Comment by ehnto

I left out a bit, before I saw the doctor that told me surgery is the only way, I was consulted by another guy that was free and he scolded me because I came without the orthosis saying stuff like I don't want to get better and basically didn't even look at me or check my recovery after 3 weeks of wearing the orthosis. Told me to go to his private clinic and get a new orthosis where I decided to see any other doctor because I was put off by his attitude. I think the private clinic had a contract with the hospital I was sent to for the surgery or something.

Anyway thank God I found a decent doctor.

Do yourself a favor and don't wait too long to get rid of the plate: when you crash on that shoulder again, the collar bone won't be able to do it's job of being the predetermined breaking point that saves the shoulder ligaments from ripping. And the AC ligament, unlike bone, will never recover. Not even with the surgery that you'll then likely need to at least restore the other shoulder ligaments. Fractured collar bone is a feature, not a bug.

Yeah, I failed to get my plate removal appointment in time, then I got a plate replacement appointment on the fast track and the next removal appointment then happened to be almost the same day as the one originally scheduled (the plates for separated shoulder stay in much shorter, and they better should, because they aren't painless at all)

Mine felt immediately worse after the ORIF. After two weeks getting comfortable in their new positions, all the ligaments really resented getting wrenched back into place.

Good illustration was that my run of the mill, 45 minute surgery ended up taking 4.5 hours.

It’s good to hear that everything felt good after your plate was removed. At 18 months post-surgery, I’m in a really good place where I can do most anything I want. Only occasionally experience discomfort if my son headbutts the plate or a backpack strap rubs on it. I was in two minds about having it removed as it would be a step backwards to post-surgical, but the likelihood of me doing something stupid again in the future means it’s worth it. Rather have the fuse that a clavicle is rather than fracture my sternum!

Almost everyone I know that mountain bikes, had broken their collarbone.

Get it removed: the next hit will be much worse than a broken collar bone if the bone can't do its job of giving in before less restorable parts of the shoulder give in.

Thanks! I've always been a surfer, but split my time with other activities. Post-accident everyone thinks I'm scared of getting back on the bike — maybe a bit? — but genuinely my first thought post-crash was how long I'd be out of the water. It was a clarification of what I truly enjoyed, and an excuse to double down on being in the water.

I'm now doing anything and everything to get in the sea and improve my surfing. Lengths at the pool for strength and endurance, free diving (and spearfishing) to reduce the anxiety of those big hold-downs. It's been liberating choosing just one sport to be good at.

Strength training can help reduce injuries from crashes up to a point.

Experience helps too but that’s harder to get safely!

For collarbones specifically? Nothing I'm aware of. At least if the explanation that was given to me for the high prevalence of collarbone injuries is correct, that makes sense. Someone explained it to me as "when you start to fall, you instinctive tend to reach our towards the ground to try to break your fall. So your hand is the first thing that hits the ground, and all the energy of the fall goes up your arm and into your shoulder / upper chest area. And the collarbone just happens to be the "weak link" there and so tends to break."

Now maybe that's just folk wisdom that isn't really true, but it sounds plausible to me. And if we reason by analogy a little, it's not too far off what my surgeon told me when I tore my rotator cuff. I fell and came down on my elbow, and he explained that the energy from the fall pushed my humerus up into my shoulder, and pinched my rotator cuff between two bone heads, which is what caused the tear.

So yeah, not much padding can do about stuff like that I guess.

> but how is that a drain on society, and not primarily the individual?

There are two factors.

The first is that a drain on individuals is a drain on society. That's why we outlaw risky behavior like lethal recreactional drugs, driving without seatbelts, driving without a driver's license, etc. We try to protect people from themselves in some of the worst aspects that we can.

Second, of course, is health care costs. Activities that constantly result in injury wind up raising the health care costs for everyone, since that's how insurance works.

> by your logic, should we also ban (or require insurance?)...

You already have to have car insurance, yes. And yes lots of kinds of guns are banned in lots of places.

We draw the lines in different places.

It is a pretty interesting thought experiment to wonder whether people shouldn't be allowed to engage in organized sports that are risky, without paying an additional health insurance premium? E.g. if you play professional football, then your league has to pay extra money into the health insurance fund to compensate for all the extra health care treatment their players need and will need.

