Fractures |
| Understanding &
Preventing Them |
| Self-Help Supplies |
All of the supplies needed or necessary that
are mentioned in our rehab guidelines and rehab exercising self-help
programs are available in our Bookstore.
Rehab
Guidelines & Rehab Exercising
1.
Rehab Treatment Guidelines
2.
Rehab Exercising
Specific Fractures see:
1. Collar Bone
Fractures
2. Shoulder
A-C Separations
3. Upper Arm
4. Elbow
5. Lower Arm
6. Wrist
Injuries
7. Hands
& Fingers Injuries
8. Hip Bone
9. Upper Leg
10. Knee joint Injuries
11. Lower Leg
12. Ankle
13. Feet & Toes
Also see the following additional readings:
1. Arch Supports
- On Prevent & Correction
2. Ankle Supports - On Prevention & Correction
2. Hot & Cold Treatments - On initial self-help treatment
3. Diapulse Treatments - On accelerated healing
4. Ceramic Magnets - On self-help treatments & accelerated
healing
5. Violet Ray Tube - On self-help treatments & accelerated
healing
6. Piezo Electric Stimulator - On self-help treatments &
accelerated
healing
7. Herbs & Vitamins - Solomon's Seal, Golden Seal, Horsetail,
& Garlic
On natural accelerated healing
8. Bio-Cleanse Procedure |
| Understanding & Preventing
Broken Bone Injuries |
Let's start off by discussing the more common
underlying problems and conditions that set the stages for breaking
bone type injuries. The most common underlying condition
that I have experienced is when the rider is in a "Growth
Phase" also known as a "Growth Spurt".
That is to say the he or she is beginning to grow and development
more.
The most common bones that break during growth phases
are:
1. Collar Bone
2. Distal aspect of the radial & Ulnar bones
3. Distal aspect of the Tibia and Fibula |
| New Growth Spurts Can Cause
Fatigue, Injuries, & Broken Bones |
Another reason for poor and/or noted performance
drops, injuries, premature fatiguing, and longer recovery times
is new bone growth.
If you are under 20 years of age this chapter applies directly
to you. Pay especially close attention to what it has to tell
you. Also, additional information can be found on growth and
development in the chapter; "Riders Racing Information
& Treatment Recipes." It may save you from serious
injuries, as well as, riding, racing, and career set-backs.
You body is programmed to genetically develop and grow intermittently
during certain time periods of your life. Especially, during
the time period that ranges from 9 months before birth until
you are approximately 20 years of age. During these time periods
intermittent new body growth and development is programmed to
selective dominate over the body's total energy levels and over
all other body functions. That is to say, the body's genetic
programming will place all available energy into new growth
and development leaving very little to no remaining energy for
your physical training workout growth and development program.
Because of this fact, training workouts will have to be strategically
and selectively planned to fit around this new growth time period.
Workout time periods will have to be shorten due to an overall
decrease in total amount of available body energy available.
Your body will require additional rest and sleeping time. Naps
may be necessary during noon to allow for extra energy during
physical activities in the afternoon. But for now, let's take
a closer look at what is going on with the body's new growth
and development program.
During these periods of new growth the muscles and bones elongate
and temporality become weaker. This process not only makes the
rider more susceptible to forearm pump-up and premature fatigue,
but to injuries, such as, bone fractures, bruising, muscle,
ligament, and tendon sprains and strains, as well. New body
growth not only predisposes the rider to injuries, but also
allows him to get hurt by less force. The most common
bone fractures involve the lower legs near the ankles.
The underlying problem is that the rider is not wearing custom
molded arch supports (see the "Arch Supports" chapter
in the "Safety Gear" section of the library.
These bone injuries involve bone fractures just above the ankles.
Note the fracture at the most distal aspect of
the radial bone in both of these views.
 
New bone growth weakens the bone and foot pronation predisposed
it to fracture
Besides bone and muscle weakening by elongation growth, a loss
of the rider's coordination and timing becomes visible. So,
new bone and muscle growth then;
1. Lowers and decreases his performance
2. And effects his riding ability and skill levels.
How can tell or know when your rider is in the active phases
of new bone and muscle growth and development? I have found
the answer to be weekly measurements and recording of both his
weight and height. Let's take a closer look.
New intermittent body and bone growth usually comes in 6-month
spurts. That is to say the body plans to start growing approximately
six months before it actually does. Then it activates its new
growth plan. New growth can be seen, monitored, and measured
in two phases, Phase One and Phase Two.
Phase One is noted by an increase in appetite and weight gain.
Phase Two is noted during the actual increase or elongation
of body height. |
| Prevention Method |
Phase two of the growth phase is where the
bones break. The best awareness and prevention method
that I know at this time is to get in a routine habit of weekly
measuring and recording both. In this manner you can tell exactly
when each phase begins.
Other outward signs and symptoms of new growth and development
include:
1. There are no gains from his physical fitness workouts, with
increasing
fatigue factors
during workouts.
2. He will sleep more awaking with a feeling of still being
tired.
3. A loss in stamina, endurance, and physical and mental performance
are
noted.
4. A marked loss in total body energy.
When Phase Two begins what will the rider exhibit and notice?
Let's take a look.
1. Decrease in the rider's performance abilities
2. Fatigue levels noted early in each moto
3. Make more riding mistakes than normally
4. Gets hurt easier and requires longer healing time periods
5. Loss of drive
6. Sleeps long hours and still feels tired
7. Mopes around
8. Lethargic
What will the rider notice about his physical and mental conditioning?
Let's take a look.
1. The body will fatigue much earlier or sooner in every moto
2. Bones break much earlier
3. Healing times are prolonged and require a longer healing
time
4. The rider is more susceptible to injuries, such as;
A. Bruising (muscle, ligaments, & bone
B. Sprains & Strains (tearing of muscles, tendons, and ligaments)
C. Fractures
What is your first course of action when you notice new bone
and muscle growth signs and symptoms? I suggest the following:
1. Immediately start measuring both his height and weight
2. Start him on a good chelated vitamin supplement and plan
a healthy diet
3. Alter his training schedule and workout time periods to accommodate
or
fit this new growth and development
4. And call me for additional information and planning. How
can you combat
this time period? A best
plan that I have found to be very successful is to
allow.
A. Longer resting periods, additional
time for sleeping and more rest time
in-between motos.
B. Proper stretching
and warm-up of the body's muscles, particularly the
legs and forearms, help to minimize injury.
C. A good chelated vitamin, such as GNC's, "Ultra Mega."
Supplying the
body with good vitamins, nutrition, and food during this
new growth
time period is extremely important.
D.
Expect less performance out of the rider.
This plan has consistently produces fewer set-backs and unwanted
injuries. Also, be careful not to be to demanding, over expectant,
or intimidating.
Making the rider work and train harder during this new growth
and developmental time period is definitely the wrong course
of action. However, the uneducated individual still will. This
allows continued aggravation of the condition. And, as this
aggravation gets worse the condition worsen, as well. The above
signs and symptoms will grow and become more pronounced. This
leads to growth developmental problems, mental depression, anxiety,
frustration, and unnecessary injury. This uneducated action
causes more harm than good, and includes extreme fatigue, exhaustion,
mental depression, and loss of drive. Depleting the body's energy
levels is, not only detrimental to the rider, but will retard
his TRP. It is the uneducated race team who falls into this
trap!!! How can you beat this problem?
It's simple. Educate yourself to the problem and understand
and know their solutions. If you understand and recognize these
intermittent new growth periods you can effectively accommodate
and adapt for them. This solution bypassing the mental hardships
and physical problems induced by race team members.
Eliminating potential problems and set-backs before they happen
gives us a tremendous edge over those riders who don't. I call
this type of planning; "20-20 Fore-sight." And, as
you know, "20-20 hindsight" is such an unpleasant
teacher and a God-awful experience for those other riders and
their team members. |
| Vitamins & Foods |
| In all injured tissue healing processes remember
to avoid eating red meat, drinking colas, and all products containing
caffeine. Also avoid eating any foods that has preservatives
placed within them. Preservatives contain phosphorous,
which can lead to bone density loss and osteoporosis. Taking
a Boron supplement is also very important for the quality of
the repair in the healing process within broken bones. |
| Raw Foods |
| Organic raw foods are your best source of
the vitamins and minerals that are necessary for a very good
quality of healing. Eating raw fruits and vegetables and/or
taking bone-healing supplements that contain Calcium, Magnesium,
Potassium, and Zinc are a very good idea. The healing
properties of these minerals are essential to the quality of
repair of injured and broken bones. These healing minerals
are also very important for maintain the quality of the muscles
within your body including those of your heart, as well. |
| Digestive Track Aging |
Unfortunately, one of the facts of aging
is the gradual weakening of the digestive system. The
stomachs of every individual simply produce less and less of
the digestive acids and enzymes. When digestive aids are added
back into the diet they encourage better intestinal absorption
of calcium and all other ingredients vital to bones, muscles,
hair, skin and nails health care.
These digestive acids can be found naturally in
1. Papaya Fruit
2. Pineapple Fruit
3. Betaine HCI (hydrochloric acid) |
| Self-Help Rehab Plan |
If you are using your own self-help rehab
plan you can obtain good qualities of raw foods from Natural
Health Food stories. And for an OK quality of vitamin
try any General Nutrition Center's (GNC) and ask for their Ultra
Mega endurance vitamin. We have found through from testing
many different types of reportedly good quality vitamins that
the Ultra Mega performs very well and cost less. We recommend
at this time that you should them at the following rate:
1. Take twice per day for the first week, one in morning and
one at lunch
2. After one week take them one per day - during breakfast.
3. And during race day or any high stress day - take two, one
for breakfast
and one at lunch.
As a point of major concern let me say that if your young rider
is getting ready to start a growth phase or you discover that
he is in one already immediately start him on a good quality
vitamin and a raw diet, as much as possible. If you already
practice prevention he should be on one already. Limit or avoid
completely all meats & dairy products as much as possible
during this time period. |
| Potassium Salts - Replacement |
Potassium Replacement or measured intake
(liquid or tablet from) for nerve and muscle functions. As a
high performance athlete you must learn to measure the amount
of potassium loss during hard physical activities by measuring
water loss. Make a nude weight both before and after each moto
to calculate the exact amount of water loss in pounds for that
ride. Add back into your water system approximately one 99-mg
potassium glutamate pill for every quart of water loss. Water
weights 8 lbs. per gallon or two pounds per quart.
Going into a hot weather mid-afternoon moto be sure to take
at least two 99 mg potassium pills before. The first approximately
20 minutes before the race. And the second one approximately
10 minutes before. Note: take the potassium tablets with Lemon
water, drinking at least a 10 to 12 oz. glass full.
Potassium is the key chemistry for both nerve and muscle function.
As it depleted through physical activities, both the nerve and
muscle cease to function. |
| Purified Water |
Also see "Water Management" (dehydration
& hydration). Mineral, spring, distilled, or water
from home are the types of water to carry with you during raci41
events. Changing water sources, types, and locations often times
cause intestinal disturbances and poor raci41 performances.
Beware to especially carry your own water supply during all-important
raci41 events. Always keep your water supply constant and reliable.
Lemons in water = Functions replacement of cellular salts, prevents
dehydration, quenches thirst, helps eliminates. Recipe = Add
two to three lemons to a gallon of water. However, in hot weather,
use three lemons per gallon.
Preventing Dehydration
By Knowing Water Intake Levels
One of the best ways I know of to prevent dehydration is by
measuring the weight the rider (nude) before and after each
exercising workout as well as each practice moto workout.
Keep a record the location, time of day, time of workout, temperature,
humidity, and the before and after nude weights of the rider.
We weight nude because the riding gear and clothing will retain
sweat (water) and give a false true weight. Before and
after nude weights are a lot more accurate and reliable when
it comes to accurately determining the about of water you should
drink before each workout and moto.
Water weights 8 pounds per gallon. So if your rider measures
a loss of 4 pounds raci41 in a 15 moto he or she is loosing
1/2 gallon of water. And so this water allotment should
be added before the up coming next moto. Remember do not
drink a half gallon of water just before going out to race.
This is not a race smart idea. But it is a much better
idea to start drinking 16 ounces of water every 15 minutes one
hour before the race starts. This allows enough time for
water absorption and an elimination before starting the competition
event.
Foods to avoid = carbonated beverages (sodas and sparkling water),
tobacco (cigarettes & chewing tobacco's), alcohol, drugs
of any kind (prescription or illegal)
1. Carbonated beverages attack cardiovascular tissues (heart
and blood
vascular system).
2. Cigarettes attack lung tissues decreasing the amount of air
intake and
the transfer of
O2 & CO2. Chewing tobacco is the leading cause of oral
cancer
3. Alcohol attacks the cardiovascular system and the liver.
The liver is the
mechanic of the
body.
