QuestionMy 16 year old son who is in great physical shape at 6'1", 190 lbs had a ATV accident 2 wks ago. He was riding up a sand hill, had to bail off backwards and the ATV (approx. 600 lbs)rolled backwards over him. We went to the emergency room, took x-rays, nothing broken, just abrasions and severe pain of his ribs on the left side. They gave us anti-inflamatory and muscle relaxer. We chose to take over the counter anti-inflamatory and no muscle relaxer because he doesn't like to feel doppy. Its been 2 wks and he's is in more pain now than when the accident happened. Someone suggested he could have a bone contusion. Is that more painful that just a normal bruise? What do you suggest we do? Would the prescription anti-inflamatory & muscle relaxers help at this point? Is there anything we can do that doesn't require medication so he can still function at school?
Answercontusion , curtis high school football
Hello Malinda Heller,
Sorry to hear of your son's injury, pain, accident.
At 16y/o, 6'1", 190#; ,,, I hope he is playing some High School Football!! I work with the NYC Curtis High School Football team, we have been Champions several times, but could always use a good athlete with that good size !!!
Enough socializing.
I am glad you took your son to the hospital emergency room. Take a look at what is happening today- the death of Natasha Richardson from a relatively mild blow to the head- skiing. What a shame- but people often pooh- pooh or minimize an injury. Your immediate trip to the ER is the right thing to do !!
The ER ruled out BAD things like a punctured lung- the ER is concerned about critical, emergent issues. So, we can be pretty safe to assume the biggest baddest things are out of the way.
But, an Xray at the time may NOT pick up a fractured, NONdisplaced rib- he could have a fracture that may not show up for a week or two until AFTER the injury. Why does it take sometimes 10- 14 days AFTER an injury to see a fracture?- if the fracture is small, but still in place, the Xray may NOT see the 'crack'. But after a week or two, we can see the HEALING of the crack. Just as our hands get 'calloused' when we injure them repeatedly, the bone heals by growing a 'callus' that can be seen on Xray- TWO weeks after injury. So- first thing, I recommend re-taking Xrays of the point of pain to view IF there is a healing process going on.
After the retake of the Xray, then we can talk about other possibilities.
When the Hospital cleared him,,, did he return to rough-housing, to athletics, to competition, to the usual ACTIVE, strenuous adolescent life? Even though he was NOT injured severely-- IT TAKES TIME TO HEAL. When we are hurt, we HAVE TO slow down. This may be difficult to impress upon a 16y/o.
Did he return to riding that ATV over rough terrain? Did he play sports and get RE-hit in the ribs? Did he climb a mountain and RE-strain the area? These are questions to be looked at.
Did you treat the area--
here is an information handout I utilize in my office, not only for Curtis High School Football players, but for my older, weekend warriors as well:
P.R.I.C.E. =
P protection. R rest. I ice. C compression. E elevation.
Hurt yourself ?? injury/ trauma/ bruise/ not even sure - - a broken bone ??
You should certainly get to the Doctor or trained health professional to be examined if you think it is bad enough.
BUT in the meantime, some simple steps may help.
PRICE.
The PRICE protocol will usually help just about any musculoskeletal injury.
P = Protection; protect the area from further injury- stop what you are doing, can you pad or bandage the area ? Tape the area? Do something to protect the area !
R = Rest; rest the area as much as possible, if a part is damaged, give the body time to repair the area
I = Ice; ice is a potent anti-inflammatory; it will slow swelling, help with pain control (ice is analgesic), place ice over cloth over the injured area for 5, 10 minutes, off the injured area for 30 minutes; then back on again
C = Compression; to help prevent swelling compression may be helpful- for example if it is an ankle, wrap the ankle with an ace bandage and ice the area. Many body parts may not be applicable to compression.