Yes, we should absolutely ban, at the very least, contact football among minors. We have ample evidence of football (and soccer, too, for that matter) student athletes developing full blown CTE by their 20s, and with lifetime risk thousands of times the general population.

> now I want to add obesity, and all mental health conditions

If you have a way to just not have those, the way you can just not use trampolines, I would love to hear it.

Don't forget about the alternatives. Is mountain biking worse than watching movies - biking will of course have more injuries, but it also builds physical fitness and so long term is probably better for you. (or maybe just my anti-movie bias is showing?)

I agree that a ban doesn’t make sense, but even “ephemeral” injuries routinely generate significant costs.

(In my experience, musculoskeletal injuries are rarely completely ephemeral, they tend to have long-term effects, even if minor.)

Controversial take: On a population level, the negatives of smoking are at least partially mitigated by the "smoking suppresses obesity" side effect. Obesity is such a huge (pun not intended) public health issue in modern American society that any intervention reducing it is actually quite valuable.

It's at least arguable and perhaps even true that we as a society would be better off if everybody used tobacco at 1950's rates and therefore got skinnier, especially if we all just dipped Zyns or similar smokeless "low harm" nicotine formats instead of smoking.

That said, I personally use 0 tobacco/nicotine etc.

The way I always looked at it (based on my own anecdotal experience, plus those of my friends around me)... you're probably more likely to get "hurt" in some sense while mountain biking, but probably more likely to get "killed or maimed" while road cycling (eg, being struck by a car).

Curiously enough, I have been road cycling for 10+ years now (and mountain biking much longer) and I only just picked up my first crash and injury from road cycling on Jan 1. I crashed and sprained my wrist. :-(

Another factor worth considering is that being physically active also prevents other ailments, so (even downhill) bikers may still be more profitable for insurance companies!

> Certainly, compared to road cycling, I know more people with major injuries from being hit by cars than from crashing solo on a mountain bike.

Speed must be part of it. Low sun and going into the back of a parked car or other obstacle is a common mistake, and road bikes get up some good speed on most rides. Many riders pass 80kmh on a regular basis, which doesn’t leave a lot of room for error. I’m rather slower than that, but 50-60kmh would be a daily event.

> A lot of the injury risk when mountain biking is reasonably easily mitigated by controlling your speed and walking the bike through terrain that's above your skill level. There was a report out of British Columbia a few months ago about injury rates, and they were high, but BC is also a major downhill trail region.

Yeah, with downhill biking, “controlling your speed” means making sure you go fast enough to land the jump on the intended downslope. Go too slow and you’ll land wrong.

> I know more people with major injuries from being hit by cars

_hit by drivers_, you meant?

Yeah. I did have a fall (for no good reason) cycling on a carriage path in Acadia National Park. But that's almost certainly safer than road biking on a busy road. And I do think a world in which you have insurance companies micromanaging what they will cover for various outdoor activities is not one we want--and it's not clear that it even distinguishes from people who are very sedentary.

One thing which comes to mind is - why should we stop at sports, then? we'll immediately be at the point where smokers, alcoholics, obese people etc. should pay more, after all, their way of life statistically causes higher costs.

(i don't think either of those things should result in higher insurance prices, just continuing the thought.)

I play recreational hockey. All of the rinks around here (and most of the US) require membership to USA Hockey which, among other things, provides some kind of insurance to both the rinks and the players.

https://www.usahockey.com/insurancemanagement

> Medical insurance generally covers your own accidents/mistakes, because it's not like you're going out searching for them for fun.

I wonder if the guys from Jackass had trouble finding health insurance.

You mostly aren't. But you're also foolish to not carry health insurance and homeowner's insurance (even aside of liability) in the US.

Get 8 billion people to flip a coin 30 times in a row, and one is likely to get heads 30 times in a row. It means nothing.

You haven't addressed the argument (riskiness of the activity) with your anecdote.

I've been advocating mandatory shower-helmet laws for many years now; it would make as much sense as a lot of the other nanny-state regulation does.

We probably should have lanyard-equipped showers.

I wonder how likely that is? I suspect their understanding of their diagnostic technique is flawed, but beyond that, would a small enough group have a similarly small pool of common afflictions such that you could develop a useful body of medical lore?