[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 : 579 points
Date : 2025-02-19 12:36 UTC (1 days 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 :-/
| 77pt77 wrote:
| But plenty of people here are saying to just force it...
| 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:
| 77pt77 wrote:
| > It took 4 or 5 months to start to fuse
|
| That's an insanely long time-frame for healing.
|
| Bones usually start fusing in weeks, not months.
| 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.
| webmaven wrote:
| The smokers who DON'T get lung cancer still have more
| heart and lung problems (like emphysema, COPD, etc.), and
| those get significantly worse late in life.
| 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?
| AngryData wrote:
| I don't know about alcoholics, but smokers and obese
| people actually cost less in medical care because they
| usually die before age-related diseases takes hold which
| are the most expensive, they most often die of heart
| attack and stroke which are the cheapest deaths, and
| being fat or a smoker disqualifies you from many
| procedures and operations that they otherwise would do
| without hesitation.
|
| On top of that for smokers, the amount of sin taxes they
| pay on cigarettes over their lifetime almost always
| exceeds their entire life-time medical costs.
| autoexec wrote:
| insurance companies already buy up information from data
| brokers and use that to jack up people's rates according
| to whatever they happen to find to justify it. They won't
| tell you when they do it, you'll just be offered a very
| different price than you would have been given if you
| didn't buy as much alcohol, spent more time at the gym,
| only drove your car in the daytime, or lived in a
| different zip code.
| cma wrote:
| Aren't there already insurance rebates in the US or
| something for tobacco-free attestation?
| 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
| lmm wrote:
| Nah. Decades of politeness have failed, it's time to get
| more aggressive about people deciding it's ok to kill
| other people as long as you do it by driving a car into
| them and aren't drunk at the time.
| 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.
| tomjakubowski wrote:
| > Medical insurance generally covers your own
| accidents/mistakes, because it's not like you're going out
| searching for them for fun.
|
| I wonder if the guys from _Jackass_ had trouble finding
| health insurance.
| 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.
| cma wrote:
| Nicotine itself isn't very dangerous, it's the
| carcinogens in tobacco that are and the combustion
| products in the smoke.
| 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.
| alistairSH wrote:
| 100% anecdotal... one of my town's youth football
| (American) clubs shut down before COVID due to lack of
| interest. When my son played ~15 years ago, the club was
| fielding 2 teams per age group.
|
| And knowing what they know now, I wouldn't let a child
| play today.
| ghaff wrote:
| I do suspect that soccer has whittled down youth American
| football over time. It's not quite true that no one
| played youth soccer when I was growing up but certainly
| nothing organized at scale to today's degree. I have a
| friend who has been reffing soccer forever. I should ask
| him as he probably has some insight.
|
| ADDED: I suspect a combination of the negative publicity
| for football, less equipment for soccer, etc. Even if
| American football still largely dominates as you get to
| college and the pros. Some rugby in college but
| relatively not a lot in the US.
| 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.
| crazygringo wrote:
| > _but how is that a drain on society, and not primarily
| the individual?_
|
| There are two factors.
|
| The first is that a drain on individuals _is_ a drain on
| society. That 's why we outlaw risky behavior like lethal
| recreactional drugs, driving without seatbelts, driving
| without a driver's license, etc. We try to protect people
| from themselves in some of the worst aspects that we can.
|
| Second, of course, is health care costs. Activities that
| constantly result in injury wind up raising the health care
| costs for everyone, since that's how insurance works.
|
| > _by your logic, should we also ban (or require
| insurance?)..._
|
| You already have to have car insurance, yes. And yes lots
| of kinds of guns are banned in lots of places.
|
| We draw the lines in different places.
|
| It is a pretty interesting thought experiment to wonder
| whether people shouldn't be allowed to engage in organized
| sports that are risky, without paying an additional health
| insurance premium? E.g. if you play professional football,
| then your league has to pay extra money into the health
| insurance fund to compensate for all the extra health care
| treatment their players need and will need.
| lemming wrote:
| _We draw the lines in different places._
|
| e.g. amateur MMA is illegal in Norway and I think a
| couple of other places too.
| guitarlimeo wrote:
| > It is a pretty interesting thought experiment to wonder
| whether people shouldn't be allowed to engage in
| organized sports that are risky, without paying an
| additional health insurance premium? E.g. if you play
| professional football, then your league has to pay extra
| money into the health insurance fund to compensate for
| all the extra health care treatment their players need
| and will need.
|
| Isn't this already in use in multiple countries? I.e. if
| you want to play football (european) in a league, you
| have to have a license and also insurance that covers
| playing it in an organized way - for example in a league.
|
| So team sports are already covered by such things, but
| individual sports like mountain biking or skiing aren't
| at the moment.
| grayhatter wrote:
| > The first is that a drain on individuals is a drain on
| society.
|
| Citation needed. I don't outright disagree, but I do
| think you state this as if it's a much simpler fact of
| life then it really is.
|
| > That's why we outlaw risky behavior like lethal
| recreactional drugs,
|
| Outlawing drugs is a perfect example, that's something
| we've done in the US that has gone flawlessly. No one has
| any notes, complete unambiguous success.... oh wait!
|
| You even elude to this, I assume, by restricting it to
| just lethal drugs. That's misleading at best. There is
| plenty of space to say this is more likely to harm the
| community, than it is to support the individual. PCP is a
| popular example where the misapplication directly causes
| said individual to become a direct danger to the
| community.
|
| > driving without seatbelts, driving without a driver's
| license, etc. We try to protect people from themselves in
| some of the worst aspects that we can.
|
| It's legal to drive a car without a license. You need a
| license to prove you're able to do it safely on public
| property. It's very different to say, you can't do X
| ever, and you can't do [something unsafe for other
| people], around other people who are being safe.
|
| > Second, of course, is health care costs. Activities
| that constantly result in injury wind up raising the
| health care costs for everyone, since that's how
| insurance works.
|
| > You already have to have car insurance, yes. And yes
| lots of kinds of guns are banned in lots of places.
|
| > We draw the lines in different places.
|
| Right, I'm aware, but prove that's actually a bad thing?
| That's what I'm asking. Is it sane to go "AHHHHH THAT'S
| RISK! All risk is bad for society! Quick, ban it!".
