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

scientificamerican.com

31–40 of 342 posts

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

#31
post #11

Earlier quoted context omitted.

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.

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.

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

#32
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...

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

#33
post #30
post #24

Earlier quoted context omitted.

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.

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.)

> 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.

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

#34
post #11

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.

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.

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

#35
post #32

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/bon…

source?

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

#36
post #32

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/bon…

Squats/Deadlifts, not bicep curls with 3lb dumbbells. And yes, it absolutely will improve bone density.

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

#37
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.

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).

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

#38

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.

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.

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

#39
post #29

Earlier quoted context omitted.

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.

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.

You haven't addressed the argument (riskiness of the activity) with your anecdote.

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

#40
post #30
post #24

Earlier quoted context omitted.

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.

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.)

You mean like an additional tax on tobacco, alcohol, and sugar?

You're behind the times lol -- UK

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