Clavicle Fractures: Also known as a broken Collar bone
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A clavicle fracture is a break in the collarbone — the long, S-shaped bone that connects the sternum (breastbone) to the scapula (shoulder blade).
It is one of the most common fractures in both adults and children, accounting for approximately 2–5% of adult fractures and up to 15% of fractures in children.
Although common, it should not be dismissed as “just a broken collarbone.”
The clavicle plays a crucial mechanical role in shoulder function. It acts as a structural strut, holding the arm away from the body and allowing efficient shoulder movement, strength and force transfer between the trunk and arm. When the clavicle breaks, this system is temporarily disrupted, affecting movement, strength and comfort.
Most clavicle fractures heal well. Understanding the injury, expected recovery, and appropriate rehabilitation is key to achieving the best possible outcome.
This page explains:
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What and Where is the Clavicle?
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How a Broken Collarbone Happens
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Classification of Clavicle Fractures
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Direct Blow vs Indirect Force
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Why the Midshaft Breaks Most Often
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Age and Bone Strength
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High-Energy Trauma
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What Patients Often Experience at the Moment of Injury
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Other Immediate Symptoms
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When to Be Concerned
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What Happens in A&E After a Suspected Clavicle Fracture?
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Do All Clavicle Fractures Need Physiotherapy?
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The Overall Outlook
What and Where is the Clavicle?
The shoulder is one of the largest joints in the body, formed by the articulation of the scapula and the bone of the upper arm (humerus). The clavicle plays a vital role in maintaining shoulder stability and allowing a wide range of movements.
Given its prominent position and role, the clavicle is susceptible to fractures, especially during high-impact activities. If you suspect you have a clavicle fracture you should seek immediate medical attention.
Why the Clavicle Is So Important in Shoulder Function?
To understand a clavicle fracture properly, it helps to understand what the clavicle actually does.
The collarbone is not just a piece of bone that happens to sit across the front of your chest. It is a structural link between your arm and your trunk. Without it, the shoulder would collapse inward.
The clavicle holds the shoulder blade in an optimal position away from the ribcage. This spacing allows the arm to lift, rotate and generate force efficiently. When people describe the shoulder as feeling “unsupported” or “unstable” after a broken collarbone, this is often what they are sensing — the temporary loss of that structural strut.
Every time you:
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Reach overhead
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Push yourself up from a chair
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Lift a child
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Drive
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Carry shopping
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… force is transferred through the clavicle.
When a clavicle fracture occurs, that force pathway is interrupted. Pain is not just coming from the break itself — it also comes from the surrounding muscles, ligaments and joint structures trying to compensate.
This is why even a simple midshaft clavicle fracture can make everyday movements surprisingly difficult.
How a Broken Collarbone Happens
Most clavicle fractures occur after a fall directly onto the shoulder. This is particularly common in cycling accidents, rugby or football tackles, skiing falls, horse riding incidents, and simple slips on wet pavement or ice.
When people search “how does a clavicle fracture happen?” they often assume the bone breaks because they landed on an outstretched hand. While this can happen, the more typical mechanism is different.
In most cases, the injury occurs because of a direct compressive force through the shoulder.
Imagine falling sideways and landing hard on the point of your shoulder. The shoulder blade is driven inward toward the ribcage. The force then travels across the shoulder girdle until it reaches the clavicle. Because the collarbone acts as a rigid strut between the shoulder and the sternum, it absorbs that load.
If the force exceeds the strength of the bone, it fractures — most commonly in the midshaft, which is the narrowest and biomechanically weakest section.
This is why broken collarbone injuries are so common in cyclists. When a cyclist is thrown over the handlebars, the instinct is often to tuck or roll, and the lateral shoulder absorbs the impact. The clavicle becomes the mechanical “failure point.”
Classification of Clavicle Fractures
There are several ways to categorise differing types of clavicle fracture but in the UK the Allman classification is commonly used and is simply based on the location:
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Group I (midshaft): Fractures of the middle third of the clavicle.
