[HN Gopher] Broken legs and ankles heal better if you walk on th...
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Broken legs and ankles heal better if you walk on them within weeks
Author : sohkamyung
Score : 257 points
Date : 2025-02-19 12:36 UTC (10 hours ago)
(HTM) web link (www.scientificamerican.com)
(TXT) w3m dump (www.scientificamerican.com)
| clumsysmurf wrote:
| It was ~20 years ago, so my memory is a little foggy, but I gave
| myself a "dancer's fracture" in one foot.
|
| After many months, it was looking like a non-union. The
| podiatrist was worried any pin would split the broken bone even
| more. It wasn't looking good.
|
| I had read something along these lines even back then, so with my
| crazy immobilizer boot on, I head to the gym and started doing
| light squats several times per week.
|
| Next x-ray: healed.
| 77pt77 wrote:
| What did the doctors say after it healed?
|
| Did they take credit for it?
| TomK32 wrote:
| Those little bones are fragile... I broke the second from the
| outside last summer, too much running, and then started running
| again a little bit too soon and the next one broke :-/
| sethammons wrote:
| I dropped a few hundred lbs on my foot and got my ballerina's
| fracture. I like "dancer's" better haha. I went to the gym 4
| times a week, every week, even in the boot. Just did mostly
| sitting exercises. It took 4 or 5 months to start to fuse
| still. :shrug:
| ehnto wrote:
| The pathology for broken collar bones was changing right as I
| took up mountain biking, and subsequently shattered my
| collarbone.
|
| It was hotly debated at the hospital, if my specific case should
| be operated on or not. Each time I had a checkup, one doctor
| would say "wait and see" while the other was saying "I can't
| believe we didn't operate on this".
|
| At any rate, the outcome was as good as if they had operated on
| it, according to the doc anyway. Nice of them to test it out on
| me!
|
| More related to this though, I have broken both my collarbones,
| the first time I had little direction and just held my arm still
| for 2-3 months. It took forever to heal, and my arm atrophied
| significantly. The second time, similar severity. I was guided
| through rehab and I was back using my arm within the first month,
| very little atrophy.
| miketery wrote:
| I had a clean break on mine. If I had not had surgery I believe
| my shoulder would have been a centimeter or two lower. So I got
| a plate and 7 screws.
|
| Am I right to understand that had I not gotten the surgery my
| shoulder would've likely returned to the normal position?
| ghufran_syed wrote:
| _usually_ it shouldn't affect position or function of the
| shoulder once healed, and while the clavicle does tend to
| heal with a "bump" in it at the site of the break, its long
| been thought that the risk of surgery at that site outweighs
| the benefit. But it does depend on the specifics of the
| fracture: https://www.orthobullets.com/trauma/1011/clavicle-
| fractures-...
| edwcross wrote:
| Given the amount of injuries related to mountain biking, is
| there some specific insurance needed for it? It seems one of
| those "net-negative for the society activities", like
| trampolines.
| ghaff wrote:
| In general, "society" deciding what activities are too
| dangerous to routinely allow is a really nasty slope. Yes,
| there's some special insurance offered through private
| organizations for things like higher altitude mountaineering.
| But it's not that big a step to rule that any contact sport,
| for example, should require special insurance. I'm sure the
| insurance companies wouldn't mind.
| 4ggr0 wrote:
| 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.)
| doix wrote:
| > 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.
|
| Wait, do they not? I genuinely assumed they did. I
| remember when I got private insurance through my work I
| had to fill in some questionnaire. It was "free", but it
| was a taxable benefit so you knew how much you were
| costing the company and me and my friends had different
| rates.
|
| I wonder what the actual statistics are when it comes to
| costs with active people that are more likely to be
| injured vs obese people that are less likely to be
| injured but more likely to suffer obesity related
| illnesses.
| ghaff wrote:
| Private life insurance may. I don't think health
| insurance generally does. Certainly Medicare doesn't ask
| about any of those things.
| SoftTalker wrote:
| Health insurance can't ask about this since ACA (I
| think).
|
| Life insurance can and often requires an actual physical
| exam. And can exclude specific activities such as flying
| on small private aircraft from coverage.
| philwelch wrote:
| Health insurance premiums used to be different based on
| whether or not you smoked; maybe they still are. It would
| still be nice if you could lower your health insurance
| premiums by losing weight or buying a policy that didn't
| cover mountain bike injuries or whatnot.
| ghaff wrote:
| At a former company, there was some trivial discount for
| an annual health care screening which I stopped doing
| because it was trivial and something that wasn't between
| me and my doctor. I would absolutely not sign onto a
| screening that invasively wanted to know about specific
| athletic or other activities of that sort. (Which would
| probably also give the insurance company untold levers to
| deny your claim.) "Oh, you said you don't rock climb,
| well that 'hike' looks like a rock climb to us."
| thaumasiotes wrote:
| >> we'll immediately be at the point where smokers [...]
| should pay more, after all, their way of life
| statistically causes higher costs.
|
| > Wait, do they not?
|
| Why should they? It's not obvious at all that smoking
| causes higher costs; a smoker who gets lung cancer is a
| smoker who never needs the medical care we give to the
| elderly.
| corobo wrote:
| You mean like an additional tax on tobacco, alcohol, and
| sugar?
|
| You're behind the times lol -- UK
| Zanfa wrote:
| Some countries tax tobacco, alcohol and sugar at higher
| rates to offset the costs incurred to society?
| parineum wrote:
| 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
| ghaff wrote:
| That must be relatively new. Never heard of such a thing.
| Wonder if it's a reason my undergrad really cut back on
| intramural hockey.
| Scoundreller wrote:
| Hockey Canada is similar.
|
| Paid out a lot of $$$ to quietly settle numerous sexual
| abuse claims/lawsuits.
|
| https://en.m.wikipedia.org/wiki/Hockey_Canada_sexual_assa
| ult...
|
| https://www.cbc.ca/amp/1.6695731
| alistairSH wrote:
| I don't know that "normal" mountain biking is any worse than
| cycling in general, or sports like tackle football.
|
| 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.
|
| 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. And for my own cycling injuries - a few
| concussions, the worst of which was on the road bike (during
| a race) and a few torn rotator cuffs/mild AC joint
| separations.
| ghaff wrote:
| 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.
| kqr wrote:
| 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!
| lostlogin wrote:
| I couldn't agree more. Road biking has entirely fixed my
| lower back and neck issues, my knees have come right and
| getting up hills has knocked 15-20kgs off me in the last
| year. I just wish I could get out there more.
| mindcrime wrote:
| 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. :-(
| wiether wrote:
| > I know more people with major injuries from being hit by
| cars
|
| _hit by drivers_, you meant?
| alistairSH wrote:
| Well, it was the car that touched them. But yeah, the
| driver was at fault in ALL instances.
| burnished wrote:
| I think I like what you're getting at (placing blame on
| the human not the object), but could you tone the
| attitude down? This read to me as an almost snide
| correction, I genuinely think you'd convince people if
| you 'invited' them instead
| lostlogin wrote:
| > 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.
| Scoundreller wrote:
| > 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.
| Daneel_ wrote:
| No? I've been mountain biking for over 20 years and never any
| broken bones or had to go to hospital as a result, despite
| doing downhill, trials, and dirt jumping. And I have 20 years
| of fitness to show for it - that's about as positive as it
| gets.
| sejje wrote:
| You haven't addressed the argument (riskiness of the
| activity) with your anecdote.
