Alexander M. Crespo, MD, is IBJI’s newest orthopedic surgeon with fellowship training in orthopedic trauma. He weighs in with expert knowledge and cautionary advice regarding the viral Milk Crate Challenge.
What is the Milk Crate Challenge?
The Milk Crate Challenge is a viral craze that started, like most bad ideas, on the internet. Several milk crates are stacked in the shape of a pyramid and challengers attempt to scale up one side and down the other. The danger is created by the unsteady nature of the stacked crates, which often results in wild – and often dangerous – wipeouts. TikTok banned the challenge on August 27 due to safety concerns.
Why are people doing this?
The answer is quite simple: big wipeouts and falls are a form of slapstick humor. The videos are funny, provided you aren’t the one falling from a height and breaking an ankle, or worse, your neck. Thanks to social media platforms, these videos have spread like wildfire. As a result, the increasingly serious injuries are also beginning to pile up.
What are some of the risks/injuries involved with participating in it and what are your recommendations?
The risks are endless because of the precarious nature of stacked milk crates. As the challenger walks higher, the more unstable the boxes become, the longer and harder the fall. As the boxes fall out from underneath the person’s legs, their body is often turned upside-down and the challenger is placed in an exceedingly vulnerable and dangerous position.
Arm, wrist, and shoulder injuries
As seen here, patients oftentimes use their arms to brace for impact, leading to broken wrists, dislocated elbows, and broken arms or shoulders:
Knee, ligament or broken hip injuries
Some patients are able to remain in a position with their legs underneath their body as seen below.
However, a fall from a height in this position, with the knee fully straight, can lead to broken bones in the knee, ruptured ligaments within the knee (such as the ACL or PCL), or broken hips.
Spinal and neurologic damage
Other patients fall from a height, landing with their spines stretched over the boxes that have fallen below, as seen below. This is an extremely dangerous position that can lead to fractures of the spine and even neurologic damage. In the worst case scenario, some of this damage can lead to permanent paralysis.
Spinal cord injury and paralysis
An increasingly dangerous scenario arises when patients are thrown into an inverted position, landing directly on their head and neck, as seen below. This impact exposes the neck, or cervical spine, to compressive forces that can easily lead to severe spinal cord injury. We are all aware of the dangers of diving into a shallow pool head first; this image below is no different. An injury from this mechanism can easily leave a patient permanently paralyzed from the neck down.
Severe brain bleed
Finally, some patients rotate through the air even further and absorb the majority of the impact with the skull as seen in the final image. The force of this impact can be devastating and result in fractures of the skull and life-threatening bleeding in or around the brain. In fact, there has been at least one report of a severe brain bleed caused by this exact mechanism.
Just say ‘No’
So while the Milk Crate Challenge may seem relatively easy, and the lure of a “viral” video may be appealing, it’s important to understand that the game is really just another form of Russian Roulette. It’s not worth playing for the entertainment of others. What begins as a “funny” challenge may very easily result in a life-changing injury.
About the Author
Alexander Crespo, MD, is a fellowship-trained orthopedic trauma surgeon at Illinois Bone & Joint Institute. His primary areas of interest include fracture care and repair, including the surgical and nonsurgical treatment of broken bones, and total hip arthroplasty. Dr. Crespo treats injuries that vary in acuity and complexity, ranging from broken wrists and ankles to complex fractures of the pelvis and hip.