Saturday, January 27, 2018

Osteoarthritis, and a Post-Industrial Era Mystery

The latest issue of Harvard Magazine looks at a curious mystery.

Two biology researchers from Harvard University discovered the mystery after visiting medical institutes across the country and examining skeletons over the centuries.

They were searching for evidence of knee osteoarthritis (bone-on-bone rubbing in places where the cartilage has completely eroded, which leads to polished bone surfaces that are a telltale sign of the disease).

When they compared the skeletons from the prehistoric and industrial eras to those from the postindustrial, they found that the prevalence of knee OA has more than doubled since World War II.

You might think: Sure, of course it’s higher. People live longer. More people today are obese.

But controlling for age and body mass index didn’t make the difference go away. To be sure, obesity contributes hugely to knee OA. But it wasn’t causing the spike in cases.

The researchers still aren’t sure what’s going on, but they’re testing a hypothesis that I think will yield their answer.

Physical inactivity, they speculate, may be what’s to blame. The mid-twentieth-century shift to service-sector jobs put more people in workplaces where they got less movement. The modern desk rat was born.

We sit, and sit, and sit, and sit, and then wonder one day why our knees hurt.

Because our knees weren’t designed to do nothing at all for long stretches?

Or, as the article says, in more prolix language: there’s a “suspicion that OA is a case of human physiology being partly maladaptive to modern environments.”

Healthy, joint-nourishing motion IS important.

This, I believe, is the key to preventing knee pain, or once you have it, recovering your pain-free knees once again.

8 comments:

  1. Before I read as far as 'desk rats' I was thinking 'sitting at a desk most of the day'. I'm sure that played a big role in my demise. On the plus side, I've cut back to 4 days/week at a desk job now, hoping to cut back to 3 days within the next 5yrs.

    BTW, I'm now a 'real cyclist'. Been cycling for over 30yrs without a major prang, but getting into MTBing has fixed that. A few weeks ago crashed the MTB and broke a collarbone (now plated) and cracked a few ribs. Knees are good - back on the windtrainer within 6 days of surgery doing some intense 25min interval sessions. Bit spooked about getting back on the MTB single track though. I've crashed a lot on that track. Helmets are compulsory cycling in Oz, which has definitely saved my life more than once on the MTB track.

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  2. Ach, sorry to hear that. I've done the cracked rib thing before, but luckily haven't broken my collarbone yet. Glad to hear the knees are good! I know it's been a long journey for you.

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  3. TriAgain, I am so sorry to hear about your accident! Not what you needed after all your hard work rehabilitating your knees - I am glad they weren't affected!

    To the surge of inactivity in the modern lifestyle, I would add diets high in processed foods as a potential contributing factor in OA. People's bodies can't be expected to maintain and repair themselves if they are not getting adequate amounts of the vitamins, minerals, proteins etc. that they need from real, unprocessed foods.

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  4. TriAgain, have you written the full version of your knee history and rehab somewhere here? I have been reading these pages lately and it's wonderful to hear somebody' s knees are well and to read success stories. I myself have suffered bilateral PFPS for 1.5 years now after minor knee trauma for right knee and have tried about everything. T. Päivi (38 yrs)

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    1. Hi there mate
      I've not written a full history here, but have done a long boring story on a triathlon forum here - http://forums.transitions.org.au/topic/68825-stay-that-knife-surgeon-knee-pain/

      I should add, I'm not 100% cured - my knees are a lot better, but I can't do what I used to do, but they are much easier to live with now. I think the reason I never got a full cure like Richard is that I never fully backed off for long enough. The pain now however is more like Chondromalacia pain than the awaful full-blown PFPS burning. I've also recently discovered taking low-dose aspirin daily helps a lot.

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    2. TriAgain, would you object if I grabbed this account from the message board, edited it down, provided a link, then ran it as a success story here? I know a lot of people see your name here and bits of your story, so they'd probably be quite interested. Anyway, your call -- people do like the success stories!

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    3. Yes Richard, that is fine, though I don't see myself as much as a success story as yourself. Even so, I'm much better than I was at my worst 5yrs ago, and while I don't compete in Tris at present, I do a lot more than I could previously.

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  5. TriAgain thank You for sharing that link-interesting to read and giving me hope. I think that all knees are differential, and so are recoveries. I do not even wish to return to my time and knees consuming half-athlete volleyball hobby, but I hope to be able to walk and cycle a lot and run some. I think it is realistic. My dream is to hike with my kids (I am a mother of four year old twins). Reading these stories has confirmed me I am on the right track, just need to be patient. Thank you!

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