 Poster: A snowHead
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stoatsbrother, i agree with your guideline evidence, think the point was missed however. difficult to know what the mechanism of broken ribs was here to see if needs further evaluation can't say if it was a minor or moderate injury can we?. Not sure this thread is place to bad mouth peoples practice, who knows where referals come from? who knows who you are referring to??
All I was trying to point out is that a pain in the ribs following trauma is not always a broken rib! Sure many who have played game of rugby or fallen heavily onto chest and have felt bruised have not broken ribs. Either which way its the soft tissue injury that is the one that is going to limit the skiing enjoyment and that is the bit we are really talking about here i.e the skiing / boarding.
Dose oneself up with some analgesia and hit the slopes!!
btw have cut trees down in my time but not for money
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| Lorenzo wrote: |
| chect2000 wrote: |
| If you have nothing constructive to add please feel free to post on other threads. |
I was trying to be constructive. My constructive advice was to listen to the experts and follow what they recommend.
You seem to have some advice now from a surgeon so maybe you should start up a dialogue with him/her to get to the bottom of things?
You are getting solid advice here from proper professionals, free of charge, and should be grateful for that and take it on board.
I am really sorry that this injury has happened to you right before a holiday, and hope that everything works out (whatever you decide to do).
L'enzo |
No problem . The worst bit was i did it at Chill Factory in Manchester. I felt a right goon. 
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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| empinky wrote: |
have you definitely broken these ribs or is it just someone telling you that you probabaly have - big difference as a lot of the time i see folk who claim ribs are broken, get an x-ray and no evidence of the ribs being broken.
If x-ray shows broken ribs then i agree that risk of collapsed lung (pneumothorax) is one which is not worth risking
If no x-ray showing break then i recon that the bruising around the ribs giving the pain is one that you need to judge if its too much or not. Personally i would tend to just get on and ski/board
Have boarded for a week with a broken wrist needing mrs empinky to do up bindings!!
surgeon btw |
Hi.
Doctor said i had fractured/broken ribs. When i told him i was off skiing in 3 weeks he seemed unconcerned. He listened to my breathing and again was unconcerned. Was given CO-Dydramol and Naproxen
I have no clicking but it is generally just painfull. When iam up and walking around it's ok. When i sit down it's uncomfortable. Struggle to get into bed but when iam in it's ok. Not lost any sleep. Struggle to get out as it very painfull.
The pain is now just as i would say uncomfortable after 10 day's and getting better by the day.
Thanks Shane
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sounds all ok to me without seeing you. Unidentified drinking injury???? commonly known as a UDI. or whilst messing about on the white stuff?
Keep on the painkillers and enjoy the snow if it were me.
legal bit - this is just an opinion based on facts over the net and i can't totally say what is wrong without having seen you. nuff said eh?
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Surgeon my a***
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| empinky wrote: |
sounds all ok to me without seeing you. Unidentified drinking injury???? commonly known as a UDI. or whilst messing about on the white stuff?
Keep on the painkillers and enjoy the snow if it were me.
legal bit - this is just an opinion based on facts over the net and i can't totally say what is wrong without having seen you. nuff said eh?
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I was sober as a judge. Said to mate i will race you to the bottom on our last run and smack.
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chect2000, snapped ribs = can hardly move and 2 hours sleep max per night for first week, cracked ribs/cartilage damage = very painful but reasonable movement and decent night sleep, bruising = painful but not too bad after a couple of weeks
Take your pick, but if you had snapped your ribs you would not even be thinking about sliding around 
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rayscoops, agree entirely
robnic, up to you to believe or not ..blwyddyn newydd dda i ti hefid
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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empinky, agreed - but we wouldn't want all snowHeads to think they needed to insist on an xray after any possible rib injury to see if they had a fracture or not - in order to see if it was safe to ski - which is perhaps a bit how your post read?
Bottom line is - pain is usually the main issue - and alcohol may help!
(disclaimer - other wiser, more sincere and safer medical opinions are available - your life expectancy may go down as well as up - if you see a Surgeon privately your home may be at risk )
Last edited by You'll get to see more forums and be part of the best ski club on the net. on Wed 7-01-09 17:16; edited 1 time in total
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stoatsbrother, if you see a burglar then home is more at risk.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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| Tommy4681 wrote: |
| stoatsbrother, what's the reasoning behind that (I'm neither a GP nor a tree surgeon)? If there's a risk of pneumothorax resulting from a fall whilst, say, skiing, then surely it's better the patient is aware of the break and takes the proper precautions. From what you've said, it seems that broken ribs will only be diagnosed in people involved in high energy/ multi-trauma scenario or with signs of pneumothorax and/or surgical emphysema. |
An x-ray isn't going to change the management of the patient. Main risk after a relatively minor chest injury is opportunistic infection caused by inability to clear secretions through coughing. The advice would be the same whether there is a fracture or not, which is, take plenty of good pain killers, mobilise as the pain allows, and seek advice if you develop a cough or shortness of breath.