| grayhatter wrote:
| That was his point, or if it wasn't it's my point. It's a
| physical activity, one that from my POV improves health
| much more than reduces it. Take the hypothetical where he
| doesn't ever find a replacement activity, and instead of
| being fit becomes obese and depressed. that would be
| worse for society than mountain biking wouldn't it?
|
| For society only; what's the TCO of a mountain biking
| injury times the rate of injuries, over the TCO of
| obesity and depression times the likelihood a sedentary
| lifestyle results?
|
| without access to that data, his anecdote does appear to
| be a stronger argument than literally no data, no?
| _Algernon_ wrote:
| 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.
| Fricken wrote:
| He's been flipping the same coin for 20 years and it has
| never come up tails. That's quite the coin. There is no
| data set more relevant to a person than their own
| experience.
|
| Meanwhile I don't have enough fingers and toes to count
| up all the people I've known personally who have been
| killed or crippled in auto collisions.
| Dylan16807 wrote:
| > He's been flipping the same coin for 20 years and it
| has never come up tails. That's quite the coin.
|
| That also means nothing, because you said nothing about
| how often the coin is flipped.
|
| The first papers that show up in google say "Mountain
| biking athletes were found to have an overall injury risk
| rate of 0.6% per year and 1 injury per 1000 h of biking."
| and "75% of the injuries were minor, such as skin wounds
| and simple contusions"
|
| 4000 hours per serious injury would mean 2000 hours per
| coin flip. A hypothetical person that bikes twice a
| month, 4 hours each time, for 20 years with these
| accident rates, would have flipped the coin _once_.
|
| But if the accident rates were 10x higher, you could
| easily still get the same results. One person is just not
| enough data here. Let's use the real data that show it's
| pretty safe.
| _Algernon_ wrote:
| Why should you be forced to pay insurance if you don't
| endanger others? Most situations where you are forced to have
| insurance are cases where _others_ are endangered (eg.
| driving).
| ghaff wrote:
| 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.
| bombcar wrote:
| Trampolines are indicated because YOUR home insurance could
| be on the hook for someone ELSE being hurt on your
| trampoline. And it's easy for them to exclude it.
|
| Medical insurance generally covers your own
| accidents/mistakes, because it's not like you're going out
| searching for them for fun.
| grayhatter wrote:
| this is such a wild take to me... it's impossible to quantity
| at what point something becomes a net negative for society.
| Smoking seems to be an obvious example, because it's
| addictive quality inhibits a fair decision to the smoker, and
| it's something with a lifelong pathology.
|
| But trampolines and mountain biking are both activities that
| result in ephemeral injuries. There is the rare case where a
| particular injury might become chronic, but how is that a
| drain on society, and not primarily the individual?
|
| by your logic, should we also ban (or require insurance?) for
| football (hand egg), boxing, martial arts, (Tai chi?), cars,
| religion, guns, knives, prescription medicine, children,
| leaving your house at all?
|
| edit; I'm happy to steal more ideas from sibling comments! I
| already stole football, but now I want to add obesity, and
| all mental health conditions.
|
| I'm really curious about the context the idea of net negative
| comes from, but I probably should also take a stab at a
| conclusion; why contrast individual actions and decisions in
| the context of society at all? The decision to do anything
| should stop at 1st order, and maybe 2nd order effects. That
| is to say, when trying to improve society, it's fair to look
| down into smoking and say, we should spend attention on
| fixing this. But it's incorrect to look at an individual
| decision "should I smoke" and weight it's effects on society.
| (How will this effect my family, or my environment is 2nd
| order, and should be accounted for)
| layer8 wrote:
| 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.)
| grayhatter wrote:
| I'm gonna call that sample bias. If you exclude all
| injuries that are ephemeral, (because they don't get
| reported, because they're ephemeral, and forgotten),
| you're left with the injuries that aren't ephemeral. I
| mean duh, obviously lol. But my point is still, yes
| injuries are bad, and as a society, we're pretty trash at
| healing them, but injuries are more impactful for the
| individual, than for society.
|
| And bonus point; if we're talking about sociatial
| responsabilities, given injuries are unavoidable,
| shouldn't we be trying to fix our responses to them
| rather than trying to limit people from enjoying life?
| Mountain biking in fun, so are trampolines. Strictly
| speaking, the world where we've solved injuries (think
| any sci-fi pantopia) is better than the world where we
| didn't because we just outlawed getting injured.
| layer8 wrote:
| My point is, most injuries aren't ephemeral in the sense
| that your body would end up as if you didn't have the
| injury in the first place. In particular the sports
| injuries we are talking about. You may only truly realize
| that a decade later or so. So I find making that
| distinction questionable, it trivializes the injuries.
|
| As I said, I agree that bans don't make sense. But the
| costs are real, and therefore one should take care to
| avoid injuries instead of trivializing them.
| bluGill wrote:
| 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?)
| avn2109 wrote:
| 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.
| aerostable_slug wrote:
| Smoking is significantly worse for you and your family
| than obesity. It causes a greater reduction in life
| expectancy, and can impact the physical health of those
| who live or work with you via secondhand smoke.
|
| It is simply wild how many ways nicotine can find to kill
| humans. All kinds of stuff stems from the lowly
| cigarette. Obesity impacts many more people (that is to
| say, we have more fat people than smokers/tobacco users),
| but it's far from as significant a health risk. I'm not
| sure we know enough to quantify vapes and chew vs.
| obesity.
| TylerE wrote:
| 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.
| ghaff wrote:
| A few years back, I thought there would be more of a push
| to regulate/limit American, at least contact, football.
| But didn't happen. Soccer? Good luck.
| Dylan16807 wrote:
| > 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.
| SomaticPirate wrote:
| By this logic, most software engineers would also be
| considered high risk since they work a sedentary job and have
| higher risks for heart disease and obesity (which likely
| leads to higher healthcare costs over the long term)
| myheartisinohio wrote:
| People slip in the shower so lets stop bathing.
| Qem wrote:
| We probably should have lanyard-equipped showers.
| bluGill wrote:
| people will hang themselves on the lanyard and die. Not
| all such cases will be suicide.
| SoftTalker wrote:
| Why do you suppose hotel showers all have grip bars?
| ghaff wrote:
| All? Ha ha.
| marssaxman wrote:
| 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.
| thaumasiotes wrote:
| On the other hand, mandatory rough surfaces on the floor
| of showers seem pretty reasonable.
| ghaff wrote:
| There's so much about showers in hotels that I hate a
| good proportion of the time: super-slick tiles, high
| step-in tubs, accompanied by no handholds. I've gotten
| more sensitive to this over time but even when I was much
| younger, nearly took spills a couple of times.
| marssaxman wrote:
| That's fair. It's one thing to tell people "don't build
| things in such a way that other people would be put at
| risk", and quite another to threaten people with
| punishment for choosing to take risks themselves.
| doubled112 wrote:
| My friend's parents dropped a shampoo bottle in their new
| build, and it broke through the bathtub. I hope this
| rough surface will be more durable.
|
| I'm imagining some rough sandpaper layer that comes off
| every time you shower until it's smooth anyway. Glue is
| expensive, you know?
| ghaff wrote:
| There are smoother and rougher tile surfaces. When
| getting tile put in my house I've made something of a
| point of avoiding the very slickest/smoothest tile.
| wiether wrote:
| I'm all in behind your idea: let's do the net result for
| society of every activity, and mandate people to do the most
| positive one, while banning the most negative ones!
