30 ms·

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

641 points by sohkamyung 2y ago

clumsysmurf 2y ago
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.
- TomK32 2y ago
  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 2y ago
    But plenty of people here are saying to just force it...
- 77pt77 2y ago
  What did the doctors say after it healed? Did they take credit for it?
- sethammons 2y ago
  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 2y ago
    > 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.
  - clumsysmurf 2y ago
    > It took 4 or 5 months to start to fuse still Yeah it was almost half a year for me. My doctor even started prescribing "non-standard" treatments like electrical stimulation, etc, which didn't work.
ehnto 2y ago
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 2y ago
  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 2y ago
    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--midshaft https://www.orthobullets.com/trauma/1011/clavicle-fractures-...
- edwcross 2y ago
  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.
  - erikerikson 2y ago
    Kids have so much joy on trampolines! I know they have dangers but net negative? Do you have data or anything?
netbioserror 2y ago
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 2y ago
  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 2y ago
  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 2y ago
    Most of these fractures would be deadly affairs thousands of years ago anyway. Immobilization has its uses. Surgery is many times essential.
    - bluGill 2y ago
      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 2y ago
"Use it or loose it"
faitswulff 2y ago
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 2y ago
  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 2y ago
    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 2y ago
      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 2y ago
        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
canucker2016 2y ago
from https://www.outsideonline.com/health/training-performance/four-laws-muscle/ 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 2y ago
  Some good videos on Starting Strength of what they have done for older people: https://www.youtube.com/watch?v=ekJOT0kn5vs https://www.youtube.com/watch?v=ekJOT0kn5vs (Such as the 86 year old lady in the video).
- MichaelDickens 2y ago
  > 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/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8325614/
  - canucker2016 2y ago
    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/65/10/2862/35009/One-Week-of-Bed-Rest-Leads-to-Substantial-Muscle 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 2y ago
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 2y ago
Because the more they break the stronger they are.
highfrequency 2y ago
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 2y ago
  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 2y ago
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 https://photos.app.goo.gl/z8J8RfhnZ2jnVHFYA
- wkirby 2y ago
  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 2y ago
    What's your leg circumference at, now? Mine is also smaller, due to patella tendinopathy.
alexandrehtrb 2y ago
Related, bone tissue regeneration using coral and marine sponges: https://web.archive.org/web/20240705042256/https://web.stanford.edu/group/mota/education/Physics%2087N%20Final%20Projects/Group%20Gamma/bone.htm https://web.archive.org/web/20240705042256/https://web.stanf...
taneq 2y ago
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 2y ago
  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 2y ago
    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 2y ago
  Yes and no. Professional athletes are usually miserable later in life due to doing exactly that.
- timewizard 2y ago
  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.
- 2y ago
Aromasin 2y ago
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 2y ago
  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 2y ago
  What surgical treatment do you expect to improve your outcome?
  - Aromasin 2y ago
    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 2y ago
      Brutal. Hope you can make the best of it and the arthritis doesn't advance further.
77pt77 2y ago
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 2y ago
  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 2y ago
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/exercise-for-bones/ https://theros.org.uk/information-and-support/bone-health/ex...
- WithinReason 2y ago
  source?
  - TomK32 2y ago
    https://theros.org.uk/information-and-support/bone-health/exercise-for-bones/ https://theros.org.uk/information-and-support/bone-health/ex...
    - WithinReason 2y ago
      That page directly contradicts you since it lists weight lifting exercises like barbell squats
      - TomK32 2y ago
        It does not contradict, it lists weight lifting under muscle training, not under bone density.
        WithinReason 2y ago
        "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 2y ago
  Squats/Deadlifts, not bicep curls with 3lb dumbbells. And yes, it absolutely will improve bone density.
trollied 2y ago
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 2y ago
  Same! Big shoutout to Dr Thuillier at UCSF. Really changed my life.
lexicality 2y ago
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 2y ago
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_rehab 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 2y ago
  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 2y ago
  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 2y ago
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 2y ago
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 2y ago
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 2y ago
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 2y ago
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 2y ago
  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 2y ago
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 2y ago
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 2y ago
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 2y ago
  Primum non nocere
  - Panzer04 2y ago
    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 2y ago
  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 2y ago
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 2y ago
  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 2y ago
  Remember, "Pain is weakness leaving your body".
  - m463 2y ago
    Well in my case pain was half a bone trying to leave my body. :)
  - imp0cat 2y ago
    Pain is an illusion of the senses. Literally, it's just electrical impulses travelling through your body.
    - Sharlin 2y ago
      Doesn’t make it any less real though.
  - interludead 2y ago
    That phrase always felt more like a gym bro mantra
- interludead 2y ago
  Imagine how many people end up with stiff joints just because they were told to keep still
greenchair 2y ago
a vet estimated that ~50% of animals that he treats would have recovered fine without his involvement
merb 2y ago
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 2y ago
if you dont use it... you might lose it...
clausecker 2y ago
I wonder if this phenomenon was part of the reason why Küntscher's intramedullary nailing was so effective at speeding up the recovery from broken legs.
dwedge 2y ago
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 2y ago
My main take away from this thread is to never take up mountain biking.
- myself248 2y ago
  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 2y ago
  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 2y ago
    Damn I hit 30 this year and planned to buy one.
  - yoyohello13 2y ago
    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 2y ago
  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 2y ago
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 2y ago
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 2y ago
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 2y ago
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 2y ago
  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 2y ago
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 2y ago
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 2y ago
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 2y ago
  Interesting. For me PF gets worse when I walk more. Even with special soles. Still trying to figure out what works.
  - jraby3 2y ago
    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 2y ago
      Thanks I’ll try that! Stretching and rolling with a small foam roll helps me as well.
  - Panzer04 2y ago
    I wonder how it would go without shoes. It's an enjoyable change from wrapping your feet up all the time anyway :)
  - hinkley 2y ago
    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.
rodary 2y ago
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.
- nurettin 2y ago
  Anti-anecdotal: Old family member cracked a femur neck. Tried to stand on it after a few weeks despite warnings, broke it, had to go to surgery, plates and screws. A few more weeks of resting and she would have been fine.
- rodary 2y ago
  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 2y ago
  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?
  - 2y ago
keepamovin 2y ago
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 2y ago
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 2y ago
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 2y ago
Yeah I hurt my arm, had surgery, and couldn't wait to use it.. Now its fuct again lol
amatecha 2y ago
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 2y ago
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 2y ago
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 2y ago
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 2y ago
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 2y ago
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 2y ago
  Care to elaborate on what they meant by that?
  - theultdev 2y ago
    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__ 2y ago
    Many athletes are playing with injuries?
  - nasmorn 2y ago
    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 2y ago
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 2y ago
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 2y ago
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 2y ago
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.

