Updated: Aug 19, 2019
St. Augustine wrote, “ Men go abroad to wonder at the heights of mountains, at the huge waves of the sea, at the long courses of the rivers, at the vast compass of the ocean, at the circular motions of the stars, and they pass by themselves without wondering”. Do you ever stop and wonder?
Step back with me a few years when one cell from your mother and one cell from your father connected to start the process of you. In just three days, you became sixteen cells. In a few months, you had billions of cells and by the time you’re an adult, you are made of 100 trillion cells! Inside of each cell is six feet of DNA (the map of who you are and what each cell will be). Each six-foot strand of DNA contains 9 billion (yes billion) characters to make up that strand of DNA. There is so much information stored in your body that you could extend each six-foot strand of DNA and place all 100 trillion of them end to end and go to the moon and back over 170,000 times! You are amazing! 100 trillion cells of awesome.
We have 206 bones, 650 muscles along with miles and miles of arteries and nerves in our body. We have 80 billion neurons in our brain that have up to 10,000 connections each. To take a step, it requires the firing of those neurons, the oxygen we breath in to be carried to the muscles and energy to fuel us to move 200 muscles that are required to move for that one step. To speak a word, it requires over 70 muscles. Every 3 seconds 50,000 cells die and every 3 seconds 50,000 cells replenish. One scientist once joked...no wonder we’re tired at the end of the day!
What then is the problem? Why, if we are so amazing, do we have pain, difficulty moving and other health issues? Is it because we’re getting older? It has been shown in the research that we lose up to 1% of our muscle mass every year after the age of 30 and even lose bone density starting in our 30’s as well. However, recent studies such as one in AGE 2013 showed the ability to increased muscle mass, strength, bone density and even cardiovascular endurance into our 90’s. Even though we are aging every second of every day, we have the potential to improve on our current condition essentially until we die.
How about arthritis? Is that the problem? It could be but consider this. Research going back to 1994 with Dr. Jensen in the NEJM and now dozens of studies since show that we change on the inside much like we change on the outside. Think about it! When is the last time you compared yourself to a picture of you at the age of 20? What is different? A few wrinkles? Maybe a gray hair or two? A sag here or there? Our insides change like our outside does. If your outside doesn’t look the same as you did at the age of 20, your insides probably won’t either. Changes on the inside to bones and cartilage are commonly called arthritis or arthritic changes. Can they hurt? Absolutely! Is arthritic or age-related change always painful? Not at all! The study by Jensen showed in those who have never had back pain that 60% will have a bulging disc, 38% will have two levels of bulging discs and 90% will have arthritic changes in their spine all without pain at the age of 40. Similar studies have shown the same with rotator cuff tears in the shoulder, meniscal tears in the knee and arthritic change at most every joint by the age of 40.
What is the cause then if we can improve our current condition into our 90’s and arthritic changes don’t always have to be painful? When it comes to musculoskeletal problems (bone, cartilage, joints, discs, muscles, nerves), we talk about the Rule of Too’s. Anything that is performed too strong, too quick, too often or too long can cause tissue injury. We typically remember something too strong or too quick as the pain or movement limitation happens right then. However, most issues arise from doing something too long or too often. The repetition of day to day activities can cause tissue injury. Sustaining a position too long can cause stiffness, soreness or even pain. Think of falling asleep on your arm with your elbow bent. The longer you stay on a bent elbow, the more ache and numbness will present. It will also be stiff when you try to straighten the arm. We recognize the need to straighten the elbow if in a position too long, but do we recognize the need when our back starts to hurt from sitting or standing too long? Do we recognize the need to go the opposite direction of the position we have been in to prevent the stiffness and ache that has occurred?
Understanding the mechanisms that cause tissue injury, understanding the warning signs that something needs a change of position or stretch, and then knowing what to do for that issue is vital to not only help immediately but also to prevent future recurrence of symptoms. Seeing a physical therapist first for musculoskeletal problems isn’t always a first thought. However, current research (Fritz et al. 2012) shows that seeing a physical therapist first within the first fourteen days of onset of pain demonstrates a reduced likelihood for the need of imaging (CT Scans, MRI’s) by 34%, injections 42%, surgery 45% and opioid medication by 78%!
Knowing what the mechanism is, educating you on what to do for the problem and then giving you strategies to self-manage so you can get relief whenever you need are core to what we as physical therapist strive to do. You are amazing, but pain and movement limitations happen and slow us down or prevent us from doing the things we love. Remember despite your age or even arthritic changes, you can improve on your current condition. Keep moving friends and when you can’t because of pain or stiffness, seek care by a physical therapist.
David Grigsby PT, MPT, Cert MDT
MidSouth Orthopaedic Rehab - A HEALTHY MIDSOUTH CATALYST