|
| The good thing is, then, I'll be mandated to go
| mountainbiking instead of staying sitted in front of a
| computer all day long!
|
| How can I vote for your program?
| marssaxman wrote:
| Telling people they're not allowed to have fun in the manner
| of their choosing because it would be bad for society sounds
| like a great way to discourage people from caring about
| society.
| erikerikson wrote:
| Kids have so much joy on trampolines! I know they have
| dangers but net negative? Do you have data or anything?
| webnrrd2k wrote:
| There is no specific insurance required that I'm aware of...
| It's an activity that's well within the normal allowance of
| jackassery that everyone is entitled to.
|
| I think that a big part of the issue is that banning it
| sounds a little like banning all sex because someone might
| get a venereal disease. Yeah, maybe there are some negatives,
| but there are also a lot of positives, and people are _really
| like_ the positives.
| mindcrime wrote:
| Apropos of nothing in particular, when I first started mountain
| biking, a guy I was riding with told me: "You can divide all
| mountain bikers into two groups: the ones who have broken their
| collarbone, and the ones who are about to break their
| collarbone."
|
| Knock on wood, 20 years later I still haven't broken a
| collarbone, but I've had plenty of scrapes, bruises, cuts, etc,
| a couple of concussions, a torn rotator cuff, and quite
| probably a broken neck (never went to the doctor to have it
| diagnosed, but I landed on my head hard enough to crack my
| helmet and knock me unconscious for a few minutes and my neck
| hurt for like 6 months afterwards).
|
| Still, wouldn't trade it for anything in the world. Nothing
| like being out in the woods, on a bike.
| jack_pp wrote:
| I had a broken collar bone last year in Bucharest and I moved
| back to my hometown because of it. I had to check in after a
| week or two to see how it's healing but was lazy about it so I
| went to the hospital after 3 weeks and was told there's a
| waiting list 10 days long and go to a private clinic. At the
| private clinic the doctor didn't even look at me, or the x-rays
| I just took and just told me to go into surgery back in
| Bucharest. Luckily when my mother heard she found a surgeon
| through a friend of a friend that looked at my x-rays on
| whatsapp and told me it's fine but just to be sure to visit him
| in Bucharest feel it in person, which the private care doctor
| never did.
|
| So after 4 weeks I went to this last guy in a public hospital,
| told me I'm fine and can take off my brace, wait a week or two
| and go into physical therapy. Also told me in 20 years he only
| had to once or twice do a collar bone surgery so it's almost
| never the answer.
|
| It's amazing that just being told I'm fine I could relax and
| all my muscle aches literally were gone 1 hour after that
| meeting so my advice in general is, be very careful what doctor
| you choose because medical hexing really is a thing. We put
| doctors on this pedestal and if God forbid you catch them in a
| bad mood they can fuck you up worse than before you saw them.
| jamiedumont wrote:
| I shattered my collarbone - and I do mean shattered, ~8 pieces
| - in a mountain bike crash September 2023. I went over the bars
| after the back wheel of my hardtail caught a berm. Landed on my
| head and shoulder and compressed it laterally inwards by about
| 2 inches.
|
| Even with this mess, it was hotly debated for around two weeks
| whether I needed surgery. A good chunk of my collarbone was
| trying to push through my skin and the other half was fusing to
| my scapular and was starting to compromise nerve function. Even
| then, because the non-surgical route is now considered the
| standard, I was meeting resistance to have an ORIF. It seems
| that the about turn from surgical intervention has been so
| strong that getting ANY surgical intervention is a battle.
|
| I eventually came across a surgeon who took one look at me
| (never mind the imaging) and scheduled me for surgery. ~18
| months later I'm now on a waiting list to have the plate
| removed, and strangely have gone off cycling... Surfing has
| happily taken its place.
| gnarcoregrizz wrote:
| Shattered mine mountain biking as well (6 pieces). Ortho took
| one look at it and scheduled surgery for the next day. It
| wasn't a 'standard' break since it included my AC joint and
| coracoclavicular ligaments which needed a special type of
| plate. Ultimately it took 2 surgeries (ORIF, then plate
| removal). Total recovery was 9 months. My arm/shoulder is as
| strong as it was before, and it looks anatomically correct.
|
| My shoulder immediately felt "better" after ORIF. I would
| suggest it if it's way out of whack... mine was drooping
| probably 2". I can't imagine how much it would suck if the
| bones healed that way.
| jamiedumont wrote:
| 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!
| gnarcoregrizz wrote:
| I should restate - mine definitely did not feel better
| post-surgery, the ORIF pain was worse than the break, but
| it felt good to have my bones secure with my shoulder in
| its anatomically correct place, and not have any more
| crepitus.
|
| My plate was extremely uncomfortable, it was a "hook
| plate" which held my collar bone to my scapula. I
| couldn't raise my arm above shoulder height with it
| installed, it had to be removed after 6mo.
|
| Plate removal was a bit tougher than anticipated (short
| term). I read accounts of it being a 'relief' but I was
| in quite bit of pain.
| osmano807 wrote:
| Functional outcomes seem similar, trough we have a increased
| rate of malunion, delayed or non-union with nonoperative
| treatment. We usually indicate surgery if it's an active
| patient.
| ziml77 wrote:
| You must have broken yours around the same time my dad broke
| his. They didn't operate and apparently some of the people who
| saw the x-rays were quite surprised how well the natural
| healing process handled pulling the bone pieces back together.
| 11235813213455 wrote:
| Also broke my collar bone and no surgery, shoulder is less
| large by 2cm, I had no issues in the short term, but now after
| 10+ years it's cracking more, it doesn't age well
|
| I asked if it was possible to do a surgery now, so they'd have
| to break and restore a longer collar bone, more straight, but
| surgeons don't seem positive for this
| noah_buddy wrote:
| A personal philosophy in medical decisions: - unless there is a
| severe risk I might die from lack of intervention (on any
| reasonable timeline besides life), I avoid intervention.
|
| In some cases (my messed up jaw and a whole 9 wisdom teeth), I
| broke this rule. But generally, it has served me well.
| tomaskafka wrote:
| My wife is a physiotherapist in Europe, and even ten years ago
| she would tell you to start exercising it (with guided
| exercises) as soon as possible.
| akudha wrote:
| When I was a kid (not in the U.S), I remember village elders
| diagnosing all kinds of illnesses simply from checking one's
| pulse, without asking any questions or even talking. These are
| people with minimum education, minimum or zero exposure to
| science or labs or modern medicine.
|
| Now we have all kinds of powerful, fancy machines and drugs and
| procedures and today's doctors still misdiagnose, mistreat even
| relatively simple issues.
|
| I don't know if it is because we as humans have lost touch with
| nature, our own bodies or we have way more illnesses today than
| I was a kid 4 decades ago or what else is the reason. It is
| kinda depressing and mind boggling at the same time.
| adammarples wrote:
| I get the impression from the second part of this that you
| think the village elders were correctly diagnosing things?
| netbioserror wrote:
| I fractured my elbow mountain biking, the tip of my radius. The
| urgent care doctor gave me a sling and suggested months of
| immobility. The orthopaedic said to throw away the sling and
| start exercising the elbow as soon as I could, and prescribed PT.
| Turns out that was the right move, there are some permanent
| changes to mobility but it's about 97% what it was before the
| crash. Immobilizing joints can apparently cause the muscles,
| tendons, and nerves to seize up and lose significant range of
| movement permanently.