| Again, using "Non-lethal" drug, seem to suggest that the
| risks of banning something out weight the risks of that
| thing. We already learned that banning alcohol was a net-
| negative, and we seem to be figuring that out for
| marijuana now too.
|
| > It is a pretty interesting thought experiment to wonder
| whether people shouldn't be allowed to engage in
| organized sports that are risky, without paying an
| additional health insurance premium? E.g. if you play
| professional football, then your league has to pay extra
| money into the health insurance fund to compensate for
| all the extra health care treatment their players need
| and will need.
|
| Is this a good idea? Car insurance protects others from
| your carelessness. Sports insurance protects you from...
| you? Is it reasonable for society to subdivide itself
| like that? Should old people have to pay more money for
| insurance? Should people with diabetes pay more? Should
| women of childbearing age pay more? Or should we as a
| society, look down from a higher level view, acknowledge
| that healthy individuals are better for society, and
| decide that we're not going to treat individuals
| differently, that because everyone is in this game of
| life together, where nobody gets out alive, that we're
| all going to make it as easy as we can for everybody to
| be their best, while refusing to define best for any
| individual.
| 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.
| aitchnyu wrote:
| I feel only rocky texture will be satisfactory after a
| year. Or is there any chemical that can safely strip the
| soaps and other fatty stuff from the mineral?
| ghaff wrote:
| My roughest and lightest tile--which has to be replaced
| for other reasons after a couple decades in what we call
| a mudroom in New England--could probably be cleaned but
| would be a procedure. In general, darker and just
| somewhat textured tile seems to work pretty well in less-
| trafficked areas.
| 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.
| hnburnsy wrote:
| Is there padding or gear sold that can reduce the likelihood?
| mindcrime wrote:
| For collarbones specifically? Nothing I'm aware of. At
| least if the explanation that was given to me for the high
| prevalence of collarbone injuries is correct, that makes
| sense. Someone explained it to me as "when you start to
| fall, you instinctive tend to reach our towards the ground
| to try to break your fall. So your hand is the first thing
| that hits the ground, and all the energy of the fall goes
| up your arm and into your shoulder / upper chest area. And
| the collarbone just happens to be the "weak link" there and
| so tends to break."
|
| Now maybe that's just folk wisdom that isn't really true,
| but it sounds plausible to me. And if we reason by analogy
| a little, it's not too far off what my surgeon told me when
| I tore my rotator cuff. I fell and came down on my elbow,
| and he explained that the energy from the fall pushed my
| humerus up into my shoulder, and pinched my rotator cuff
| between two bone heads, which is what caused the tear.
|
| So yeah, not much padding can do about stuff like that I
| guess.
| webmaven wrote:
| Hmm. Every time I've been in a similar scenario (breaking
| a fall, warding off an incoming projectile) it has been
| my wrists that broke.
| albinowax_ wrote:
| Strength training can help reduce injuries from crashes up
| to a point.
|
| Experience helps too but that's harder to get safely!
| 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.
| danuker wrote:
| Placebo and nocebo are strong effects. Even when the people
| taking placebos knows it, they still work.
|
| https://www.nature.com/articles/s41598-021-83148-6
| interludead wrote:
| Man, that's a wild ride just to get a proper diagnosis. It's
| crazy how much a doctor's attitude can shape recovery
| jack_pp wrote:
| I left out a bit, before I saw the doctor that told me
| surgery is the only way, I was consulted by another guy
| that was free and he scolded me because I came without the
| orthosis saying stuff like I don't want to get better and
| basically didn't even look at me or check my recovery after
| 3 weeks of wearing the orthosis. Told me to go to his
| private clinic and get a new orthosis where I decided to
| see any other doctor because I was put off by his attitude.
| I think the private clinic had a contract with the hospital
| I was sent to for the surgery or something.
|
| Anyway thank God I found a decent doctor.
| 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.
| jamiedumont wrote:
| Ah, thanks for the clarification. That post-ORIF pain
| being worse than the break was my experience too. Even
| with the plate I became quite paranoid about shifting the
| screws because it provided so much immediate stability I
| was worried I was able to do things that may loosen the
| screws.
|
| A hook plate sounds horrible! Mine is a simple straight
| plate, bent into a helix shape to follow the natural
| rotation of the bone. I've got almost full mobility,
| although that shoulder does seize up quite readily. Not
| sure whether that's the plate or just remnants of the
| reduced mobility post-crash and post-surgery.
|
| I've been told to expect two weeks of surgical healing
| and a further 4 weeks of babying it and avoiding impacts.
| I'm hoping your removal being tougher was due to the
| different plates. Would quite like it gone and to get on
| with my life now.
| eweise wrote:
| Almost everyone I know that mountain bikes, had broken
| their collarbone.
| cooljacob204 wrote:
| I plan to purchase one in the spring. This thread is
| giving me second thoughts lmao.
| __mharrison__ wrote:
| Multiple folks in my family have broken their collarbone
| (myself included). None that ride mountain bikes 2-3
| times a week have broken it biking.
|
| (More anecdata to persuade you to buy a bike. Great fun.)
| 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.
| fossuser wrote:
| I also broke mine in a crash, had surgery, but have not
| bothered to get the plate removed and it's fine?
|
| The only time I really notice it is if someone pushes on it
| or if I'm doing front squats with a bar.
| usrusr wrote:
| Get it removed: the next hit will be much worse than a
| broken collar bone if the bone can't do its job of giving
| in before less restorable parts of the shoulder give in.
| foobarbecue wrote:
| Welcome to the waves! Best sport in the world, especially if
| you can avoid the crowds.
| jamiedumont wrote:
| Thanks! I've always been a surfer, but split my time with
| other activities. Post-accident everyone thinks I'm scared
| of getting back on the bike -- maybe a bit? -- but
| genuinely my first thought post-crash was how long I'd be
| out of the water. It was a clarification of what I truly
| enjoyed, and an excuse to double down on being in the
| water.
|
| I'm now doing anything and everything to get in the sea and
| improve my surfing. Lengths at the pool for strength and
| endurance, free diving (and spearfishing) to reduce the
| anxiety of those big hold-downs. It's been liberating
| choosing just one sport to be good at.
