How Significant Is The Inward Shoulder Rolling In Shoulder Narrowing Surgery?

Q: Dr. Eppley, there’s a small discussion going on (url below) on one your patient’s threads about the shoulder rolling which you write can occur temporarily during healing. The point I’d like to clarify with you please (so I can add to the discussion), is, skeletal wise, how do/can the shoulders go back to being straight/back again despite the ‘geometry’ of the clavicle bones being shorter and thus pulling the shoulders forward? 

Also, post healing, would back arch exercises (which really pull the shoulders back) be contraindicated, or would they be fine?

 A: All I can say about it is that, so far, no patient has told me yet that inward shoulder rolling is a long term problem. The operative words here are  ‘told me’ which could mean maybe some patients have it but have not gone out of their way to tell me about it during our postop virtual followups. 

The medical answer to your question is that, according to the orthopedic literature based on extensive clinical data from patients with unoperated clavicle fractures where length shortening is a common sequeale, shoulder function is not adversely affected when the clavicle length has been compromised by less than 30% of its original length. They do not comment on appearance since this is from the orthopedic surgical literature.

Once the clavicle is full healed (8 weeks) shoulder/back stretching can certainly be safely done which would very likely overcome any inward shoulder rolling from clavicle length reduction if it persisted.

Dr. Barry Eppley

Indianapolis, Indiana