Expert: Dr. Victor Dolan, DC, DACBSP - 8/7/2009

Question
Hi Dr. Victor,

I believe I have an anterior collar bone impingement/dislocation...My right-side clavicle protrudes like a bulb at the base of my throat, similarly the left side rib one step below is protruding like a bulb.  I've read that a chiropractor can do a reduction on the shoulder by manipulation/adjustment, but i haven't found much luck that gets into the meat of my issue. So i wanted to ask your input on that? Also, i've been having success at realigning the structural areas above and below these 2 bulb problems by doing rehab exercises, especially chest since i've had 13 full yrs of swimming thru my childhood.  Are there specific exercises that should help my collarbone into place?  The best 'feel good' stretch that I know at this point is to raise my arm at a 45 degree angle from vertical and roll my arm in a big circle from front to back.  I've just started to incorporate that motion in my rehab exercise with light weights (tho waiting weeks for experimentation results always sucks).  It seems logical to me that doing certain back exercises like rows, in particular the 'elbows to shoulder level' rows, might actually keep my clavicle in the anterior dislocated position...?  i appreciate any input and thanks for reading my long story:) roger

Answer
collar bone bulbs , staten island kinesiotape





Hello Roger,



I am sorry to hear of your problem.


Does this prominence of the sternal end of the clavicle cause you any pain?, dysfunction?
Your description makes it sound as if the problem is bilateral- both sides have 'collar bone bulbs'?


Please do not hesitate to RE-connect with me here at all experts if I am reading your question incorrectly.


Many Doctors of Chiropractic do perform extremity manipulations, extremity adjustments; especially when connected to a spinal complaint.  there are many different specialties among chiropractic doctors (just as there are different specialties amongst medical doctors).  I would recommend a doctor with sports injury credentials, or orthopedics or rehabilitation.  for the different types of Chiropractic specialties see:  http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf


How and when did you injure your chest to cause this dysfunction/ misalignment?  Did you go for Xrays when you hurt yourself?  Have you seen a medical doctor- such as an Orthopedic, sports injury specialist, or physiatrist?  When they first 'popped out', when you first hurt yourself, what were you doing?  What activities aggravate the condition?  What activities seem to help?
Do you place hot or cold over the inflamed areas?


You state, "....I believe I have an anterior collar bone impingement/dislocation...", when, how did you hurt yourself, who have you gone to see, what pain do you have, what treatments have you tried, who gave you this diagnosis ?


You say,  ".....I've read that a chiropractor can do a reduction on the shoulder by manipulation/adjustment, but i haven't found much luck that gets into the meat of my issue.....",
Yes, just about any Doctor of Chiropractic will do simple maneuvers to reduce a subluxated sternoclavicular joint.  "....but i haven't found much luck that gets into the meat of my issue....."- I do not understand this; you HAVE been to the chiropractic doctor?, you have NOT been to the DC?  I do not understand; if your clavicle were/ is subluxated, simple chiropractic extremity manipulation, perhaps supported by kinesio taping and adjunctive physiotherapy should handle the problem efficiently and quickly.  If luxated, or dislocated; then an orthopedic or perhaps thoracic surgeon should replace the clavicle into the joint with appropriate supportive suturing.

"....Are there specific exercises that should help my collarbone into place?...."- i am sorry, I do not know of any exercises to put your collar bones into place.  Surgical or manipulative procedures to properly place the bone end into the aligned joint position would be necessary first.

"....It seems logical to me that doing certain back exercises like rows, in particular the 'elbows to shoulder level' rows, might actually keep my clavicle in the anterior dislocated position...?...."- I would agree-- working on the back muscles would tend to open the chest, and possibly make the chest more pronounced, bringing out the sternum and sternoclavicular joint.



For more information, I would recommend the following websites:

http://www.healthscout.com/ency/68/608/main.html

The ligaments and capsule of the SCJ contribute enough stability to make this one of the least dislocated joints in the body. Sternoclavicular dislocations are uncommon, accounting for only 3% of a series of 1603 shoulder girdle injuries.  http://emedicine.medscape.com/article/828642-overview  

http://orthopedics.about.com/od/shoulderelbow/a/scjoint.htm  


Sternoclavicular subluxation:  http://findarticles.com/p/articles/mi_qa3912/is_200608/ai_n17183173/

http://www.rehabedge.com/cgi-bin/ultimatebb.cgi?ubb=get_topic;f=1;t=000465;p=0

http://www.chiroweb.com/mpacms/dc/article.php?id=15417


In anatomy we learned an old saying:  "Anatomy IS Anomaly", meaning that we all have anomaly within our individual anatomy.  For example- I have a spina bifida at L5.  My spina bifida is occulta, so it is relatively insignificant; I never knew until Xrays in Chiropractic School.
Your prominent 'collar bone bulbs', are they specific to you, peculiar, anomalous but 'normal'?
Are your 'collar bone bulbs' the result of injury, a dysfunction, or,,, just the way you are built?  Are you very slim and that build makes them look more prominent?, or is it the result of a trauma.  Only you can answer that question.


I recommend visiting a Doctor of Chiropractic with sports injury, orthopedic, or rehabilitation credentials.  A proper evaluation will reveal if this is indeed treatable or not, manipulatable or surgical.  The doctor could/ should manipulate the joint, then support with kinesiotaping, and perhaps some adjunctive physiotherapy.



I hope this all helps.

If you need further information, do not hesitate to RE-contact me here at
AllExperts.com
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm



Thank you for your question,
I wish you luck in attaining and maintaining good health naturally,
your Staten Island Chiropractic expert,


Dr. Victor Dolan, DC, DACBSP
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