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juegas
Jan 16, 2008, 3:34 PM
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So about 5 weeks ago I broke my calcaneus and I've been in a cast since. Not only am I going stir crazy I've gotten it wet a couple of times and it smells horrid. Here's my question/thought I have less then a week before it is to be removed, would it be that horrible if i removed it myself and took care of this stink that is driving me up the wall? I know I'm justifying with the smell but would it be that bad if removed it a couple days ahead of schedule.
Ohh as a second question about foot/heel breaks from someone how has gone through it, how long was your total recover time? And do you have any advice / exercises I should do for my foot/ankle/heel.
thoughts and input are appreciated.
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billl7
Jan 16, 2008, 3:52 PM
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You've worn it 5/6 of the recommended time. Right? Chances are it won't hurt to clean things up as you suggest and then continue wearing it. Not sure it will really help though since I would guess much of the stank is embedded in the cast.
My biggest worry would be should something go wrong - even unrelated to your cleaning things up. Suppose the doc screwed up in giving care so there's a real and unrelated problem but just not yet evident. But suppose it is evident at your next visit (and recorded) that you did not wear the cast some of the recommended time. This could be tricky to work out in terms of liability for the problem.
Bill L - not a lawyer, not a doctor, never had a cast
P.S. Maybe call the doctors office, explain the situation, and ask what you can do?
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maldaly
Jan 16, 2008, 4:51 PM
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juegas, watch out. The calcaneous is one of the hardest bones in the body to heal because it has such little blood flow. It's not infrequent for calcaneous hairline fractures to end up needing an ankle fusion because of poor healing.
Live with the stink for another week.
You need to do whatever you can to maximize blood flow while you're healing. Lay off the caffeine and cigarettes - they're vaso-constrictors that will restrict the blood flow. A drink a day won't hurt you but more that that might. Eat spicy food with lots of chili peppers and garlic - both will increase your circulation. Drink lots of water and eat only good food.
The next couple of months may determine the quality of your mobility for the rest of your life.
Mal
(Edited to fix the dilator/constrictor controversy. Sorry I dyslexed it.)
(This post was edited by maldaly on Jan 16, 2008, 9:43 PM)
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onceahardman
Jan 16, 2008, 5:01 PM
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In reply to: they're vaso-dilators that will restrict the blood flow.
HMMM...vaso-dilators IMPROVE blood flow. Cigarettes are vaso-constrictors...I dont think caffeine is a vaso-constrictor, though.
That stinky material may contain nasty infectious agents worse than your fracture. Contact your doc.
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coolcat83
Jan 16, 2008, 5:03 PM
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maldaly wrote: You need to do whatever you can to maximize blood flow while you're healing. Lay off the caffeine and cigarettes - they're vaso-dilators that will restrict the blood flow.
I don't mean to nit pick but vaso dilators increase bloodflow, dilating the blood vessels makes them bigger, I belive you were referring to vasoconstrictors which decrease the diameter and blood flow of the vessels.
But yes lay off those things, they mess with your electrolytes, cigarettes affect iron intake and other minerals so you want to really avoid that, caffine messes with your fluid levels(as does alcohol) and can effect other systems.
I wish you a speedy and whole recovery, I know from my own injuries that it's not easy to just sit and follow a regiment, but in the long run it's worth it.
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verdon_forever
Jan 16, 2008, 5:17 PM
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maldaly wrote: Lay off the caffeine and cigarettes - they're vaso-dilators that will restrict the blood flow. A drink a day won't hurt you but more that that might. Mal
Caffeine and cigarettes are vasoconstrictors, and therefore reduce blood flow. Heat is an easy vasodilator to use.
Also, you should try to move as much as possible (without putting weight on your calcaneus) to maximize blood flow which will help with nourishing your bone.
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gogounou
Jan 16, 2008, 5:22 PM
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If you are considering ignoring the advice that your doctor gave you, then I have no idea why you'd follow the advice proffered on an internet forum, but...