| riv991 wrote:
| Something really similar happened to me, I broke my radial head
| cycling last year.
|
| 2 days later I got a call from the doctor telling me to start
| moving it as much as I could, I asked when I should stop with
| the sling and he told me yesterday.
| Aeolun wrote:
| Feels kinda reasonable. Human bodies cannot possibly have
| eveolved to require 6 months of rest to fix. All those humans
| would have died out thousands of years ago.
| 77pt77 wrote:
| Most of these fractures would be deadly affairs thousands of
| years ago anyway.
|
| Immobilization has its uses.
|
| Surgery is many times essential.
| bluGill wrote:
| We archeological evidence of broken bones that healed. If
| you are alone in the woods fractures would be deadly, but
| humans generally exist in society, and society often (not
| always!) takes care of them own. Maybe you can't walk, but
| we will carry you around and hunt food and such until you
| heal. Clearly their rest of life was worse after the
| fracture, but it is also clear that many had a long life
| after the fracture.
| jessekv wrote:
| "Use it or loose it"
| faitswulff wrote:
| If anyone's heard of RICE (Rest, Ice, Compression, Elevation) for
| healing joints, the new guidance is called POLICE: Protect,
| Optimal Load, Ice, Compression, and Elevation. The key
| differences being Protect and Optimal Load, meaning don't re-
| injure it and expose it to some level of weight-bearing or usage.
| dfxm12 wrote:
| Anyone can RICE their joints. It's foolproof, more or less
| objective and requires no monitoring from a professional.
|
| What defines optimal load? It sounds impossible to gauge,
| unless maybe if you're working with a physical therapist. Then,
| what happens if load more than the optimal level? Is the
| outcome worse than if you just stuck to RICE? I think these are
| things that have to be considered for medical protocols.
| miketery wrote:
| Optimal load is right before it starts hurting. You
| progressively load, and when it starts hurting you unload.
| Your body will send pain before there is damage to be done.
|
| Edit: in fact some discomfort or right kind of pain is good.
| Else you give to atrophy.
| shermantanktop wrote:
| That's not how pain works. Pain is a noisy and error-prone
| signal that gives you a good approximation for "stop doing
| that." But the edge of pain sensation doesn't indicate what
| is or isn't a good idea during recovery. It's not a bad
| place to start, but everyone has different pain tolerances,
| some injuries are in nerve-poor areas, and repetitive
| stress or tendinitis are definitely not going to appreciate
| getting lit up right away.
| jacksnipe wrote:
| I'm in PT and dealing with orthos right now, and
| according to them, that IS how pain works for the vast
| majority of ortho injuries
| layer8 wrote:
| Your edit shows that there is no good rule for the
| threshold where pain would indicate too much load vs. still
| being in the beneficial range. We don't even have a good
| way to assess subjective pain (one's 3 is another one's 7,
| etc.). "Optimal load" is really just a tautology.
| pessimizer wrote:
| "As soon as it starts to hurt" is not some hopelessly
| complex and useless standard that involves delving into
| philosophies of subjective pain sensation. It is actually
| obvious and easy to follow.
|
| Use it, but when it hurts, stop.
| Dylan16807 wrote:
| > "Optimal load" is really just a tautology.
|
| It's not _just_ a tautology, because it correctly implies
| that the right amount of load is not zero.
|
| And it's hard to expect an acronym by itself to be very
| specific.
| paulcole wrote:
| > I think these are things that have to be considered for
| medical protocols
|
| What makes you think those things haven't been considered?
|
| The comment you replied to said, "the new guidance is..." I
| took that to mean those things have been considered.
| dfxm12 wrote:
| I mean considered _per patient_. Pro wrestler Kerry von
| Erich had to get his broken foot amputated because he
| thought it felt good enough to walk across the room to get
| a cheeseburger. Not everyone can gauge these things on
| their own, especially considering people with broken bones
| may be taking pain killers. Not everyone can have
| professionals, or even loved ones, around them to monitor
| it.
| darrenf wrote:
| > _Pro wrestler Kerry von Erich had to get his broken
| foot amputated because he thought it felt good enough to
| walk across the room to get a cheeseburger._
|
| Honestly, I don't think wrestlers -- certainly those from
| the von Erich era -- are beacons of authority when it
| comes to sensible recuperation/rehabilitation from
| injury. Kevin von Erich said it was due to his brother
| trying to get some food but there are other accounts:
|
| > Moody says Kerry turned up on crutches and was feeling
| too much pain, so the doctors injected a liquid-type
| numbing painkiller on his injured foot so he could go on.
| The match went under 6 minutes with Kerry beating Adias,
| but according to Moody, even with his foot under a
| painkiller influence, Kerry still felt a lot of pain,
| which led to the amputation of his foot.
| dfxm12 wrote:
| Maybe they aren't, but they also aren't unique in this
| regard. Obstinate tough guy types are obstinate no matter
| what their job is. I have neighbors and family members
| who had similar issues where the doctor says something
| like "you can walk, but take it easy" but they misjudge
| what "taking it easy" really means.
| paulcole wrote:
| I mean so we don't make a generally good recommendation
| because one pro wrestler got their foot amputated?
|
| The fact that general medical guidance isn't tailored to
| you shouldn't come as a surprise. Whether you take it or
| not is up to you.
| dfxm12 wrote:
| _I mean so we don 't make a generally good recommendation
| because one pro wrestler got their foot amputated?_
|
| Please try to converse in good faith.
|
| _The fact that general medical guidance isn 't tailored
| to you shouldn't come as a surprise._
|
| In general, doctors treat people, not ailments.
| paulcole wrote:
| > Please try to converse in good faith.
|
| Can you just trot that out when you don't like that the
| other person thought your point was ridiculous?
|
| If you are able to say that the majority of people are
| bad candidates for POLICE over RICE then I'd engage with
| that. But it feels unlikely that you can do this because
| the prevailing medical wisdom seems to be that the
| majority of people are good candidates for POLICE over
| RICE.
|
| I will acknowledge that if a patient is a drug-addled
| professional wrestler who is desperate for a burger then
| yes perhaps they should just stay off the foot.
| lwarfield wrote:
| When I broke a joint in my pinky a few years ago it was
| pretty easy to tell. Early on the range of motion was the
| limiting factor, and I'd move it back and forth as much as I
| could without any pain. After that I worked on strength in a
| similar way, do as much as I can with no pain. I went from
| "you'll never play an instrument again" to rock climbing and
| Viola practice.
|
| Overall, seeing my strength and range of motion slowly get
| better was immensely satisfying and your body is pretty good
| at letting you know when you're getting close to a limit.
| brendoelfrendo wrote:
| RICE, as a protocol, isn't all that effective. The doctor who
| invented it recanted support after new evidence showed the
| importance of inflammation for the healing process. And, it
| turns out, he just kind of made it up to fit a handy
| pneumonic. POLICE is similarly invented and hard to
| recommend, but modern practices _do_ recommend bearing load
| sooner rather than later. Can determining optimal load be
| done without a doctor? It probably depends on the severity
| and type of injury. But that 's not really the point of a
| medical protocol, the point is to define best practices that
| help achieve the best outcomes.
| mathieuh wrote:
| I broke my elbow last year (in a very minor way but still),
| when I was in the A&E the doctor told me to keep moving it
| and that I wouldn't be able to move it in a way that would
| affect negatively affect recovery. Within about 10 days it
| was markedly better and within 21 days I was back riding my
| bike, and now a year later as far as I can tell it's as good
| as new.
