Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

scientificamerican.com

Post reply on HN
Print view View original

221–230 of 342 posts

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

#221

Post by foobarbecue »

jamiedumont wrote: post #111
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 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 an…

Welcome to the waves! Best sport in the world, especially if you can avoid the crowds.

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

#222

Post by rodary »

spacemark wrote: post #220
rodary wrote: post #212

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 wa…

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…

> 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.

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

#223

Post by james4k »

tomjakubowski wrote: post #202
askvictor wrote: post #176

Earlier quoted context omitted.

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.

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...

As I understand it such diets allow the immune system to work more effectively, not suppressing it like, say, corticosteroids do.

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

#224

Post by steve_adams_86 »

spacemark wrote: post #220
rodary wrote: post #212

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 wa…

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…

> 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.

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

#225

Post by ghaff »

alistairSH wrote: post #201
ghaff wrote: post #148

Earlier quoted context omitted.

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.

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.

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.

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

#226

Post by devilbunny »

pessimizer wrote: post #154
layer8 wrote: post #82

Earlier quoted context omitted.

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.

Yeah, but given the huge variations in pain tolerance, some will reinjure it while others will never use it again.

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

#227

Post by idiotsecant »

pkulak wrote: post #203
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'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…

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.

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

#228

Post by Aromasin »

Panzer04 wrote: post #160
Aromasin wrote: post #25

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?

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.

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

#229

Post by selcuka »

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.

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

#230

Post by [deleted] »

crazygringo wrote: post #209
grayhatter wrote: post #47

Earlier quoted context omitted.

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…

> 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.…

[deleted]
Post reply on HN