🧊 Should you ice that sprained ankle?


August 24, 2024

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Good morning. It's back-to-school season. Which means lots of excitement, way too many Amazon orders, and cooler mornings. Wishing all parents out there the best of luck finding babysitters for the myriad welcome coffees, PTA lunches, and back-to-school nights you have scheduled over the next few weeks...

But don't worry. There's also still plenty of warm weather left to sprain that ankle or jam that thumb.

Which begs the question of the week β€” should you put an ice pack on it? Or does that do more harm than good?

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πŸ‘€ X-ray of the Week πŸ‘€

We spent a lot of time discussing arthritis here. But what does it look like?

The x-ray on the left is a normal knee x-ray. Notice the femur bone coming from above to meet the tibia. The fibula is the small skinny bone on the far left side.

What you'll notice is the large dark grey space between the femur and tibia. This is not truly a space, but rather a thick layer of cartilage at the end of both the femur and tibia. The cartilage doesn't show up on x-ray, which is why it looks like a space.

Remember, cartilage is the soft squishy padding at the ends of bones that allows them to glide smoothly through motion.

Now notice the picture on the right. This knee has advanced arthritis. There is only a sliver of space remaining between the bones.

That cartilage has worn away over the years. It's clear to see why this would feel painful. This would be an example of what grandma calls a 'bone on bone' knee. You can even see the surrounding bone has become more white, and small cysts are forming inside the bone as part of a reaction to the increased contact forces it's experiencing.

All of these are changes associated with arthritis. It might be time to call up that knee replacement surgeon...

πŸ•°οΈ Meme Time πŸ•°οΈ

Which one are you?

Food for Thought

I'm going to ramble for a moment. I'd be interested to hear if any of you have noticed this trend too.

We seem to be living in an increasingly 'hack-y' culture. We're always on the lookout for the next greatest 'hack' or shortcut. In many ways, a hack can be a great thing. A better way to cook a quick dinner or fit all your clothes into a compact carry-on? Who wouldn't want that?

But this mentality has seeped into the health and wellness space, and it's snowballing. Perhaps out of control.

I'm not sure who's to blame (podcasts, marketers, Buzzfeed...), but there's an increasing expectation that there must be a pill, a supplement, or an injection that will cure any ailment.

When we learn that we're vitamin D deficient, why do we immediately order a supplement? Why don't we just eat more vitamin-D-rich foods and budget some time for sunlight? The same could be said for protein, calcium, vitamin B12...the list is endless.

And don't get me wrong. I do this too! I take protein, vitamin D, and magnesium supplements every day. Heck, I even partner with a protein supplement company because I believe in the benefits!

What worries me is the increasing frustration I see in my patients.

I notice it throughout my practice, but it's most visible in patients with bad sprain injuries. These injuries aren't broken bones and aren't unstable enough to need surgery. But they hurt a lot, and they typically limit activity levels for months on end. And it drives most people nuts.

These injuries heal on their own, but there is no quick fix for them. These visits always go the same way. I explain the typical healing process of rest, bracing, and therapy. And then I get peppered with questions about what pills, supplements, or injections exist that will get them back to rock climbing next week.

It almost feels assumed that I'm secretly hiding the real treatment from them.

This phenomenon is starting to fascinate me more and more. These visits are painful for the patient β€” and for me. Nobody's happy. Nobody wants to hear this. Heck, you may not even like reading this!

But it's the biology of the injury. And we can't hack that.

I'm also searching for the cultural counter-current. Beneath any trend, there's the rebound reaction. My favorite recent example is the proliferation of old-school Nokia 'dumb phones' as people grow tired of smartphones taking over their lives.

Can we bring a level of stoicism and simplicity to our physical health?

I don't have the answers yet. But I'm on the lookout.

🩸 Finger on the Pulse 🩸

🐜 Life-saving amputations: Would you let a friend gnaw off a limb to save your life? Apparently we just found out that's exactly what ants do.

β€οΈβ€πŸ©Ή Just a Band-Aid: This Colorado research team developed a 3-D printed Band-Aid for the heart. But way cooler? It may also work in joints on cartilage! Ok, maybe I'm biased...

🦠 Antibiotic miracle: As an orthopedic surgeon, pretty much the only time I save a life is against rare flesh-eating bacterial infections. This breakthrough may have just changed the game.

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-Dr. G

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If you are having a medical emergency, call 911. Do not attempt to contact or obtain medical services through this site. This content is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this site or materials linked from this site is at the user's own risk. The content of this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their healthcare professionals for any such conditions. The content is my own and does not necessarily reflect the views of OCC.

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