefore, you will most likely be able to resume all your pre-injury activities within a few weeks or months.

A complication can occur, but this happens very rarely. This complication is delayed union or nonunion, which occurs:

• in 5% of cases of fractures in the middle third of the clavicle (Asadolallahi 2019);
• in 1 to 33% of cases of distal clavicle fractures, with or without surgery (Oh 2011).

Even in cases of delayed union or nonunion, people usually recover functionally well in the vast majority of cases (Oh 2011, Lindsey 2021). For example, most people no longer have pain in the years following the fracture, and pain is rated between 0 and 2/10 in people evaluated 5 years after the fracture (Lindsey 2021).

In general, a few days to a few weeks off work is necessary. Here are the average lengths of time off work after a clavicle fracture in the United States 🇺🇸:

• 8 days to 193 days (6 months) for a surgical fracture;
• 24 days to 69 days (2 months) for a non-surgical fracture.

It is highly likely that you will not have any long-term complications from your clavicle fracture.

When can you resume sports after a clavicle fracture🏃🏿?

Several dozen studies evaluate how long it takes for people who have had a clavicle fracture to return to sports. These studies involve people who were already practicing a sport before the fracture.

Here are the average timeframes observed, depending on the type of fracture and treatment:

Type of fracture	Treatment	Average time to return to sports	Source
Non-displaced midshaft fracture	Conservative treatment (=non-surgical)	11 weeks (2.5 months)	Robertson 2017
Displaced midshaft fracture	Conservative treatment (=non-surgical)	22 weeks (4.5 months)	Robertson 2017
Displaced midshaft fracture	Surgical treatment	9 weeks (2 months)	Robertson 2017
Distal fracture	Surgical or non-surgical treatment	19 weeks (4 months)	Robertson 2016

⏱️ Therefore, it takes 2 to 4 months before gradually resuming sports.

Most people can resume sports:

• 97% of people with a midshaft fracture;
• 86% of people with a distal fracture.

These are the types of sports:

• cycling 🚴🏻‍♀️
• American football 🏈
• horse riding 🏇
• motorcycling 🏍️
• soccer ⚽
• rugby 🏉
• running 🏃🏿.

When can you drive after a broken collarbone?

You will find very different opinions on the subject of resuming driving after a clavicle fracture.

In France 🇫🇷: The Highway Code does not provide any specific guidance on this issue. It is up to the driver to ensure that their condition is compatible with reactive driving. There is no formal contraindication to driving with a sling. However, in theory, you must ensure that you are as reactive as you would be in a normal state.

In United-States 🇺🇲, some states may also have specific reporting requirements for medical conditions that could impact driving ability, so it is important to check with the local Department of Motor Vehicles for any relevant regulations. In general, the person should be able to move their affected arm without significant pain or limitation, have adequate range of motion and strength, and be able to react quickly and effectively in emergency situations.

If the movement of turning the steering wheel is no more painful than at rest, there is little risk that driving will exacerbate the pain.

This is provided that you start with short distances (a few minutes). And gradually increase the duration and intensity of driving as tolerated.

In general, the patients I have cared for after a clavicle fracture resumed driving between 2 and 6 weeks after a broken collarbone.

What happens if clavicle healed wrong?

If the clavicle heals incorrectly, it can result in a variety of outcomes depending on the severity of the misalignment.

• Individuals may not experience any noticeable negative effects from the misaligned bone.
• In other cases, there may be some functional limitations or cosmetic changes. For example, the person may experience reduced range of motion in the shoulder, pain, or discomfort during physical activity. In some cases, the misaligned bone can lead to visible deformities, such as a bump or an unevenness in the collarbone.

Not all misalignments require treatment. However, if the individual is experiencing significant pain or reduced function, they may require additional medical attention, such as:

• physical therapy,
• pain management,
• immobilization,
• or surgery to realign the bone.

What is the healing an recovery time for a clavicle fracture?

Here are some recovery durations you can expect after breaking your collarbone:

Stage	Healing Time (typical ranges)
You have much less pain	A few days to a few weeks
Bone consolidation is complete or well underway	6 weeks to 3 months
Swelling and bruising disappear	A few days to a few weeks
You no longer need immobilization or a brace	A few days to a few weeks
You can gradually start using your arm for eating, dressing	A few days to a few weeks
You can drive again	1 to 2 months
You can begin carrying weight (bags, dumbbells) with the fractured arm	1 to 4 months
You can resume all pre-injury physical and sports activities	2 to 8 months

🚭 How to maximize the chances of quick and good healing? Consider quitting smoking or limiting your consumption, as smoking slows tissue healing (including bone tissue).

There is no medication or physical treatment that can accelerate healing time.

The healing time for a clavicle fracture is generally a few weeks.