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Broken legs and ankles heal better if you walk on them within weeks

scientificamerican.com

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Re: Broken legs and ankles heal better if you walk on them within weeks

#11

Post by dfxm12 »

faitswulff wrote: post #6

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.

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.

Re: Broken legs and ankles heal better if you walk on them within weeks

#12

Post by miketery »

ehnto wrote: post #3

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,…

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?

Re: Broken legs and ankles heal better if you walk on them within weeks

#13

Post by tomaytotomato »

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 £70,000 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

Re: Broken legs and ankles heal better if you walk on them within weeks

#14

Post by miketery »

dfxm12 wrote: post #11
faitswulff wrote: post #6

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.

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.

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.

Re: Broken legs and ankles heal better if you walk on them within weeks

#16

Post by wkirby »

tomaytotomato wrote: post #13

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 ankl…

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.

Re: Broken legs and ankles heal better if you walk on them within weeks

#17

Post by paulcole »

dfxm12 wrote: post #11
faitswulff wrote: post #6

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.

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.

> 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.

Re: Broken legs and ankles heal better if you walk on them within weeks

#18

Post by lwarfield »

dfxm12 wrote: post #11
faitswulff wrote: post #6

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.

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.

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.

Re: Broken legs and ankles heal better if you walk on them within weeks

#19

Post by riv991 »

netbioserror wrote: post #4

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…

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.

Re: Broken legs and ankles heal better if you walk on them within weeks

#20

Post by edwcross »

ehnto wrote: post #3

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,…

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.
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