|
| I didn't need physio or anything, the doctor just told me to
| keep using it as normally as possible.
| parliament32 wrote:
| >What defines optimal load?
|
| Uncomfortable but not painful, just like pretty much
| everything else physiology-related in life.
| windward wrote:
| We're still icing and elevating? I've always felt dubious about
| our attempts to rectify our bodies evolving inflammation. It
| doesn't seem like any great evil to let the body part get more
| blood, signals to stop us using it, and a lower range of
| movement.
| gamblor956 wrote:
| It's HELM now: Heat, Exercise, Lower, and Massage. They're all
| designed to maximize blood flow to, and inflammation in, the
| injured area. (Note that exercise just means to keep it
| moving.) Ice and elevation restrict the flow of fluids in and
| out of the injured area; ice especially slows down recovery and
| is only recommended for pain management.
|
| (This is basically a simplified version of the protocol NFL
| teams have been using.)
| Panzer04 wrote:
| I love how this is basically the complete opposite of the old
| protocol lmfao.
|
| Makes sense to me, though :D
| kenjackson wrote:
| The guy who termed RICE (Gabe Mirkin) later came out and said
| he made a mistake. Specifically with the "Ice" part (and
| partially with Rest). See: https://drmirkin.com/fitness/why-
| ice-delays-recovery.html
| askvictor wrote:
| IIRC the underlying assumption was that you should be
| reducing inflammation (RICE is almost all about reducing
| inflammation). Since then, we've learned that inflammation is
| a good thing, and helps things heal faster.
| canucker2016 wrote:
| from https://www.outsideonline.com/health/training-
| performance/fo... ... After a heroic research
| effort that took 2.5 years and 500,000 euros, he and his
| colleagues had managed to shepherd a large group of frail,
| elderly subjects through a six-month strength-training program.
| Those who had taken a daily protein supplement managed to pack on
| an impressive 2.9 pounds of new muscle. Success! Old people could
| be strong! ... On his phone was a photo one of his
| students had just sent him of a large plate stacked high with
| bulging cubes of raw beef. In total, there were 3.1 pounds of
| beef--a graphic visualization of the muscle lost in just one week
| by subjects of a bed-rest study the student had just completed.
| "I usually put this in more obscene language," van Loon says,
| "but you can mess up a lot more in one week than you can improve
| in six months of training."
| gadders wrote:
| Some good videos on Starting Strength of what they have done
| for older people: https://www.youtube.com/watch?v=ekJOT0kn5vs
| (Such as the 86 year old lady in the video).
| MichaelDickens wrote:
| > In total, there were 3.1 pounds of beef--a graphic
| visualization of the muscle lost in just one week by subjects
| of a bed-rest study the student had just completed.
|
| This is significantly out of line with other research I've
| seen. Marusic et al. (2021) meta-analysis[1] found an average
| muscle loss of ~2% after 5 days. It did not report average
| absolute muscle loss, but the average person has about 1/3 of
| bodyweight as muscle, so at an average weight of ~180 pounds,
| that would represent 1.2 pounds of muscle loss in a ~week, not
| 3.1 pounds.
|
| [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC8325614/
| canucker2016 wrote:
| The meta-analysis study you cite suggests 2% loss @ 5 days
| and 5% loss at 10 days at the knee extensor muscles.
|
| Notice that percentage loss is more than double for a
| doubling of bedrest time. It's not linear.
|
| You're suggesting that muscle loss at the knee extensor is
| the same percentage for the rest of the body.
|
| from the full text of the bedrest study mentioned in the
| outsideonline.com article - muscle loss was measured via DXA
| scan. see https://diabetesjournals.org/diabetes/article/65/10
| /2862/350... After 1 week of bed rest,
| participants lost 1.4 +- 0.2 kg (range: 0.6 to 2.8 kg) lean
| tissue mass (Fig. 1A) (P < 0.01), representing a 2.5 +- 0.4%
| loss of lean tissue mass.
| delichon wrote:
| I betchya it's the same with psychological injury such as death
| of a loved one or rejection. Getting back on the horse of living
| your life stops your social connection tendons from shriveling up
| and becoming chronically hermetic. Take it from someone who
| learned the hard way.
| feverzsj wrote:
| Because the more they break the stronger they are.
| highfrequency wrote:
| Very interesting, and seems like a delicate balance. Partial
| weight bearing reminds your body that you do need this bone to
| heal (much like lifting weights stimulates muscle growth). Too
| much instability, though, and the fracture won't heal properly.
| flyinghamster wrote:
| I went through a similar thing with a sprained knee (due to
| pandemic-related inactivity and resulting obesity). I had
| squatted down to pick something up, and when I got back up my
| knee, dodgy for years, finally said FU. I was still able to
| walk, but just barely, and I had to help myself get up out of
| chairs.
|
| I started walking as much as I could stand, and after a long
| while, the knee improved dramatically. Then I noticed I was
| also losing weight even though my diet hadn't really changed.
| After a long enough time of this, I was able to once again put
| bike rides into the mix, weather permitting.
|
| Daily walks (or equivalent/better exercise like bike rides or
| snow shoveling) have become part of my routine. I'm down 60
| pounds from 2022, and at my best weight in over 20 years.
| tomaytotomato wrote:
| I had a bad pilon fracture of my ankle a couple of years ago with
| both a break on Tibia and Fibia.
|
| I fell off a ramp whilst pushing a wheelbarrow full of rubble
| into a skip (should've stuck to building code instead of building
| a house!).
|
| Normally that type of injury is associated with car crashes when
| someone instinctively puts all their force on the brake and the
| shock of the crash travels up the pedal into the ankle.
|
| It was a really scary time for me as the doctors were trying to
| manage expectations and plan how to fix my ankle. There was a
| possibility of my foot being fused to my leg permanently at 90
| degrees angle.
|
| Fortunately I had an awesome team of orthopaedic surgeons who
| managed to do ORIF surgery with about PS70,000 worth of titanium
| inside my leg.
|
| 6 weeks later I was out of my plaster cast and into a "moon boot"
| with my physio starting and doctor telling me to put weight on it
| already as the titanium was holding it together effectively.
| Always pushing me to break the mental barrier of protecting my
| broken leg.
|
| Long story short, physio, putting weight on my toes meant my
| ankle is about 95% back to how it was, just a small limitation in
| dorsiflexion and plantarflexion.
|
| Can run, cycle, Jiu-jitsu etc.
|
| NHS emergency care - great!
|
| NHS physio care - poor, had to go private.
|
| Here's a photo of the damage -
| https://photos.app.goo.gl/z8J8RfhnZ2jnVHFYA
| wkirby wrote:
| I suffered a very similar break playing soccer. ER surgeon
| asked if I fell off a roof. 3 metal plates and 15 screws later
| I was non-weight bearing for 14 weeks. I lost almost 5 inches
| in circumference from my left thigh while waiting to put weight
| back on that leg.
|
| My post-break recovery has not been as good as yours sounds.
| Almost 3 years later and I rate my ankle at 75% of what its
| sibling is capable of. I had follow-up surgery to remove one of
| the plates and clean up scar tissue, and _that_ surgeon was
| appalled at how long I was immobilized.
|
| Anecdata and all that, but my personal experience says waiting
| for weight ain't it.
| mrfox321 wrote:
| What's your leg circumference at, now?