4. Drugs attack all the systems of the body especially the nervous
tissues.
No nerves - no life!
A fracture is a break in a bone. The break is classified as
either being "Complete" or "Incomplete".
A complete fracture is one in which the bone is entirely broken
across. An incomplete fracture is one in which the bone is not
entirely broken across. But remember in riding and raci41 motorcycles
every bone in the body can be fractured. The most common broken
bones (in their descending order of occurrence) from riding
and raci41 motocross are:
1. Collar Bone (most common)
2. Distal Tibia & Fibula (lower leg)
3. Distal radial & Ulna (lower arm)
4. Spinal Vertebrae
5. Femur (upper leg)
6. Humorous (upper arm)
7. Fingers
Riding and raci41 can produce sufficient force to fracture any
bone in the body. But the actual breaks can happen in a number
of ways. These ways include, but not limited to:
1. Riding and raci41 during times of bone elongation and new
body growth,
which are highly susceptible
to fractures
2. Mis-landing jumps
3. Landing on someone else or being landed on by another rider
4. Starting straight-a-way pile up
5. Crashing into another rider or being crashed into by another.
6. Being in a place where you are not supposed to be, such as
being sitting
on the landing down ramp
of a jump. |
| Accidents Associated With Broken
Bones |
Collar bones are the most fractured bone
in riders. If you ride long enough you could fracture your collar
bone. Collar bones usually are broken when the rider falls off
of his bike and is body slammed to the surface in the superman
position but does not immediately roll following that initial
impact. There is no recommended surgery that has had any kind
of success of any kind for fractured clavicle bones. The best
and highly recommended procedure is to wear a "Figure-Eight"
shoulder belt, which pulls the shoulders backwards, aligns the
bones, and takes the compression pressure off of the fracture
site. The figure eight belt is supported with an arm sling and
torso belt that hold the arm to the trunk. These three immobilization
techniques work the best for broken collar bones.
A bone can be fractured from hard impacts; such as when a rider
getting landed on by another rider. Also, a rider can fracture
his distal forearm or foreleg bones when he front faces a landing
ramp or impacts in the whoop-de-do section of the track.
The forces being transmitted from the area of impact to another
area can break Bones indirectly. An example is when a rider
falls, land on his feet yet break his upper leg or hip. Also
an impact blow to the knees could cause a dislocation or fracture
to his hip as seen when front facing of the landing ramp of
the triple jump. |
| Twisting Force |
| Twisting type of fractures commonly occur
in cornering where the inside leg is extended, catches a surface
pocket and get twisted and bent and either the knee joint get
torn or a femur get broken. Also in this same situation the
ankle by get caught in the surface pocket and For instance,
a person’s foot may be caught and twisted with sufficient
force that one of the leg bones is fractured. |
| Other Causes of Fractures |
| Powerful muscular contractions may cause
pieces of bone to be pulled away (avulsions). A history of taking
prescription drugs (causing osteoporosis) and disease processes
also weaken bones to the point that only a little force is needed
to produce a break. Elderly individuals have a high incidence
of spontaneous hips fractures resulting from osteoporosis and/or
falls. |
| Types of Fractures |
Fractures are classified according to the
visual appearance of the broken bone. There are six principal
types of fractures. They include:
1. A Transverse Fracture is a break at a right angle, straight
across, or
perpendicular to the longitudinal
shaft of a bone.
2. A Greenstick Fracture is an incomplete fracture, so called
because it
looks like a green stick that
is bent but not broken. It is called a
Greenstick because the bones are still soft
and growing so they do not
break but
rather bend. From the bending force some bone fibers are
separated or pulled apart (on the convexed
side of the bend) and some
fibers are
compressed (on the concaved side of the bend). The
concaved or compressed bone fibers usually remain intact. Greenstick
fractures are commonly seen in young adults
and children below the age
of 14.
3. An Oblique Fracture is a break that forms odd angles to the
longitudinal
angle of the bone’s
shaft.
4. A Comminuted Fracture is an injury in which the bone is fragmented.
A
severe crushing impact injury can cause
the bone to break into many
smaller pieces.
5. A Spiral Fracture has the appearance of a spring; the break
twists
around the shaft of the bone.
6. An Impacted or Compression Fractures are the ones in which
the
ends of the broken bones are jammed together
and compressed into
each other. Compression can also occur
when the bone, itself is
compressed from the force. The most common
compression fractures
in riding and raci41 are seen in the spine.
