DR. DAVE HEPBURN  |  MAY 29, 2013

Pain personified

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Skateboarding is pain personified. A skateboarding park recently opened up around the corner from my clinic. This has added color (primarily red) to my practice and hipness to my vocabulary. With no shortages of fractured this and lacerated that now skating through my office door, I have become, unofficially, the doctor to these cement-surfin’ sons of stitches.

“Yo, doctor dude, I was carvin’ some phat air, like I was totally amped bro, when I ate it and bought me this gnarlacious swellbow.”

Translated: “My elbow hurts.” 

What has surprised me is that these swellbow, tweaker and hipper victims are not only 16-year old baggy-pant boarders but also dudes and dudettes in their twenties and thirties who actually hold jobs that don’t require supersizing stuff. In fact, 170 injured skateboarders who were hospitalized last year in North America were over age 65! 

And so I have decided to give the wheels a go. Sort of. My sons, with a twinkle in their eyes, convinced me I should try roller blading, a sport which I have eschewed, possibly due to the frequency with which roller bladers tend to end up on the hood of my car with relatively little effort on my behalf. And for a lifelong hockey player, roller blades are frightening. Stopping on ice skates means a quick turn to the side. Doing the same thing on roller blades means a quick turn to the hospital. And so it was, that with 600 lbs. of armor draped about my joints, head and any skin that might possibly become intimate with asphalt, I teetered on these blades like a newborn giraffe on ice on the Serengeti during an unusual equatorial blizzard, during a hockey game. “Cowabunga Dad!” My fear of these wheels of death was validated when I met my first speed bump at ramming speed. Unable to brake I was promptly launched headlong, in a horizontal plane, landing with an unceremonious splat and coming to a halt only after deploying my elbows as brakes. First day, first swellbow, a condition known to the uncool as bursitis of the elbow. 

At least I didn’t have a hipper or a tweaker. More than 100,000 skateboard injuries show up in the emergency room each year; a third have less than one week’s experience. Most experienced boarders treat themselves, usually by punching their head repeatedly until the injury hurts less than their head. Skaters suffer some significant smacks to the skull, followed by broken wrists, faces and ankles.  

HIPPER: “Yo, doctor dude, I got this outrageous hipper from goofy-footin’ into a fakie.” 
To inspect a patient’s hip it is necessary to remove some clothing. but given the skaters’ sartorial tastes, this is rarely required. “Yep, I can see it from here, you have a traumatic greater trochanteric bursitis.” “Whoa, awesome! Can I keep skating or do I smoke some, ... er ... play XBox for a while?”  

Reach down to where you think your hip is located. Feel that bony thing jutting out? (If not, consider Atkins.) This is the infamous greater trochanter, a part of the femur that is covered in a fluid-filled sac called a bursa, a shock absorber that prevents muscle from rubbing up against bone. Bump this too hard or lie on it too long and the bursa will be traumatized, swell and hurt. If it doesn’t get better on its own, then a well-placed cortisone shot works wonders.   

SWELLBOW: Another bodacious bursa sits over the bony part of the bent elbow. This olecranon bursa is easily traumatized as well as easily infected. This swollen bursa (bursitis) blows up like a blowfish’s blowpop and feels like a jug of water has been taped to your arm. I will often drain these and place a pressure dressing on them (or they fill right back up). If they do fill back up then a cortisone injection may keep it at bay. An infected bursa, however, is a serious bummer given its proximity to the joint.

TWEAKER:  Kickflip down a rail, fall on an outstretched hand and you may suffer several serious injuries to the wrist. You may fracture one of eight wrist bones, the scaphoid bone being the most dangerous. The fracture may not be overtly obvious but persistent pain where the thumb seems to join the wrist (the snuffbox) is highly suspicious. More than a wrist tweaker, if a fractured scaphoid is not set properly, you may be in for some real gnarly surgery.  

Yep, these skaters have brought some outrageous injuries into my clinic, and for that ... I am totally stoked.

Listen live or call in to Dr. Dave on his fun yet informative radio show, Wisequacks, heard each Sunday at 2 p.m. at www.cknw.com.