| sheriffofpaddys wrote:
| Also shattered mine mtn biking (2022), and the surgeon
| scheduled surgery as soon as he saw the x-ray. I broke it
| twice as a teenager, and went through the sling route for
| both of those.
|
| The craziest part about the plate is how quickly the pain
| from instability was relieved. I could finally sleep and
| honestly could've used my arm at ~80% days after surgery. I
| still have the plate which causes some discomfort, but I
| likely won't worry about it.
|
| In light of the article, I wonder if the plate
| encouraged/allowed me to use my arm in ways I wasn't aware
| of. Funnily enough, it's almost the definition of a crutch
| but one that allows me to use my arm more than if I was just
| hugging my body in an attempt to avoid that sharp pain.
|
| Never lost my fear of the mtb, just focus on the uphill and
| cross country more.
| usrusr wrote:
| Do yourself a favor and don't wait too long to get rid of
| the plate: when you crash on that shoulder again, the
| collar bone won't be able to do it's job of being the
| predetermined breaking point that saves the shoulder
| ligaments from ripping. And the AC ligament, unlike bone,
| will never recover. Not even with the surgery that you'll
| then likely need to at least restore the other shoulder
| ligaments. Fractured collar bone is a feature, not a bug.
|
| Yeah, I failed to get my plate removal appointment in time,
| then I got a plate _replacement_ appointment on the fast
| track and the next removal appointment then happened to be
| almost the same day as the one originally scheduled (the
| plates for separated shoulder stay in much shorter, and
| they better should, because they aren 't painless at all)
| sheriffofpaddys wrote:
| Good point, thanks. Will look into it.
| ddoolin wrote:
| Interesting. I shattered mine similarly while snowboarding,
| but back in maybe 2018. There was definitely no debate on the
| matter, surgery via ORIF was the recommended option. Then
| again, my doc was a sports medicine surgeon so perhaps that
| played into it. Either way, I was never too light with it and
| it healed very quickly. I was back at 100% about 2 months
| later.
| 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.
| tenzing wrote:
| I have a similar viewpoint; over a decade ago, I had a
| nuisance tendon issue and went to a specialist who
| recommended surgery.
|
| The surgery had a risk of serious, life-long consequence if
| it went wrong. He said that if I can live with the tendon
| issue, we can delay surgery indefinitely... so we delayed.
|
| A month later, I stopped doing a certain workout at the gym,
| which resolved the issue within days. No need for surgery at
| all.
|
| I do think that some specialists can be so focused on their
| speciality (i.e. surgery) that they don't think outside of
| that paradigm (try a different workout at the gym), and it's
| up to the patient to effectively shop around to get the best
| advice.
| 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?
| burnished wrote:
| I wonder how likely that is? I suspect their understanding
| of their diagnostic technique is flawed, but beyond that,
| would a small enough group have a similarly small pool of
| common afflictions such that you could develop a useful
| body of medical lore?
| hatthew wrote:
| when my grandma was a kid she remembers the village doctor
| telling her she has ghosts in her blood and she should do
| cocaine about it
| pkulak wrote:
| I've still never heard a satisfactory explanation for how in
| the hell two parts of a bone, broken such that they aren't even
| touching, can find their way back to each other and heal. My
| son broke his collar bone, and the hospital sent him home in a
| sling. When I looked at the x-ray, I couldn't believe that's
| the correct treatment. But a month or two later and he was good
| as new. Absolutely blows my mind every time I think of it.
| jvanderbot wrote:
| They sense other bone tissue and grow together I guess. Same
| for severed nerves, up to a point.
| brewdad wrote:
| I broke my collarbone about 30 years ago. Then had it
| partially rebroken when a friend forgot about my healing bone
| and greeting me with a shoulder grab from behind. (He felt
| like shit afterwards). I got the most basic healthcare a free
| college clinic could offer. Today, you can only tell I ever
| broke it when I'm shirtless and at my skinniest weight.
| pgreenwood wrote:
| Mine ended up healing with a 15mm overlap. So it is a weird
| shape. It gives me 0 issues however.
| idiotsecant wrote:
| It starts with bleeding. The blood in the region of the bones
| forms a squishy mass that is not bone, but through which
| cells can flow. Specialized cells deposit calcium into this
| mass, guided by hormonal and chemical signals. If you imagine
| the two open bone ends as emitting a sphere of chemical
| signals, where the two spheres interfere constructively is
| where the 'signal' is strongest and where you want to deposit
| calcium. Bones are not _just_ calcium of course, but that 's
| the gist.
| 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
| potamic wrote:
| Sorry, which comment are you affirming?
| jacksnipe wrote:
| Go until just before it hurts, which is a moving target
| that you will have to calibrate carefully
| 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.
| devilbunny wrote:
| Yeah, but given the huge variations in pain tolerance,
| some will reinjure it while others will never use it
| again.
| theultdev wrote:
| tolerating it doesn't mean you can't detect it.
|
| no amount of pain tolerance will help you if something is
| broken.
|
| you _WILL_ feel it. simply stop when you do.
|
| it's not a hard thing to grasp.
| devilbunny wrote:
| Clearly, you have never worked in healthcare.
|
| Sleeve tattoos but needs an IV? "Oh, I'm not good with
| needles, you need to sedate me first."
| theultdev wrote:
| How is that relevant?
| devilbunny wrote:
| Perception of pain is highly individual. Like I said,
| people who have tons of tats will complain about an IV.
| You aren't afraid of needles, you just don't like them
| when they are used for your health instead of marking up
| your body.
| 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.
| tempestn wrote:
| No, reducing inflammation can help manage pain, but beyond
| that is not beneficial (actually is detrimental) to healing.
| https://drmirkin.com/fitness/why-ice-delays-recovery.html
| 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.
| tomjakubowski wrote:
| I'm curious now if the anti-inflammatory diets popular with
| dietitians and health influencers could have a negative
| effect when you really do want inflammation, like when
| fighting an infection or recovering from injury.
|
| https://www.health.harvard.edu/staying-healthy/quick-
| start-g...
|
| https://nutritionsource.hsph.harvard.edu/healthy-
| weight/diet...
