The New Injury DeJure

[greybeard]

Fifth Metatarsal breaks. There's been another one. Levance Fields, the guy from Pitt who hit the dagger, won't be hitting anything for a while, except with a crutch.

Back when I was real, real young, it was ankles. They were easy, you taped em up real tight, and guys grit their teeth and played, in the pros with a lttle help, but they really were not a big thing. Early 60's, every body started discovering that they had carteleges and that those rubbery things could actually tear. Seemed improbable based upon our collective experiences in trying to get the last bit of meat off of drumsticks, but, so it was.

Miniscus became a household term, sort of like "ice box" or "Frigidare" (am I dating myself here).

Then, and I'm not sure when this happened, it became ACL tears and rotary cuff injuries. I mean, ask a Junior High School kid what the capitol of NJ is, and you get a blank stare. Ask how you rehab from ACL surgery, chapter and verse.

Now, it's that fifth metatarsal, or so it seems. I think that this is a nasty one, particularly because it doesn't seem like it, the break, happens because of a mishap. Seems that they are just breaking. And, unlike cartileges and ACL's, what myth will be created for how people need only find a way to train better to avoid them. Heck, it seems that if there was ever an injury that is due to overtraining, this here is it.

So, where to from here? Insurance, baby, that's where I see this thing going. Guys are going to go out and get their fifths insured special. Not like the rest of them. They're going to double down at least on these babies.

Nope, I'm not worrying about the players. What, with insurance companies abandoning insuring houses in droves, built in a flood plain, sorry, built in a fire plain, sorry, we got too many at risk properties we haven't unloaded yet, sorry, insurance agents will be seeking players out like crazy.

The guys I'm worried about are the coaches. Be interesting to see how they handle it.

[Lavabe]

The "Fraulines Rock" was great greybeard, but "DeJure"??

5th metatarsal has been an old one for ballet/dance folks ... one form of 5th metatarsal fracture is known as "dancer's fracture."

Sorry to hear about it on Fields. Hope he recovers quickly. He's young ... unlike me, as the Frigidaire reference probably dates me too greybeard!

Cheers,
Lavabe

[billy]

...but, the same guiding principles for ACL prevention (mostly for non-contact injuries in female adolescents - ideal for teenage soccer teams) would hold for base of the 5th metatarsal fractures, most of which occur as a result of ankle instability rather than overuse (i.e. stress fracture, more common in the longer 2nd and 3rd metatarsal). Jones' and dancer's fractures occur from rolling the ankle inward, with the peroneus brevis muscle on the outside of the leg pulling or avulsing the "base" of the 5th metatarsal off of the rest of the metatarsal. Prevention-wise, anything that prevented the greater magnitude inversions would decrease the liklihood of the injury. An ASO brace (the black band you see above many collegiate and professional players shoes) would do the trick as would standard physical therapy protocols for ankle instability (commonly used by athletic trainers). I wonder if peroneal strengthening exercises alone might actually cause an increased likelihood of injury - more likely to pull the base of the bone off?

[greybeard]

...but, the same guiding principles for ACL prevention (mostly for non-contact injuries in female adolescents - ideal for teenage soccer teams) would hold for base of the 5th metatarsal fractures, most of which occur as a result of ankle instability rather than overuse (i.e. stress fracture, more common in the longer 2nd and 3rd metatarsal). Jones' and dancer's fractures occur from rolling the ankle inward, with the peroneus brevis muscle on the outside of the leg pulling or avulsing the "base" of the 5th metatarsal off of the rest of the metatarsal. Prevention-wise, anything that prevented the greater magnitude inversions would decrease the liklihood of the injury. An ASO brace (the black band you see above many collegiate and professional players shoes) would do the trick as would standard physical therapy protocols for ankle instability (commonly used by athletic trainers). I wonder if peroneal strengthening exercises alone might actually cause an increased likelihood of injury - more likely to pull the base of the bone off?

How come we're seeing more 5ths' bustin these days is what I want to know. Greater ankle instability in today's players? I'm not buying it. Sorry.

Maybe overuse, greater torque being placed on ankles overtime. But, here are a few questions one might want to ponder: 1. Why aren't the ankles giving out, as in a sprain or ligament tear, before the 5ths bust? 2. If the ankle is frozen by those braces, where is all the torque that the ankle normally absorbs going to go? 3. Why would anyone want to put even more stress on the worse constructed joint in the entire body, that would be the knee, by wearing an ankle brace, unless, like most kids, they can't see past their next rice chrispy? "hint, the experts, coaches and orthopods, tell parents and kids that wearing ankle braces will let a hurt kid play and prevent ankle sprains that occur because of the idioic way volleyball is being played).

I walked into a gym early for a summer league game at Georgetown and encountered free play for a young women's volley ball summer camp. All the chicks were wearing these black spats. I thought it was a fashion statement and then somebody told me that they ALL were wearing ankle braces.

The idea that ACL tears are not directly related to the stress of high end athletics insults the intelligence. Complete and utter nonsense. Were it otherwise, we would see as many girls in science class wearing those g-d awful knee braces as we do girls playing soccer, basketball, and yes, volleyball. Those games are too rough and that is why there are ACL tears, and ankle braces can't help but contribute.

If you think that the increase in 5ths is not the direct product of the ever increasing intensity of physical training to which high end athletes are put I suppose we'll have to wait until it starts hitting the 4th and 3d. Like