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

(www.scientificamerican.com)
611 points sohkamyung | 15 comments | 19 Feb 25 12:36 UTC | HN request time: 0.001s | source | bottom
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faitswulff ◴[19 Feb 25 14:20 UTC] No.43102422[source]▶
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.
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dfxm12 ◴[19 Feb 25 14:31 UTC] No.43102512[source]▶
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.

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1. miketery ◴[19 Feb 25 14:46 UTC] No.43102665[source]▶
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.

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2. shermantanktop ◴[19 Feb 25 15:42 UTC] No.43103279[source]▶
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.
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3. layer8 ◴[19 Feb 25 16:00 UTC] No.43103541[source]▶
Your edit shows that there is no good rule for the threshold where pain would indicate too much load vs. still being in the beneficial range. We don’t even have a good way to assess subjective pain (one’s 3 is another one’s 7, etc.). “Optimal load” is really just a tautology.
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4. jacksnipe ◴[19 Feb 25 18:23 UTC] No.43105462[source]▶
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
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5. pessimizer ◴[19 Feb 25 21:06 UTC] No.43107692[source]▶
"As soon as it starts to hurt" is not some hopelessly complex and useless standard that involves delving into philosophies of subjective pain sensation. It is actually obvious and easy to follow.

Use it, but when it hurts, stop.

replies(1): >>43111101 #
6. Dylan16807 ◴[19 Feb 25 21:33 UTC] No.43108012[source]▶
> “Optimal load” is really just a tautology.

It's not just a tautology, because it correctly implies that the right amount of load is not zero.

And it's hard to expect an acronym by itself to be very specific.

7. devilbunny ◴[20 Feb 25 04:22 UTC] No.43111101{3}[source]▶
Yeah, but given the huge variations in pain tolerance, some will reinjure it while others will never use it again.
replies(1): >>43117235 #
8. potamic ◴[20 Feb 25 05:07 UTC] No.43111331{3}[source]▶
Sorry, which comment are you affirming?
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9. theultdev ◴[20 Feb 25 17:05 UTC] No.43117235{4}[source]▶
tolerating it doesn't mean you can't detect it.

no amount of pain tolerance will help you if something is broken.

you WILL feel it. simply stop when you do.

it's not a hard thing to grasp.

replies(1): >>43118629 #
10. jacksnipe ◴[20 Feb 25 18:17 UTC] No.43118157{4}[source]▶
Go until just before it hurts, which is a moving target that you will have to calibrate carefully
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11. devilbunny ◴[20 Feb 25 18:57 UTC] No.43118629{5}[source]▶
Clearly, you have never worked in healthcare.

Sleeve tattoos but needs an IV? “Oh, I’m not good with needles, you need to sedate me first.”

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12. theultdev ◴[20 Feb 25 19:05 UTC] No.43118717{6}[source]▶
How is that relevant?
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13. devilbunny ◴[20 Feb 25 20:41 UTC] No.43119882{7}[source]▶
Perception of pain is highly individual. Like I said, people who have tons of tats will complain about an IV. You aren’t afraid of needles, you just don’t like them when they are used for your health instead of marking up your body.
14. shermantanktop ◴[21 Feb 25 23:11 UTC] No.43134241{5}[source]▶
Would you give the same advice to someone with a chronic pain condition?
replies(1): >>43135412 #
15. jacksnipe ◴[22 Feb 25 02:14 UTC] No.43135412{6}[source]▶
I don't know, I'm not a doctor and I'm not giving advice to anybody!