E = Elevation; again to fight swelling and pain, raising the injured body part above the heart may be helpful- ie raise an ankle or knee, you lay down, raise the injured part
PRICE may help : Sprains, Strains, musculo-skeletal injury, bruise, contusion
Sometimes a slip, trip, fall, heavy lift, athletic injury, or a motor vehicle accident can cause a bump or bruise, sprain or strain. Sometimes also involved with the injury is a vertebral subluxation (or other joint subluxation) (subluxation is a mechanical problem- of any joint- and requires a mechanical correction). In the spine, a sprain/strain is a misalignment, a 慿ink?in the joint, a stretch of the muscles, tendons and/ or ligaments:- more properly termed a Vertebral Subluxation. Sometimes symptoms can come immediately, sometimes days, weeks or even months later!- Well after the actual trauma !!!
Spinal = Vertebral Subluxation Complex (a.k.a. 憇ubluxation? ; ( subluxation COULD be any joint )
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
This is a serious condition identified by its five parts:
Spinal Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
Histopathology:
A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
Pathophysiology:
Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment. For good health- Treat the Cause, not just the Symptoms. Sprain/ strain/ bump/ bruise?= may result in subluxation of the nearby joint. CORRECT the subluxation !!!!
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine
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"....Someone suggested he could have a bone contusion...", yes this is a possibility, and will take longer to heal. Have you done the
'PRICE' protocol above?
Besides the small rib bones which may be badly bruised, there are small intercostal muscles between the ribs that may have been injured, torn, strained, contused, etc.
".....Is that more painful that just a normal bruise?.....", yes.
"....Would the prescription anti-inflamatory & muscle relaxers help at this point?.....", I am NOT a Medical Doctor, I am a Doctor of Chiropractic. Your medication question has to be answered by a licensed medical practitioner.
As a Doctor of Chiropractic, I would try to treat with alternative means, as I am describing here.
"....What do you suggest we do? .... Is there anything we can do that doesn't require medication so he can still function at school.....", I recommend seeing the local Doctor of Chiropractic.
With a sports injury practice, I am of course partial to the Doctor of Chiropractic with a sports injury credential (CCSP, DACBSP). Just as Medicine has various specialties, so does Chiropractic; for a list of Chiropractic Specialties you may go to: http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf
All kidding aside, if your son does play sports at school, a call to the coach or trainer may help you find a good Doctor of Chiropractic who works with injury such as this.
Chiropractic examination, evaluation, a REtake of the rib/ chest Xrays, and possible treatment if appropriate- hot/ cold/ muscle stimulation/ ultrasound/ infrasound/ manipulation- these could be non-drug, non-invasive treatments that could help speed recovery.
I know it has been two weeks since injury-- but I still like Ice applications- see PRICE above.
If this is getting MORE painful, he definitely needs to be seen again by a licensed health professional and re-evaluated. He definitely needs a REtake of the Xrays.
If you do not see a DC, preferably with sports, orthopedic or rehabilitation credentials, I would recommend an MD orthopedist or physiatrist - - all of these with an Xray retake.
I hope this helps.
If you need further information, do not hesitate to REcontact me here at ALLExperts.com http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC.htm
Thank you for your question.
I wish you and your son Good Luck and Good Health Naturally,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (Email newsletter)
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a note on Athletic Performance:
Athletic Performance Improvement, Accelerated Recovery
Chiropractic is well known to improve athletic performance, prevent sport injury, and accelerate recovery from injury or hard training.
With Doctors of Chiropractic serving on almost every nation抯 Olympic Team, with Chiropractic holding official status with the USOC and serving almost every US Olympic Athlete: the results of chiropractic cannot be denied.
Coaches and athletes are aware of terms such as
enhanced performance, performance improvement,
accelerated recovery, restoration and regeneration.
Many coaching conferences discuss strategies on these aspects of exercise, competition, sports and athleticism.
An interesting study was performed and published way back in 1991. The January 1991 issue of the Journal of Chiropractic Research and Clinical Investigation published findings that demonstrate significant increases in athletic performance after a twelve week program of Chiropractic treatment.
