#647 How does a displaced fracture heal naturally without medical treatment? - DOC

#647 How does a displaced fracture heal naturally without medical treatment?

How does a displaced fracture heal naturally without medical treatment? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



Now today’s episode actually comes from one of the YouTube viewers Doc on the Run YouTube channel who had watched one of the videos on fractures and he asked a question, and this is actually a great question. This is from Saif, and if I pronounced your name wrong, please forgive me, but I wanted to try to give you credit, and this is a fantastic question. What he said was, “Thank you for such a short and effective, informative video. My question was, does displaced fracture heal naturally without medical treatment? And the thought process was that how did our ancestors and primitives heal without medical care or deal with these displaced fractures?” And this is a great question.

So imagine you’re running from the saber-toothed tiger, you’ve got your club in your hand and you trip over a log, and when you do, you actually snap one of your metatarsals and it breaks and it moves out of position. So it’s in the wrong position. It’s not in the right place, but it’s broken. And there it is. Well obviously you’re not going to go to some cave where there’s a doctor and get an x-ray, so you may not even be able to see that. If it’s really displaced, like you break your arm and your arms completely crooked, well then you could tell that and maybe splint it back in place, but these subtle displaced fractures, obviously in primitive times when we didn’t have any x-ray and before we had lots of medical imaging modalities that we have now, well, it may have been more difficult to actually figure out the position that it’s in. So this is a great question. So how could they heal naturally without medical treatment?

Well, obviously if you had an injury, somebody would try to take care of it. And if a bone was broken, I think, although I didn’t practice back then, I’m not quite that old, I would assume that they would try to put it back in position. So if it looked crooked, grossly deformed, then the idea was to push it back into position and hold it there with a splint. Now, if you have a subtle fracture where it’s under the skin and you can’t actually really tell that it’s badly displaced, well that might be harder to fix. Now this may sound like it’s crazy and it may sound like it’s rare, but it’s not, and this does happen all the time. In fact, when you break a toe, if you catch the pinky toe and you break, it’s very easy to actually displaced it so much that you can tell it’s completely crooked and you can tell by looking at it is not right. And most of the time we would reflexively try to put it back where it belongs and hold it in that position until it heals.

Now, if the edges of the bone are close enough together that it will actually heal, well, that will happen whether or not you actually see a doctor. Obviously if it’s in a better position, that’s important, but if it’s slightly displaced and it still heals and turns into solid bone, well then it’s healed. At least it’s stable. The other thing is if it’s too far apart for bone to actually bridge that gap and it heals like that, what we mean by healing is that you develop a thing called a non-painful non-union.

This is where you get a whole lot of scar tissue in between those two ends of the bone, so it doesn’t hurt or grind when it moves back and forth and the scar tissue or collagen strands that kind of join those two pieces of bone that were loose and moving around before, they kind of hold it together like a little bit of glue and duct tape and keep it a bit more stable so you might actually be able to use that foot or whatever the extremity is that’s broken for a long time without any pain.

In fact, I saw a woman one time who had broken a metatarsal in high school, it “healed,” but never actually turned into solid bone. She had what looked like still a fracture in the bone and she played tennis on it for 50 years before it actually ever started to bother her. So in that case she had a non-painful non-union for most of her life and didn’t even know it. And in that case, it doesn’t really matter. So that’s not to tell you that you should not seek medical treatment if you have a fracture, because always putting it in the best position, doing everything to help it heal as quickly as possible can help a lot.

If you want to learn more about fractures, more specifically about stress fractures, you can go check out the Stress Fracture Masterclass. You can go join me there. We’ll take a deep dive into all of the things that runners should know about stress fractures, and it’s free. You can get it at docontherun.com/stressfracturemasterclass. So go sign up and I’ll see you in the training.