|
| Mine is also smaller, due to patella tendinopathy.
| wkirby wrote:
| They are within 1 inch of each other, which is fine with
| me. I haven't measured in over a year, I know there's still
| a strength imbalance but that's not what feels limiting to
| me anymore.
| tomaytotomato wrote:
| Sorry to hear about the outcome on your leg, I am sure you've
| tried lots of things to beef up your muscle. Just looking at
| my two legs I can still see a slight difference in calf
| thickness.
|
| One thing I didn't appreciate is that in a break the bone is
| the easy part, but getting the muscle back or preserving it
| is the hard part.
| wkirby wrote:
| For sure! Not to mention all the tendons and nerves. My
| recovery continues, as I'm sure yours does too -- I'm back
| to my pre-injury PRs for most weight lifting, and my goal
| for this year is to match my pre-injury mile time.
|
| All things considered I'm still pretty lucky. This could
| have happened when I'm much older and been debilitating for
| life.
| pavel_lishin wrote:
| I wonder how and when they choose to remove plates, vs.
| leaving them in. They left mine in, and when I originally
| asked them, they mentioned that there was significantly more
| risk in removing it than leaving it in.
|
| 20 years on, and it's still hanging in there.
| wkirby wrote:
| I asked to have them removed because my physical therapist
| believed they were impinging on a nerve, preventing me from
| regaining mobility in my toes. They didn't want to but I
| kept insisting.
| osmano807 wrote:
| Unless we have a clear indication, plates are not meant to
| be removed. For example, plating children we usually remove
| the plate as to not interfere with growth, or in some cases
| a fibula plate can irritate the tendons and should be
| removed, or in cases of infection.
| nsbk wrote:
| I'm going through a very similar process after breaking my
| ankle in a motorcycle accident. Tibia and double fibula
| fracture with dislocation and open wound, an ugly one which
| needed 2 titanium plates and 18 screws.
|
| I was out of my plaster after week 2 so that I could start
| moving the ankle, and started physical therapy on week 5. I'm
| currently on week 7 and have already started _walking_ with the
| "moon boot".
|
| I can stand on the brokenish ankle with 90% of my weight on it.
| It's kind of scary to be doing all this to the ankle when the
| bone is still not fully fixed, but it improves the recovery
| time and final outcome. I will probably be out of the boot on
| week 10-12. I'm 10 degrees away from full dorsiflexion range,
| and apparently it will still take some time and effort to get
| to the full range, if at all.
|
| Treatment for these kind of injuries have definitely come a
| long way, this is a massively different experience from
| breaking my ankle 20 years ago playing football in the US and
| being on a cast forever, plus dealing with ankle pain for a
| year after the injury as I didn't get any physical therapy
|
| EDIT: some of the parts for the curious
|
| - https://www.arthrex.com/foot-ankle/titanium-ankle-
| fracture-s...
|
| -
| https://www.arthrex.com/products/AR-9943H-03?objectID=human....
| pavel_lishin wrote:
| I also broke my ankle about 20 years ago. Once I was out of
| the cast, I regained all function, and only recently has my
| ankle been starting to ache. The doctor I saw about it even
| commented that it was as clean of a fix as he'd ever seen!
|
| I also didn't do much physio, but that was mostly due to me
| being a 23 year old moron (which, believe it or not, also had
| a lot to do with me breaking my ankle in the first place!)
| nsbk wrote:
| I can relate, 21 year old moron in my case. No surgery
| needed and clean fix. The problems were gone after a year
| when I decided to get some help in the form physical
| therapy. It never hurt again until recently when I broke it
| again
| Panzer04 wrote:
| If it's not an articular injury and they fix all the bones,
| you can more or less walk on these immediately. I've read
| about protocols like two weeks, and even immediately (albeit
| that has issues with wound healing)
| pfdietz wrote:
| That's much more serious than the break I had in 2023. Slid and
| fell on an icy ramp coming off a river boat in Regensburg,
| Germany. Snapped the fibula in the middle, but didn't get it
| x-rayed until I was back in the US. Walking around Newark
| Airport wasn't fun. After that, wore a boot for four weeks, no
| cast was needed.
| madaxe_again wrote:
| I crushed my leg a few years ago, my wife and I dropped a
| bridge on it, and I suddenly had 200kg of steel and wood grind
| down the back of it, and the front slammed into a concrete
| footing.
|
| Internally degloved my calf, broke my fibula, and took a chunk
| out of my tibia - and being me, decided to ice it, strap it,
| look out for compartmentalisation and rhabdomyolysis, and
| hobble around on it until it was better. Took about two months
| before I could walk normally.
|
| I only know what I did to it because I dislocated my knee last
| year skiing, and they were thoroughly confused as to what they
| were looking at - had to explain that I mashed my leg and
| couldn't be bothered wasting my time sitting in A&E for a few
| days.
|
| Either way, it healed just fine with zero intervention. My calf
| is a slightly funny shape from the fascia still being bunched
| up around my ankle, but it doesn't seem to do any harm, and the
| break to the fibula healed almost perfectly - slightly offset
| but works just fine.
| cyrillite wrote:
| Having recently walked away from that exact situation
| miraculously unscathed (the teenage drunk drivers also managed
| to walk away somehow), that's an interesting insight into the
| type of injury I avoided. Grim, scary, but very interesting.
| Glad you recovered.
| alexandrehtrb wrote:
| Related, bone tissue regeneration using coral and marine sponges:
|
| https://web.archive.org/web/20240705042256/https://web.stanf...
| taneq wrote:
| The human body (like most fit organisms) is antifragile. It
| _needs_ to be challenged. In this context, people who think "ooh
| that hurts I'll never do that again" and carefully avoid
| discomfort find that, by middle age, they can't do anything, and
| everything hurts. Meanwhile people who think "ooh that hurts, I'd
| better practise it until it doesn't" are still fully functional
| into old age because they push their bodies in the right way, and
| so their bodies stay strong.
|
| Don't get me wrong, the latter group still hurt. Getting old
| sucks. But their bodies _work_.
| bluGill wrote:
| The right level is hard though. I know more than one old person
| who spent time in a hospital because they thought they could do
| something they couldn't and broke their bone. "For $20 they
| would install the new dryer, but no we thought we could do it
| and that is how my foot got broke in the fall". You should have
| a cane handy when you need one, but don't use it if you don't
| need it.
|
| I have no idea how to find the right balance.
| Panzer04 wrote:
| Accidents are almost always bad, for sure. Doing things that
| you are physically capable of, though, is rarely a problem.
|
| The perception of things like weightlifting being dangerous
| or bad for your back though are almost entirely a myth. It is
| possible to screw it up, but from what I've read it's very
| rare for people just lifting things to hurt themselves.
| 77pt77 wrote:
| Yes and no.
|
| Professional athletes are usually miserable later in life due
| to doing exactly that.
| timewizard wrote:
| I broke my shoulder and they immediately offered me a
| handicapped placard.
|
| I am the type of person to become offended at the suggestion.
|
| I parked at the back of the lot and took the longest walk I
| could instead.
|
| That has paid off.
| Aromasin wrote:
| I can certainly attest to the consequences. I unfortunately
| shattered my ankle and broke my back simultaneously, which meant
| I didn't walk on my ankle until 6 months after the incident. As
| such, even 10 years later my ankle is a constant irritant to me.
