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Comment by oh_sigh | Hacker News Reader

> Crutches and leg braces: I saw many more people with crutches and leg braces walking around than I typically see in San Francisco. It was a striking difference, so I don't think it was just a fluke. A few hypotheses:

I too have noticed this. Does anyone have any explanation? Due to better health care? Worse health care? More of a walking culture? more interest in soccer which causes these types of injuries? Something else entirely?

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Nearly half of Londoners don't own a car and a lot of people who grew up in London don't have a driving license. It just doesn't make sense to drive in central London - it's slower than a bike or the tube, there's an £11.50 ($15) daily charge just to drive into town and parking costs a fortune.

I suspect that most Americans with an injured leg would travel by car unless they had absolutely no alternative, while a lot of Londoners see nothing wrong with hobbling about on crutches.

A minor addition to your hypothesis is that most cars in London are manual (stick shift) - even if they could find somewhere to park, pay the congestion charge, etc they might well be less able to operate the vehicle too.

Manual cars are more popular but automatics are still easy enough to find. Also if you're registered disabled you may qualify for a specially adapted Motability car.

Both good points.

I was assuming that most people are on crutches temporarily, as I've only ever known people to use them this way. I would assume this group are less likely to get a special car just for the duration or their use.

A quick google didn't give me any idea of what proportion of people use them permanently/long-term, although there are reports of complications increasing with prolonged (>1 year) use [0] so it implies they definitely are around.

[0] https://www.cege.ucl.ac.uk/arg/Lists/ARGnotes/Attachments/6/...

I live in London and travel to America 10 times a year over the last 3 years. I would agree with above.

In the USA I see more people with chronic healthcare issues that have not been treated (they just get on with it). I suspect its because of the cost of healthcare - in the UK minor issues like leg injuries dont require you to think about cost before seeking treatment. whilst in the US you would have to consider if its a good ROI based on your income.

So the cost may be enough to nudge US ppl to ignore, whilst the free element means more ppl seek intervention in the UK

Of course this is just opinion and not real data.

Maybe because driving in London is not an option (congestion charging / insane traffic / no parking), so you see more walking wounded.

After having lived in London for a few years, I noticed this everywhere too. I am no expert but I have a theory that it's a combination of: Genetics - you'll notice this when you watch people walk and have odd knee/ankle flex. Discipline - not learning how to walk properly. This sounds silly, but when you drag your feet and wear improper shoes injury is more likely. Healthcare - I have noticed that people are more likely to go to the doctor compared to the States

Among older folks it is perhaps also related to nutrition - unlike the US, we had rationing through the war and well into the 50s so many people will have grown up with a barely adequate diet.

You think English people have genetically weak legs?

I blame the Ministry of Silly Walks.

This is really quite an offensive statement, and I can't quite believe I've read this on here.

I just want to mention that what you've written is not ok.

I’d be tempted to say football and running in parks?

I would wager that joggers are less inclined to get leg injuries than non runners

Maybe the northerly location reduces sun exposure making bones weaker?

You seem to be getting downvotes, but the NHS did issue guidelines suggesting that British people increase their vitamin D intake or supplement it: https://www.nhs.uk/news/food-and-diet/the-new-guidelines-on-...

Fewer steep hills?

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