Here’s Why You Don’t Need to Shower With Soap

Photo: Getty Images

Most of us think of germs as ‘dirty’—and dangerous. But as you’ve probably heard, you’re crawling with bugs, and these microbes are crucial for digestion, skin health, and immunity. People now know to take it easy on antibiotics and eat lots of fermented foods, but our squeaky-clean lifestyle is still a big problem, says Robynne Chutkan, MD, the founder of the Digestive Center for Women in Chevy Chase, Maryland, and author of The Microbiome Solution ($16, amazon.com). 

Why? Regular contact with dirt and grime teaches your microbiome how to recognize friendly germs versus foes, Dr. Chutkan explains. She gave us some tips for swapping out our super clean lifestyle for one that’s filled with more bugs.

RELATED: 13 Best Foods for Your Gut Health

First things first, what’s wrong with soap?

There’s a role for the occasional bar of soap when we’re particularly grubby, but a mild soap made from organic ingredients, rather than anti-bacterial soaps that are often full of harsh chemicals, is definitely the way to go. By scouring ourselves in the shower every day, we are actually stripping our skin of bacteria that keep us acne- and eczema-free. Unless you’ve just finished a Mud Run, the only places that need daily soaping are your armpits and groin. The rest of your body does fine with a rinse—even after a sweaty workout.

Dirt doesn’t cause disease—but repeatedly killing off the good bacteria on our skin may actually harm our immunity. Think about that the next time you swap a little bit of dirt for some body wash.

RELATED: 9 Probiotic Foods That Aren’t Yogurt

What is one thing that most people do in terms of cleanliness that is unnecessary?

Harsh hand sanitizers! Unless you’ve been hanging out on an Ebola ward, the vast majority of microbes on your skin and hands are not virulent germs that cause serious infection; they’re harmless bacteria that won’t hurt you.

Even during cold and flu season?

Yes, you should take a bit more precaution when your co-workers are coughing and sneezing non-stop. But you still don’t need anti-bacterial soaps and cleansers; those work against bacteria, and the common cold and flu is caused by a virus. All that’s necessary during cold and flu season is regularly washing hands with all-natural soap and warm water for at least 20 seconds. This dislodges viruses and bacteria, so they wash down the drain, whereas antibacterial soaps expose you to antibiotics you don’t need in your life.

What are some other ways we can “live dirty” in our everyday lives?

Like I said before, rinse with just water in the tub or shower, and skip the antibacterial soaps and shampoos. Also, spending just one day on a farm can better your microbiome. So volunteer at a community garden, or simply sit in the grass at the park. Even little things can do a lot over time. Open a window in your house or car to let some good microbes in. Buy food from the farmer’s market that you know is grown in real soil, rather than produced in a factory. Try to keep in mind that in general, soil-derived microbes are good!

RELATED: The Gentler Way to Kill Germs

This interview has been edited and condensed.

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Infants Born to Drug-Abusing Mothers Often Readmitted to Hospital

TUESDAY, Oct. 6, 2015 (HealthDay News) — Newborns with drug withdrawal syndrome are more likely to be readmitted to the hospital than those without the condition, a new study finds.

Drug withdrawal syndrome can occur shortly after birth in babies whose mothers abuse narcotic painkillers during pregnancy. These infants are at increased risk for breathing and feeding problems, seizures and low birth weight, researchers from Vanderbilt University in Nashville explained.

Drug withdrawal syndrome among babies is becoming more of an issue in the United States due to the epidemic of prescription narcotic painkiller abuse, previous studies have reported.

In this study, the researchers reviewed information from more than 750,000 births in New York state between 2006 and 2009.

They found more than 1,600 infants with drug withdrawal syndrome. These babies were nearly 2.5 times more likely to be readmitted to the hospital within one month after birth than full-term infants born without complications, the study found.

The most common reason for readmission among infants with drug withdrawal syndrome — also called neonatal abstinence syndrome — was withdrawal. By contrast, jaundice — a condition that causes yellowing of the skin — was the most common reason preterm babies had to be readmitted to the hospital.

