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Re: [at-l] Q5 - Fractures/breaks and Bone Problems

Ah, at last something I can actually claim to know something about!

>    As I gather information about the AT, I find that stress fractures,
>and broken bones are a distinct possibility for a long distance hiker.
>I would be interested to hear knowledgeable accounts of these types of
>injuries.  For example:
>
>1.  Anyone know a percentage of hikers attempting a thru-hike that have
>their hike ended by a fracture or broken bone?
>

Don't know this one.

>2.  What usually causes them?  (Sudden trauma, repeated stress, etc.)

Basic fractures are caused by sudden trauma, falls, etc.

Stress fractures are caused by repeated OVERuse, especially of a
relatively unfamiliar stress nature.  Like walking with a heavy pack
for too many steps in a day.  Can be much worse in individuals with
the wrong footwear for their foot structure.  That's why the right
footwear is so important, and why the same "GREAT boot" isn't great
for everybody.  So when training for a hike, lots of walking up and
down hills with loaded pack is very important, so you gradually
accomodate to the stress.

Also very important is to listen to your body.  Persistant pain, especially
if it is very localized in one spot on your foot (typically around the
part under the laces (3rd or 4th metatarsal bones) or your shin is
a sign of a stress syndrome, which if it continues getting worse will
cause a tiny crack in the bone (the stress fracture).  These don't show
up on x-ray until they are almost healed (callous forming at the fracture
site shows up on x-ray).  They are diagnosed clinically and can be confirmed
with a bone scan, but usually the history and exam are enough evidence.
>
>3.  How long are hikers with these problems typically off the trail?

Depends completely on how bad it is.  If you take heed of the pain
before the fracture occurs, lighten your load or shorten your days,
you can maybe head off a full blown stress fracture -- which CAN leave you
prone to an outright fracture.  If it gets to the point of a stress
fracture, your hike may be done, since you would have to rest and then
you would be de-trained while resting.

If you have an outright fracture it is usually immobilized for 4-6 weeks.
Depending on where it is and if there are complications.
>
>4.  What do doctors, etc., prescribe typically? (splints, casts, rest)
>

For stress fractures, usually rest is enough, usually 3-6 weeks, but you
may feel better sooner.  Sometimes you need a cast (if you know you won't
rest).  This isn't the best thing, since then you get muscle atrophy and
weakness
from not using the muscles.

>5.  What are the symptoms of a stress  fracture?

see above.
>
>6.  Etc.
>


Good luck Mike!!

Sharon

Sharon Sharpe
Head Athletic Trainer
Wellesley College
Wellesley, MA
ssharpe@wellesley.edu



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