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With testing now over, Jack Miller has joined the ranks of riders undergoing surgery in the off season. Flying back from Sepang to Barcelona, Miller had an operation to remove four loose screws from his right collarbone, the aftermath of an old injury sustained at Indianapolis in 2013.

That injury was fixed with a plate, but preseason crashes on the KTM Moto3 bike caused a number of complications for the Australian.

With testing completely, Miller now has time to have the remaining screws removed from his shoulder, and allow it to heal. Miller will be unable to train for five days while the scar heals, but will be able to resume his training program after that.

The 2013 MotoGP season has been a bad one for shoulder injuries. Shoulder problems have caused Ben Spies to miss almost the entire MotoGP season, and now Karel Abraham has also decided to sit out the remainder of 2013.

The Czech rider injured his shoulder in a bad fall at Indianapolis, causing ligament damage which needs surgery to correct. Abraham is currently undergoing therapy to prepare for surgery, scheduled to take place in early October.

Ben Spies has undergone surgery on both his shoulders in Dallas yesterday. The Ignite Pramac rider had surgery to fix the acromioclavicular joint in his left shoulder he dislocated in a practice crash at Indianapolis.

Spies also had a minor procedure already scheduled for his previously injured right shoulder, to clean out scar tissue, according to a report in US publication Cycle News. The Texan posted a picture of himself after surgery on his Twitter page, announcing his surgery, but no official word has come from Ducati or Pramac just yet.

Ben Spies’s run of truly appalling luck continues. During the Saturday morning FP3 session of practice for the MotoGP race at Indianapolis, Spies was thrown from his Ignite Pramac Ducati and fell very heavily on his left shoulder.

The Texan was taken to the medical center at the circuit, where he was diagnosed with an acromioclavicular joint dislocation, the separation of the collarbone from the shoulder blade. Spies has been forced to withdraw from the Indianapolis GP.

The composition of the MotoGP grid at Laguna Seca remains uncertain at the moment, as injuries sustained at the Sachsenring continue to take their toll. On Tuesday, Andrea Iannone announced that he would not be fit enough to race at Laguna Seca, after a CT scan showed up problems with the shoulder he hurt at the Sachsenring.

Iannone had a massive crash at Turn 1, as he accidentally selected the pit lane mapping while braking for the corner, locking up the rear wheel and being thrown from the bike. The Italian dislocated his right shoulder in the crash, and was forced to withdraw from the race in Germany.

An examination in Italy revealed a large amount of fluid in the joint, making it impossible for him to race in the US GP, the Italian press service ANSA is reporting.

After Jorge Lorenzo’s heroic ride at Assen, where he’d broken his left collarbone only two days before, the German GP had many of us asking “how much is too much?” in terms of riding with injuries.

Two weeks after Lorenzo had risked, perhaps not ‘everything’ but certainly ‘a lot,’ to limit his injury’s effect on the championship standings (he finished 5th, one place behind a struggling Dani Pedrosa), the topic came up in Thursday’s Press Conference at the German GP. Cal Crutchlow remarked that Lorenzo’s decision at Assen had raised the bar for all riders facing the question: Should I race with this injury?

Ironically, or perhaps not, Crutchlow himself had raised this bar at Silverstone last season when he slipped past the medical exam process to turn in his own amazing ride through the pack with a broken ankle. He pointed out that now more riders would be using Lorenzo’s Assen ride as a precedent: if he was allowed to ride at Assen, why can’t I?

Lorenzo didn’t like the sound of that, saying other riders should not use him as an example and instead listen to their own bodies to determine if they should sit out or compete while injured.

All weekend I heard different responses to the situation, from respect for athletes who push through pain, to scorn for the willingness to put others at risk by competing at well below 100% fitness.

One paddock insider expressed the opinion that riding a MotoGP bike is difficult enough at full fitness–any physical or mental weakness is a liability that increases the risk of crashing, and thus increases the chances of a crash involving other riders.

Two days, two big highsides, and two championship contenders down and out. Friday and Saturday at the Sachsenring saw both Jorge Lorenzo and Dani Pedrosa have massive crashes, and forced to withdraw from the race in Germany.

Jorge Lorenzo bent the titanium plate holding together the collarbone which he broke at Assen, while Dani Pedrosa suffered an imcomplete fracture of his collarbone, and had problems with blood pressure and dizziness.

Though both Pedrosa and Lorenzo were ruled out of the Sachsenring race, there was much speculation about whether either of the two would be racing at Laguna Seca next weekend.

Dani Pedrosa is in doubt for Sunday’s race after suffering a major highside on Saturday morning at the Sachsenring. The Repsol Honda man entered the slow right hander at Turn 1 on his first full flying lap when the rear of the bike came round on him, flinging him a long way off the bike.

Pedrosa fell heavily on his left shoulder – the shoulder he injured badly at Motegi in 2010, and then again at Le Mans in 2011, suffering complications until the end of the 2011 season. He got up holding his collarbone, and as rushed to the medical center.

There’s an expression in the Dutch language, “een ongeluk zit in een klein hoekje,” which translates literally as “accidents hide in small corners.” It seems particularly relevant at the Sachsenring on Friday, as while there were crashes galore at Turn 11, the fast corner at the top of the long downhill run to the two final left handers, Jorge Lorenzo crashed at Turn 10, the uphill left which precedes Turn 11.

It is not much of a corner, just the last of the long sequence of left handers which proceed from the Omegakurve towards the top of the hill, and the plunge down the waterfall. But it was enough to bend the titanium plate holding Jorge Lorenzo’s collarbone together, and put him out of the German Grand Prix, and maybe Laguna Seca as well. That relatively minor corner may have ended Jorge Lorenzo’s championship hopes.

Jorge Lorenzo’s title hopes have suffered a major setback. The Spaniard crashed heavily during the second session of free practice at the Sachsenring, being thrown from his bike at Turn 10, the final left hander before the fast right hander at the top of the hill. Lorenzo fell on his left shoulder once again, getting up clearly in pain.

The reigning world champion was taken to the medical center, where scans suggested that his collarbone had sustained further damage. He was then transported to hospital, where further tests revealed the plate on his collarbone had become bent, and would have to be replaced.

Unlike Assen, however, Lorenzo will not make a dramatic return to the circuit, and is almost certain to skip both the Sachsenring race and the Laguna Seca round next weekend. That would give the Spaniard over a month to recover, in time for the following round of MotoGP at Indianapolis, in mid-August.

Bending the plate holding a collarbone together is a common occurrence amongst racers, even months or years after the original accident which required the plate to be fitted. A heavy crash on a plated collarbone will sometimes cause it to bend, requiring the plate to be replaced.