– The most common type, accounting for around 69–82% of all cases.
– Often associated with overlap or shortening of the bone fragments.
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Group II (distal): Fractures of the lateral third of the clavicle (closest to the shoulder).
– Make up about 21–28% of fractures.
– May cause the bone to displace upwards if the coracoclavicular ligaments are involved.
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Group III (proximal): Fractures of the medial third (nearest the breastbone).
– Uncommon, representing only 2–3% of cases.
– Sometimes linked to higher-energy trauma due to their location.
Direct Blow vs Indirect Force
There are two broad mechanisms behind a clavicle fracture:
1. Direct impact to the shoulder
This is the most common cause of a broken collarbone. The shoulder is compressed inward, and the clavicle breaks under load.
2. Indirect force through the arm
Less commonly, a fall onto an outstretched hand transmits force up the arm into the shoulder girdle. If the energy is high enough, the clavicle may fracture rather than the wrist or elbow.
Patients are often surprised by how much force is required. However, the collarbone is designed to transmit load — not absorb sudden high-energy trauma.
Why the Midshaft Breaks Most Often
The majority of clavicle fractures occur in the middle third of the bone.
There are three main reasons for this:
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The midshaft is thinner than the ends
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It has no strong ligament reinforcement at this point
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Muscle forces pull in opposite directions once the bone breaks
After a midshaft clavicle fracture, the inner fragment is often pulled upward by the sternocleidomastoid muscle, while the outer fragment is pulled downward by the weight of the arm. This explains why some displaced clavicle fractures appear visibly uneven.
Patients often notice:
“It looked like my shoulder had dropped forward.”
That visible asymmetry reflects the biomechanics of muscle pull after the fracture.
Age and Bone Strength
The way a clavicle fracture happens is strongly influenced by age and bone quality.
Bone is not a static material. It is living tissue that constantly remodels in response to load. In childhood and adolescence, bone contains a higher proportion of collagen and has greater elasticity. This means it can absorb energy by bending before it breaks.
In younger children, this sometimes produces what is known as a greenstick fracture — where the bone cracks on one side but does not completely snap through. The periosteum (the outer covering of bone) remains partially intact, which helps stabilise the fracture and supports rapid healing.
Children also have a remarkable capacity for remodelling. Even if a clavicle heals with a visible bump, that prominence often reduces significantly over 6–18 months as the bone reshapes in response to normal movement and loading.
This is why broken collarbone recovery in children is usually quicker and more forgiving than in adults.
In contrast, adult bone behaves differently.
From around the fourth decade of life onwards, bone mineral density gradually declines. The internal structure of bone becomes less dense and more brittle. This process is accelerated in:
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Post-menopausal women
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Individuals with low body weight
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Smokers
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People with reduced physical activity
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Those with osteoporosis
In this context, a fall that might cause only bruising in a 25-year-old can result in a clean midshaft clavicle fracture in someone over 50.
This is why clavicle fractures in older adults sometimes occur from relatively low-impact mechanisms, such as slipping on a pavement or tripping over at home.
High-Energy Trauma
At the other end of the spectrum, high-energy trauma produces a different injury pattern.
In road traffic collisions or high-speed cycling crashes, the force transmitted through the shoulder can be substantial. Instead of a simple break, the clavicle may fracture into multiple fragments (a comminuted clavicle fracture). The displacement may be greater, and surrounding soft tissues may also be injured.
In these cases, the fracture pattern reflects the magnitude of force involved.
Importantly, fracture severity is not just about pain — it is about the energy transferred through the shoulder girdle.
What Patients Often Experience at the Moment of Injury
Most people describe a very similar sequence when a broken collarbone occurs. There is usually a clear moment of impact — a fall onto the shoulder, a collision during sport, or a sudden sideways landing. Within seconds, a sharp, intense pain develops at the front of the shoulder or directly over the collarbone. The pain is often immediate and unmistakable.
