Tendons, ligaments and muscles?

 

 Here’s a bit of chat about an injury that happened on the July Borneo trip. One of the students injured her ‘heel’ before the expedition and complained of some soreness, but nothing that would prevent her from climbing the second highest mountain in Northern Borneo! Brave words, still it needed to checked out by a doctor before the all-clear for the trek was given. Dosed up with an anti-inflammatory she did well on the way up, although as we all know going up is the easy part.  Coming down hill puts far more strain on muscles, bones, ligaments and tendons. Normally we follow the RICE (Rest, Ice, Compression and Elevation) acronym for any sprain or strain, with the thought being that one minuet delay in RICE’ing an injury can add one hour to the overall healing time. New thoughts on caring for sprains and strains suggests that anti-inflammatories are avoided  for the first 24hrs as it can prevent the natural clotting process of the capillaries damaged by the initial injury. BUT, on the side of a mountain in the middle of a tropical rain-forest, with the humidity of 98% and temperatures in the 80’s all of the components of ‘RICE’ are not that readily available. Sometimes the best option is to strap up the injury, dose with painkillers and get them out rather than prolong an evacuation and put the rest of the team at risk.

I tried making a walking splint by slotting a samsplint into the patients boot (see picture) and then strapping with an ace bandage. Not bad, looking at the picture the strapping should have gone all the way down over the boot, remember the ankle was also strapped up under the samsplint. It worked for a couple of miles and got the injured student over the worst of the rough terrain. Would I recommend using it again? Maybe. The main problem was caused by movement at the ankle joint, and although reduced by the splint, the splint eventually split and tore. A couple of sticks could have solved this I guess, so I’ll just have to wait until the next ankle injury, shouldn’t be too long, seems to be the most common injury on expedition. So what was the outcome? Good I’m glad to say, in so much as we managed to get her off the mountain safely. After many visits to doctors at home, physio-therapy and an eventual MRI it was found that she’d actually ruptured a ligament, no surgery required, but a lot more physio and rest..  

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Tags: Borneo, expedition, medicine, wilderness

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