Main reason not to ski would be pain IMO. I don't know a huge amount about the increased risk of pneumothorax from recurrent trauma to an already fractured rib, but it's not something that I've heard of commonly.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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If it were me, and I didn't think that it would be too painful, I'd be skiing.
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empinky, probably... 
kramer agreed
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You know it makes sense.
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sounds like we're all in agreement.
if you can stick the pain with some simple painkillers then get out there and ski
My opinion at least!
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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should chect2000, break something else and need an xray for other reasons, we may see what actually happened to his ribs - worked every time for me 
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Poster: A snowHead
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| Kramer wrote: |
| An x-ray isn't going to change the management of the patient. |
I would agree - if an x-ray makes no difference to treatment, then you shouldn't expose the patient to radiation unnecessarily and also spend money on tests you don't need. I'm a physio so although I'm not a doctor, I do work with them
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Both times I suspected I had broken ribs, I was X-RAYed, and the X-RAYs confirmed they were broken. Both times were in France - are practices different there p'raps?
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Patch, my experience is that the French over-medicate, over-X-Ray, over medicalise generally. It's no coincidence that even the tiniest French village usually boasts a huge 'polyclinique' and a 'pharmacie' the size of an average church!
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You need to Login to know who's really who.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Chect
If the rib is not broken, its all about hte pain level but after 5 weeks you wouldnt imagine it to be too bad.
If it is broken, its a different kettle of fish.... although i agree with stoats that the risk of pneumothorax would be pretty low after >5 weeks healing - would require a decent wallop to displace it and that level of wallop would probably break a never-broken rib anyway....
Ultimately, the key guide is your own pain level.
If you can re-schedule without major hassle and expense, do it, because it will clearly be playing on your mind no matter what people say and you will end up skiing like a gimp and when faced with a fall, you will do everything to protect your ribs and end up landing on your head............the technical term is "swings and roundabouts".
As for the xray for ?broken rib debate, stoats is technically correct but, lets be honest, a lot of A&E departments do a poo-poo load of tests for no good reason other than to please and supposedly reassure worried patients/avoid legal ramifications down the road....
BTW, im a former doc who is now a medical lawyer so, naturally, none of the above should be read as medical and/or legal advice and i refer you to clause 44.3.12 of............ blah....blah
Enjoy it, whatever you do!
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I'm glad the real doctors had spoken!
I broke my ribs last April (confirmed by x-ray, cracked at 2 places). Since it was day 1 of my holiday, I continued gingerly the next day. The pain level, surprisingly, was not too high at all starting from day 3 post crash (first 2 days was quite bad, I could only skied half day each). So I continued for the whole week, including one or two more new crashes. 
My GP, also a skier, was equally unconcerned as that of chect2000, when I asked about skiing. Though she did advice me not to go too close to trees, not for the already broken ribs but to prevent new ones. It was only after I inquired about the structural integrity of the rib cage, that she hesitated a bit and say something in the line of "well, try not to crash too hard for a while...".
With that blessing, I went on to EoSB (hence the VERY last MINUTE joining) and skied normally, including a bunch of off-piste in whiteouts (without much crash though). By then, there's very little pain...
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The only reason UK doctors do not xray for possible broken ribs is for financial reasons and this 'may get cancer' argument is bollax otherwise they would be a lot more frugal when it came to other xrays - funny how when you are paying for an xray then it is not an issue also whilst the treatment may not change whether you have had an xray or not, the post injury management will be assisted by knowledge of the injury - for example whether ski or not, time for rest etc. How many professional sportspeople with insurance have been refused xrays for the reasons that the docs have suggested here
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rayscoops, That is total and upper rubbish. And - as I mentioned earlier - the guidelines are European.
[additional] you might alsowant to ask yourself why Doctors in some countries - who stand to gain financially directly or indirectly - request investigations which do not alter treatment and which do increase the lifetime risk of Cancer for a patient. Sometimes maybe it is because it is easier than spending time explaining the situation. Sometime perhaps it is because of unjustified fear of legal consequences. As the majority of quacks have pointed out in this thread - knowing whether a rib is broken or not makes absolutely no difference to the management 4-5 weeks down the road. I can see that if someone "needed" to play football (because of their cost to the club) at a professional level 3 days later, the situation might be different. But this is analgous to the way that sportsmen are pressured/pressure themselves to return to contact sports as early as possible - and sometimes with long term consequences.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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FWIW - I'm a doctor. Two pieces of advice 1) Don't ask for medical advice on a skiing forum. 2) Don't take advice from a doctor willing to give it on a skiing forum.