Some people report hearing or feeling a crack or snap at the time of injury. Others do not hear anything but describe a sudden sensation that “something gave way” or that the shoulder no longer felt structurally sound. Almost immediately, lifting the arm becomes extremely difficult.
This sudden loss of function can be alarming. The inability to raise the arm is not caused by pain alone. When the clavicle fractures, the structural link between the shoulder blade and the chest wall is disrupted. The collarbone normally acts as a stabilising strut, allowing the shoulder to rotate and elevate efficiently. Once that support is lost, the shoulder girdle feels unstable and mechanically compromised.
Many patients instinctively bring the injured arm in toward their body, supporting it with the opposite hand. This protective posture reduces tension across the fracture site and limits movement of the bone fragments. It is a completely natural response and often the most comfortable position in the early hours after a clavicle fracture.
As swelling develops and muscle spasm increases, even small movements — such as reaching forward, rolling in bed, or allowing the arm to hang unsupported — can significantly increase discomfort. For many people, this is the point at which they realise the injury is more than a simple bruise or muscle strain.
Other Immediate Symptoms
Within the first few hours, swelling and bruising may begin. Bruising can sometimes spread downward toward the chest or upper arm over several days due to gravity.
Some people notice a visible step or bump along the collarbone almost immediately. In displaced clavicle fractures, the deformity can be obvious.
Pain is often worse with:
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Reaching
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Rolling in bed
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Coughing or sneezing
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Trying to lift the arm unsupported
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Sleeping can become particularly uncomfortable, and many patients prefer to rest slightly upright in the early phase of recovery.
When to Be Concerned
Even if a clavicle fracture appears straightforward, it should always be assessed in an emergency or urgent care setting. A suspected broken collarbone requires medical evaluation and X-ray imaging to confirm the diagnosis, determine the fracture pattern, and rule out associated injury. What feels like a simple fracture can occasionally involve displacement, shortening, or injury to surrounding structures that are not obvious without proper assessment.
Certain features increase the urgency of medical review. High-energy mechanisms — such as road traffic collisions or high-speed cycling crashes — raise the likelihood of more complex fracture patterns or additional injuries. A visibly distorted collarbone, significant deformity, or bone pressing firmly against the skin (known as skin tenting) requires prompt evaluation. Although the skin is usually intact, prolonged pressure from displaced bone can compromise circulation.
Numbness, tingling, weakness, or unusual heaviness in the arm may indicate irritation or compression of the brachial plexus — the network of nerves that passes beneath the clavicle. While uncommon, nerve involvement must be assessed urgently. Similarly, shortness of breath after shoulder trauma should never be ignored. The top of the lung lies just beneath the medial clavicle, and although rare, high-energy trauma can result in a pneumothorax (collapsed lung).
It is important to emphasise that serious complications are uncommon in isolated midshaft clavicle fractures sustained during routine falls or sporting incidents. However, because important blood vessels, nerves, and lung tissue sit beneath the clavicle, every suspected broken collarbone should be assessed medically at the time of injury, even if it appears uncomplicated.
Prompt evaluation ensures appropriate management from the outset and reduces the risk of avoidable complications.
What Happens in A&E After a Suspected Clavicle Fracture?
If you attend Accident & Emergency (A&E) or an urgent care centre with a suspected broken collarbone, the process is usually straightforward and systematic.
First, a clinician will take a history of how the injury happened. The mechanism matters. A simple fall while walking is assessed differently from a high-speed cycling accident or road traffic collision.
They will then examine the shoulder and collarbone area, checking for:
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Visible deformity
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Swelling and bruising
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Skin integrity
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Tenderness along the clavicle
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Shoulder movement
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Nerve function in the arm and hand
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Circulation in the affected limb
Neurovascular assessment is routine. Even though nerve or vascular injury is uncommon in isolated midshaft clavicle fractures, it must always be checked.
