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  1. #1
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    Question How do you break a collarbone?

    The recent lance armstrong incident sparked my interest. I've been thinking about it for a long time and can't figure out how you can break it. Also why do people say that if you put your hand out to break the fall that you have a higher chance of breaking it?

  2. #2
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    The best way to make sure you break it is to stick out your hand in a fall. What happens is your elbow locks out, so all the force is transmitted to your shoulder. Since your shoulder doesn't really "give" in that general direction, a large percentage of the force goes into your collarbone. In this situation, your collarbone is in compression (i.e. the forces acting on it are trying to "squash" it).

    Your collarbone is what is known in engineering terms as a "long slender member". In engineering, long slender members are (almost) never designed to be loaded in compression, because they have a tendency to buckle or shear (aka break). This is precisely what happens to your collarbone.

    Collarbones are actually not really load-bearing bones at all for most of your shoulder's range of motion: they serve as more of a stabilizer; you can live just fine without your collarbones. In fact, horse jockeys used to have their collarbones surgically removed BEFORE they broke, so they wouldn't break it at an inopportune time.

    There are, of course, other ways to break your collarbone besides sticking your arm out in a fall. Hitting it transversely hard enough will break it, but it's pretty rare in cycling accidents to have something hit you hard enough in your shoulder/upper chest area to break your collarbone. Additionally, if you are unlucky enough to land on your shoulder at just the right angle, you could break you collarbone.

    Full Disclosure: I broke my right collarbone in a mountain biking accident about a year ago. I got launched off my bike at about 20 mph and flew for about 25 - 30 feet and landed on my chest. To my memory I didn't stick out and lock an arm, but I think the impact was hard enough that merely having the arm slightly extended (due to my windmilling while airborne) was enough to break my collarbone. The initial pain was surprisingly little, but I still do not recommend attempting to replicate the experience.

  3. #3
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    I'm a mechanical engineer so your explanation is pretty clear, but what I don't get is since that shoulder can move up, down, left, and right, won't it act as a damper to absorb some of the forces or better yet put the collarbone in a position which the force acts in tension to the collarbone?

    Edit: Also, why would you lock your elbow? You would have a better range of motion to break the fall if your elbow was bent. Plus you can use your muscles instead of your bones to break the fall as well.

    Like I get why basketball players land on their heels instead of their toes to decrease the probability of spraining an ankle, but I don't see the advantage of locking up your elbow.
    Last edited by Ichijin; 03-30-2009 at 05:32 PM.

  4. #4
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    When you fall, your arm is typically close in in-line with the tops of your shoulders, (or above) and rotated slightly towards the front of your body. This essentially means your collarbone ends up directly in line with the force vectors.

    The best way to prevent breaking your collarbone (or anything else) is to KEEP YOUR HANDS ON THE BARS as you go down. This is totally counter-intuitive, but will save your bones and skin from serious injury.

    P.S. ME student here. Glad to know I can throw the lingo at you and have it make sense

    As for acting as a damper, much of the shoulders ROM (range of motion) is rotational, which doesn't absorb impact. When you hit, your shoulder wants to move towards the center of your torso; your collarbone is directly opposing this motion, so *SNAP*!

  5. #5
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    wrestling training

    Pull your hand to your waist, keep elbow tight on your rib cage, tuck your shoulder and roll your body on impact

  6. #6
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    I agree with your statement that the shoulders are almost purely rotational, but what I meant was the muscles to rotate your shoulder could act as dampers

  7. #7
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    Also in the case where you grab on to the handlebars and fall to the ground the force vector parallel to you collarbone (although a little less than the normal force from the ground) could still break your collarbone no? It could be even bigger as well since you didn't absorb any of the energy from trying to break the fall.

  8. #8
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    Quote Originally Posted by onlineflyer
    Pull your hand to your waist, keep elbow tight on your rib cage, tuck your shoulder and roll your body on impact
    A lot of martial arts incorporate techniques to help reduce the damage in falling, some of which do stick their arms out.

    But haha, I don't think you answered my question, but thank you for bringing that into the discussion

  9. #9
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    Dampers

    Quote Originally Posted by Ichijin
    I agree with your statement that the shoulders are almost purely rotational, but what I meant was the muscles to rotate your shoulder could act as dampers
    Of course they do. But that doesn't mean that they dissipate enough force to prevent the fracture.

  10. #10
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    When I broke my collarbone, my hands were still on the handlebars and my feet still on the pedals. It happened so fast, there wasn't time to blink. I suffered no damage to skin or clothing or bike. In fact, the only thing damged was my collarbone.

  11. #11
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    Quote Originally Posted by Kerry Irons
    Of course they do. But that doesn't mean that they dissipate enough force to prevent the fracture.
    I agree, it doesn't.