Athletic Ability Research:
Male and female athletes between the ages of 18 and 42, representing a variety of sports backgrounds, were recruited to participate in this study. None had ever before been under chiropractic care. Each of these participants underwent eleven separate tests, each test designed to measure a specific aspect of athletic performance. Then, half the participants were evaluated through chiropractic analysis and placed on a twelve week program of chiropractic treatment ( consistent regimen of chiropractic, similar to a consistent regimen of physical athletic training/ exercise ). ( measured aspects: side step test, dodging run, right boomerang run, modified bass tests of dynamic balance, vertical power jump, standing broad jump, distance perception jump, horizontal linear space test, nelson hand reaction test, nelson speed of movement test, nelson choice of response-movement test )
All subjects continued to train and practice as usual in their sports. At the half-way point of six weeks, they were all reevaluated and changes in scores for each group were compared. All increases in performances by each group were measured by the average percent of change in all eleven tests combined.
The control group, those not receiving chiropractic care, showed slight improvement in eight of eleven tests ( this group had been training 慳s usual?for the time period ). By combining the average percentages of change on each test it was found that the control group showed an overall improvement of 4.5%.
Those receiving chiropractic treatment (along with their 憉sual training?, the test group, had dramatically different results. They showed improvement on all eleven tests for a total 10.7% average increase after six weeks. And when retested again after the second six week period of care this test group demonstrated a remarkable 16.7% average increase in athletic ability.
( consider that one/ onehundredth of a second ( 1/100th ) is the difference between win ?lose,,, 16.7% is HUGE )
What Do Chiropractors Do?
Chiropractors analyze the structure of the body, looking for misalignments, primarily in the spine, and also the extremities. Spinal misalignments, termed vertebral subluxations, irritate the nerves which in turn inhibits the body抯 ability to function optimally. Like a high performance automobile, the human structure must be balanced and in alignment to be at it抯 best. A Ferrari with pistons that don抰 fire in sequence, wheels that are out of balance or alignment, and high performance specifications that are improperly set will not only have it抯 performance compromised but will also have dramatically increased potential for parts to wear out and breakdown. The human body, far more delicate and complicated than even the most advanced automobile is similar. If the framework, particularly the spine, isn抰 properly aligned and balanced- the body cannot perform to it抯 potential and is more susceptible to illness and injury, with slower recovery when injury does occur.
What Do Vertebral Subluxations Do?
Vertebral subluxations cause nerve conduction interference. This inhibits millions of messages from the brain from flowing smoothly along the nerves and in this in turn interferes with the coordination of the actions of the body. The only health care provider trained to diagnose and correct vertebral subluxations is the Doctor of Chiropractic. Like a properly tuned Ferrari, the chiropractic patient athlete, when properly aligned, functions at a level of peak performance.
Famous Athletes Utilize Chiropractics.
Many athletes have discovered the relationship between proper spinal alignment and their own level of achievement. San Francisco Forty-Niner Greats Joe Montana and Roger Craig as well as heavy weight champion Evander Holyfield are examples of professional and world-class athletes who realize(d) the value of proper structural alignment and balance in their bodies. They have learned through their own experiences what research has shown; that through chiropractic care - one can demonstrate faster reaction time, better balance, improved coordination, increased muscular power; and when injured- accelerated recovery and regeneration.
The Competitive Edge.
Emphasis on athletic excellence continues to escalate in this country in terms of both dollars and extremes in personal sacrifice. Though the dangers of taking anabolic steroids have been widely publicized for years, the number of athletes who suffer serious health problems caused steroids continues to grow. Now, however, the athlete looking for the competitive edge need not look beyond the framework of his(her) own body. Increased public awareness is leading many to realize that a natural method is available in achieving performance enhancement. The method is Chiropractic!
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine
