Broken Collarbone: Symptoms, Treatment and Recovery

A clavicle fracture, commonly known as a broken collarbone, is a fracture of the bone that runs between the breastbone and the shoulder.

It is a common injury after falls, cycling accidents, contact sport, motorbike accidents, or direct impact to the shoulder.

The clavicle helps connect the arm to the body and plays an important role in shoulder movement, strength and stability. When fractured, it can cause significant pain, reduced arm movement, and difficulty with daily tasks such as dressing, sleeping, driving, lifting, work or sport.

What Is a Clavicle Fracture?

A clavicle fracture is a break in the collarbone. Fractures can occur in different parts of the clavicle, but the most common area is the middle third of the bone, known as a midshaft clavicle fracture.

Clavicle fractures may be:

• Non-displaced, where the bone remains relatively well aligned

• Displaced, where the bone ends have shifted apart

• Comminuted, where the bone has broken into multiple pieces

  
  

The type of fracture will influence whether treatment involves a sling and rehabilitation, or whether surgical review is required.

Why It Happens

Clavicle fractures usually occur after trauma.

Common causes include:

• Falling directly onto the shoulder

• Falling onto an outstretched hand

• Sporting collisions

• Cycling accidents

• Motorbike accidents

• Direct impact to the collarbone or shoulder

  
  

The injury is common in contact sports such as rugby league, rugby union, AFL and soccer, as well as cycling and other high-impact activities.

In simple terms, the collarbone can fracture when the force through the shoulder is greater than the bone can tolerate.

Signs and Symptoms

Common signs and symptoms of a clavicle fracture include:

• Pain over the collarbone or front of the shoulder

• Swelling, bruising or tenderness

• Difficulty lifting or moving the arm

• Pain with shoulder movement

• A visible bump or change in shoulder position

• Holding the arm close to the body for comfort

  
  

Urgent medical review is required if there is skin tenting, an open wound, numbness, pins and needles, weakness, coldness in the arm, colour changes in the hand, chest pain or shortness of breath.

Diagnosis and Imaging

A clavicle fracture is usually diagnosed with a clinical assessment and confirmed with an X-ray. An X-ray helps identify the location of the fracture, the degree of displacement, whether there are multiple bone fragments, and whether specialist review is needed.

In more complex injuries, additional imaging may be required, particularly if there is concern about the shoulder joint, sternoclavicular joint, ribs, lung, nerves or blood vessels.

Treatment Options

Treatment depends on the type, location and severity of the fracture. Many clavicle fractures are managed without surgery using a sling, pain relief and gradual rehabilitation.

Surgical review may be required if the fracture is significantly displaced, shortened, open, affecting the skin, associated with nerve or blood vessel symptoms, or involves certain lateral clavicle fractures.

Surgery may involve plate and screw fixation to stabilise the bone while it heals.

How Physio Helps

Physiotherapy plays an important role after a clavicle fracture, whether it is managed with or without surgery. Early rehab focuses on protecting the fracture, reducing pain, maintaining safe movement, and preventing stiffness in the neck, elbow, wrist and hand.

As healing progresses, physio gradually restores shoulder movement, shoulder blade control, rotator cuff strength and general arm strength. Later-stage rehab focuses on returning to normal activity, gym training, manual work, overhead movement and sport.

Physio treatment may include:

• Sling and posture advice

• Sleeping and daily activity advice

• Gentle mobility exercises

• Shoulder range of motion exercises

• Scapular control exercises

• Rotator cuff strengthening

• Progressive shoulder and arm strengthening

• Manual therapy for stiffness where appropriate

• Return-to-work or return-to-sport planning

  
  

The timing of rehab depends on the fracture type, healing stage, pain levels and any specialist or surgeon instructions.

Other Possible Causes

Not all collarbone or shoulder pain after trauma is caused by a clavicle fracture. Other injuries can present in a similar way, including:

• AC joint injury: Pain at the top of the shoulder where the collarbone meets the shoulder blade.

• Sternoclavicular joint injury: Pain closer to the centre of the chest where the collarbone meets the breastbone.

• Shoulder dislocation: Severe shoulder pain, deformity and difficulty moving the arm after a fall or collision.

• Proximal humerus fracture: A fracture near the top of the upper arm bone, which can feel similar to a shoulder or collarbone injury.

• Scapula fracture: A fracture of the shoulder blade, usually after higher-force trauma.

• Rotator cuff tear: Shoulder pain and weakness, especially when trying to lift the arm.

• Rib fracture: Pain around the upper chest or shoulder region, often worse with deep breathing, coughing or twisting.

• Brachial plexus injury: Irritation or injury to the nerves around the neck and shoulder, which may cause burning pain, numbness, pins and needles or weakness down the arm.

• Cervical spine injury: Neck-related injury that may refer pain into the shoulder, collarbone or arm, especially after high-force trauma.

  
  

When to Get Help

You should seek medical assessment if you suspect a clavicle fracture after a fall, collision or direct impact to the shoulder.

Urgent assessment is important if there is severe pain, obvious deformity, skin tenting, an open wound, numbness, pins and needles, weakness, coldness in the arm, colour changes in the hand, chest pain, shortness of breath, or symptoms after a high-speed accident.

Once the fracture has been assessed and cleared for rehabilitation, physiotherapy can help restore shoulder movement, strength and function safely.

If you are recovering from a clavicle fracture or ongoing collarbone and shoulder pain, the team at Urban Physiotherapy in North Sydney can assess your movement, guide your rehab and help you return safely to work, gym and sport.