“The recent rise of neonatal abstinence syndrome led to efforts in many hospital systems to improve hospital care being delivered to infants with the syndrome,” said lead investigator Dr. Stephen Patrick, assistant professor of pediatrics and health policy at Vanderbilt University School of Medicine.

“Our findings suggest that these improvements need to extend beyond the initial birth hospitalization to ensure a safe discharge home,” he said in a Vanderbilt news release.

The study was published Oct. 1 in the journal Hospital Pediatrics.

More research is needed to find ways to reduce the risk of rehospitalization among infants with drug withdrawal syndrome, Patrick said.

“As state and federal policymakers work towards strategies to improve outcomes for women with substance use disorder and their infants, it will be important to ensure that families are supported during the critical transition from hospital to home to limit the risk of hospital readmission,” Patrick said.

More information

The U.S. National Library of Medicine has more about drug withdrawal syndrome in newborns.

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Hospitals Doing Better Job of Promoting Breast-feeding: CDC

By Dennis Thompson
HealthDay Reporter

TUESDAY, Oct. 6, 2015 (HealthDay News) — U.S. hospitals have made significant improvements to breast-feeding support programs in recent years, providing better help to new mothers, federal health officials reported Tuesday.

Nearly twice as many hospitals have adopted most of the Ten Steps to Successful Breastfeeding initiative, a global standard for hospital support of breast-feeding before, during and after a new mom’s hospital stay, the officials said.

The percentage of U.S. hospitals using a majority of the Ten Steps increased from about 29 percent in 2007 to 54 percent in 2013, according to the report from the U.S. Centers for Disease Control and Prevention.

But there’s still work to be done, the CDC report added. Nearly 4 million babies are born each year in the United States, but only 14 percent are born in “baby-friendly” hospitals that have successfully implemented the entire Ten Steps program.

“Every one of the Ten Steps is important to use in a hospital to give babies the best start, to help mothers start and continue to breast-feed as recommended,” CDC Director Dr. Tom Frieden said during a media briefing. “Ideally, we would like every birth hospital in this country to adopt all of the Ten Steps and become ‘baby-friendly.'”

Breast milk is loaded with antibodies and other germ-fighting factors that pass from mother to baby. Babies who are breast-fed are less likely to develop ear, respiratory, stomach and intestinal infections. They’re also at lower risk of asthma, obesity and sudden infant death syndrome, the CDC says.

The American Academy of Pediatrics recommends that babies be exclusively breast-fed for the first six months of life, and that they continue to receive breast-milk as part of their diet for at least 12 months.

However, studies have found that by six months of age, only about half of all infants are receiving any breast-milk. And only 22 percent breast-feed exclusively for the recommended first six months of life, according to background information in the CDC report.

There’s strong evidence that many mothers want to breast-feed longer, but stop due to inconvenience and lack of support. Six out of every 10 mothers who stop breast-feeding during the first year report that they stopped earlier than they would have liked, the CDC report said.

The main complaints that new mothers cite for quitting breast-feeding include pain, problems with the baby latching on appropriately, and concern that the baby isn’t getting enough milk, said report lead author Cria Perrine, an epidemiologist in the CDC’s Division of Nutrition, Physical Activity and Obesity.

“These are things can be overcome with early professional support and management, which is why that early period in the hospital and immediately after the hospital is so critical,” Perrine said.

To help mothers start and maintain breast-feeding, the World Health Organization and UNICEF started the Baby-Friendly Hospital Initiative. The Ten Steps to Successful Breastfeeding stand as the core of that initiative.

The CDC report said the policies from the Ten Steps that had been successfully implemented by a majority of U.S. hospitals in 2013 include:

• Showing new mothers how to breast-feed, including how to position their baby and how to express and store milk for later use (92 percent of hospitals).
• Providing prenatal breast-feeding education to expecting mothers (91 percent).
• Encouraging new mothers to breast-feed when their baby is hungry, instead of feeding on a set schedule (87 percent).
• Helping mothers initiate breast-feeding within one hour of birth (65 percent).
• Giving adequate training to nurses and birth assistants so they can effectively help new mothers (60 percent).