| james4k wrote:
| As I understand it such diets allow the immune system to
| work more effectively, not suppressing it like, say,
| corticosteroids do.
| jalla wrote:
| Also, elevation is useless and compression is potentially
| harmful as restricting blood circulation and compressing
| tissue limits healing.
| 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?
| Aromasin wrote:
| An ankle arthroscopy leading to debridement of the joint. I
| have some bone or scar tissue that is causing impingement,
| meaning my tibia doesn't glide along the top of the talus
| like it should do. There's little I can do to fix the
| arthritis in it now, but I can at the very least free to some
| movement such that the rest of my body isn't limited by my
| lack of mobility.
| Panzer04 wrote:
| Brutal. Hope you can make the best of it and the arthritis
| doesn't advance further.
| 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
| TomK32 wrote:
| It does not contradict, it lists weight lifting under
| muscle training, not under bone density.
| WithinReason wrote:
| "Bones stay strong if you give them work to do. The best
| way to keep bones strong is to do both weight-bearing
| impact and muscle-strengthening exercises."
| 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.
| tonyarkles wrote:
| After my knee surgery (meniscus cartilage tear/repair) and
| after my appendectomy, I was pretty keen to get up and moving
| so that I could go outside and smoke. Both times the nurse
| commented that while smoking on its own isn't great for
| healing, the fact that it forces you to get up and moving
| quickly and frequently is generally helpful. In both cases the
| doctor was quite surprised at how quickly I'd healed up when I
| went for the follow-up/stitch removal.
| 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.
| sexy_seedbox wrote:
| Remember, "Pain is weakness leaving your body".
| m463 wrote:
| Well in my case pain was half a bone trying to leave my body.
| :)
| imp0cat wrote:
| Pain is an illusion of the senses.
|
| Literally, it's just electrical impulses travelling through
| your body.
| Sharlin wrote:
| Doesn't make it any less real though.
| interludead wrote:
| That phrase always felt more like a gym bro mantra
| interludead wrote:
| Imagine how many people end up with stiff joints just because
| they were told to keep still
| 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.
| yoyohello13 wrote:
| My main take away from this thread is to never take up mountain
| biking.
| myself248 wrote:
| I noticed this years ago. First thing two cyclists do upon
| meeting each other is compare injuries. It's like dogs sniffing
| each other's butts.
| ArlenBales wrote:
| Mountain bikers becoming injured isn't a question of IF, but
| WHEN.
|
| If you have a coworker in their 30s or 40s who is just starting
| to get into mountain biking (a common midlife crisis hobby),
| expect them to have a MTB related injury within the next year.
| cooljacob204 wrote:
| Damn I hit 30 this year and planned to buy one.
| yoyohello13 wrote:
| Mountain Biking just seems dangerous in general. I do a lot
| of trail running, and at this point I feel like my most
| likely source of injury is from a mountain biker colliding
| with me.
| imp0cat wrote:
| It's not that bad. And if you start early in your life, any
| injuries that might happen to you will heal much faster.
| wingofagriffin wrote:
| This is interestingly relevant to me right now as I just
| fractured my shoulder this weekend. Urgent care gave me a sling
| despite the chip being small, though everything I'm reading
| online is saying to use it and to not take pain killers to let my
| body do the healing naturally. Talking to my primary care now to
| see what the recommendation is.
| imroot wrote:
| In the 90's my grandma had her knee replaced. She was bed-bound
| for 2 weeks before they'd start physical therapy to get her knees
| back in order. (Ironically enough, her first knee was
| recalled...so she had a total of three knee surgeries Left,
| Right, then Left again) over a span of 11 years.
|
| In 2018, my mom had her left knee and right knee done at the same
| time...and they had her up walking the halls of the floor the
| next day and was back at home less than 72 hours after her
| surgery, and she's walking just fine these days without any
| assistance.
| bluecheese452 wrote:
| My counter anecdote I fractured a bone in my leg. Kept walking on
| it for a year. Only healed when I finally got in a boot.
| maccard wrote:
| I've had a handful of broken bones and other ailments over the
| years, and some fairly awful back and spine issues. I've noticed
| the change from "rest avoid weight and keep the fragile bones
| away from danger" to "don't overdo it, but try use it" over the
| years. It makes me wonder how much of our "rest" when sick is
| really the best course of action. I'm not suggesting
| weightlifting with a flu, but instead of being bed bound trying
| to get out walking, etc.
| DidYaWipe wrote:
| I had a chipped right kneecap in 6th grade, around 1980. At
| that time the practice was to put the whole leg in a brace and
| baby it; I don't remember for how long.
|
| Being a kid and wanting it to heal, I took that advice to
| heart. But of course I still wanted to do stuff... even riding
| my bike pedaling with only one leg.
|
| This was highly detrimental. There was no mention of physical
| therapy or rehabilitation of the knee. The favoring was so
| quickly ingrained that it continued unconsciously even after
| the brace came off; now my formerly-injured leg is longer than
| my other one, leading to mild scoliosis and a lifetime of
| asymmetrical foot and/or leg problems. I can see (although the
| casual observer probably wouldn't notice) that my whole body
| developed to put more weight over my left leg.
|
| It's infuriating. This blunder during a child's growth years
| can be a disaster. Even as an adult I experienced doctors
| dismissing this entire sequence of events as the source of
| measurable deformity. WTF?
|
| I experienced a minor brush with a similar mistake much more
| recently. A falling basketball fractured my finger by jamming
| it dead-on from the tip. My general doctor put it in a splint,
| where it was to remain for a while. I noticed that the swelling
| and color were not improving over an extended period, and went
| to a hand specialist. He immediately removed the splint and had
| me flexing the finger as hard as I could every day. He said if
| I'd left it in the splint I would have permanently lost some
| range of motion.
|
| I believe in medicine, but even with access to "good" care it's
| a minefield. Even a relatively informed and interested patient
| can't dodge all the harm from incompetent, ignorant, and
| outright corrupt healthcare and drug purveyors.
|
| Don't even get me started on the serious harm visited upon
| people by corticosteroids and fluoroquinolones...
| Vaslo wrote:
| I hurt my back a couple of times over the years between squats
| and leg press. Each time I went to the doctor, they pushed
| chiropractor or the physical therapist. PT was useless the 3
| injuries that I went for, and Chiropractor maybe helped once.