641 points by sohkamyung 2y ago

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.

TomK32 2y ago
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 2y ago
  But plenty of people here are saying to just force it...
77pt77 2y ago
What did the doctors say after it healed? Did they take credit for it?
sethammons 2y ago
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 2y ago
  > 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.
- clumsysmurf 2y ago
  > It took 4 or 5 months to start to fuse still Yeah it was almost half a year for me. My doctor even started prescribing "non-standard" treatments like electrical stimulation, etc, which didn't work.

ehnto 2y ago

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 2y ago
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 2y ago
  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--midshaft https://www.orthobullets.com/trauma/1011/clavicle-fractures-...
edwcross 2y ago
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.
- erikerikson 2y ago
  Kids have so much joy on trampolines! I know they have dangers but net negative? Do you have data or anything?

netbioserror 2y ago

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 2y ago
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 2y ago
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 2y ago
  Most of these fractures would be deadly affairs thousands of years ago anyway. Immobilization has its uses. Surgery is many times essential.
  - bluGill 2y ago
    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 2y ago

"Use it or loose it"

faitswulff 2y ago

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 2y ago
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 2y ago
  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 2y ago
    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 2y ago
      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

canucker2016 2y ago

from https://www.outsideonline.com/health/training-performance/four-laws-muscle/ 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 2y ago
Some good videos on Starting Strength of what they have done for older people: https://www.youtube.com/watch?v=ekJOT0kn5vs https://www.youtube.com/watch?v=ekJOT0kn5vs (Such as the 86 year old lady in the video).
MichaelDickens 2y ago
> 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/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8325614/
- canucker2016 2y ago
  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/65/10/2862/35009/One-Week-of-Bed-Rest-Leads-to-Substantial-Muscle 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 2y ago

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 2y ago

Because the more they break the stronger they are.

highfrequency 2y ago

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 2y ago
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 2y ago

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 https://photos.app.goo.gl/z8J8RfhnZ2jnVHFYA

wkirby 2y ago
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 2y ago
  What's your leg circumference at, now? Mine is also smaller, due to patella tendinopathy.