However, U.S. hospitals are falling short in other key areas, the CDC researchers found.

Only 26 percent of hospitals make sure that healthy babies are solely fed breast milk, for example. Newborns should not be fed infant formula unless it’s a medical necessity, according to the Ten Steps guidelines.

And just one-third of hospitals provide ongoing support for breast-feeding mothers after they’ve left the hospital. This support can include a follow-up visit, a phone call, or referrals to breast-feeding support groups.

The CDC researchers also found that only 45 percent of hospitals kept mothers and babies together throughout the entire hospital stay, which provides opportunities to breast-feed and helps mothers learn their baby’s feeding cues.

The CDC report also noted that mothers who breast-feed are less likely to get breast cancer, ovarian cancer, type 2 diabetes and heart disease.

And breast-feeding can save money. An estimated $2 billion in yearly medical costs for children could be saved if breast-feeding recommendations were met, according to the CDC.

The CDC report urges more American hospitals to get on board with the Ten Steps program, and to work with professionals in their area to create breast-feeding support networks for new mothers.

Perrine noted that a year ago there were no “baby-friendly” hospitals in Georgia, but since then four hospitals have gained that designation by fully implementing the Ten Steps. Those hospitals account for 10 percent of births in Georgia, she said.

“As a mom who gave birth to a baby a year and a half ago in the state of Georgia, this is very exciting to me,” she said.

More information

For more on breast-feeding, visit the U.S. Centers for Disease Control and Prevention.

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The 8 Craziest Beauty-Related Injuries I’ve Had and How to Avoid Them

Photos: Giphy

I’m a pretty clumsy person. I’m so clumsy, in fact, that saying I’m “prone to small disasters” is a wildly inaccurate understatement. I’ve been known to injure myself in pretty much every situation that there is a possibility for injury — I’ve cut myself on knives while washing dishes, I’ve tripped and fallen in heels and broken bones, and I’ve gotten a black eye and bloody lip from an ill-timed opened door. Therefore, it should come as no surprise to anyone that my inherent clumsiness coupled with my love for beauty has led to innumerable beauty-related injuries.

Despite how embarrassing these beauty-related bumps, bruises, and scratches have been, because I don’t want anyone else to suffer from the same fate as me, I’ve decided to detail my 8 most epic beauty injuries AND tell you how to best prevent them. (Though, if I’m being honest, some of these are total freak accidents. Just my luck!)

Don’t do your eye makeup in a moving car

I know you think you know where this one is going, but you’re wrong. In the winter of 2008, I was doing my eyeliner in the passenger’s side mirror while my then-boyfriend drove us to his parent’s house. This was going to be the first time I met them, and I was also planning on spending Christmas with them in the English countryside, so my eye makeup had to be especially on-point for a first impression. As I was about to perfect my subtle cat-eye, my boyfriend drove over a bump in the road. I’m very lucky I didn’t lose an eyeball, but instead I jerked my neck to the side and heard a sickening crunch. I met my boyfriend’s very conservative British parents while being unable to move my head from side to side, and I spent the entirety of Christmas Eve and Christmas in a prone position with a heating pad on my neck. Not exactly a killer first impression, though definitely a memorable one.

Exercise caution with your curling wand

I bought a curling wand before it was cool, and believe me, I love the free form-curls I can create. However, in the 7 years that I’ve been a wand devotee, I have accumulated a plethora of tiny scars across both of my hands from accidental burns. My advice? Don’t be me. Wear the glove that comes with your curling wand while you do your hair. You might feel silly, but your fingers will thank you.

Lip plumpers are your friends…until they aren’t

When I was in college, I suffered from what I like to call “Kylie Jenner Syndrome”, constantly wanting my lips to look bigger. Thankfully, in hindsight, I wasn’t rich enough to get plastic surgery at 19, but I did experiment a ton of different products intended to plump up lips. One night, I got a little aggressive with a particularly effective product that contained many irritants intended to cause the lips to intentionally swell. After my third repeated application of the lip gloss, I realized that the burning sensation in my lips was not going away after a few minutes. In a panic, I ran to the restroom to find my lips scarlet red and swollen like I’d been stung by hornets. It took ice packs and several hours for the reaction to calm down.

