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

scientificamerican.com

151–160 of 342 posts

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

#151
post #99

Earlier quoted context omitted.

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.

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.

> 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.

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

#152

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.

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.

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

#153
post #92

Earlier quoted context omitted.

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 poi…

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…

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

#154
post #82

Earlier quoted context omitted.

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.

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.

"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.

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

#155

Earlier quoted context omitted.

On the other hand, mandatory rough surfaces on the floor of showers seem pretty reasonable.

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?

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.

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

#156

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.

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 m…

> 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.

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

#157

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 wee…

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:

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

#158
post #49

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’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 s…

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)

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

#159

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.

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 be…

I love how this is basically the complete opposite of the old protocol lmfao.

Makes sense to me, though :D

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

#160

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 t…

What surgical treatment do you expect to improve your outcome?
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