broken clavicle...surgery or not?

hummer

This sounds similar to what I started with at my PT. Since I was only getting new exercises infrequently I told my PT that all these visits were stupid. I told him to show me exercises, watch me do a few to make sure I am doing them correctly and give me a schedule as to when I need to do them. He did resist this plan, but agreed as long as I promised to do the workouts he would agree to cut back to once every two weeks. I made my appointment with his receptionist for three weeks out. Since he was happy with my progress after the following 3 weeks he agreed to set the next appointment 4 weeks out. I made the appointment 6 weeks out. On my next visit, if he does not give me meaningful new exercises I will cut back further or quit all together.

I think the PT has been very helpful for me personally. I don't think the guy will ever say "I have done all I can for you, don't make any more appointments." Like I said, you have to set the terms with these people. They are not going to cut off the insurance money flowing their way.

alienator

I don't know what PTs you people see, but the PTs I've seen, from different offices, different practices, different states, have all let me know when I've reached the point that I could continue on my own without them....and no it wasn't years down the road.

The insurance money quip is pretty much an insult to any good PT out there and demonstrate you really don't have a clue what they do. Sure there are some bad ones, and sure there are some PTs out there that are in in for the money, but they're the minority.

The doc and PT have far more knowledge about such things than you or I. Hell, maybe your PT let you go, let you "think" that it was the limits you set that defined things, because you were a less than decent patient.

It is entertaining, though, to hear the dumb ass opinions, though, of some folks on how medical things work.

Curb

Alienator, what do you think about my thread below # 428. The Orthopedic told me I don’t need to go to PT anymore. But we have just begun strength training with just 1 and 2 pound little dumbbells.

Also there are still some points in my range of motion that needs to be work on, especially when I try and put on my jacket!

I am not so sure if I should be strength training by myself at 16 weeks out from surgery with heaver weights.

The otrho refuse to write me a new prescription. So either I pay for the additional PT myself or go to my primary doctor and see if he will write the prescription?

What would you do?



The funny thing at this orthopedic visit, the Orthopedic looked and felt my plate and Clavicle and said “this bone is heal man, get back on that road bike and resume your training! He also said that they did not put that plate in me for me to sit around and gain weight! I was like speechless and happy at the same time.

But he did not take X-rays this time.How does he know the bone is healed? I suppose he has the experence and knows better....



Any comments?

alienator

Go to your primary doc. Another alternative would be to talk with your PT, tell them your concerns, and have the PT talk to the ortho and/or your primary. Usually, if the PT thinks you need more help, the doc will go along with that.

As for the x-rays.....it's hard to say why the doc didn't take more x-rays. How many or how often did he take x-rays previously?

One thing that orthos sometimes forget is that the PT isn't just about healing a bone, it's also about regaining proper ROM and use, while avoiding the adoption of some incorrect compensatory movement. For many months after breaking my hip--also after shattering a leg a few years earlier--the PT and I worked on a proper gait, i.e. walking without a limp. Improper compensatory movements or adaptations can lead to further injury, new injury, or decreased use of the affected body part.

hummer

Alienator,

Your forum name was quite well chosen on your part. If you read my posts you will see that I am quite pro PT. In my last post for example I wrote "I think the PT has been very helpful for me personally." In previous post I also wrote "I have found this [PT] coaching to be helpful." I continue to go to my PT.



Perhaps my comment on insurance was a bit over the top. I have often discussed the number of visits I need and the progress I have been making when I visit my PT. He is always quite happy with my progress. He generally reviews past exercises to make sure I continue to do them correctly. He has never had to correct my technique. As time has progressed the number of new exercises have dropped to zero. Yet, when my appointment comes to an end he wants to set a new appointment for the next week. This generally leads to a discussion about the majority of his patients. He tells me most of his patients don't or won't do the exercises unless they are in his office. Perhaps lots of visits are just habit on his part. After such a discussion he then very easily agrees to a longer period of time until my next visit. The day is coming when I won't see the value of further PT advice and coaching. Advice and coaching that I have stated many times have been and continue to be important to my recovery. At that time I will discuss it with my PT. I will be surprised however if my PT comes to that conclusion before I do.



Perhaps Curb's ortho has had similar experiences with other patients.



