[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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