Injuries in clinic seem to be like buses. You do not see one for ages then half a dozen come by at the same time. This week it has been the turn of broken collar bones. Although no one has walked in through the doors saying “my clavicle is in pieces, can you help?” the missing part of the jigsaw in at least 3 cases this week has been a childhood fracture. As a fellow member of the broken collar bone club, I can empathise with the long term consequences of bouncing on my parent’s bed as a 4 year old, missing the mattress and subsequently spending 6 weeks in a sling. My niggling history of sacroiliac joint pain can be traced back to that fait full day 30…. something years ago.
Here are three very different presentations all with the same root cause:
Patient 1 – A man after my own heart. He fractured his right collar bone and has been presenting with left sided sacroiliac pain (where the lower back meets the pelvis). Due to the original pain his body avoided swinging his arm backwards in walking gait, meaning that he could never fully leave his left leg. The result an overused left leg that never enabled the left sacroiliac joint to breath as he stepped onto his right.
Patient 2 – A keen runner who after 2 years is starting to get lateral knee pain. Diagnosis iliotibial band syndrome that would start after several miles and ease on rest. The reason a broken collar bone aged 14. We know that as the left foot hits the floor the thorax should be side bent to the left and the neck side bent to the right, however as the muscles have guarded the shoulder over the years this is not currently possible. The result – once again stuck in the right leg and an over worked right knee….ouch!
Patient 3 – A long history of back pain and prolapsed discs that is relieved by manipulation but keeps returning every few months. Yes you guessed it, a collar bone fracture 15 years ago that resulted in having to wear a sling. 15 years later that arm still believes it is in a sling and has swing amnesia resulting in a spine that only rotates one way.
The solutions to all the above are going to require movement home work and some hands on osteopathic work, but the results are going to be global. A rub of the ITB, soft tissue work around the sacroiliac joint or a manipulation to the lumbar spine might offer temporary relief, however watching the body move never lies.