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Orthopedic doctor and postural alignment specialist discuss osteoarthritis

2/20/2014

4 Comments

 
Dr. C. Thomas Vangsness Jr. has just published a book called "The New Science of Overcoming Arthritis." He is an orthopedist and chief of sports medicine at USC's Keck School of Medicine. Here's an excerpt from an interview Paula Span did with him for the New York Times:
Q. It sounds like we’re all headed for osteoarthritis, eventually.

A. Pretty much. If you’re 55 or over, you have a 75 percent chance. By 79, almost everyone has some symptoms.
That's a scary thought! Why would we all be headed for osteoarthritis? 100 years ago almost no one had osteoarthritis. What changed in the last 100 years? Did the human species de-evolve so quickly that our joints now can't handle our pampered lives? Did some genetic flaw insert itself into our DNA and quickly spread throughout the world? 

I don't think so. I believe our bodies and joints are designed perfectly and the reason why osteoarthritis is on the rise is because we are not using our bodies the way they are designed. We are not moving enough to maintain our musculoskeletal health. As our posture deteriorates so does our body's ability to function properly and this causes the wear and tear in the joints that is causing osteoarthritis. 

The interview continues as Paula Span asks:
Q. Why do you say the prevalence of arthritis will get worse before it gets better?

A. The pervasiveness of obesity is one issue — if you’re heavy, it affects your joints. Plus, we’re living longer, so we take more steps and use our joints more, and they wear out over time.
So our bodies can't handle 50 extra pounds? What about all the people a 100 years ago who worked building railroads 12 hours a day lifting hundreds of pounds daily and didn't develop arthritis? Is the body so fragile that it can't handle a couple extra pounds? 

I believe the body is designed to handle the extra weight, but the reason overweight people tend to have more arthritis can be found in why those people are overweight. In general, people are overweight because we are not moving enough to maintain an strong vibrant metabolism. Without a robust metabolism, calories are not burned and are instead stored as excess body fat. 

What about living longer? Do our body and our joints come with expiration dates? Are they only good for 50 years and then spoil? Where's the internal clock that's keeping track of the days and years? 

I've never seen an expiration date on a human body nor have found the internal clock that keeps track of how old we are and when we hit 50 or 60 years old orders the body to start shutting down all systems. I believe our bodies are designed to live well beyond a 100 years without wearing out or breaking down. Osteoarthritis is not caused by age or people in their 20's wouldn't have it and everyone in their 70's would and neither is true. 

Dr. C. Thomas Vangsness Jr. went on to say:
Every time you do a heel strike, that puts shattering force up through the bones, increasing the wear and tear. If the muscles stay strong, they decrease the force across the joint. They take up some of that pounding, sort of like shock absorbers.
"Shattering force"? 

Really? Science has proven that gravity is necessary for health and the heel strike during walking gait is essential for maintaining bone density and muscle tone. Without weight bearing activity bones and muscles weaken leading to osteoporosis, bone fractures, and balance problems.

"Increasing wear and tear"? 

With every step? That just doesn't make sense to me. There are studies that have shown that running strengthens bones, muscles, and cartilage and non-runners have more osteoarthritis than runners do. Wear and tear does not come from exercise or pounding movements, but from misaligned joints and postural imbalances. 

Paula asks Dr. Vangsness Jr.:
Q. What kind of exercise do you recommend for people with arthritis?

A. Nothing pounding. I use an exercise bike; you’re still putting weight on your joints, you get the aerobics, but it’s not like a treadmill. Less stress on your knees. Jogging isn’t as good an idea. Swimming is the best — moving your joints in a weightless environment.
Nothing pounding? Swimming is best? What happens to people in a weightiness environment? Astronauts for example? 

Astronauts quickly lose bone density, muscle tone, and functional capacity from living in a weightless environment. Gravity and its affects on the body are positive and necessary for health. People develop osteoarthritis in the knees because their posture is misaligned and their hip muscles are not doing their jobs and the spine has lost its normal curve. An exercise bike does not restore hip muscles function (but rather locks the hips in flexion) and contributes to spinal misalignments (especially excessive spinal flexion). This strengthens the very imbalances that caused the knee problems in the first place and does nothing to correct the underlying cause of the osteoarthritis. 

Swimming is often recommended as a helpful exercise for people with many injuries and pain conditions including osteoarthritis but the problem is swimming reinforces faulty movement patterns. Because of the weightless environment, deep postural muscles are not required to work and the peripheral muscles do all the work. This leads to more postural imbalances and increased wear and tear on the joints over time. 

Ms. Span asks about pharmaceuticals...
Q. How good are the drug options?

A. I tell patients they fan the smoke away from the fire, but the fire is still there. At this point, there’s nothing we have that can resurface cartilage.
What caused the cartilage damage in the first place? Is cartilage living tissue? Wouldn't you think the body would be able to repair and heal itself? 

Cartilage damage is caused by misaligned joints - a posture problem. Correcting posture is the only way to truly fix the problem. Every tissue in the human body is living and going through a process of birth-death-renewal. The problem in osteoarthitic joints is the faulty movement patterns are wearing the cartilage away faster than the body can repair it. Correcting postural imbalances takes the wear and tear component away and the body is now repairing cells faster than cells are dying and renewal happens.
Q. You’re a surgeon so, not surprisingly, you see surgery as a good option.

A. On younger patients, we can transplant cells or do whole cartilage grafts — harvest cartilage cells, grow and expand them, and replant them. We can also do partial knee replacements, and that’s been a big improvement.

In an older patient, the inclination is to do the definitive single operation, the hip or knee replacement. The risks of surgery are higher with age — blood clots, infections. So, one operation and then they’re done.
What caused the cartilage damage in the first place? If we implant cartilage cells or do partial or full joint replacements, have we fixed the problem or only treated the symptom?

Again, postural imbalances are the cause of the joint damage and without realigning the posture, not treatment, procedure, or surgery will have long term success. As a Postural Alignment Specialist, we like to say, "its the position, not the condition". 
New York Times: An Osteoarthritis Primer
4 Comments
ray mcclanahan link
3/17/2014 04:05:45 am

Great article and comparison Matt! Thank you for sharing!

Reply
Matt link
3/18/2014 07:53:54 am

Glad you liked it Ray!

Reply
Mary Kay
11/4/2019 01:11:26 am

I don't understand who is doing the commenting in dark print? Is it Matt? And are you, Matt disagreeing with the doctor answering the questions?

Reply
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    About Matt Whitehead

    I'm an Egoscue Institute certified Postural Alignment Specialist (PAS) and Advanced Exercise Therapist (AET), certified personal trainer, PatchFitness performer, FiveFingers wearer, trail runner, mountain biker, dad, music lover, environmentalist, and wanna-be slam dunk champion. I will be providing you with the latest posture exercises to help you live, play, and be pain free.

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