Here is a video that a reader found quite valuable. The title apparently was "Rethinking Osteoarthritis – Is It More Than Just The Joint?"
The speaker has that kind of irrepressible, smart-sounding Ted Talk energy, paired with a collection of visuals that are meant to be accessible, not intimidating. Even when some of the terminology gets technical, the talk is fairly easy to follow.
I'd say the speaker's thinking pretty much lines up with mine (and that of Doug Kelsey, and of course Dr. Scott Dye, who are really the people who deserve the credit for first bucking conventional wisdom on this subject, or should I say, conventional pessimism).
Some key points she makes that are terrific:
(1) Let's get away from the gloomy "wear and tear" language when it comes to bad knees. We should prefer "wear and repair." We can all heal, no matter our age.
(2) Bad knees are about more than the knee. Chronic inflammation kicks off a process where pain signals being sent to the brain are intensified, and at the same time the ability of the brain to repress such signals is damped.
(3) Cartilage loves loading and can adapt. Amen! That's the "Saving My Knees" message in a nutshell.
(4) Just because your knees looks bad on an MRI/X-ray, that doesn't mean you have knee pain.
Excellent points. So why would I be reluctant to wholeheartedly endorse her message?
(1) She makes a point about "weight doesn't matter the way you think it does" that I think is kind of trivial and possibly dangerous, because I think weight does matter a lot, and a careless listener might be prone to interpreting her statements as "weight doesn't matter that much." It is certainly true that there are different kinds of weight (fat vs. muscle e.g.) and that excess bad weight brings inflammation.
(2) It worries me when people stray a bit too much down that road of "it's not just the joint," even though this is undeniably true. One problem can be that, if you think it's just the "pain signal," you can take drugs to reduce that, and you could do further damage to the joint while exercising. So I think you have to be careful not to focus too much on the pain signal and lose track of the joint, which is presumably in some state of disequilibrium.
(3) It's true that knees pockmarked with cartilage lesions can be pain free, and knees with no signs of damage can hurt. But this is another argument I would be hesitant to take too far because of correlation. If MRIs of 100 knees show multiple grade 4 lesions, and MRIs of 100 other knees look fine, I am willing to bet with high confidence there are more knee pain sufferers in the first group than the second, even if a few people in the first group have no pain and a few in the second group have a lot of pain.
I suppose I'm not quite as skeptical about the usefulness of these tests as she is.
Still, this is a really good, and watchable presentation, that was only posted on YouTube 7 months ago, so it seems fresh. Enjoy!