The longitudinal height of the
vertebrae is compressed and the horizontal
width of the vertebrae get
elongated.
|
| Classification of Fractures |
For all practical purposes, emergency
service personnel need not concern themselves with the many
types of fractures, but rather with the fact that injuries
to bones are divided into two classifications: open and closed.
An open fracture is one in which a broken bone end has penetrated
the surface of the skin, thus producing an open wound; this
form of injury is often called a "compound" fracture.
1. A closed fracture then is one in which there is no penetration
of the skin
by a broken bone end; this classification
of fracture is often referred to as
a "simple’’ fracture.
Signs and Symptoms of FracturesThe protruding bone ends easily
recognize an open fracture, but an outward sign so visible
is not always present in a closed fracture. Therefore you
must be able to identify other signs and symptoms that indicate
fracture, possible or real. Beside exposed bone ends, look
for the following indicators.
1. The patient’s information is usually accurate; he
may have felt the bone
break, or he may have even heard the bone
snap.
2. Deformity is usually a reliable sign of a fracture; compare
the suspected
part with the other extremity to determine
difference in size or shape.
3. Shortening of the limb may be present along with deformity.
4. Pain is usually severe at the injury site, but it may be
reduced in simple
fractures. Keep in mind that other injuries
may mask the pain of a fracture,
as may also drugs and alcohol.
5. Tenderness is usually present directly over the injury
site. Gently press the
tip of a finger along the line of a bone
in an effort to determine point
tenderness (the most sensitive spot that
denotes the exact location of the
break).
6. Swelling results either from injury to adjacent blood vessels
or from a
buildup of fluids over several hours.
7. Discoloration is usually evident as a reddening shortly
after the injury.
Characteristic black and blue discoloration
is not usually evident for
several hours.
8. Loss of use is an accurate indication of fracture. The
person will not be
able to use the injured arm or leg. However,
for obvious reasons do not
urge a person to use a possibly injured
part merely to determine if fracture
has occurred. Guarding usually accompanies
loss of use, that is, the
injured person attempts to hold the injured
part in the most comfortable
position.
9. Grating (crepitus) is a sensation that you can often feel
when the broken
ends of bone rub together. This is another
sign that you should never
intentionally seek. To do so will mean
added discomfort and may well add
to existing tissue damage.
10. Spasms of the muscles may be noted.
11. Loss of a pulse at the end of the extremity.
12. Loss of ability to move fingers and toes indicates interruption
of major
blood vessels and nerve pathways
adjacent to the injury site. |
| Fracture Complications |
Complications arising from fractures include
severe hemorrhage into the abdominal-pelvic cavity with resulting
shock and of course damage to the spinal cord. These are not,
however, the only complications that can be produced by fractures.
As a well-trained EMT or first responder, you should be able
to recognize two additional complications: injury to major arteries
and nerves.
Major vessels in the extremities lie close to bones. Thus when
a bone is fractured with a force sufficient to displace bone
ends, an adjacent vessel may be severed or pinched shut with
disastrous results to the portion of the extremity supplied
by the vessel. Remember that all tissues of the body need an
adequate and uninterrupted supply of oxygen-carrying blood if
they are to survive. When the supply is blocked, the tissues
die. |
| Swelling & Casting |
For the first few days to a week a splint
cast should be used to avoid swelling gangrene. If a regular
cast is initially used and swelling cuts off blood and nerve
supply and the area goes numb and painful due to swelling pressure
drinking a glass of orange juice will immediately decreases
the swelling to the area. Go back to the practitioner’s
office or hospital and get the cast cut and split or better
yet have it replaced with a splint type.
A survey for a fracture of an extremity should always include
palpation of the radial pulse in the wrist or the pedal pulse
behind the bony prominence on the inner side of the ankle. Absence
of a pulse points to the lack of circulation below the injury.
Injury to a major nerve pathway can be produced at the same
time, since major vessels and nerves lie close together. The
severing or pinching of a nerve is indicated by the person’s
inability to move fingers or toes, depending on the site of
injury. |
| REMEMBER |
| If your survey shows an absence of pulse
in the wrist or ankle or if your patient cannot move the fingers
or toes of the affected extremity, immobilize the limb immediately
and transport the person to a medical facility without delay. |
|
