You probably were hurt all along: what you need to know as person living in a body
What does being physically healthy mean? What does being ‘healthy’ vs. what does being ‘injured’ mean. Ever since reading Megan Pomarensky’s article “Stop worrying, and start living” I’ve been wondering why there’s a gap between what people think is normal and what actually is normal, with respect to orthopedic health. In this case, I’m referring to chronic and/or age related changes in the body, not acute, traumatic injuries.
For the last few years, I’ve been wondering why people are shocked to learn that they can have a diagnosable injury, but feel totally fine. Many of us in healthcare, sports medicine, and sports performance spaces take for granted that orthopedic injuries/conditions are prevalent. Regardless of if we’re talking about the general or athletic population, people have injuries. In fact, it’s common to have asymptomatic injuries. Weather it’s a low back injury, rotator cuff tear, meniscal tear, arthritis, or any other condition, people often are unaware that they have these conditions until symptoms or dysfunctional occur one day.
Back to the question: do people not know that musculoskeletal conditions are common? Maybe, maybe not. Multiple factors play into this. Some may not know the prevalence of typical orthopedic conditions. Some may have an elevated sense of injury resilience or think that they’re impervious to some orthopedic conditions. Some may be in denial about their body changing or aging. Some may not think that anything is ‘wrong’ with them. And so on…
I’m compelled to write about this because I want to help people understand that orthopedic conditions are common if you feel fine. Injuries suck. No one wants to be hurt or in pain. Good news: you aren’t alone if you are! In fact, most of the people around you probably have some sort of orthopedic ‘problem’ as well. Please understand that you can be technically ‘injured’ but functionally have nothing wrong with you. It’s a lot like when we were in school and somehow passed the class we were terrible at: you could have passed an exam, but did you actually learn the material?
Here are some statistics people should know:
40% of the population over age 60 have a rotator cuff tear. (reference 1)
An MRI study showed 55% - 72% of adults between age 45-60 who do not have any shoulder pain/symptoms have a labrum tear in their shoulder. (reference 2)
An MRI study showed 4% - 14% of young adults (<40) and 19% - 43% of older adults (40 +) have osteoarthritis in uninjured knees. (reference 3)
An MRI study of a professional male soccer team showed “100 percent of the soccer players had a least one chondral and meniscal lesion in both legs.” (reference 4)
An MRI study published in the New England Journal of medicine showed that 52% of subjects had a bulge at 1 level and 38% of subjects had abnormalities at multiple levels. The prevalence of bulges increased with age. (reference 5)
Understand there are many data points out there, which may contradict these figures. These figures are for general education purposes and should not be taken as an expert opinion or medical advice.
Disclaimer aside: what does this mean?
Like the cars we drive, shoes we wear, and phones you use, our bodies wear out. Even if you aren’t pushing your body to the level of elite athletes, you still have a high probability of something wearing out. We may not look like robots, but our bodies are machines. Machines have things wear out. All of our parts wear out at different times, but they all do eventually.
I don’t wish to cause people distress that their body is shambles. I simply want to educate the public. What’s important here: You can have an orthopedic problem and be totally fine. Let’s embrace that idea. We are all imperfect beings (and bodies). I’ve heard a doctor say to a patient “I don’t treat MRI reports, I treat the patient that’s in front of me.” That really resonated with me. Patients sometimes get attached to the label of their injury or condition.
Do not fall victim to this. You are a person who has an injury, but that injury isn’t you or who you are.
Sometimes, a medical professional can help you ‘fix’ the issue. That can look like surgery, physical therapy, medication, and everyone’s favorite: “activity modification.” This typically sounds like “if it hurts, don’t do it.” One fallacy we fall into is thinking that the doctor ‘fix it,’ the physical therapist can ‘fix it,’ an injection can ‘fix it,’ and so on. Yes, there are times where surgery is required and medication can help. But, we really need to remember that individuals are responsible for their own healthcare. Healthcare professionals facilitate healing, but it’s up to the patient to participate in the process, in my opinion.
If you exercise regularly, eat healthy foods, drink water, sleep an appropriate amount, manage stress, and floss & brush your teeth you’re going to be fairly healthy; we all know this. Odds are if you are consistent with those things, those injuries hiding in your body aren’t going to cause you too many problems. If they do, see a doctor, make a plan, and continue to take care of yourself.
Most importantly, have fun out there and enjoy your life.
References
1. Lawrence RL, Moutzouros V, Bey MJ. Asymptomatic Rotator Cuff Tears. JBJS Rev. 2019 Jun;7(6):e9. doi: 10.2106/JBJS.RVW.18.00149. PMID: 31246863; PMCID: PMC7026731.
2. Schwartzberg R, Reuss BL, Burkhart BG, Butterfield M, Wu JY, McLean KW. High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-Aged Patients With Asymptomatic Shoulders. Orthop J Sports Med. 2016 Jan 5;4(1):2325967115623212. doi: 10.1177/2325967115623212. PMID: 26779556; PMCID: PMC4710128.
3. Culvenor AG, Øiestad BE, Hart HF, Stefanik JJ, Guermazi A, Crossley KM. Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. Br J Sports Med. 2019 Oct;53(20):1268-1278. doi: 10.1136/bjsports-2018-099257. Epub 2018 Jun 9. PMID: 29886437; PMCID: PMC6837253.
4. Bezuglov EN, Khaitin VY, Lyubushkina AV, Lazarev AM, Gorinov AV, Sivakova EY, Rumiantseva EI, Lychagin AV. The Effect of Training Experience and Leg Dominance on the Prevalence of Asymptomatic Intraarticular Changes of the Knee Joints in Adult Professional Male Soccer Players. Sports Med Open. 2020 Apr 19;6(1):19. doi: 10.1186/s40798-020-00248-9. PMID: 32307676; PMCID: PMC7167386.
5. Jensen, Maureen C., Brant-Zawadzki, Michael N., Obuchowski, Nancy, Modic, Michael T., Malkasian, Dennis, Ross, Jeffrey S. Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain. July 14, 1994. N Engl J Med 1994; 331:69-73 DOI: 10.1056/NEJM199407143310201