    But how does putting your hands on the handlebar during a fall prevent you from breaking the bone? Seems that there would be more force when you land on your shoulder. Minus the energy taken away from the handlebar hitting the ground.

  12. #12
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    Falls on outstretched hands (FOOSH) will generally result in wrist and hand injuries but can also cause isolated shoulder injuries. Most commonly would be a AC (acromium clavicular) seperation. This is the joint that attaches the clavicle to the shoulder. Could also dislocate the shoulder or result in a rotator cuff injury. In order to fracture the clavicle your arm during a FOOSH it would generally have to be parallel to the clavicle, ie. sticking out at around 120 degrees from your body. To transduce enough force to break the clavicle you'd virtually be guarenteed to break your wrist. While it's possible to fracture the clavicle with the described mechanism by far and away the most common is a direct force on the shoulder. As you fall over to the side the first thing to hit and absorb all the impact is often your shoudler. Clav fx's are very common injuries but less common than an AC seperations which can also happen with a direct impact. While easier in theory than practice you should roll when you fall rather than try and stop your momentum with your arms or body. The injuries outlined in this thread all described a direct force on the shoulder.
    They hurt like an SOB. Lord knows how Hamilton did the ToF on a broken one.

  13. #13
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    Quote Originally Posted by zoikz
    Falls on outstretched hands (FOOSH) will generally result in wrist and hand injuries but can also cause isolated shoulder injuries. Most commonly would be a AC (acromium clavicular) seperation. This is the joint that attaches the clavicle to the shoulder. Could also dislocate the shoulder or result in a rotator cuff injury. In order to fracture the clavicle your arm during a FOOSH it would generally have to be parallel to the clavicle, ie. sticking out at around 120 degrees from your body. To transduce enough force to break the clavicle you'd virtually be guarenteed to break your wrist. While it's possible to fracture the clavicle with the described mechanism by far and away the most common is a direct force on the shoulder. As you fall over to the side the first thing to hit and absorb all the impact is often your shoudler. Clav fx's are very common injuries but less common than an AC seperations which can also happen with a direct impact. While easier in theory than practice you should roll when you fall rather than try and stop your momentum with your arms or body. The injuries outlined in this thread all described a direct force on the shoulder.
    They hurt like an SOB. Lord knows how Hamilton did the ToF on a broken one.

    I'd like to hear your thoughts on keeping your hands on the handlebars while falling. Whether it is a good idea/bad idea.

    Could you also elaborate on what kind of motion is needed in order to break your wrist?

  14. #14
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    I was in a crash about 4 years ago where I just dislocated my left collarbone.... trust me, when you crash like that, you don't have time to think about where you place your hands to minimize injury, it just happens so fast you deal with it when you wake up. The dislocation hurts to this day. Maybe, I would have been better off with it broken.

  15. #15
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    Quote Originally Posted by cdhbrad
    I was in a crash about 4 years ago where I just dislocated my left collarbone.... trust me, when you crash like that, you don't have time to think about where you place your hands to minimize injury, it just happens so fast you deal with it when you wake up. The dislocation hurts to this day. Maybe, I would have been better off with it broken.
    Yeah, I think when crashing, instinct takes over in many instances. I suppose you could practice crashing.

  16. #16
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    tuck and roll

    I actually had time to think about it the one time (so far) I crashed in a group ride... I was just tooling along, the mind drifted off a little bit, next thing I knew I was too fast, too close (okay, overlapped), and getting squeezed into the curb.

    Rather than falling on my outstretched arm/hand I just kept my hand on the bar, tucked my left shoulder in as best I could, and fell/rolled over onto my back... with the next couple of guys on top of me. Worked out okay that time, I try to pay better attention now (and I ride with a faster group so its not as likely to happen in the first place).

  17. #17
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    The clavicle is very superficial and provides the only bony articulation of the upper limb to the thorax.
    Clavicle fractures are very common.
    Clavicle fractures are caused by 'indirect force' through a fall on the lateral shoulder or on an outstretched hand. A direct blow to the subcutaneous clavicle is also a common mechanism for a clavicle fracture. The clavicle usually fractures in the middle third and the incidence is highest in the second decade due to MVA, and sports injuries.
    Most clavicle fractures, especially in the young are treated without surgery.
    John Lapoint / San Diego
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  18. #18
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    Quote Originally Posted by crispy010
    Additionally, if you are unlucky enough to land on your shoulder at just the right angle, you could break you collarbone.
    BTDT and have the rebuilt shoulder and scar to show for it. It was 18 years ago and hey, they did a hell of a job fixing it up because to this day it doesn't bother me at all.