|
| When I went and read a lot about muscle and back injuries, it
| sounded like the ubiquitous advice of heat, cold etc can still be
| used. BUT what really helps is to rest for a day or two to offset
| some of the bigger damage and then get back into the gym at very
| low weight and start over.
|
| If you haven't ripped something to the point of surgery, there is
| something about keeping active, keeping blood and nutrients
| flowing to the site that maximizes healing I guess. I was back to
| where I was squatting within 2 months and my form was better than
| ever with a lot of attention paid to my back.
| TinkersW wrote:
| I smashed up my wrist in a bike crash, resting it didn't fix
| shit. When I lifted weights it would tweak out and hurt, so I
| avoided that for like a year.
|
| Eventually I decided fuck this, and starting lifting weights even
| though it hurt, then I'd massage it which somehow reduced the
| pain. Repeat that, and very quickly the wrist fixed itself, zero
| issues now.
|
| When I broke my collarbone years ago, the docs said just let it
| heal on its own, which it did just fine(I was hiking/running
| about 2 hours every day, maybe that helped).
| b212 wrote:
| I battled PF for ages, tried literally everything, and when
| nothing worked, my feet were in pain I decided to do the dumbest
| thing in the world and try to only thing I was told I shouldn't
| do - run.
|
| I picked a day when my plantar fascia was not too painful and did
| the first training from c25k plan (roughly 8 minutes of jogging
| if I remember correctly).
|
| It actually helped me. Don't try it at home, I think I got lucky
| because my PF was really not a PF anymore. But I would never
| found out if I did not run that day. I've been running daily ever
| since, no issues whatsoever.
| baxtr wrote:
| Interesting. For me PF gets worse when I walk more. Even with
| special soles. Still trying to figure out what works.
| jraby3 wrote:
| Constantly stretching the heel in two ways works well for me,
| both to cute it and prevent it in the future.
|
| The first is hanging your heels off a step and letting them
| stretch down, both with straight legs and bent knees (one
| foot at a time).
|
| The second is putting your heel as close to a wall as
| possible, with toes on the wall.
|
| Both work better with sneakers on.
| baxtr wrote:
| Thanks I'll try that!
|
| Stretching and rolling with a small foam roll helps me as
| well.
| Panzer04 wrote:
| I wonder how it would go without shoes. It's an enjoyable
| change from wrapping your feet up all the time anyway :)
| hinkley wrote:
| Shoes with a wider toe box. Take your uncomfortable shoes to
| a reuse/charity drop off and never look back.
|
| Every time I wore shoes that were too narrow my problems
| multiplied. Reworking the laces helped a bit but it was not
| enough and I had to switch brands.
| hinkley wrote:
| I essentially had to relearn to walk to clear mine up. Rolling
| your ankles makes it much worse, but the entire leg is involved
| in that "decision" and it starts from the gluteus minimus
| muscles and builds down.
|
| Went from pain after more than 2km total per day to walking a
| half marathon just over three hours. And then my knees decided
| they didn't like that at all and have not yet forgiven me.
| rodary wrote:
| Anecdotal but...
|
| Broke my femur neck on a mountain bike. Surgery, plates and
| screws. Surgeon said no weight on the broken bone for 8 weeks and
| no walking on it for 12. And then we'll see he said.
|
| In 4 weeks I was on a trainer (fork fixed to the trainer).
| Started easy with 30min sessions and then increased time and
| force applied to the pedals.
|
| After 2 weeks of "riding", started putting weight on the bone
| with short walks around the house.
|
| 8 weeks after the surgery rocked up to a road race, still on
| crutches because walking was still a bit uncomfy but being on the
| bike was fine. Raced to a 3rd place (Masters A) with hard
| breakaways and all.
|
| 12 weeks after the surgery go to see the surgeon to check if I
| can start walking (already walking by this stage as normal). He
| X-rays me and says your bone is fully healed. Strange but good he
| said.
|
| I told him the story. Still don't know if he believed me.
| rodary wrote:
| Another thing - the surgeon told me I'll need a hip replacement
| in 10 years' time. This was 16 years ago and I don't feel I
| need a new hip although it's not perfect the way it works
| sometimes but nothing even remotely serious.
| spacemark wrote:
| I definitely believe you. I know from a few injuries that with
| tendons you want to be moving and applying resistance as soon
| as you are able to prevent the formation of scar tissue and
| encourage blood flow. It's not a huge leap of logic that bones,
| too, benefit from movement and resistance when healing.
|
| Honest question, how did you know to disregard the doctor 's
| instructions and start home exercises on the bone at 4 weeks?
| How did you limit yourself during your riding and other
| resistance work? How long was the recovery period after every
| session?
| rodary wrote:
| > how did you know to disregard the doctor 's instructions
|
| My background (Russian). Don't trust western approach to
| solve problems with pills etc. End up talking to (usually)
| Soviet-trained doctors who can't practice here in the west.
| The advice makes sense so I follow it believing they know
| what they're talking about. It's always about the cause, not
| the symptom. This sort of thing.
|
| > How did you limit yourself during your riding and other
| resistance work
|
| By feel. Biking is a second nature to me. Femur neck wasn't
| the only bone I broke. More plates too.
|
| > How long was the recovery period after every session?
|
| First few, felt a bit fucked but I think it was both being
| out of shape and one leg's muscles sleeping for 4 weeks. So
| the usual, sit for 5-10 min, back on the crutches, off to the
| shower and the life goes on.
| lnsru wrote:
| Best Soviet doctors! Poor guys working without any
| equipment to get perfect results. Sure good way for easy
| cases, bud hard cases are cripples afterwards. Or badly
| healed bones are separated with chisel and then comes next
| try... been there, saw that. Thanks but no, I'll take a
| western medicine with all the screws and plates. Despite
| screws and plates being much easier to work with, every
| sane doctor will try without them at first even for
| moderately hard cases.
| Fnoord wrote:
| Is this survivorship bias?
| j-krieger wrote:
| Yes.
| lnsru wrote:
| I just searched around and it's accurate and worthy
| reading by user called Minardi-Man: https://www.reddit.co
| m/r/AskHistorians/comments/73aiiu/what_...
