Leg Breaks

[BornInDroopSt'54]

Any medicos out there who can give some insight into leg breaks like Stringer’s, Dale Morris’s and Nathan Brown’s?
Why do they have such a devastating impact on ability to play AFL?
• Is it mainly the lack of confidence and a prolonged discomfort that inhibits players or is it physical inhibition?
• Supposedly the place where a bone breaks becomes the strongest point so is it the tissue/ muscle/nerve damage that is a major factor?
• Is it that the muscles and leg need to ‘relearn’ co-ordination and muscle memory?
It is clear the club has done its due diligence with Stringer although Brown’s break, which seems very similar, clearly wrecked his talented career (pity he wasn’t born with a heart, rather a cold mind) and Dale Morris has yet to prove his recovery. What evidence would the club have that Stringer’s break will not hamper him in the future?

[EasternWest]

Re: Leg Breaks

Michael Voss recovered well from his, and Barlow at Freo seems to be doing alright. I'm hopeful it's an individual thing and Stringer is able to recover fully.

I'd assume working in his favour is the fact he did it young?

[BornInDroopSt'54]

Re: Leg Breaks

Michael Voss recovered well from his, and Barlow at Freo seems to be doing alright. I'm hopeful it's an individual thing and Stringer is able to recover fully.

I'd assume working in his favour is the fact he did it young?

So you believe it's an individual thing and as Stringer was only 16 may be trouble free? One aspect of Stringer's and Brown's was that they actually broke their leg violently ( in terms of the effect- a sheer break of one of the strongest bones in the body) simply by kicking it with the other leg. It seems to defy physics, yet the result is a shocking injury.

[SlimPickens]

Re: Leg Breaks

There are a number of issues with breaking both the tibia and fibula like Stringer,Morris et al have. Post injury you are obviously dealing with many things that will not only effect his gait but also his power etc.

Some facts about breaks- the bone will theretically be stronger if the break is well aligned and was adequately braced during the healing process then it was pre break. Stringer had rods in place which would have allowed for this, the bone will not look like it previously did but will be strong enough to hold up to the rigors of footy.

Obviously over the whole bracing period there would have been a lot of muscle dystrophy (wasting), which would effect his knee, ankle and foot mechanics. This can and has been rehabilitated reasonably well but will be an ongoing process.

The biggest and most often complication with breaks like this is something called compartment syndrome and it's a nasty piece of work. Basically the lower leg has a number of muscles that are separated by fascia, bone etc. When you break a bone you get bleeding and invariable swelling. In the lower leg this can be compartmentalised which is the primary concern of the drs post surgery. If untreated it can lead to muscles death, nerve damage and in severe cases amputation. Stringer obviously didn't have this but I believe Moris may have battled with this, hence we didn't see him this year.

What Stringer will need to overcome is firstly confidence in the leg, secondly restricted movement in the ankle which he'll have worked on (a heap), and foot mechnics. When you have a low ankle fracture you need to work on strength, control and most importantly proprioception (awareness of where your foot is in space)
. The club have people in place who I'm confident will manage what is best for Stringer and will get he best out of him.

Stringer has age and enthusiasm on his side, his leg never concerned me as much as Menzals knee for example.

[Murphy'sLore]

Re: Leg Breaks

Thanks for that Slim, great to get your expert perspective.

[lemmon]

Re: Leg Breaks

Great post slim, what about power/speed? Have read Stringer hasn't quite regained these as previously, will they ever come back? Is it even possible to tell at this point?

I guess its a concern for Morris as well, his speed was key in taking the smalls

[BornInDroopSt'54]

Re: Leg Breaks

The biggest and most often complication with breaks like this is something called compartment syndrome and it's a nasty piece of work. Basically the lower leg has a number of muscles that are separated by fascia, bone etc. When you break a bone you get bleeding and invariable swelling. In the lower leg this can be compartmentalised which is the primary concern of the drs post surgery. If untreated it can lead to muscles death, nerve damage and in severe cases amputation. Stringer obviously didn't have this but I believe Moris may have battled with this, hence we didn't see him this year.
What Stringer will need to overcome is firstly confidence in the leg, secondly restricted movement in the ankle which he'll have worked on (a heap), and foot mechnics. When you have a low ankle fracture you need to work on strength, control and most importantly proprioception (awareness of where your foot is in space)
. The club have people in place who I'm confident will manage what is best for Stringer and will get he best out of him.
Stringer has age and enthusiasm on his side, his leg never concerned me as much as Menzals knee for example.[/QUOTE]

