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RapierFugue -> RE: Meds and sleep deprivation... (12/23/2010 5:32:05 AM)
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quote:
ORIGINAL: LadyPact
Lady C, I'm sorry to hear about the injury. For an animal lover, they don't seem to be loving you back lately. I do hope that you're feeling better.
quote:
ORIGINAL: ThatDamnedPanda
And good luck. Ankles are a bitch. I once fell through a roof, landing upright on a concrete floor 30 feet below, and (among other things) broke one ankle and sprained the other. The broken ankle was fine in a couple of months, the sprain took over a year before it healed. I hope your outcome is much less dramatic than mine.
I wanted to ask you about this, Panda. Do you happen to know why this is?
Quick back story on the reason I'm asking. I took a spill Myself back in October. Left ankle and foot were messed up pretty good for several weeks. Took another in November. Not nearly as bad, but it had everything to do with the ankle still being weak. I noticed the same trouble coming out of the Post Office just a couple of days ago. My foot was off just a bit and there was still pain in the ankle. Stayed on My feet that time, rather than falling on My tail, but it put a bit of wonder in Me about just how long it's going to be before it gets back to the same strength.
I guess what I'm asking here is, did your doctor ever tell you why the sprain takes longer to heal?
Soft tissue damage, like sprains, ligament tears and the like, generally take longer to heal, and have more ongoing issues, than hard tissue (bone) breaks.
There are a number of reasons for this (this from memory, not an exhaustive list, also depends a lot on the area and nature of the damage, so generalisations are a bit iffy to make, but ...);
1. Like-for-like healing: Bone heals and re-grows with a substance (new bone formation) that is almost identical to the original substance; new bone growth is liable (in the young to middle-aged) to be slightly more flexible, and more porous, than aged bone, but so long as calcification takes place at a reasonable rate you’re left with something that has very nearly the same properties as the original bone – where it doesn’t have the same properties is why people get “weather legs” i.e. after a breakage in a major (large) bone, the healed bone is slightly more flexible than the original bone, hence you can get discomfort as the bone flexes internally. Soft tissue doesn’t always heal in the same way – the new growth of muscles and tissues can be substantially different to what was there before, in terms of strength and flexibility. New ligament growth, for example, is generally far less flexible than what was present before, due to formation of scar tissue (which has very poor flexibility).
2. Wound site contamination: when new bone grows, either into a gap (“bridging”), or along a break line, you tend to get only or mostly bone growing; the body doesn't put additional substance into the area beyond those needed to supply blood to the area, whereas with soft tissue damage the area is liable to be suffused with various contaminants, like blood from ruptured blood vessels, bits of damaged cartilage or ligament, or intrusion from muscles and/or blood vessels in the area which may have responded to the damage and subsequent swelling – this is why RICE (Rest, Ice, Compression and Elevation) is important; it’s not so much to help relieve the pain (although it does), it’s more to promote beneficial healing through having the damage site as near to pre-injury as possible, so that when your body starts to heal, it does so with a “template” as close to pre-injury as possible.
3. Rate of, and strength of, new soft tissue growth: Cartilage does not re-grow much under normal conditions (hardly at all under normal conditions), and ligament only slowly and less effectively than bone. As a result, a soft tissue injury will often take longer, and have a more difficult recovery, than pure bone breaks. As an example, when I had my big crash (the one that nearly killed me), most of the bone damage was healed (or largely healed) within 12 months. The soft tissue damage to my back and neck, however, was so severe that it will never properly heal. Additionally, healed soft tissue is not generally as strong as the tissues originally present, so there’s a fair chance that subsequent injuries of the same nature become more likely.
4. Blood supply: bone has a high degree of vascularity (i.e. has a good blood supply) in most areas of the body, whereas tendons, ligaments and the like are generally (varies from body area to area but generally) avascular, i.e. they have a much lower blood supply and throughput – since most of the healing processes require blood to work properly, load-bearing soft tissues like tendons, ligaments and the like generally heal more slowly than bones.
The bad news is that, if you've severely sprained your ankle (one of the easier joints to damage semi-permanently) several times in a short time period (like, say, 3 or 4 times in a year), the likelihood is that it won’t heal properly on its own. The good news is that the operation to rectify this is very successful, and fairly non-invasive. A friend managed to permanently damage his ankle by spraining it 5 times in a year (!), but he had one operation, was in for one day, wore a cast for a few weeks (to support the “joins” and wound site and keep the joint in the correct position, and also to prevent over-stretching the repair) and he’s had not a moment’s problems with it since, and has returned to playing sports (like squash!) without further issues.
Bottom line is it can take up a year for soft tissue damage to heal properly in several areas of the body (like ankles), and if further injuries occur it can mean a small operation, but as I say that's nothing to worry about as it’s purely routine these days. Where it gets trickier is with things like knees and shoulders, the former because it’s a complex joint of fairly poor “design”, and the latter because it takes a lot of stress in everyday life.
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