| I have next to no dorsiflexion beyond a straight leg now. No
| ankle mobility means persistent pain in my hip, knee, and back on
| that side, and I'm only 29. God bless the NHS for saving my life
| at the time and not charging me a penny, but despite my best
| efforts I can't get any further treatment now to improve the
| flexion. I'm counting down the years until I can finally afford
| further surgery and get some quality of life improvements.
| tombert wrote:
| At the risk of sounding like an American stereotype, have you
| considered starting something like a GoFundMe to pay for the
| future surgery?
|
| Also worth looking into clinical trials. Obviously not ideal to
| be a guinea pig, but sometimes you can find experimental
| treatment on these things and they won't charge you.
| Panzer04 wrote:
| What surgical treatment do you expect to improve your outcome?
| 77pt77 wrote:
| Medicine is still to a very large degree hocus pocus.
|
| I had a close friend that broke his scaphoid a couple of years
| ago.
|
| There was no consensus on whether the thumb should be immobilized
| in the hitchhikers position.
|
| No consensus on whether to stabilize via surgery apart from
| extreme cases.
|
| No consensus even on weather the elbow should be immobilized.
|
| A complete joke.
|
| And nothing has really improved in a decade or so for such a
| common thing with dire consequences.
| Panzer04 wrote:
| It's really surprising, isn't it? I think they get caught up in
| minutia of this vs that. So much of medical research just ends
| up copping out with a surgeons preference option, even though
| it's meant to inform the surgeon!
|
| Just hard to do the basic science in a field like this though,
| can't go breaking bones to figure out the best way to make them
| heal.
| TomK32 wrote:
| Oh this is so bad:
|
| > In the 19th century German surgeon and anatomist Julius Wolff
| recognized that healthy bones adapt and change in response to the
| load placed on them. That is why everyone--but especially women,
| who are more susceptible than men to osteoporosis--should lift
| weights as they age
|
| No, weight lifting won't improve bone density, it's running that
| will
|
| edit: https://theros.org.uk/information-and-support/bone-
| health/ex...
| WithinReason wrote:
| source?
| TomK32 wrote:
| https://theros.org.uk/information-and-support/bone-
| health/ex...
| WithinReason wrote:
| That page directly contradicts you since it lists weight
| lifting exercises like barbell squats
| digdugdirk wrote:
| Squats/Deadlifts, not bicep curls with 3lb dumbbells. And yes,
| it absolutely will improve bone density.
| tomnipotent wrote:
| It's my understanding that weight lifting is superior to
| running for increasing bone density but that both together are
| superior to any one singular. Makes me think about a Mark
| Rippetoe article from several years back he helps an older
| woman (60? 80s?) eliminate her lower back pain with weight
| lifting and strength training exercises. Rippetoe isn't pefect,
| but he has a good-enough track record on this stuff.
|
| I had a lateral fracture of my right humerus (arm snapped in
| half) and the only thing that made the pain go away was
| strength training. High-rep endurance exercises didn't help,
| hundreds of pushups a day didn't help, but after I switched to
| high-weight lift-to-fail the pain slowly disappeared.
| TomK32 wrote:
| A mix is always the best.
|
| At 40+ I do feel the benefits of adding a weekly hour of
| stretching and winding at the gym. Exercises everyone can put
| into the daily life to improve mobility. It even helps with
| my broken hip that was bolted back together a few years ago
| :-)
| gadders wrote:
| You can see one of his coaches helping an 86 year old woman
| deadlift in this video:
| https://www.youtube.com/watch?v=ekJOT0kn5vs
| filoleg wrote:
| Source? Because I found plenty of studies on the topic, and
| there seems to be a fairly universal consensus that goes the
| exact counter of what you claim. I.e., studies state that
| weight and resistance training helps with improving bone
| density significantly, while aerobic exercise
| (walking/cycling/etc.) doesn't.
|
| Here are excerpts from one of the papers[0], but you can find
| many more agreeing with that take:
|
| "Prolonged aerobic training (e.g., swimming, cycling, and
| walking) is widely beneficial to all body systems, but there
| are clinical evidences suggesting that none of these activities
| provide an adequate stimulus to bones"
|
| "Based on the available information, RE [resistance training,
| e.g., weightlifting/machines/etc], either alone or in
| combination with other interventions, may be the most optimal
| strategy to improve the muscle and bone mass in postmenopausal
| women, middle-aged men, or even the older population.
|
| 0. https://pmc.ncbi.nlm.nih.gov/articles/PMC6279907/
| TomK32 wrote:
| Your last quote throws bones and muscles into one. Just so
| you know.
|
| The Royal Osteoporosis Society recommends "Short bursts of
| activity are ideal for bones. For example, running then
| jogging, or jogging then walking."
| https://theros.org.uk/information-and-support/bone-
| health/ex...
|
| Btw, don't confuse weight-bearing activities with the weight-
| lifting that I did quote previously. Resistance training
| alone, as for example cyclists do, has shown to not improve
| bone density as pre this meta study https://bmcmedicine.biome
| dcentral.com/articles/10.1186/1741-...
| briankelly wrote:
| I think you need to read that a bit more closely - they
| describe running and jogging as high-impact as opposed to
| walking, swimming, and cycling. These articles are almost
| always saying something fairly specific.
|
| They specifically mention a combo of the two from one study:
| "A combination of RE and weight-bearing aerobic exercise
| (e.g., running, skipping, jumping, or high-impact aerobics)
| is recommended as RE training provides muscular loading while
| weight-bearing aerobic exercise provides additional
| mechanical loading to the bone above gravity."
|
| And they still describe a need for end-to-end evidence for
| improved outcomes: "For determining the effect of RE on the
| reduction of fall and fracture risk, further large-scale
| studies are needed to be investigated."
| DebtDeflation wrote:
| I have some books translated from Russian that that I acquired
| back in my powerlifting days and that showed studies the
| Russians did on Olympic weightlifters. The children (who had
| been lifting heavy since a very young age) had bone mineral
| densities far higher than average untrained adults. The adult
| Olympic weight lifters had bone mineral densities that were
| completely off the scale, as the book put it "in polar bear
| territory". Granted, these study participants were people
| explosively lifting hundreds of pounds from floor to overhead
| in the blink of an eye, not your average gymbro, but still.
| gadders wrote:
| Further down that page it actually says:
|
| "Progressive muscle resistance training is the best type of
| muscle-strengthening exercise for your bones. It involves using
| weights or resistance bands to build up the work for your
| muscles to do over time. You do this by gradually increasing
| the weight you lift, in a slow and controlled way. As you
| train, you'll find the movements get easier as your muscles get
| stronger."
| trollied wrote:
| I had a Brostrum procedure to fix my ankle. I researched lots
| before. Was expecting months in plaster.
|
| The surgeon bandaged it and gave me an inflatable shoe. After 2
| weeks I was allowed to walk on it.
|
| I'm pleased he was progressive!
| brunoTbear wrote:
| Same! Big shoutout to Dr Thuillier at UCSF. Really changed my
| life.
| lexicality wrote:
| I was not expecting to learn that "walk it off" is actual valid
| medical advice. I have a few people to apologise to now.
| gregwebs wrote:
| There are case reports of people achieving remarkable
| rehabilitation by stressing their bones and muscles with weight
| lifting, for example:
| https://startingstrength.com/article/barbell_training_as_reh...
|
| In general the theory I usually see now is that rehabilitation is
| best achieved by putting pain-free stress on the thing being
| healed, with some arguing for low levels of pain in some
| circumstances.
