Adam C. Young, MD
Alan C. League, MD
Albert Knuth, MD
Alejandra Rodriguez-Paez, MD
Alexander E. Michalow, MD
Alexander Gordon, MD
Alexander M. Crespo, MD
Alfonso Bello, MD
Ami Kothari, MD
Amy Jo Ptaszek, MD
Anand Vora, MD
Andrea S. Kramer, MD
Andrew J. Riff, MD
Angela R. Crowley, MD
Angelo Savino, MD
Anthony Savino, MD
Anuj S. Puppala, MD
Ari Kaz, MD
Ashraf H. Darwish, MD
Ashraf Hasan, MD
Bradley Dworsky, MD
Brian Clay, MD
Brian J. Burgess, DPM
Brian R. McCall, MD
Brian Schwartz, MD
Brian Weatherford, MD
Brooke Vanderby, MD
Bruce Summerville, MD
Bryan Waxman, MD
Bryant S. Ho, MD
Carey E. Ellis, MD
Carla Gamez, DPM
Cary R. Templin, MD
Charles L. Lettvin, MD
Charles M. Lieder, DO
Chinyoung Park, MD
Christ Pavlatos, MD
Christian Skjong, MD
Christopher C. Mahr, MD
Christopher J. Bergin, MD
Craig Cummins, MD
Craig Phillips, MD
Craig S. Williams, MD
Craig Westin, MD
Daniel M. Dean, MD
David Beigler, MD
David Guelich, MD
David H. Garelick, MD
David Hamming, MD
David Hoffman, MD
David M. Anderson, MD
David Norbeck, MD
David Raab, MD
David Schneider, DO
Djuro Petkovic, MD
Douglas Diekevers, DPM
Douglas Solway, DPM
E. Quinn Regan, MD
Eddie Jones Jr., MD
Edward J. Logue, MD
Ellis K. Nam, MD
Eric Chehab, MD
Eric L. Lee, MD
Evan A. Dougherty, MD
Garo Emerzian, DPM
Gary Shapiro, MD
Giridhar Burra, MD
Gregory Brebach, MD
Gregory J. Fahrenbach, MD
Gregory Portland, MD
Harpreet S. Basran, MD
Holly L. Brockman, MD
Inbar Kirson, MD, FACOG, Diplomate ABOM
Jacob M. Babu, MD, MHA
Jalaal Shah, DO
James M. Hill, MD
James R. Bresch, MD
Jason G. Hurbanek, MD
Jason Ghodasra, MD
Jason J. Shrouder-Henry, MD
Jeffrey Ackerman, MD
Jeffrey Goldstein, MD
Jeffrey Staron, MD
Jeffrey Visotsky, MD
Jeremy Oryhon, MD
John H. Lyon, MD
Jonathan Erulkar, MD
Jordan L. Goldstein, MD
Josephine H. Mo, MD
Juan Santiago-Palma, MD
Justin Gent, MD
Justin M. LaReau, MD
Kellie Gates, MD
Kermit Muhammad, MD
Kevin Chen, MD
Kris Alden MD, PhD
Leah R. Urbanosky, MD
Leigh-Anne Tu, MD
Leon Benson, MD
Lori Siegel, MD
Lynn Gettleman Chehab, MD, MPH, Diplomate ABOM
Marc Angerame, MD
Marc Breslow, MD
Marc R. Fajardo, MD
Marie Kirincic, MD
Mark Gonzalez, MD
Mark Gross, MD
Mark Hamming, MD
Mark Mikhael, MD
Matthew L. Jimenez, MD
Mehul H. Garala, MD
Michael C. Durkin, MD
Michael Chiu, MD, FAAOS
Michael J. Corcoran, MD
Michael O'Rourke, MD
Nathan G. Wetters, MD
Nikhil K. Chokshi, MD
Paul L. Goodman, DPM, FACFAS, FAPWCA
Peter Hoepfner, MD
Peter Thadani, MD
Phillip Ludkowski, MD
Priyesh Patel, MD
Rajeev D. Puri, MD
Rhutav Parikh, MD
Richard J. Hayek, MD
Richard Noren, MD
Richard Sherman, MD
Ritesh Shah, MD
Robert J. Thorsness, MD
Roger Chams, MD
Ronak M. Patel, MD
Ryan J. Jacobs, MD
Scott Jacobsen, DPM
Sean A. Sutphen, DO
Serafin DeLeon, MD
Shivani Batra, DO
Stanford Tack, MD
Steven C. Chudik, MD
Steven G. Bardfield, MD
Steven Gross, MD
Steven J. Fineberg, MD
Steven Jasonowicz, DPM
Steven M. Mardjetko, MD
Steven S. Louis, MD
Steven W. Miller, DPM
Surbhi Panchal, MD
T. Andrew Ehmke, DO
Taizoon Baxamusa, MD
Teresa Sosenko, MD
Theodore Fisher, MD
Thomas Gleason, MD
Timothy J. Friedrich, DPM
Todd R. Rimington, MD
Todd Simmons, MD
Tom Antkowiak, MD, MS
Tomas Nemickas, MD
Van Stamos, MD
Wayne M. Goldstein, MD
Wesley E. Choy, MD
William P. Mosenthal, MD
William Vitello, MD

Avoid Injuries by Saying ‘No’ to the ‘Milk Crate Challenge’

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.

From: Apu Gomes/AFP
via Getty Images

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:

From: TikTok’s Viral Milk Crate Challenge Causing Life-Threatening Conditions!/Clevver News/YouTube

Knee, ligament or broken hip injuries

Some patients are able to remain in a position with their legs underneath their body as seen below.

From: Worse idea milk crate challenge/New Era Babies/YouTube

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.

From: Viral milk crate challenge prompts warnings/Click on Detroit|Local 4|WDIV/YouTube

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.

From: Milk Crate Challenge Gone Terribly Wrong!/Marcus Rogers/YouTube

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.

From: The Crate challenge compilation/Wanda Brea/YouTube


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

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.

You may be interested in…