Don't remove your cast.
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roy_hinkley_jr
Jan 16, 2008, 5:36 PM
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Next time request a fiberglass cast with the Gore procel lining. Well worth the extra money to be able to take showers and even swim.
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aerili
Jan 16, 2008, 5:57 PM
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verdon_forever wrote: Caffeine and cigarettes are vasoconstrictors, and therefore reduce blood flow.
Caffeine is, in fact, a direct vasodilator wrt smooth muscle in blood vessels.
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onceahardman
Jan 16, 2008, 6:01 PM
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In reply to: Caffeine and cigarettes are vasoconstrictors
ciagarettes, yes. Caffeine, NO. I didn't think so, so I looked it up:
http://en.wikipedia.org/wiki/Cafeine
(weird spelling of "caffeine"in the url...)
anyway, theobromine is a metabolic by-product of caffeine, and it is a vasodilator.
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bradkillough
Jan 16, 2008, 9:40 PM
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I crushed my rt. heel in 2003 and I kinda know what you're going through. The best thing is to be patient. It's a long process and the mental aspect is as important as part of your recovery as the injury itself. Walk and walk somemore! It will hurt but be strong and do it anyway. My movement up and down is about 40%, side-to-side is none. It did limit my climbing a bit, but I fell 25-30 ft. onto concrete and I look at it as, I'm still alive and can still climb somewhat. It took me about 2 yrs. to recover, but mine was so badly crushed they could'nt operate, So just hang in there and stay strong. The other thing is the trammatic arthritis in my ankcle is more painfull than the break itself. Don't remove the stinky cast, until your suppose to because when the cast comes off your foot will be sore, so take it easy at first. The other thing you should not freak out about is the way it will look when the cast comes off, but don't freak to bad , it will get better! So good luck and take care!!
(This post was edited by bradkillough on Jan 16, 2008, 9:41 PM)
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dreadlock
Jan 16, 2008, 11:41 PM
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I have broken both of my heels. The first one I broke(bouldering and missed the pads) I was out two months and came back from pretty quickly. The second time I broke my other heel was bad. I had a few operations, had to have my ankle partially fused and was out of climbing for about a year and a half. I took it very easy and came back slowly. The rock is not going anywhere and there are more important things then climbing such as being able to walk right. Be patient and let yourself heal properly.
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euphoriagtrst
Jan 17, 2008, 2:32 PM
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juegas
Jan 17, 2008, 3:14 PM
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Well it all happened so fast, I was in a cast before i knew it. I didn't have surgery so I guess I'm pretty lucky. The doctor said if I was to fracture my calcaneus I did it very well for a speedy recovery. But that's pretty much all I know about the break. after next week ill have the digital xrays back and I post the image. What sort of pt exercises did they have you do euphoriagtrst ?
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itstoearly
Jan 17, 2008, 3:37 PM
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Since caffeine and spicy foods increase circulation, would that also help with muscle recovery after climbing? Or is that not blood related?
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jermanimal
Jan 18, 2008, 3:54 PM
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itstoearly wrote: Since caffeine and spicy foods increase circulation, would that also help with muscle recovery after climbing? Or is that not blood related?
It would be a plus and a minus. Probably more a minus on the caffeine because it is a diuretic. You would be better off with water and a big well rounded meal.
If you were doing a lot of longer climbing where you were getting winded, you will need more calories and salt, especially if it was hot out.
If you were doing more say hard boldering and you were not really getting winded, more just hurt. You just need a well rounded meal and maybe a little more protein.
For the most part your muscles, ligaments and tendons need rest and some times help with the swelling. Ibuprofen is definitely your friend. Do be a retard and take it all the time, but it will reduce the swelling and help with healing. I am big advocate for taking two ibu 3x a day for a couple days after those really killer sessions. It is about reducing swelling and aiding in the healing, not about pain. If you are masking an injury with lots of pain killer, something is wrong and you should see a doctor and/or take time off.
