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

In conjunction with Sharon's informative post (below), as well as some
past accounts of hikers taking daily multiple doses of ibuprofen (or
other pain killer), it might be worth considering that use of pain
killers coul present the danger of allowing one's body to ignore the
warning signals of pain, thereby allowing further damage to be done if
the offending activity continues -- which use of those pain killers tends
to encourage by nullifying the body's warning system (pain).

An interesting survey might be to identify what percentage of thru-hikers
experienced stress fractures or other incapacitating damage after a
period of frequent use of pain killers versus the percentage of
thru-hikers that experienced similar incapacitating injuries without
taking pain killers.

Of course people have different tolerances for pain, and different
degrees of sensitivity to their body signals.  Quite possibly people with
a strong athletic background, especially competitive athletics, are often
conditioned to ignore pain (living the adage: no pain, no gain, etc.). 
So on the one hand a well-conditioned body might be better able to resist
stress fractures and other injuries, on the other hand a well-conditioned
body might be pushed harder, and with less regard to pain signals, thus
increasing the incidence of overuse injury, especially if pain killers
are employed as a means of overcoming "the annoyance" of pain.

A reasonable conjecture would be that anyone using pain killers daily to
get through a hike, is probably at greater risk of overuse injuries, some
of which may have effects long after the hike is completed.
---terry---


On Thu, 28 May 1998 13:31:05 -0400 (EDT) ssharpe@WELLESLEY.EDU (Sharon
Sharpe) writes:
>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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>http://www.hack.net/lists *
>

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