Lateral clavicle osteolysis


Distal clavicle osteolysis (DCO)

Lateral clavicle osteolysis is also called weightlifters shoulder. It is a painful condition that affects the outer part of the clavicle (collar bone). It is due to overuse and results from micro fractures that occur at the end of the clavicle, leading to bone resorption (osteolysis).

While it is called weightlifters shoulder it also affects other groups of people putting repetitive forces through their shoulder, including soldiers, air hammer operators, and some sports people.

In some cases there is a specific injury or event but in the majority of cases it is just the accumulation of repetitive stresses which outpace the body’s ability to heal. The bone is resorbed as part of the attempted healing process.

There may be pain at the time of weight training or activity (usually noticed in bench press and press-ups), but it is often worse later that night. Sleep can be disturbed and lying on that side can be troublesome. Pain may be localised to the top of the shoulder but can also be felt elsewhere.

Rest and adjusting your training regime may be helpful and not working through the pain. It can take several months to settle. A steroid injection may help settle symptoms while training is modified.

In those with persistent symptoms, surgery can be performed to remove the outer part of bone along with the scar tissue. This can be done either as an arthroscopic (keyhole) procedure or through a small cut on the top of the shoulder.

After surgery you will have a sling. The sling is usually worn for 2 weeks. Light two-handed activities can start at 2 weeks from surgery and moderate lifting from 6 weeks.

The majority of people recover well from the surgery and get back to physical activity quickly.