Don't be a retard about the ibu either, don't take 5 of them at a time and don't use indefinitely, it will put a hole in your stomach.
Spicy food is always a good idea. Garlic is too.
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roy_hinkley_jr
Jan 18, 2008, 4:04 PM
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jermanimal wrote: Probably more a minus on the caffeine because it is a diuretic. You would be better off with water and a big well rounded meal.
False. Caffeine is no more diuretic than water. For people who regularly drink coffee or tea, caffeine does not cause even slight dehydration.
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jermanimal
Jan 18, 2008, 5:39 PM
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roy_hinkley_jr wrote: jermanimal wrote: Probably more a minus on the caffeine because it is a diuretic. You would be better off with water and a big well rounded meal. False. Caffeine is no more diuretic than water. For people who regularly drink coffee or tea, caffeine does not cause even slight dehydration.
Wow, I assume you meant caffeine beverages, but you are right.
Interesting...I did a little research most recent studies come to the conclusion that caffeine beverages do not lead to fluid loss greater then the fluid intake from the beverage. While caffeine is a diuretic, its effects on fluid balance when ingested in drink link coffee or red bull are almost zero.
That being said, if you are mildly dehydrated from a long day climbing outside. Sipping hot drinks will not help you get back to normal fluid level as well as larger volumes of water. The addition of salt is key here too.
Strong caffeinated beverages have shown some effect, although very mild. Strong would be 2-3 cups of coffee, more then one red bull or a big gulp of mt dew. Interestingly enough, that mild amount could only be detected if the person abstained from using caffeine over several days. Regular usage almost eliminates this effect.
It will have an effect though if you are binging on coffee for an all nighter or, accidentally killed the pot-o-joe at work.
In relation to your heal though, ingest coffee as you normally do. I wouldn't increase use. I am not a PT, but wouldn't alternating hot and cold packs every 5 min for 30 min would do a better job of increasing circulation then ingesting caffeine...especialy in a beverage.
(Note: there is a difference between ingesting straight up caffeine, which some studies have done and its practical low dosage application in beverages.)
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onceahardman
Jan 18, 2008, 9:10 PM
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In reply to: I am not a PT, but wouldn't alternating hot and cold packs every 5 min for 30 min would do a better job of increasing circulation then ingesting caffeine...especialy in a beverage.
Fair Question.
Hot and cold packs will increase circulation...in the top ~1 cm. of flesh. Hot packs don't penetrate any deeper. The real question (to me) is..."Does using hot packs and/or cold packs shorten healing time, or lead to better functional outcomes?"
NO. But it will give some temp pain relief.
Caffeine has been pretty well studied, and DOES have a training-enhancer effect. But you won't speed healing just passively sipping Starbucks.
Broken bones (or really, any other connective tissue) need to heal. For the calcaneus, once the fracture is STABLE, ie the fracture isn't moving around, it is best to perform active range-of-motion (AROM) exercises on the ankle joint. BUT-remain non-weightbearing (NWB) until X-rays confirm sufficient healing. If you can feel the fracture is unstable, then it almost certainly is.
The biggest danger is a non-union fracture. You can get formation of fibrocartilage on the broken surfaces, and it can even start to look like a "joint" of sorts, with formation of hyaline cartliage, synovium, etc. This is nasty, has long term problems, and requires surgical pinning to regain simple functions. Don't get too aggressive too early with it.
AROM exercises will maintain the health of joint surfaces, IMPROVE CIRCULATION in a physiologically meaningful way (DEEP), and will lead to a quicker return to participation in sport.
Many get confused between range of motion exercises and stretching. ACTIVE ROM is moving the joint ACTIVELY (willfully) within the available range. Passive ROM is using your hands (or therapist overpressure) to move a joint passively within the available range. Neither is designed to increase ROM.
STRETCHING is moving a joint BEYOND the actively available range, using self or therapist overpressure. It is designed to increase ROM.
Don't stretch this injury until healing is complete.
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