X-Ray Imaging
An X-ray is performed to confirm the diagnosis and determine:
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The exact location of the fracture
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Whether it is displaced
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The degree of shortening
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Whether there are multiple fragments
This helps guide management decisions. In most straightforward clavicle fractures, additional scans such as CT or MRI are not required.
Initial Treatment in A&E
For the majority of patients, treatment in A&E involves:
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Providing a sling for comfort
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Advising on pain relief
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Giving written information about recovery
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Referring to fracture clinic for follow-up
The sling is not designed to “hold the bone in place” in a rigid sense. Instead, it supports the weight of the arm, reduces tension on the fracture site, and improves comfort during the early inflammatory phase of healing.
Pain relief typically includes paracetamol and, if appropriate, anti-inflammatory medication. Stronger analgesia may be provided initially depending on severity.
In some cases — particularly significantly displaced fractures, open fractures, or injuries with skin compromise — orthopaedic review may occur immediately.
Will It Be Manipulated or “Put Back Into Place”?
This is a common concern.
Unlike some wrist fractures, clavicle fractures are rarely manipulated in the emergency department. The position seen on the X-ray is usually accepted unless surgery is indicated.
Many displaced clavicle fractures heal well without being “set” in the traditional sense. The body forms callus around the fracture site during healing, stabilising the bone over time.
What Happens Next?
Most patients are referred to a fracture clinic within 1–2 weeks.
At that appointment:
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The X-ray may be reviewed again
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Healing progress is assessed
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Decisions about continued conservative management or surgical referral are made
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Advice is given about gradually increasing movement
For uncomplicated midshaft clavicle fractures, ongoing management is usually conservative.
The First 1–2 Weeks After a Broken Collarbone
The first phase of broken collarbone recovery is primarily about protection and comfort.
During this period:
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The sling is worn most of the time, especially when upright
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It may be removed for washing and gentle exercises
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Pain and swelling gradually begin to settle
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Bruising may become more visible before it fades
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Sleeping can be difficult. Many people find that lying slightly upright, supported by pillows, is more comfortable than lying flat.
Gentle movement of the elbow, wrist and hand is encouraged early to prevent stiffness. Pendular shoulder movements may be introduced depending on pain levels and medical advice.
This stage is often frustrating. The shoulder feels vulnerable and weak. However, this is a normal part of the inflammatory phase of bone healing. You must follow the guidance of your own medical team at all time. The infmration her is more generic than specific.
Do All Clavicle Fractures Need Physiotherapy?
Most clavicle fractures heal well with time, appropriate protection, and gradual return to movement.
For many people — particularly children and younger adults with uncomplicated midshaft fractures — shoulder function returns steadily once the bone unites. Everyday activities such as dressing, washing, and light lifting usually improve over 6–12 weeks as strength gradually rebuilds through normal use.
In straightforward cases, formal physiotherapy may not be required. However, bone healing and full shoulder recovery are not the same thing. Some individuals experience ongoing issues after a broken collarbone, particularly if the fracture was displaced, significantly shortened, required surgery, or occurred in someone who is older or less physically active. In these situations, stiffness, weakness, or altered shoulder mechanics can persist beyond the initial healing phase.
Common reasons someone may benefit from physiotherapy after a clavicle fracture include:
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Difficulty regaining full shoulder movement
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Ongoing weakness with lifting or overhead activity
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Shoulder fatigue during work or sport
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Altered posture or scapular control
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Loss of confidence using the arm
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Return to contact sport or heavy manual work
Even when the bone has united, the surrounding muscles — particularly the rotator cuff and scapular stabilisers — may have deconditioned during the period of immobilisation. Without gradual reloading, the shoulder can feel stiff, uncoordinated or vulnerable.
Rehabilitation in these cases focuses on restoring:
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Normal movement patterns
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Strength and endurance
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Scapular control
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Load tolerance for work or sport
For individuals who have undergone surgical fixation, rehabilitation is often more structured, with staged progression guided by surgical advice and healing timelines.
The Overall Outlook
The long-term outlook after a clavicle fracture is generally very good.