|
| The chisel part happened to my classmate. I rather take
| western medical titanium screws than second attempt to
| fix the hand old school.
| sim7c00 wrote:
| you are not wrong, shattered leg, waited too long, can't do
| shit now. never healed properly. should have listened to my
| body rather than my doctors. fucking sucks.
| grumpy-de-sre wrote:
| The story of Valentin Dikul is a great read for anyone
| interested in the importance of physical rehab,
| https://en.wikipedia.org/wiki/Valentin_Dikul
| steve_adams_86 wrote:
| > with tendons
|
| I think this is commonly accepted now (maybe?), but tendons,
| ligaments, and cartilage don't heal well without movement to
| increase fluid exchange. When I was a kid it was a big deal
| to avoid any pressure on these tissues after an injury, but
| it seems imperative for recovery.
|
| When my kids hurt themselves in sports, it's straight to easy
| yoga, light calisthenics, and lecturing them for not cross
| training and treating their tissues better when they aren't
| competing. I sound like a dumb old man to them now, but I
| think in 10 or 15 years they'll be spending a lot more time
| focused on building that kind of resilience.
| lloeki wrote:
| > I think this is commonly accepted now (maybe?), but
| tendons, ligaments, and cartilage don't heal well without
| movement to increase fluid exchange.
|
| It's getting better. RICE protocol after a sprain is still
| too unknown to/overlooked by many physicians, although I'd
| rate it to 50-80% these days.
|
| Many would recommend a 4-6 week rest after an ankle sprain,
| with a prescription of 10 sessions at a physiotherapist 2
| weeks in, and crutches til then.
|
| Luckily physiotherapists are better trained and usually
| tell you to come _yesterday_ , start with massaging to
| reduce the swelling and promote lymphatic and blood flow,
| and movements to break down scar tissue as it forms, and
| walk as much as you can, with crutches not as walking aids
| but as "seatbelts" so that you have something to
| immediately lean on instead of the injured foot should you
| trip over.
|
| Once tissue has healed enough the next step is relearning
| and recovering strength and movement (general motion, hence
| why in french physiotherapist is "kinesitherapeute" from
| greek kinesis a.k.a motion) towards normal levels. Problem
| is halfway through the allotted 10 sessions are up :/ so
| you're either down for a trip back to the physician and
| convince them you need more or you're on your own.
| potamic wrote:
| Does anyone know sources that talk about muscles, tendons and
| cartilage healing too? This article specifically talks about
| bone healing.
| notShabu wrote:
| The cost of this increased healing rate would be the tail risk
| of compounding injury though. It's not something a doctor could
| recommend even if it were true for everyone consistently.
| lennxa wrote:
| if it were true for everyone consistently (faster better
| healing), where does the tail risk come from?
| PoignardAzur wrote:
| You fall and break something.
| ses1984 wrote:
| Surgery has very well documented known risks and doctors
| recommend surgery.
|
| Also surgery has outcomes that are barely better than non
| surgical interventions, sometimes, and they still recommend
| surgery.
| stouset wrote:
| I had shoulder surgery last May. My surgeon told me no combat
| sports (BJJ, judo) for six months minimum. I was 40 at the
| time.
|
| I went back on the mats a week later. Started with only doing
| warmups and movement drills, worked up to gentle flow rolling
| (with my arm tied into my belt) at a month, then drilling
| techniques with well-chosen partners and conservatively rolling
| with those same partners at two months.
|
| This was, of course, on top of rigorously following my PT
| schedule. And being very conservative with the situations I'd
| put myself in.
|
| By three months I had regained full flexibility in the arm, and
| by six months I was back to full-contact training five days a
| week.
|
| I definitely think there's a fine line to walk here. I
| explicitly didn't do judo for six months because that involves
| direct and unavoidable impact. And I also made sure to choose
| training partners who would be very cognizant of my arm and
| limited range of motion and who wouldn't just grab a submission
| and crank it. I also would preemptively tap _any_ time that arm
| got isolated or in a position where it could be attacked. But
| there was definitely risk that a training partner would make a
| mistake or I would land on it badly and tear something.
|
| Still, I would do it all over the same way. I definitely think
| pushing things helped it heal dramatically more quickly and
| completely than otherwise. But you do have to be careful with
| the level of risk you're exposing yourself to.
| thoughtpalette wrote:
| That's honestly wild to me. I had arthroscopic labrum tear
| surgery on both my shoulders (1 in 2024, 1 in 2023), and I
| can't imagine going back to really any range of movement
| within a week. Even on my solid PT schedule. Glad it worked
| out for you but I would hesitate to expose yourself to any
| sort of risk at that stage.
|
| For me it took about 4 months to feel pretty comfortable with
| the shoulder(s) and about 6-12 months for skateboarding,
| weight lifting, etc
|
| What was your surgery if you don't mind me asking?
| reaperman wrote:
| Also note that very nearly everyone practicing BJJ past 35
| is taking exogenous testosterone. Without additional
| testosterone, it would be very difficult to sustain the
| sport due to frequent small injuries - the
| extra/"replacement" hormones help speed up recovery and
| actually allow frequent (>1x/week) training sessions.
|
| It depends on the details of the surgery, but this may have
| helped GP heal a bit faster.
|
| While testosterone is not well-known for helping to heal
| ligaments/tendons, some HRT compounds (such as nandrolone)
| that are occasionally prescribed by doctors/urologists,
| have a lot of anecdotal accounts of reducing perceived
| joint pain.
| stouset wrote:
| I do not take testosterone. I occasionally try to make a
| habit of taking creatine but other than that and whey
| protein while weightlifting (another habit I struggle to
| reliably form) that's it.
|
| Maybe I'm out of touch but I would be astonished to find
| that it was even remotely close to "nearly everyone" for
| recreational hobbyists over 35.
|
| The level of injury is just not as high as you're
| suggesting for people who aren't training to be elite
| competitors. I've had perhaps one "small" injury (muscle
| pull, joint overextension, etc.) every six months or so,
| reasonably consistently for the last ~7 years of BJJ /
| judo which I do three to five days a week, 2-3 hours a
| day.