| mns wrote:
| I fractured my greater trocahnter (not sure if this is the
| proper english name) in a bike crash 2 years ago. My doctor,
| seeing the MRI told me I need an operation asap. None of the
| hospitals that he sent me to (including a sports clinic) wanted
| to operate it, and just told me to let it heal, with check-ups
| every 4 weeks. Another doctor in another country told me to get
| the operation, stay in bed 3 months and get blood thinners. 1
| month after the accident I couldn't take it to stay at home and
| stand still so I started walking again quite a lot and started
| weight lifting (upper body and trying to not stress the hip too
| much). 4 months later you couldn't even notice that I had the
| accident, no limping, could start running again, fracture was
| fully "welded" on its own.
| Panzer04 wrote:
| In my experience you do have to tolerate pain for things like
| range of motion/stretching. My ankle wouldnt have near the
| range of motion it has now after breaking it if I wasn't
| pushing into a decent amount of pain to stretch it.
| codr7 wrote:
| Goes for most injuries, in western medicine there has been an
| unfortunate tendency to fixate injuries from my experience. That
| just teaches the body to route around it, as it's seemingly not
| used anymore. Just lying still in a hospital bed for a few weeks
| is a terrible experience once you start moving again, been there
| done that.
| novaleaf wrote:
| I broke the bone that runs along the top of your left foot when I
| was around 20 (Metatarsal Bone?), about 25 years ago.
|
| Being a stupid youngun, I didn't go to the doctor, thinking that
| it was just a really bad sprain, and I could "walk it off".
|
| It really really hurt but I tried to walk (even run) normally on
| it, and gradually over months the pain subsided until maybe 6
| months later it was "normal".
|
| Except, maybe 10 years later I noticed that I couldn't balance on
| my left foot as well as on the right, and see that the top of my
| foot is noticeably less convex (not quite concave though).
| Probably less structure for muscles and tendons to use for
| stability. But feels fine and I can walk and run okay :D
| hartator wrote:
| Maybe the people who walk early on it doesn't have any pain when
| they do, which bias the results as it's obviously select for not
| as bad of an injury.
|
| I broke my ankle a few months ago. I read similar papers online
| about early walking on it. Well, if you feel any pain, don't.
| It's easy to undo weeks of healing by doing a bad move.
| DennisP wrote:
| Couple decades ago I split my femur in half. Docs put a metal rod
| down the middle and had the PTs getting me on my feet the next
| day. It was not pleasant. After a couple days they sent me to a
| rehab facility for a week, then home with a walker which they
| replaced with a cane as soon as I was stable enough.
|
| It took a while but I fully recovered. I'm not sure how relevant
| this is since the metal bore a lot of the load; I'm a little
| worried that may cause me problems eventually.
| cortic wrote:
| Sounds like one of these stats where they just invert the cause
| and effect to get a story; i.e. People who are healing better
| will obviously walk sooner. Inverted to people who walk sooner
| are healing better.
| Panzer04 wrote:
| There is a lot of hokum and bad statistics in the medical
| field. Doctors truly don't have a great idea what improves post
| op outcomes.
|
| There are some bigger studies coming out that show that early
| weight bearing is non-inferior to traditional protocols that
| ask for many weeks of NWB though, and given the obvious qol
| benefits of walking earlier it seems to me the standard should
| be mobilise ASAP.
|
| There really isn't good evidence for immobilisation. It seems
| to be a hold over particularly for surgical fixation, where
| there's no real fear of displacing things if it's been fixated
| properly.
| BizarroLand wrote:
| My brother broke both of his legs in the Army Ranger parachuting
| school a few years ago. He landed wrong because of weird
| instructions and heard the crack but after they patted him down
| and told him he was good he spent 2 weeks trying to walk it off.
|
| Finally the pain got to be too much and they took him in for
| x-rays. Needed screws all throughout his legs and 2 months to
| heal.
|
| Now he's fine, goes out for daily runs, still in the military
| (but failed the Ranger class because he couldn't finish the jump
| training) and is mostly upset about not being a ranger.
| bitwize wrote:
| In 2017 I suffered a nasty fall. I landed on my right arm that
| was so in pain afterwards I was T-Rexin' that one arm for a few
| weeks. Too much flexion or extension hurt. Guess what set my arm
| right again: gym rehab. I was lifting weights then, and as soon
| as I was able I put the dinkiest weight on the bicep curl
| machine, 10 lbs or so, and just repped with that arm for a couple
| of sets. It hurt a bit, but training the arm got my body's repair
| mechanisms headed right to the site, and after a few sessions of
| this the arm became quite usable if not 100% pain free. It's
| pretty much back to normal now.
| Panzer04 wrote:
| I broke my ankle 15 weeks ago, and decided to weight bear early
| against the advice of my doctors. In my experience, it caused me
| no issues and prevented my calf from atrophying further. My foot
| was also super tight, and I can't imagine that would have gotten
| better by staying off it.
|
| I think a lot of medical advice is based on what doesn't go
| wrong, rather than what might give the best outcome. I'm sure
| there are doctors who have tried one thing or another, had it go
| wrong and then become more conservative as a result. This
| prevents the worst outcomes, but also gives a lot more people and
| average or subpar rather than great outcome.
|
| In any case there's a lot of research showing that rest is almost
| always the wrong answer nowadays. Tbh, I don't understand how
| people can stand it; I was thoroughly sick of the hospital bed
| within a day and sick of being a couch potato within a week. I
| would have walked even earlier I think knowing what I know now.
| treetalker wrote:
| _Primum non nocere_
| Panzer04 wrote:
| It's certainly an understandable view. At least there is more
| research showing that at least some of these measures aren't
| meaningfully reducing harm anyway.
| m463 wrote:
| I broke an arm and the emergency room couldn't see it on the
| x-ray and gave me a sling to wear.
|
| A couple days later I got to see an actual bone doctor and he got
| the x-ray and immediately pointed to the fracture.
|
| What surprised me was that he said not to use the sling, because
| it would lose my range of motion.
|
| "Keep moving your arm, use the entire range of motion, and let
| pain be your guide."
| UncleOxidant wrote:
| Frozen shoulder isn't fun. I had it for almost 2 years - from
| onset to the point where my shoulder mobility was pretty much
| back to normal. That's probably why your doc recommended to
| keep the arm in motion.
| greenchair wrote:
| a vet estimated that ~50% of animals that he treats would have
| recovered fine without his involvement
| merb wrote:
| In Germany this is already common knowledge. I had a fractured
| radial head. It gets fixiated for 2 weeks (to let the bones heal)
| and than the fixture gets removed and you need to move it , you
| also get therapy sessions for that. Of course this depends on the
| fracture degree , but it's really uncommon to have a fixture for
| more than a few weeks since it makes it really hard at a certain
| age to still move it 100%
| fiendsan wrote:
| if you dont use it... you might lose it...
| clausecker wrote:
| I wonder if this phenomenon was part of the reason why
| Kuntscher's intramedullary nailing was so effective at speeding
| up the recovery from broken legs.
| dwedge wrote:
| Last year I went to the hospital with a suspected broken foot.
| They xrayed it and told me it was just a sprain, but that
| "interestingly" I had an extra bone in my foot. I walked as much
| as I could for two weeks, went back for a second appointment and
| was told it wasn't a sprain (or an extra bone) and was in fact
| broken in three places.
|
| It's good to know they accidentally gave me good medical advice.
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