Scrolling through various social media platforms it is VERY common to come across the analogy that the human body is a lot like a machine, often compared to a car. One such example found it’s way into my twitter feed from a very prominent American strength coach, they stated “strength training is like putting miles on your car. You can’t roll back the odometer”.

Firstly, this is factually incorrect, and I will explain why later. Secondly, is this really the message we should be delivering as healthcare professionals?

The idea that the body is like a machine begun as early as the 1500’s when the likes of Leonardo da Vinci and Andreas Vesalius begun documenting via anatomical drawings human dissections, it did look as though bones and muscles were just fancy systems of levers, ropes and pulleys – like a machine.

The most imperative difference here being – machines wear out with use, an example of this being the tires on your car requiring you to replace them at regular intervals. Humans on the other hand are bioplastic and adaptable, we have the ability to load our tissues and recover, to get stronger, fitter and more robust.

I am sure if you haven’t personally been told that you have “wear and tear” someone close to you has. I feel most people can get along with the idea that if we load our muscles they will respond positively with increased fitness, strength and size. But for whatever reason when we start talking about joints this unhelpful idea of the body being similar to a car/machine becomes more prevalent.

But it’s most certainly NOT the case, when Holden et al., (2012) surveyed 1,276 individuals looking to gain insight into how they viewed exercise with osteoarthritis (OA) they found that people viewed exercise as something that “could wear joints”, was “Unlikely to help” and they displayed a fear of “future surgery”. See how unhelpful and damaging the “body is a machine” analogy can be?

How about the societal narrative that running is bad for your knees? Literally putting miles on your wheels. Well, Alentorn-Geli et al., (2017) thought it would be a good idea to dig into the data around this! Pooling data from 125,810 individuals they found that “the overall prevalence of hip and/or knee OA was a low 3.66% in runners, 13.3% in competitive runners and 10.23% in sedentary individuals”. Important to note that even in those competitive runners with a 13.3% OA prevalence their training was not interrupted, nor did they report pain.

Let’s finish this blog with what I feel is a better analogy, imagine you plant two trees, one you plant in a confined shed away from all the elements, the other you plant out on a windy cliff top. The tree in the sled grows frail and weak, the tree on the cliff top exposed to all the elements grows a deeper root system and a thicker trunk. We are a bioplastic organism, like the tree, not the car.

References:

Darlow, B.,Brown, M., Thompson, B., Hudson, B., Grainger, R., McKinlay, E., & Abbott,J. H. (2018). Living with osteoarthritis is a balancing act: An exploration of patients' beliefs about. BMC Rheumatology, 2, 15. doi:10.1186/s41927-018-0023-x

Lo, G. H.,Musa, S. M., Driban, J. B., Kriska, A. M., McAlindon, T. E., Souza, R. B.,Petersen, N. J., Storti, K. L., Eaton, C. B., Hochberg, M. C., Jackson, R. D.,Kwoh, C. K., Nevitt, M. C., & Suarez-Almazor, M. E. (2018). Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clinical rheumatology, 37(9), 2497–2504. https://doi.org/10.1007/s10067-018-4121-3

Holden, M.A., Nicholls, E. E., Young, J., Hay, E. M., & Foster, N. E. (2012). Role of exercise for knee pain: what do older adults in the community think?. Arthritis care & research, 64(10), 1554–1564. https://doi.org/10.1002/acr.21700

Alentorn-Geli,E., Samuelsson, K., Musahl, V., Green, C. L., Bhandari, M., & Karlsson, J.(2017). The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. The Journal of orthopaedic and sports physical therapy, 47(6), 373–390. https://doi.org/10.2519/jospt.2017.7137

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