Colloquial Czech does not distinguish between a foot and a leg. The word “noha” normally refers to the whole limb from the hips down. Medical terminology differs from this and the word “noha” means only the foot, and “dolní končetina” is used for the whole limb. Professor Kos has hammered this point home throughout multiple lectures and we were suspecting that if someone were to use the term “noha” in its colloquial sense during an exam, it would be an insta-fail.
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Legs and feet are our means of movement, so they are very important. It is therefore important to look after them. Which, regarding the bones, means adequate exercise and not more than the body can handle.
What ordinary people do not usually know is that bones are not fixed structures. They are consumed from within and regrown throughout our lives. That way they can heal, but also change shape. That way they can also get injured in a rather peculiar fashion.
One of the stories Professor Kos was telling was a story of “march fractures”. Fresh army recruits, especially those from cities who were not accustomed to walking a lot, were often complaining about pains in their legs and feet bones after long marches. Initially they were deemed as pretenders becaue the x-rays looked normal, but some of them broke their legs when forced to go on. Then someone took a magnifying glass to an x-ray of the alleged pretenders legs and feet and noticed microscopic fractures developing before a clearly visible fracture occurred.
These are so-called fatigue fractures and they happen when a bone is deprived of nutrients. The bone continues to be consumed at a normal rate, but it does not manage to regrow back fast enough. Over time these tiny deficits accumulate and the bone starts to hurt and can even break.
A colleague of mine has developed just that in her foot during nordic walking strolls that were just a bit too much, too sudden and too long for her. It took a few weeks to develop and over a year to heal, with a surgery and a very long rehab being necessary.
Too much exercise is just as bad as none.
Yep. I’m bow-legged and pigeon-toed, so I end putting serious pressure on specific bones. Makes walking for long distances difficult, and I don’t even think of going for a long wander without a good walking stick.
Last week I heard a fascinating lecture about just that process at the cellular level. I learned that osteoblasts are the cells that make new bone, osteoclasts are the ones that degrade bone, and osteocytes control the activity of both to ensure there is the needed balance between degradation and consumption for adequate bone remodeling. Any factor that affects this balance will obviously lead to problems, but the final part of the lecture was about a few papers that have come out claiming that exposure to certain nutrient deficits during pregnancy may program the fetus to develop osteoporosis later in life. Interesting stuff but from what I understood the evidence for it is still not very strong, kind of just a speculation.
Many years ago I lived in the world of the organic matrix of mineralized tissues. Osteocytes were still a mystery then. An anatomist/microscopist our lab knew took amazing 3-D photos of osteoclast resorption pits. They were clear enough to quantitate the activity of a single osteoclast.
In military service, one way to prevent march fractures is to have recruits wear sneakers instead of boots for the first few weeks, It looks silly (especially with dark gray uniforms and bright blue sneakers), but it probably works.