The vast majority of broken collarbones heal successfully and allow return to normal daily activity. A small visible bump at the fracture site is common and usually does not affect function.
Persistent problems such as non-union or significant long-term weakness are uncommon but can occur, particularly in high-energy injuries or individuals with risk factors such as smoking or low bone density.
The key points to understand are:
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Most clavicle fractures heal without surgery.
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Most people regain good shoulder function.
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Recovery takes time and progresses in stages.
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Some individuals benefit from structured rehabilitation to restore full strength and confidence.
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Understanding what is normal during healing — and recognising when recovery is not progressing as expected — helps ensure the best possible outcome after a broken collarbone.
Educational Notice
This content is intended for educational guidance only and reflects current evidence and clinical reasoning at the time of publication. It does not replace individual assessment, diagnosis, or treatment provided by your healthcare practitioner. Management decisions should always be based on personalised clinical evaluation.
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Clavicle Fracture FAQs
1) How long does a broken collarbone take to heal in adults?
In adults, a clavicle fracture typically takes between 6 and 12 weeks to unite on X-ray. Younger adults may heal closer to the 6–8 week mark, while adults over 40 may take longer. However, bone healing is not the same as full recovery. Regaining strength, endurance and confidence in the shoulder can take 3–6 months depending on the severity of the fracture and activity level.
2) Can a broken collarbone heal without surgery if it is displaced?
Many displaced midshaft clavicle fractures heal successfully without surgery. The decision depends on the degree of displacement, shortening, fracture pattern, and individual factors such as age and activity demands. Surgery may reduce the risk of non-union in certain cases, but it is not automatically required for every displaced fracture.
3) When can I drive after a clavicle fracture?
You should only return to driving when you can comfortably control the steering wheel with both hands and perform an emergency stop safely. This usually occurs after the sling is no longer required and shoulder movement has improved, often around 4–6 weeks. However, recovery varies, and you should follow medical advice and inform your insurer if necessary.
4) When can I return to sport after a broken collarbone?
Return to sport depends on the type of sport and the stability of healing and you should always follow the advice of your own medical team. Non-contact activities may resume once strength and movement have returned, often around 8–12 weeks. Contact sports typically require confirmed bone healing and near-normal strength, which may take 12 weeks or longer. High-impact sport should only resume once medically cleared.
5) Is it normal to have a lump after a clavicle fracture?
Yes. A visible bump at the fracture site is common, especially in displaced fractures. This represents bone callus formation during healing. In children and younger individuals, this bump often remodels and becomes less noticeable over time. In adults, a small prominence may remain but usually does not affect function.
6) What should I avoid doing in the first few weeks after a broken collarbone?
In the early weeks after a clavicle fracture, you should avoid heavy lifting, overhead reaching, pushing movements, and allowing the arm to hang unsupported for prolonged periods. The sling is used mainly for comfort and protection. Gentle movement of the elbow, wrist and hand is encouraged to prevent stiffness, but activities that cause sharp pain should be avoided.
7) Can a clavicle fracture fail to heal properly?
Most clavicle fractures heal without complication. However, a small percentage may develop delayed union or non-union, where the bone does not fully heal. Risk factors include smoking, significant fracture displacement, high-energy trauma, and poor bone density. Persistent pain beyond the expected healing timeframe should be reassessed medically.
8) Why does my shoulder feel weak after the bone has healed?
After a period of immobilisation, the surrounding muscles — particularly the rotator cuff and scapular stabilisers — can become deconditioned. Even once the fracture has united, strength, coordination and endurance may not have fully returned. Gradual reloading and strengthening are often required to restore normal shoulder function.
9) Is it safe to sleep on the injured side after a broken collarbone?
Sleeping on the injured side is usually uncomfortable during the early healing phase and should be avoided until pain has significantly reduced. Many people find sleeping slightly upright or supported by pillows more comfortable in the first few weeks. Once healing progresses and pressure is no longer painful, side sleeping can gradually resume.
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