Throw your old nail polish away

This story is so embarrassing I’m legitimately cringing while writing it. A few years ago, I was trying to open a bottle of Essie nail polish that I’d accidentally let dry out, when I pulled so hard on the cap that the bottle slipped out of my hand, my arm flung backwards, and I accidentally punched myself in the face. Giving myself a mild black eye. (Yes, I’m serious.) The moral of the story, of course, is throw your old nail polish away, or take care to store it properly so it doesn’t dry out and become sealed shut.

Use SPF everywhere

This should be obvious, but I’ve unfortunately fallen victim to accidentally forgetting to use SPF on seemingly innocuous body parts, and suffered the consequences. After one too many sunburnt ear lobes, lips, fingers or parts, you learn to take extra precautions.

Destroy your acne, not your skin

Like everyone, I hate when I get acne. My skin is always on the temperamental side, but when I get a terrible breakout, I still panic like it’s my first one. When I was a bit younger, my immediate reaction to breakouts involved slathering my face with pretty much every single strong anti-acne product I could find — sometimes all at once. Listen to me: don’t do this. Once I ended up with an actual burn on my skin from the amount of products I was piling on. According to dermatologist Monica Halem, using too many harsh products can make your skin worse. The best solution is to work with a dermatologist to try to identify the underlying cause of your acne, and use a product that specifically works for your skin and it’s issues. Oh, and use that product in moderation.

Don’t DIY heat your eyelash curlers

Yet another “Kathleen is an idiot” story — but in high school, I read in a beauty magazine that you could make your eyelash curler more effective by heating it with your hairdryer before using it. Excited for my new uber-curly lashes, I heated my eyelash curler, held it to my lashes, and immediately yelped in extreme pain. I had neglected to check the temperature of my curler before using it, and the scalding metal burnt my eyelid and took a bunch of my eyelashes as well. Ouch.

At home waxing is harder than it seems

This list wouldn’t be complete without a hair removal story, now would it? Let’s just say it is not wise to forget you’re waxing while getting sucked into The O.C., leaving your waxing strip on until it completely cools, and then try to rip it off slowly. You will lose leg skin as well as leg hair.

This article originally appeared on MIMIchatter.com.

MIMI Chatter is an endless stream of beauty content. We bring together the must-knows and the how-tos from your favorite sites, beauty influencers, our editors, and YOU.

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Misty Copeland’s Latest Performance Will Leave You Speechless

What can we say, we will never get tired of watching Misty Copeland.

The Late Show with Stephen Colbert swapped comedy for class last night when the history-making ballerina and world-renowned cellist Yo-Yo Ma stopped by. The duo teamed up for a performance of “Courante” from Bach’s Cell Suite No. 2. 

Dancing across the stage in a bright red leotard, Copeland once again reminds us of her power, bringing to mind something she told us last time we caught up with her: “I think it’s about time that ballet is recognized within the world. It is not just a niche art form. It is athletic, it is an art and we are athletes and actors; we are all of these things.”

A documentary about Copeland’s life called A Ballerina’s Tale comes out next Wednesday, Oct. 14th.

RELATED: The Badass Ballerina Video That Will Seriously Motivate You

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General Mills Recalls 1.8 Million Boxes of Cheerios

Photo: Getty Images

Cheerios are being yanked off supermarket shelves after an incident at a California manufacturing facility may have mistakenly added wheat to the boxes labeled gluten-free.

On Monday, General Mills released an official statement announcing the voluntary recall of 1.8 million boxes of original yellow box Cheerios and Honey Nut Cheerios after wheat flour was accidentally introduced into the gluten-free oat flour system at the company’s facility in Lodi, Calif.