| stouset wrote:
| Mine was similar, labral repair as well as rotator cuff
| arthroscopy.
|
| I had nearly zero ability to lift the arm under its own
| power at one week and limited (but good for one week)
| flexibility. To be clear, I did not engage in any actual
| drilling or movement of that shoulder in training for
| perhaps a month. It was in the sling, tightly affixed to my
| body. I started with one-sided warmup movements and drills
| and progressed as I felt able.
|
| By a month I was helping newcomers by helping them with
| some details of techniques. Due to being unable to lift the
| arm under its own power, I would "crawl" my arm using my
| fingers where it needed to go to show them. This was with
| zero actual resistance, but I was at least using the arm:
| moving it, contracting the muscles, working through scar
| tissue, and getting blood flowing.
|
| Again, I 100% acknowledge that I exposed myself to greater
| levels of risk by doing this. I did try to mitigate that
| risk as best I could, but that never drops it to zero. And
| while I was pushing things, I was also adapting things day
| by day to what I realistically felt my capabilities were.
| thoughtpalette wrote:
| Ahhh gotcha. Thanks for the response. That puts it in
| much better perspective for me.
| rodary wrote:
| I guess worth mentioning another story..
|
| Some years after my fuck up, Chris Froome, multiple Tour
| winner, crashed badly. Much worse than me, broke a lot of
| bones.
|
| One of them was the femur neck. This one (and maybe in
| combination with other broken bones) took him a long time to
| recover from. By the time he did, he was finished as the Chris
| Froome, no more wins.
|
| Not saying he did anything wrong, the fuck do I know, but I
| wondered for a while if he tried, how shall I say it, a more
| head on approach to the fractured bones recovery and if that
| made any difference.
| raverbashing wrote:
| Doctors are good at doing the "fixing" work, but the recovery
| work is something else
|
| Good physios will insist on working as soon as possible, even
| if it's very light work.
| jq-r wrote:
| Anecdata but I agree. Had two spine surgeries at two highly
| regarded places and those surgeons had no clue whatsoever on
| the recovery. They've fixed their part and the rehab part is
| someone else's problem.
|
| Luckily I have a good therapist. But still I'm disappointed
| as they should know that part better.
| interludead wrote:
| Sounds like you basically tricked your body into healing faster
| by gradually loading it
| obl1que wrote:
| That is awesome! Thanks for sharing. Reminds me of a similar
| story from a friend. He, too, broke his leg and healed it
| quickly enough to surprise his orthopedist by riding a
| stationary bike. He said that initially the broken one was
| kinda just all by for the ride, but he thinks the circulation
| helped.
|
| He too was an elite athlete (baseball).
|
| Another friend was a bodybuilder. He said that bodybuilders do
| so many experiments that they sometimes know better than their
| own physicians. They are biohackers.
|
| "Power users" of a product sometimes end up schooling the
| customer support team.
| DrBazza wrote:
| On the other hand, I'm 6 weeks on from 3 fractured ribs, and
| still no exercise. I'm sure there are a few medical people on
| here that will tell you that ribs are a special case.
|
| If I were to breathe too deeply during the first few weeks,
| there was a good chance that I'd re-fracture them; sneezing is
| known to do this. And for what it's worth, despite what you
| might see on the TV, broken ribs are no joke.
|
| Recovery time is, apparently anything between 6 and 12 weeks.
| The first 3 weeks were the absolute worst. I'm finally at the
| 'it feels like a bruise' stage. As a sporty person I know that
| if I 'feel fine', I need to add at least 2 weeks on that before
| I actually start any sports again.
| Foobar8568 wrote:
| I had a small rib crack when I was teenager, laughing was a
| pain, as it was winter, flu was going around.
|
| I had to use the maximum dosage of codeine for two months,
| school was fun...
|
| I don't even want to imagine the pain with 3 fractured ribs.
| sandos wrote:
| I probably broke a rib, or damaged some cartilege last
| summer. I never went to a doctor because it was "fine", also
| our 1177.se site even says not to go unless its very painful
| and so on.
|
| Week 2 was worst I would say. I was sneezing a lot for some
| reason.
|
| The weird thing though, it was fully healed (it felt like)
| week 4, but then suddenly several weeks later the same exact
| pain came back, without me having done anything similar to
| the first fall from a MTB. It did go away again though, so
| its all good now!!
| flocciput wrote:
| How old were you?
| criddell wrote:
| Great point!
|
| A couple of weeks ago I went over the handlebars on my
| bicycle and broke my collarbone, needed 5 stitches on my
| forehead, got a little road rash on my hip, and an avulsion
| (?) fracture on one finger resulting in mallet finger. I'm 54
| and have noticed that I'm healing much more slowly than I
| remember healing when I was a teenager.
|
| Mostly, things are going smoothly and the only thing I'm
| really worried about is the mallet finger. I've been told to
| keep it in a splint for 8 weeks and if I accidentally bend it
| a little before then any healing will have to start over and
| I might end up needing surgery for it.
|
| If anybody here has had mallet finger, I'd love to hear how
| it went for you.
| ngd wrote:
| Sorry to say I'm in almost an identical seat. I broke my
| thumb and have a gnarly but closed tuft fracture - after 4
| weeks I saw a specialist who said there wasn't much healing
| or bone growth yet, and so decided to do a more aggressive
| splinting and lock down the whole thumb for another 4
| weeks.
|
| Oddly enough I had a similar injury 10 years prior on a
| different finger and that healed up in 6 weeks as if
| nothing ever happened to it.
| flocciput wrote:
| Yep, something I'm realizing is a lot of
| guidelines/expectations around how long something will take
| to heal seem to be based on people in the 30-45 range. In
| your teens and twenties you might get injured and heal
| faster than expected and think "huh, must be my
| genes/technique/etc" when really it's probably just youth.
| Suuuuucks when you start to realize that superpower of
| yours is fading.
| rodary wrote:
| 43 at the time.
|
| Probably relevant too - systematic endurance training since
| 12, elite-level racing since 18 (world champion at that
| point). So not a stranger to all kinds of injury and what
| works and what doesn't. For me that is.
