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January 11, 2024 | SUBSCRIBE
Happy Saturday. This week I have a couple updates. This includes a slight change to my typical weekly deep dive. I've also completed work on my biggest deep dive (by far) to date. It's more of a mini-book than an article.
But first, as a total non sequitur, I have to share something my friend recently brought up. "We all talk about unicorns being so magical and a thing of the fantasy world. But unicorns are really just one evolutionary horn away from a horse. The real question is, why aren't we talking about giraffes? These things are cows on stilts with 10-foot-long necks and a face like a camel. How unlikely is that??"
I have to say, I can't argue with him.
**This newsletter has occasional affiliate links (at no cost to you). These small commissions will always be re-invested into Rules of Thumb to improve the experience for all.**
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☝️ First Hand
Through the first almost year (what?!) of this newsletter, I've done a deep dive each week on the most common topics I deal with in my upper extremity orthopedic clinic. To make sure I'm still bringing you the best educational information rather than just writing for the sake of it, I'm going to start spacing out the Deep Dives just a bit.
Which gives me space to provide even more value to you. If you're anything like a normal human, you probably either didn't read every article or don't remember every tip I've shared. So let's use this space to highlight important health tips you may or may not have missed.
First up? Reviewing the safest way to use your thumbs.
The Truth About Thumb Positioning: Take a moment to notice how you use your thumbs throughout the day. When picking up your phone, grabbing a coffee mug, or pulling up socks, you're probably using that narrow "key pinch" grip hundreds of times (the way you would pinch a key between your index and thumb - see linked article for images).
This puts 13-15x more pressure through your thumb CMC joint than necessary. Which could mean early arthritis for you.
Instead, think about making the "OK" sign when you grip — it centers the force through your thumb joint rather than edge-loading it. This isn't just about preventing pain; it's about preserving your thumb function for decades to come. Your thumbs participate in nearly every hand function, so these small positioning changes can translate to major protection over time.
Want to review the entire article, complete with images for demonstration? I have it linked for you here below.
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👀 X-ray of the Week 👀
The ol' monkey bars strike again. They always do.
This is perhaps the worst version of the most common pediatric elbow injury: the supracondylar humerus fracture.
Doing orthopedic training at a children's hospital is a surefire way to see a steady stream of at least a couple of these injuries every single night.
In fact, most OR mornings started off with fixing one or two of these gnarly fractures. While they don't all need surgery, a lot of them do.
The above one, however, needed surgery in the middle of the night. That sharp spike of bone unfortunately went right through the patient's artery. That's a late-night phone call no surgeon (or parent) ever wants to experience.
PS. The patient did great when it was all said and done.
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📣 Update 📣
For the last 3 months, I’ve been working late nights and early mornings on a resource that I believe will provide significant educational value to those suffering from carpal tunnel syndrome — numb, painful, burning hands that wake you up in the middle of the night.
And you helped me create it (to thank you, it's steeply discounted, see below)! I polled you all a couple months ago and asked what topic you needed to learn more about. Carpal tunnel was the landslide winner.
So I wrote the (40-page) book on it.
The only thing more common than carpal tunnel syndrome is a lack of easy access to valuable information on what it is, what's causing it, and how it might be treated. Rather than some ad-optimized online health article, this is real education from someone who treats the condition multiple times daily (me!). I've packed in more education than the average visit to a specialist — for less than the average co-pay.
I haven’t yet shared this publicly, but I wanted folks on my email list to be the first to know about it.
If you're curious to learn more or are tired of dealing with numb hands in the middle of the night, this is your invitation to take a virtual 'masterclass' from me on all things carpal tunnel syndrome.
Click here for discounted 'Guide to Carpal Tunnel Syndrome'
(If you're reading this, then you're what I consider an Original Reader of Rules of Thumb. For the month of January, this resource will be 75% off with the code: ORIGINAL75. Thank you for being here and supporting the newsletter!)
Cheers,
Dr. G
PS. If you find yourself in serious need of this information but can't afford it, please just shoot me an email :)
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🕰️ Meme Time 🕰️
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12:34 PM • Dec 4, 2024
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📚 What I'm Currently Reading 📚
As I continue to work my way through "The Anxious Generation" by Jonathan Haidt, the social media + teens equation strikes me as highly concerning. Perhaps more than we fully appreciate.
Before the teenage years even arrive, one of Haidt's main points revolves around what he calls our new 'phone-based' childhood replacing the tried and true 'play-based' childhood. All over the span of just 15 years (compared to 200,000 years of human evolution).
This essentially amounts to an uncontrolled experiment. It turns out, kids need unstructured play to develop appropriately. Think of the way puppies or tiger cubs wrestle and bite. It's the same thing.
Through play, our kids learn to make up games, negotiate conflict with one another, and establish friendships. None of these benefits exist in the virtual world. And normal human interactions are skewed. Think of the difference between negotiating a game of Capture the Flag at recess versus scrolling through the faces of 100 strangers in 100 TikTok videos in just 10 minutes.
Some of this even extends to organized activities. Think sports, after-school activities, and summer camps. While these all have their own benefits, the evidence points to truly unstructured play as the area of childhood development that has disappeared the most...and has the greatest impact on normal development.
Next up on this topic for me is going to be a recommended book called Free Range Kids by Lenore Skenazy. Will let you know when I get to it.
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🩸 Finger on the Pulse 🩸
🍭 Fructose accelerates cancer: Ever thought fructose was just another kind of sugar? Think again. Scientists have recently honed in on why fructose helps tumors grow — like pouring gasoline on the fire.
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If you're enjoying "Rules of Thumb," it would be a huge help if you'd consider sharing.
Just forward this email to a friend or send them to rulesofthumb.nickgolinvauxmd.com/join.
The more this grows, the more I can invest in it!
-Dr. G
PS. Rules of Thumb is a completely free resource to all those who want to learn more about the human body. Support Rules of Thumb here 🙏.
**Please do not use this email to try to obtain medical advice. I cannot legally or ethically provide that. If you are having a medical emergency, please call 911 and do not attempt to contact me through email.**
Rules of Thumb Archive • www.nickgolinvauxmd.com
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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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