General Mills found out about the problem when two consumers reported illnesses after eating Cheerios, while additional complaints were shared online, General Mills spokesperson Kirstie Foster told CNNMoney. The food company confirmed that the recall is an isolated incident: The original Cheerios and Honey Nut variety out of other facilities remain FDA compliant and gluten-free, General Mills said in a separate statement on the Cheerios website.

RELATED: 14 Types of Food That Can Make You Sick

“We’ll also continue to test products and our oat flour supply extensively to ensure our products meet the gluten-free standard. We care about what you and your family eat and we are truly sorry for this mistake,” the statement said. “We will work extremely hard to earn back your trust.”

Those with wheat allergies, celiac disease, or gluten intolerance should not consume Cheerios products labeled with “LD”  (indicating that the box was produced at the Lodi facility) and the “Better If Used By” dates here:

Honey Nut Cheerios

July 12, 2016
July 13, 2016
July 14, 2016
July 15, 2016
July 16, 2016
July 17, 2016
July 18, 2016
July 20, 2016
July 21, 2016
July 22, 2016
July 23, 2016
July 24, 2016
July 25, 2016

Yellow Box Cheerios

July 14, 2016
July 15, 2016
July 16, 2016
July 17, 2016

If you bought one of the affected boxes, you can contact General Mills for a replacement or full refund at 1-800-775-8370.

RELATED: More Recalls: 14 Brands of Bread and General Mills Green Beans

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The Powerful Way Amber Rose Is Standing Up to Slut-Shaming

 

Hundreds of supporters gathered in L.A.’s Pershing Square this weekend for a SlutWalk hosted by an unlikely (at least to some) gender equality activist: model and author Amber Rose.

SlutWalks have been around since 2011, when a group of women in Toronto took to the streets in protest after a police officer told a group of female college students: “Women should avoid dressing like sluts in order not to be victimized.” (The officer later apologized.) Since then, rallies have been held globally as an outlet to express “outrage toward issues of sexual violence, gender inequality, derogatory labeling, and victim blaming.”

Rose took up the cause earlier this year, deciding to host her own event after ex-boyfriend Kanye West made disparaging comments about her to the press and after dealing with criticism online.

SlutWalks generally involve a march of people dressed in revealing clothing, holding up signs with messages like “My Clothes Are Not My Consent” and “The Way I Dress Does Not Mean Yes.” And the walkers this weekend didn’t disappoint with their signs.

RELATED: 10 Things You Never Knew About the Clitoris

The goal is to raise awareness for the need to shut down slut-shaming and victim-blaming that create a hostile environment and may even keep people from reporting sexual violence. In other words, the rallies try to remind the world that no matter what someone is wearing, they are never “asking for” anything, sexual or otherwise, nor should they be blamed for any acts of sexual violence they experience. This may seem silly if you’ve never experienced it before, but it’s important because slut-shaming can really take a toll on women’s mental health.

The walk also raised more than $55,000 through a GoFundMe account for her non-profit, The Amber Rose Foundation. According to the site, the money will “support our foundation and groups and organizations of women who have been subject to slut shaming, a lack of implication of double standards, sexual assault, and even rape.”

RELATED: 13 Reasons to Have More Sex

The L.A. SlutWalk ended up a major success, but Rose’s advocacy efforts aren’t limited to her demonstration this weekend. Over the past year, she’s been a major proponent of gender equality, especially in regards to sexuality.

At the MTV Video Music Awards this year, Rose and her best friend Blac Chyna (who’s also a model and entrepreneur) boldly wore outfits printed with common derogatory words used against women.

 

Even more recently, she starred in a Funny or Die’s sketch “Walk of No Shame” which promotes a woman’s right to be completely in charge of her own body and choices about sexuality.

 

RELATED: What ‘Bachelorette’ Kaitlyn Bristowe Has to Say About Being Slut-Shamed by the Show

The countless times she used social media as a platform to call out folks on these issues.