| flocciput wrote:
| Nice! I was gonna say 43 is encouraging to hear, as someone
| who's worried about how age will affect my proneness to
| injury/ability to recover, but that's an impressive
| background and probably a major factor. Guess that's
| another good reason to stay active.
| solarmist wrote:
| This has been knowledge for the top orthopedic surgeons for
| decades (at least 20 years). But for your local orthopedic
| surgeon, it depends on when they graduated whether they know
| this or not.
| keepamovin wrote:
| Also another hack - doxycycline speeds up repair, and nothing to
| do with fighting infection. It assists the matrix proteins build
| faster and better.
|
| Don't believe it? Try it out. It's well tolerated. There's
| research on how it works, too. Search for it.
| pavelstoev wrote:
| 20 years ago, I broke my ankle in a friendly soccer game on the
| Cambridge Commons field. I was shocked when the doctor who
| performed surgery to put it back together ordered me to walk on
| crutches the next day after surgery and to continue placing more
| load on the ankle thereafter. 20 years later I can't complain :)
| selcuka wrote:
| Another anecdotal story: My brother was hit by a bus and broke
| his hip when he was in his 20s. The doctors said that there was a
| good chance that he could stay lame after the bones heal.
|
| He started getting up and trying to walk as soon as he could, way
| earlier than recommended, to speed up (according to him, possibly
| instinctively) healing. Fast forward a couple years and there was
| no visible issue in his walking. Never heard of him complaining
| about his hip either after that.
| psyclobe wrote:
| Yeah I hurt my arm, had surgery, and couldn't wait to use it..
| Now its fuct again lol
| amatecha wrote:
| I broke my wrist on an 11-day hike this past summer (Tour du Mont
| Blanc). The awesome doctor I dealt with in Switzerland was like
| "you can finish your hike, just don't fall on your wrist again or
| it will be really bad" (or something along those lines). It
| healed so fast I can't even believe it. I was still using poles
| for the hike, too. The combination of sustained high-output
| (12hrs+ hiking per day with major elevation deltas) and some
| usage of the wrist surely bolstered bloodflow and oxygen
| throughput, etc. .. eating well surely helped too. Was a really
| cool experience. My climbing friends back home were surprised how
| quickly I was back on the wall after such a short period of
| healing up! At this moment I literally don't remember which wrist
| I broke... lol
| interludead wrote:
| A few decades ago, full immobilization was the gold standard, now
| it turns out early movement is actually better. I wonder what
| other long-held recovery protocols will be overturned in the next
| 20 years. Interesting, but I haven't broken anything in my entire
| life so far...
| grumpy-de-sre wrote:
| Same goes for meniscus injuries in the knee (excluding probably
| things like bucket handle tears that risk further damage with
| use).
|
| Tore my right meniscus in a skateboarding accident, was
| recommended keyhole surgery to shave it down but due to being
| fresh out of university and starting my career I couldn't be
| bothered to deal with the downtime of surgery etc. Figured I'd
| deal with it later if it got worse / didn't improve.
|
| And you know what, after 24 months or so of limping about I was
| pretty much completely recovered and ten years later the knee is
| still in good shape. Meniscus injuries do heal, they just take a
| very long time and most surgeons/patients just don't have the
| patience for rehab. All-in-all no regrets.
|
| I think clinical guidelines are actually swinging back to
| conservative treatment now. Kind of a reminder about how poorly
| evidence based surgery can sometimes be (but of course like any
| tool also a lifesaver).
| davidw wrote:
| It turns out a friend has a broken ankle right now, so as an
| experiment I tried walking on it, but he just yelled a lot. I'm
| suspicious of these results.
| lucideng wrote:
| There seems to be some truth to 'walk it off'.
|
| My theory is exercise, within certain limits of the injury,
| increases blood flow to the injury, allowing it to heal faster.
| If there is inflammation, that means restricted blood flow, so
| getting your heart to push more blood into those areas from
| physical activity makes sense to help recovery. No blood flow, no
| healing.
|
| We can also only remove waste 3 ways. Urinating, defecating and
| sweating. Sweating is less 'efficient' from a waste removal
| perspective, but it does help regulate lactic acid and
| electrolytes. If you're riding the couch, you won't be activating
| this system. Increased blood flow from exercise throughout would
| also improve the other waste removal systems in your body, aiding
| recovery.
| nasmorn wrote:
| A friend of mine who is a doctor, osteopath a once played pro
| basketball in Austria said: if pro sports injuries would be
| treated like the general population is treated there would be no
| pro sports.
| hosteur wrote:
| Care to elaborate on what they meant by that?
| theultdev wrote:
| It means pro-athletes would never recover so there would be
| noone left to play pro sports.
|
| Because pro athletes get procedures that actually work, vs
| general population procedures that can be detrimental.
| __mharrison__ wrote:
| Many athletes are playing with injuries?
| nasmorn wrote:
| Basically conservative therapy takes off so much load that
| you have no muscle strength left once you start training. Pro
| athletes will always apply the max stress they can currently
| handle.
| hinkley wrote:
| This is one of those areas where it's quite obvious how much
| confirmation bias there is in medicine. I told the patient to do
| X, they did X and they are better. Only the patient either didn't
| do X and lied or they did X and something else and didn't argue
| with the doctor about it.
|
| How many people over the centuries have been told to stay off
| their cast but got up to get their kid or themselves some cookies
| from the top shelf? Or to do chores because nobody else was
| picking up the slack?
| shadowtree wrote:
| Yes, of course. Same with herniated discs - you need to keep
| walking, no matter the pain.
|
| If you stop moving, you die.
|
| A ton of biomechanics at play, but walking is the baseline of all
| human activity. Not running, not swimming.
|
| It's why the 10k steps thing is both a myth and absolutely true.
| cryptonector wrote:
| What doesn't heal better when you use it?
|
| Didn't we learn this when that Australian nurse invented physical
| therapy for treating children with polio in the 1920s? (It took
| decades for consensus to form that PT was better than
| immobilization for polio.)
| Arch-TK wrote:
| I was in a cast for 6 weeks. Once they cut me out of it, it was
| straight into walking.
|
| I wonder now if 6 was a bit long. It has healed fine but its
| still a bit sore over a year later.
|
| But I also have a metal plate which probably doesn't help the
| soreness.
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