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You Are Not a Machine: Wear & Tear Vs. Wear & Repair

Writer's picture: Iain HarringtonIain Harrington



The belief that our bodies are like machines that “wear away” is the primary reason why many people with osteoarthritis struggle to control this condition. You're a wonderfully complex, adaptable, biological, living, breathing being, not a factory-made machine.


This perspective matters greatly, and here's why: In my early twenties, I tore a very important structure in my knee, which required surgical removal. This event set me on a path to early-onset knee osteoarthritis.


If I were to avoid physical activity to 'protect' my knee, I'd actually be increasing my risk of developing a range of lifestyle-related diseases—35, to be precise. These conditions include diabetes, heart problems, and even depression. Unfortunately, many people with joint pain are told to stop doing the exercise they love to “protect” their joint. This is a significant factor behind the fact that 2 out of 3 people dealing with osteoarthritis also develop another chronic health issue. physical activity protect us from life-style related diseases. It's a crucial reminder of the connection between our overall well-being and staying active.


Ask yourself these questions:


Does your car repair itself after a fender bender?

Does your car grow bigger tires if you take it off road?

Does your engine become more efficient after a long road trip?


As cool as that would be, your car doesn’t do that.


But, your body can do stuff like that:


Our bones become tougher & muscles grow with resistance training.

Our hearts become more efficient with cardio exercise.

Our wounds repair.

Joints and cartilage undergo wear & repair too!


We are in a constant state of wear & repair. Hold on the this wear & repair idea.

I'll provide you with clear proof that challenges the wear and tear idea.


Researchers from Denmark looked at how exercise affects knee health in people with knee osteoarthritis. They used MRI scans and took samples to check for molecules related to osteoarthritis. Then, these folks followed an exercise program for 72 weeks. After the exercise program, they went back into the MRI machine, and more samples were taken. If the "wear and tear" theory were correct, knees would look worse on the MRI, and osteoarthritis molecules would increase after 72 weeks of exercise.


But here are the results:


Knee joint loading exercise doesn't appear to harm the cartilage in people at risk of or with knee osteoarthritis.


What we see with osteoarthritis and exercise is a positive relationship.


When gradually increased over months, exercise is very, very good for cartilage. “Even running”, you might ask?


You might think runners experience a lot of "wear and tear," but in a study from 2017, they found something surprising. People with knee osteoarthritis who ran actually had fewer symptoms than those who didn't. It turns out that exercise can actually help your body repair itself.


In fact, recreational runners have the most beautiful cartilage in their knees.


Exercising with osteoarthritis can be a challenge to start. That’s why a big portion of this program will be dedicated to finding a optimal place for you to starting using your joint again in a comfortable way.


But we can be very optimistic that the best research shows exercise will not make your osteoarthritis worse or progress faster. Load and exercise will very likely make your condition improve. It will also protect you from or help manage 35 other chronic lifestyle illnesses. We’re not just interested in your joint health. We’re interested in you and your whole health!

Your knee relies on physical activity for it's health, your whole body does.


Let's recap:


The 'wear & tear' idea is an outdated one, but is still very common.

Exercise doesn't harm or progress OA - Think “Wear & Repair”

To recover, it might be necessary to let go of "wear & tear"

Advice to move more makes absolutely no sense unless you first understand that OA is not a 'wear & tear' disease of the joint.


In future content I'll cover what we need to consider when re-engaging with exercise, how to find a starting place and how to control pain.

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SJT

I work in Campbell River and Courtenay, on the unceded traditional territories of the Laich-Kwil-Tach, Wei Wai Kum, We Wai Kai, and K'ómoks First Nations. I acknowledge and respect the histories, cultures, and contributions of all Indigenous Peoples connected to these lands.

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