    Quote Originally Posted by Ichijin
    A lot of martial arts incorporate techniques to help reduce the damage in falling, some of which do stick their arms out.
    Yes, but usually you don't put your hand down so that your palm hits the ground. Instinct makes you want to do that, but to properly "roll" to dissipate the energy of the impact over a large area, you land on the back of your hand, or kind of the outside of your hand, and make an arc with your arm that extends from that hand up and through your shoulder. Tuck your head towards the opposite shoulder to keep it out of the way as you roll.

    I think everyone who participates in sports where falling is possible should take a few Aikido or Judo classes to practice how to fall! It's saved me so many times (30years of skateboarding...no head impacts, and the only time i broke something was when i put my palm down - the wrist guards i was wearing keep the hand bent like that and the impact transfered all the way up and broke my arm at the elbow. ouch. should have just rolled...)

  19. #19
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    Quote Originally Posted by Ichijin

    Could you also elaborate on what kind of motion is needed in order to break your wrist?
    I had a soccer ball ram straight into my wrist as my palms were facing outwards with the fingers pointed downwards.

    Absolutely no time to react to parry the ball at all. Pretty close range. Broke both my radius and ulna.
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  20. #20
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    Ok, so why do people keep saying to hold on to the handlebar when you fall? Still doesn't make sense to me.

  21. #21
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    Quote Originally Posted by Ichijin
    Ok, so why do people keep saying to hold on to the handlebar when you fall? Still doesn't make sense to me.
    Think about it. If you're falling sideways and you stick an arm out to catch yourself, all that force (and it's a lot) goes straight into your arm in a linear way.

    If instead, you keep your arms on the bars, four good things happen:

    1. Your body now has a tendency to roll when you hit the ground. Rolling can absorb a lot of energy that would otherwise be going into you. Even if you stay attached to your bike, you can roll well over 90 degrees before your bike hits the ground again.

    2. The impact force is now spread over a wider part of you: nearly the entire side of your torso rather than your hand. Distributing the force greatly reduces the chance you'll break a bone. Plus, the bones in your torso are more substantial than the ones in your hand, wrist, and arm. Even better, your ribcage is naturally springy, making it ideal to absorbing impact without breaking ALL your ribs.

    3. Your side gets scraped up instead of your hand. Hands take forever to heal, and they're pretty useless while they do.

    4. You present a smaller target to the riders around and behind you. Smaller means you're easier to avoid. Once on the ground, curl up tightly and stay there.

    Crashing is always a messy business, no matter how it happens. By keeping your hands on the bars you tilt things in your favor. Yeah, it's still gonna hurt like hell.

  22. #22
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    Quote Originally Posted by sdjeff
    I actually had time to think about it the one time (so far) I crashed in a group ride... I was just tooling along, the mind drifted off a little bit, next thing I knew I was too fast, too close (okay, overlapped), and getting squeezed into the curb.

    Rather than falling on my outstretched arm/hand I just kept my hand on the bar, tucked my left shoulder in as best I could, and fell/rolled over onto my back... with the next couple of guys on top of me. Worked out okay that time, I try to pay better attention now (and I ride with a faster group so its not as likely to happen in the first place).
    This and what an earlier poster said is totally true: roll with the bike. I took judo as a kid and they embed this trait into you, so you instinctively roll when falling. And, unfortunately, this instinct came into play many times over my many years. Made for nice road rash, but never any broken bones. And many of my spectacular spills were taken at high speed in crits and fast rides.

    When Levi fell in the ToC, he put his arm out to break the fall. Lance, Tyler, and other pros ought to take judo or wrestling.

  23. #23
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    Quote Originally Posted by Ichijin
    Ok, so why do people keep saying to hold on to the handlebar when you fall? Still doesn't make sense to me.
    If you put your arm out straight, all the force can be transmitted through the outstretched arm to the shoulder, causing a big load to the clavicle. If you hang on, before the shoulder contacts the ground you will typically have some impact of the pedal, leg, hip, and the handlebar. All of that absorbs some energy and slows the deceleration borne by the shoulder and clavicle. You can still break your collarbone, of course, but it's less likely

    But there's another factor: wrist and arm fractures, which can be as bad as or worse than the collarbone, slower to heal, with worse long-term consequences. Putting your arm out greatly increases the risk of those breaks.

  24. #24
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    Then it seems the easiest solution would be to not have your arm completely straight, and have it slightly bent

  25. #25
    Fat'r + Slow'r than TMB
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    Quote Originally Posted by Ichijin
    Then it seems the easiest solution would be to not have your arm completely straight, and have it slightly bent
    How do you brake a collar bone. EASY, rapid deceleration trauma, and I have the Xrays to prove it.
    Just fast enough to know I am slow.

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