 

 

 

 

 

RELATED: The Most Powerful Body-Positive Celeb Selfies We’ve Ever Seen

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Less-Invasive Surgery May Not Be Best Option for Rectal Cancer

By Alan Mozes
HealthDay Reporter

TUESDAY, Oct. 6, 2015 (HealthDay News) — Minimally invasive surgery does not match standard surgery for the treatment of rectal cancer, new research indicates.

The finding is based on a pair of studies, one conducted in the United States and Canada, and the other conducted in Australia and New Zealand.

“Back in 2000, research concluded that rectal cancer can be treated with a minimally invasive laparoscopic approach that uses small holes in the abdominal wall and guided cameras, and that it gave good outcomes and provided early recovery,” explained Dr. James Fleshman, study author of the North American report. Fleshman is chairman of the department of surgery at Baylor University Medical Center in Dallas.

“But what we found is that laparoscopic surgery is not equivalent to [standard] open surgery, based on our determination as to whether or not either operation achieved adequate success,” Fleshman said. “So, that basically means that some patients may not be able to be treated safely with the laparoscopic approach.”

The findings are published in the Oct. 6 issue of the Journal of the American Medical Association.

A second, similar study, led by Andrew Stevenson from the University of Queensland in Brisbane, Australia, appears in the same issue of the journal.

Though covered by insurance, laparoscopic surgery is a slightly more expensive operation, said Fleshman.

Fleshman’s team focused on rectal cancer patients who underwent surgery at one of 35 different health centers in the United States and Canada between 2008 and 2013.

All the patients were diagnosed with advanced but curable (stage 2 or 3) rectal cancer that had not yet spread beyond the area in which it had initially developed. For such cases, surgery is the typical go-to treatment. Every year, more than 39,000 new cases of rectal cancer are diagnosed in the United States, according to the American Cancer Society.

Laparoscopic surgery was performed on 240 of the patients, while another 222 underwent standard invasive surgery.

Among the top 10 surgeons (who performed 137 of the laparoscopic procedures and 134 of the open surgeries), operational “success” was based on three very specific criteria. They were: having to do with which tumor tissue was removed, how precisely it was removed and how the removal process affected surrounding healthy tissue. Information regarding post-surgery survival and disease recurrence rates is still being gathered and analyzed.

Fleshman and colleagues determined that eight of the 10 surgeons achieved a success rate with laparoscopic surgery that was either worse or no better than the success rate they achieved with standard surgery.

That translated into an 82 percent success rate for laparoscopic procedures versus 87 percent for standard surgeries, according to the study.

Both procedures had a roughly similar risk for complications, and were comparable in terms of length of hospital stay and readmission risk. However, laparoscopic surgery required much more time under the knife than standard surgery, the findings showed.

The Australian team also compared the two procedures among 475 patients who were diagnosed with both early stage and advanced rectal cancer (stage 1 to stage 3). About half underwent laparoscopic surgery and half got standard surgery at one of 24 centers in Australia and New Zealand.

In the end, the findings almost matched the results of Fleshman’s team: 82 percent success rate among the laparoscopic group versus 89 percent for the standard group.

“Now, I’m sure there will still be some patients who would be better treated with laparoscopic surgery,” Fleshman acknowledged.

“Overall, it reduces pain, can shorten a hospital stay, improves recovery and generally gets people back to their daily activities faster than we can with open surgery. And we would all like to provide that to our patients. But we need to make sure that the successful treatment of cancer is our main priority,” Fleshman said.

Dr. Andrew Chan, an associate professor in the department of medicine at Harvard Medical School in Boston, said the findings should give surgeons pause.

“Of course, we need to await the results of longer term follow-up of these patients to determine how laparoscopic surgery compares to traditional surgery for the most important outcomes, such as cancer recurrence or survival,” Chan said.

“Until then, these data do suggest that we should be cautious about assuming that laparoscopic surgery offers a better alternative to traditional surgery for our patients,” Chan added.

More information

There’s more on rectal cancer at the U.S. National Cancer Institute.

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Hormone Replacement May Protect Women’s Kidneys, Study Suggests

TUESDAY, Oct. 6, 2015 (HealthDay News) — Hormone replacement therapy may be good for a woman’s kidneys, a preliminary study suggests.