Brilliant thanks Slim, your insight and understanding must have been hard earned and address the curiosity about these cases. That compartmentalisation sounds vile and it's so good that Stringer has escaped it. The critical bracing of the healing break reminds me of the work I'm doing with the hotface of my wood fired oven- a clay/sand/cement mix that has to withstand 600* C yet has cracked and I'm bracing it. Hope with all my heart that Dale Morris has limited prob's with his lower leg being compartmentalised.
The process of proprioception is a fascinating concept and although I'd never heard of it I suppose I'd imagined it being active. I guess the break puts a process that is normally instinctive (spatio/temporal relationship and awareness) out of kilter and the conscious mind and other aspects of the psyche need to play a hand to intervene, like learning to steer,change gears and brake in a car. Repetition no doubt could build up 'muscle memory' (probably a misnomer from your pov) and hopefully Jake and Dale can become proprioceptually proficient.
Tales of people who lose a leg still feeling things in it - like part of the psyche still can't accept the change- spooky stuff.

[Dancin' Douggy]

Re: Leg Breaks

Thanks Slim, good insights.

Does the fact that he was not fully grown (he may still be growing as well) when he broke it have any positive or negative impact on the healing process.

Will a badly broken leg bone grow at the same rate as an undamaged one?

[LongWait]

Re: Leg Breaks

Thanks Slim - fascinating contribution. The club has spoken about assisting Jake to make biomechanical adjustments to his gait. Any comments on what that entails and degree of difficulty?

[SlimPickens]

Re: Leg Breaks

Thanks Slim, good insights.

Does the fact that he was not fully grown (he may still be growing as well) when he broke it have any positive or negative impact on the healing process.

Will a badly broken leg bone grow at the same rate as an undamaged one?

Will only have implications if he broke his growth plates, which i suggest the break would have been too high for that. To answer your question, it should but if blood supply is effected and remember he would of been bolted into place for six months then it may mean he is out of whack. That being said you would think that the fracture leg side may be longer as more bone would have been laid down during he healing process.

Males don't mature skeletally till they're 25, meaning his bone density will get better and stronger and yes he may still grow.

[EasternWest]

Re: Leg Breaks

So you believe it's an individual thing and as Stringer was only 16 may be trouble free? One aspect of Stringer's and Brown's was that they actually broke their leg violently ( in terms of the effect- a sheer break of one of the strongest bones in the body) simply by kicking it with the other leg. It seems to defy physics, yet the result is a shocking injury.

No I don't believe that, I'm hopeful of that. I have no expertise etc, just hopeful that's how it pans out. Sorry should have clarified that. Part of my reasoning is that my broken bones as a youth healed much more quickly and better than my broken bones as an adult.

Also, Voss' injury was easily as severe as Brown's. His occurred when his leg hit another guys leg midair (Voss was on a lead IIRC). I remember vividly his leg flopping around after the impact. Awful to watch.

[chef]

Re: Leg Breaks

Thanks Slim.

[BornInDroopSt'54]

Re: Leg Breaks

No I don't believe that, I'm hopeful of that. I have no expertise etc, just hopeful that's how it pans out. Sorry should have clarified that. Part of my reasoning is that my broken bones as a youth healed much more quickly and better than my broken bones as an adult.

Also, Voss' injury was easily as severe as Brown's. His occurred when his leg hit another guys leg midair (Voss was on a lead IIRC). I remember vividly his leg flopping around after the impact. Awful to watch.

Voss's break in midair was freakish as I suppose all these guys breaks are. It's great that Voss and Barlow made it back and augurs well for Stringer. Dale Morris we can only wait and see but if anyone can, Dale can.

[Cyberdoggie]

Re: Leg Breaks

I liked how Carlton after drafting Menzel were trying to explain how Troy's injuries didn't concern them because they were totally unrelated to his brothers.

They basically said Troy had a PCL and then LARS from collision injuries, and not the 2 ACL's his brother had where his knee just gave way.

Dress it up all you want his knees still gave way. 2 brothers with 4 knee related injuries is more than coincidence, it's a trend.

[Ghost Dog]

Re: Leg Breaks

Ah well. He was pretty close to coming to us. I wish the kid well.