alexandrehtrb 2y ago

Related, bone tissue regeneration using coral and marine sponges: https://web.archive.org/web/20240705042256/https://web.stanford.edu/group/mota/education/Physics%2087N%20Final%20Projects/Group%20Gamma/bone.htm https://web.archive.org/web/20240705042256/https://web.stanf...

taneq 2y ago

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 2y ago
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 2y ago
  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 2y ago
Yes and no. Professional athletes are usually miserable later in life due to doing exactly that.
timewizard 2y ago
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.
2y ago

Aromasin 2y ago

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 2y ago
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 2y ago
What surgical treatment do you expect to improve your outcome?
- Aromasin 2y ago
  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 2y ago
    Brutal. Hope you can make the best of it and the arthritis doesn't advance further.

77pt77 2y ago

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 2y ago
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 2y ago

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/exercise-for-bones/ https://theros.org.uk/information-and-support/bone-health/ex...

WithinReason 2y ago
source?
- TomK32 2y ago
  https://theros.org.uk/information-and-support/bone-health/exercise-for-bones/ https://theros.org.uk/information-and-support/bone-health/ex...
  - WithinReason 2y ago
    That page directly contradicts you since it lists weight lifting exercises like barbell squats
    - TomK32 2y ago
      It does not contradict, it lists weight lifting under muscle training, not under bone density.
      - WithinReason 2y ago
        "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 2y ago
Squats/Deadlifts, not bicep curls with 3lb dumbbells. And yes, it absolutely will improve bone density.

trollied 2y ago

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 2y ago
Same! Big shoutout to Dr Thuillier at UCSF. Really changed my life.

lexicality 2y ago

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 2y ago

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_rehab 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 2y ago
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 2y ago
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 2y ago

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 2y ago

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 2y ago

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 2y ago

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 2y ago

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 2y ago
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 2y ago

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 2y ago

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 2y ago

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 2y ago
Primum non nocere
- Panzer04 2y ago
  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 2y ago
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 2y ago

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 2y ago
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 2y ago
Remember, "Pain is weakness leaving your body".
- m463 2y ago
  Well in my case pain was half a bone trying to leave my body. :)
- imp0cat 2y ago
  Pain is an illusion of the senses. Literally, it's just electrical impulses travelling through your body.
  - Sharlin 2y ago
    Doesn’t make it any less real though.
- interludead 2y ago
  That phrase always felt more like a gym bro mantra
interludead 2y ago
Imagine how many people end up with stiff joints just because they were told to keep still

greenchair 2y ago

a vet estimated that ~50% of animals that he treats would have recovered fine without his involvement

merb 2y ago

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 2y ago

if you dont use it... you might lose it...

clausecker 2y ago

I wonder if this phenomenon was part of the reason why Küntscher's intramedullary nailing was so effective at speeding up the recovery from broken legs.

dwedge 2y ago

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 2y ago

My main take away from this thread is to never take up mountain biking.

myself248 2y ago
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 2y ago
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 2y ago
  Damn I hit 30 this year and planned to buy one.
- yoyohello13 2y ago
  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 2y ago
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 2y ago

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 2y ago

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 2y ago

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 2y ago

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 2y ago
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 2y ago

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 2y ago

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 2y ago

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 2y ago
Interesting. For me PF gets worse when I walk more. Even with special soles. Still trying to figure out what works.
- jraby3 2y ago
  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 2y ago
    Thanks I’ll try that! Stretching and rolling with a small foam roll helps me as well.
- Panzer04 2y ago
  I wonder how it would go without shoes. It's an enjoyable change from wrapping your feet up all the time anyway :)
- hinkley 2y ago
  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.

rodary 2y ago

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.

nurettin 2y ago
Anti-anecdotal: Old family member cracked a femur neck. Tried to stand on it after a few weeks despite warnings, broke it, had to go to surgery, plates and screws. A few more weeks of resting and she would have been fine.
rodary 2y ago
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 2y ago
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?
- 2y ago

keepamovin 2y ago

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 2y ago

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 2y ago

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 2y ago

Yeah I hurt my arm, had surgery, and couldn't wait to use it.. Now its fuct again lol

amatecha 2y ago

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 2y ago

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 2y ago

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 2y ago

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 2y ago

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 2y ago

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 2y ago
Care to elaborate on what they meant by that?
- theultdev 2y ago
  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__ 2y ago
  Many athletes are playing with injuries?
- nasmorn 2y ago
  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 2y ago

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 2y ago

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 2y ago

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 2y ago

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.