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foggy, which is why I waited till I saw some advice I and guidelines disagreed with before posting...
But I think you are right - and rayscoops offensive intervention brings to an end my discussing any clinical matters here.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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rayscoops, I was refused a knee x-ray privately as it was deemed that the need was not great enough and I had just had one and the risk to me thus increased.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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stoatsbrother, do not be so touchy and sensitive just because I disagree with you, I respect you opinion but I do not believe it as simple as you make out and I have recently had cause for extensive consultation with my local GP surgery which resulted in surgery on my spine, and the decision making process was most definitely influenced by financial matters as much as medical matters, so I am sorry if I was a bit bolshie but it struck a raw nerve , so to speak, and I was just heading off to my 8am physio session at the hospital (last one )
So an example, if JW had painful ribs two weeks before a rugby WC final would he be refused an x-ray to find out if he had a hair line fracture (in which case he would not play in the World Cup final) or if he simply had bruising (in which case he would play in the WC final) on the grounds of the risk of cancer?. I doubt it because any professional rugby player who has had a knock on the ribs will have an x-ray to see if he should rest for two weeks or four weeks or six weeks. I am not suggesting we go out and have x-rays every day of the week, but the reason for not giving an x-ray is not quite as clear cut as suggested. you admit sportsmen get x-rays (because they are willing to pay for it) if their job depends on the outcome of the x-ray, so the inverse must be the case, in part, for Joe Public.
Frosty the Snowman, doubling up of x-rays I can understand as increasing risk, but you did have the first one, but even then would JW have been refused in the circumstances ? or would the risk have been acceptable because the gains/losses to him are more?
Last edited by So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much  on Thu 8-01-09 11:12; edited 2 times in total
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You know it makes sense.
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rayscoops, Pro sportsmen often take courses of treatment that are not in their long term best intertest.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Frosty the Snowman, and amateur ones ... remeber the use of cortisone injections to reduce knee pain/inflammation ?
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Poster: A snowHead
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Frosty the Snowman, agreed and they must be mad, but they will not be refused an x-ray in the circumstances I have set out above for fear of the risk of cancer.
If your lad was two or three weeks weeks away from a schools or regional rugby final and had sore ribs I am sure it would be an interesting decision whether you would want him to have an x-ray to see if he could play ?
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Agenterre, Well I was fast.... like a bloody whippet
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Frosty the Snowman, I agree that there is no point for an xray too becasue nothing can be done to speed up recovery, so the expense of an x-ray to know if the rib is broken or not is not really justified
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| Quote: |
The only reason UK doctors do not xray for possible broken ribs is for financial reasons and this 'may get cancer' argument is bollax otherwise they would be a lot more frugal when it came to other xrays
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This statement is "bollax", as you put it!
There is a risk associated with xrays. Before I prescibe one, I have to be certain that it is clinically justified, and will alter my management, so that the benefit of the intervention outweighs any associated risk.
As the treatment for a fractured rib is conservative ie rest and painkillers, my management would be similar to severe bruising once clinical exam had ruled out any evidence of underlying lung injury, therefore there is no benefit of an xray, in this instance.
Also, about 50% of rib fractures cannot be seen in the acute phase on a chest xray.
Once again, Kramer's advice hits the spot perfectly.
Really, the advice (in a do not quote me, entirely non-legally binding way) would be not to ski for about six weeks, and then be guided by symptoms. However, if it was me, I'd probably go!
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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rayscoops, I can honestly say that for simple Xray imaging requests this consideration does not even enter my head. They are cheap tests (but not if done privately). This is about legal requirements before you irradiate people.
For expensive and unnecessary drugs or referrals, cost is a consideration. If somebody was pushing for an unnecessary MRI or ultrasound scan (which is not associated with radiation risk) and it might delay investigation of other more needy patients - that might be a consideration.
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stoatsbrother, serious question, if you were working in a private hospital and I turned up with suspected broken ribs (and I had not had an x-ray for a few years) and I was going skiing in one/two weeks time, bearing in mind I would be paying for my x-ray on a 'cost-plus' basis that would be generating revenue for the hospital, would you refuse my request for an x-ray ?
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FAQ
