Is it broken?

 

My kids will tell you that one of my biggest pet peeves is the misinterpretation of the terms “broken” and “fractured.” I’ve heard it too many times “it’s a good thing it’s only fractured and not broken.”

Cue the eye roll out of dear old dad. They used to use that one just to bother me. They knew that there was no difference. Broke is fractured and fractured is broke. They are the same thing.

A partial break is still broke. Stress fractures might fall into a bit of a gray area, as there are certainly degrees to those. And there is definitely a difference between a simple fracture and a compound fracture, but both are really different levels of the same thing. A broken bone.

I’ve been told that everyone has a superpower. It has been said, that maybe Xray vision is my superpower. I don’t know. I know I’ve seen my share of broken bones in 40 years as an Athletic Trainer. And I’m right most of the time.

After you see a lot of them, you really know what to look for.  If someone comes off the field hunched forward and clutching their elbow, they probably have broken their collarbone, medically known as the clavicle.

Again, there are simple clavicular breaks and then there are breaks that are in multiple pieces with bone ends going different directions. Either way, it’s broke and the game is over. What happens next depends on the needs of the athlete and the advice of the orthopedic surgeon.

One of my favorite stories is based on the very first game that I was on the sidelines of a Maryville High School football game. Don Story was the coach and at halftime, his star lineman asked me to look at his jaw. It was really hurting.

I looked at it, decided it was broke, and told Coach Story that he shouldn’t play the second half. The player protested, admitting that he had broke it in a fight at school that day and that since he had already played the first half with a broke jaw, he should be able to continue playing.

Coach Story looked at me and asked “should he play?” Now keep in mind, Coach Story had just met me. He hadn’t worked with me. He really didn’t know that much about me. And he sure didn’t have much reason to trust me.

But he did. “Go put your clothes on—you’re out for the second half.” That was just the kind of man Don Story was and still is. One of my greatest compliments was when Coach/AD Jim Campbell told others that I was a “Don Story-kind of guy.”

The bottom line is that I was right. He had actually broken his jaw on both sides and it was absolutely unsafe for him to continue playing.

Athletic Trainers that work with all our schools don’t really have the latitude to be wrong. Yet, you can’t let every little bump and bruise end with a visit to the Emergency Room. You’ve got to know when to pull them out of the game and when to let them play.

It’s part of the basic skillset of the Athletic Trainer, but the good ones can be a little more bold in their decision making. In the heat of the game, you’ve got to make a decision in seconds.  You’ve got to know what to do without the benefit of X-Rays. And you can’t be wrong.

Now before you jump to the conclusion that I’ve never been wrong, or that my Athletic Trainer colleagues are never wrong, let me tell you that I’ve been wrong plenty of times. I allowed a basketball player with a partial ACL tear back in the game one time. And then she tore it the rest of the way through. I told a young athlete once that I didn’t think his foot was broke but it was.

That’s just the nature of the beast.  Every minute of every game, Athletic Trainers have to make decisions that might  impact the long term health of our athletes. We accept that responsibility because it’s what we do. It’s who we are.