Curb,

As you have requested, I have tried to give you my opinion. You now know what others think of it.

Quote:

Originally Posted by alienator It is entertaining, though, to hear the dumb ass opinions, though, of some folks on how medical things work.

Curb

Ok, that's good advice and thanks; I'll have the PT contact either my primary or the orthopedic.

I saw the orthopedic 4 time over the 16 week period. He took x-rays after the surgery, after the 2nd and 3rd visit but not this 4th visit. So he took 3 X-rays all total except this final visit this past Friday.



And you right, there is more going own with me like, in PT when I do this small

weight training exercise of 1-2 pounds, I get tightness in the shoulder the afterwards until it loosens up, sometimes it still hurt the day afterwards, sometimes when we get a little aggressive in PT there is some mild pain but goes away and like I said I still cannot put my coat on properly when I reach around and insert the arm in the sleeve, I can do it but there is still a small impingement there and I don’t like it.

Don’t get me wrong, I’ve progress considerable since the surgery but I can’t be messing around doing reps on my own with this plate in me. And as you know, proper technique in rehabilitation is the up most important at this time.

Curb

Oh yeah, I take all this advice and it's great. One of the things i really like is for guys and girls who have had the surgery and PT experience and share that knowledge. It really helps the newbie’s a lot.



Anyway when I told my PT guy the othro said not to come anymore he considered many ways to keep me coming back. He's a really great guy and a comfortable sitting but he has to make a living I suppose.

Remember this forum is open so one needs to make there own final decisons before taking actions on comments and opinions in these posts.

Thanks guys and please keep you comments and opinions coming!

alienator

It's possible that your orthopod with the first, second, and third post-op surgeries had a good feel for the rate at which you were healing and decided you didn't need to have any more x-rays beamed through your cells.

Curb

That's true because before the othero came into the room, I overheard the x ray tech say to one of the the nurses in the background saying something about they don’t do a certain number of x rays on patients after a number of visits… I just dismissed and thought they were talking about someone else.

horseRider

Curb, I had figured out that there was the two methods, Plate and Pin. But didn't catch on that there were two types of plates. Thanks, it's always good to go in well armed. (no pun intended) Although my English husband has been saying I'm "fairly armless" since my accident. English clavicle humor.

Hummer, Wasn't it you that said you lived a good ways away from your PT? I also live out in the middle of nowhere and would have to drive 50 miles to the nearest PT so am concerned about this part of my recovery. Don't have time or money for all that gas! My location is the reason my Doc has been giving me exercises to do at home. We'll see what happens.

hummer

Even if the PT office is just around the corner, they generally take appointments 5 days a week from 9 AM to 4:30 PM. Most of us have to continue making a living while we recover. As I have stated, I think the PT training and coaching are important to recovery. Take you PT's advice seriously and follow through on the schedule of exercises they give you. Office visits? What is the point if the routine is not changing? Your PT sould be giving you advice on when you should be increasing your workout between visits. Occasionally your PT should check your progress, but after the first little while the time between office visits should get longer. As I said in my previous posts, let pain be your guide with regard to the frequency of visits and the difficulty of your workout. My guess is if you push your PT you will find little resistance to increasing the time between office visits. This will be particularly true if it is obvious that you are doing your part at home.

Curb

This is the type I got, it's from Acumed. I think it's the most durable. There is another type, it chrome and looks like it's easy to bend.
Check out the web site.
http://www.acumed.net/product-detail.php?productID=125
Also, my PT gut is 10 mine from home 15 minutes from work so this is not an issue for me. There are hundred of PT clinices in my locations.

celia123

I believe you will well soon after that

MADMANC

Hi I Am New To This Site But Just Reading Your Post I Thought I Would Get In Touch. I Broke My Right Clavicle About Six Or So Months Ago (i Look Like I Have The Golf Ball Under My Skin ) I Was Told It Would Heel And Didnt Need Surgery. I Have Let It Be And Find That I Have More Or Less Full Movement The Only Thing I Find Is That Now And Again It Klicks And Hurts Abit. The Only Thing Is That Reading This And The Other Posts Is That I Have Been Getting Back Pain In My Upper Back Near My Sholders For The Last Five Or So Weeks And Its Driving Me Mad With Pain Does Any One Think That This Is Connected.

Cheers Madmanc