“The risks and benefits of hormone replacement therapy in postmenopausal women are still an area of active debate, and the effect of hormone replacement therapy on the kidney has shown variable results,” said study author Dr. Andrea Kattah of the Mayo Clinic in Minnesota.

Her study compared nearly 700 older women taking hormone replacements with more than 1,500 who were not.

Rates of two indicators of kidney disease — microalbuminuria and decreased estimated glomerular filtration rate — were much lower in the women taking hormone replacements, the study found.

Microalbuminuria occurs with higher-than-normal levels of a protein called albumin in urine that could be a sign of kidney damage.

After they adjusted for known kidney and heart disease risk factors, the researchers found that hormone replacement was still strongly associated with lower rates of microalbuminuria.

But only an association and not a cause-and-effect link was seen in the study.

The study will be presented Nov. 5 at an American Society of Nephrology meeting in San Diego. Data and conclusions should be considered preliminary until the results are published in a peer-reviewed medical journal.

“Clarifying the role of hormones on kidney function may have implications for explaining gender differences in chronic kidney disease, counseling women on the use of hormone replacement therapy, and future therapeutic targets for patients with chronic kidney disease,” Kattah said in a society news release.

Because of potentially dangerous side effects, hormone replacement therapy should only be taken for as long as necessary at the lowest effective dose, doctors say. It is typically prescribed for managing symptoms of menopause.

More information

The American Academy of Family Physicians has more about hormone replacement therapy.

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Rehab May Not Help After Broken Ankle: Study

TUESDAY, Oct. 6, 2015 (HealthDay News) — After a broken ankle, many patients embark on an exercise-based rehabilitation program to help speed healing and regain mobility. But a new study out of Australia casts some doubt on whether these programs help.

The findings suggest that routine care for patients should not include “a supervised exercise program,” such as those typically provided in a physical therapy program,” wrote a team led by Anne Moseley, of the University of Sydney.

However, one U.S. expert contested the findings, noting that a third of patients initially enrolled in the trial dropped out to engage in “out of trial” physical therapy. This, “supports my view that rehabilitation is an essential component to restoration of pre-injury function,” said Dr. Neil Roth, an orthopedic surgeon at Lenox Hill Hospital in New York City.

The findings were published Oct. 6 in the Journal of the American Medical Association.

As the Australian team explained, after a broken ankle is repaired, patients typically go through a period of immobilization with a cast while the fracture heals.

In some cases, this is followed by rehabilitation that includes supervised exercise and self-management advice, but it’s been unclear whether or not this helps patients.

Moseley’s team randomly assigned 214 patients with an uncomplicated ankle fracture to either rehabilitation or advice alone after their immobilization cast was removed. Those in the advice group received a single session of information about exercise and a return to activity.

After six months, patients in both groups had achieved similar levels of activity and quality of life, the researchers reported.

“We have previously shown that recovery of activity limitation after ankle fracture is rapid in the first six months and that adding passive stretch or manual therapy to a supervised exercise program did not enhance the benefits of exercise alone,” Modesley’s group noted.

“It is possible that the lack of treatment effect we observed in this trial is attributable to the fact that rehabilitation cannot accelerate this rapid recovery,” the researchers said.

But Roth disagreed.

“While some ‘uncomplicated’ ankle fractures may have similar outcomes at 6 months after injury with or without rehabilitation, not all ankle fractures are alike,” he said. “The authors do not differentiate these types of ankle fractures, which can range from avulsion fractures — similar to an ankle sprain — or more significant non-displaced fractures.”

He said the fact that a third of patients dropped out to seek physical therapy elsewhere is also important to note.

“While lesser-demand patients with uncomplicated ankle fractures may do fine with home instruction versus supervised rehabilitation, it is my expert sports medicine opinion that physical therapy after ankle fractures — and even ankle sprain — shortens the time for patients and athletes to return to their pre-injury level of activity,” Roth said.

More information

Find out more about the care of broken or fractured ankles at the American Academy of Orthopaedic Surgeons.

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