4 ms·

to be fair, op is correct that the majority of people that get replacements fall in the sedentary demographic and don't have a history of intense physical activ

to be fair, op is correct that the majority of people that get replacements fall in the sedentary demographic and don't have a history of intense physical activity. metabolic issues and pro-inflammatory factors, not mechanical stress, are for many people the primary driver of osteoarthritis and soft tissue issues more generally.

bena 2y ago
But people who play professional sports do get joint replacement at a higher rate than even the general population. Just because there are more of the "general population" doesn't mean that the subset that are "professional athlete" isn't doing it at a higher percentage. And there are other, non-extreme, things that also wreck the body. Working in the trades: plumbers, electricians, HVAC, construction, etc. will often leave you with bad backs and bad joints. And yes, living your life at the extremes is going to have extreme effects on your body. Sedentary is the other extreme of professional athlete. But even still, as things hurt more, we will be more cautious about endangering ourselves. Or even wondering if we are capable. If I can't walk without a limp, I'm sure as hell not running from danger. That's not cortisol driving our behavior, that's our behavior driving our cortisol.
- detoured299 2y ago
  I don't think anyone disputes that high-level sport can make you more vulnerable to particular msk issues than people who have led a less physically extreme existence. Overuse is a real thing! The relationship between cumulative load and tissue health is more complicated than you acknowledge, however. High cumulative load over life can be protective. Professional marathoners frequently have better knee health than sedentary people, yes, but also age-matched recreational runners, which is not what you'd expect if extreme load was straightforwardly harmful in the way you seem to think it is. Regarding your comment on cortisol. Plausibly the relationship between cortisol and behaviour here is bi-directional, as is common with hormones. High testosterone influences me to go to the gym and my workout influences my testosterone, etc.
inglor_cz 2y ago
N == 1, but when I bought a Garmin watch and started doing 10 000 steps every day, all my lower limb joint problems disappeared in two months or so. Nowadays I don't even know which knee used to hurt worse (I am 45). Mind you, I wasn't completely sedentary before, but I guess that Garmin made me move about 40 per cent more.

bena 2y ago

But people who play professional sports do get joint replacement at a higher rate than even the general population. Just because there are more of the "general population" doesn't mean that the subset that are "professional athlete" isn't doing it at a higher percentage. And there are other, non-extreme, things that also wreck the body. Working in the trades: plumbers, electricians, HVAC, construction, etc. will often leave you with bad backs and bad joints. And yes, living your life at the extremes is going to have extreme effects on your body. Sedentary is the other extreme of professional athlete. But even still, as things hurt more, we will be more cautious about endangering ourselves. Or even wondering if we are capable. If I can't walk without a limp, I'm sure as hell not running from danger. That's not cortisol driving our behavior, that's our behavior driving our cortisol.

detoured299 2y ago
I don't think anyone disputes that high-level sport can make you more vulnerable to particular msk issues than people who have led a less physically extreme existence. Overuse is a real thing! The relationship between cumulative load and tissue health is more complicated than you acknowledge, however. High cumulative load over life can be protective. Professional marathoners frequently have better knee health than sedentary people, yes, but also age-matched recreational runners, which is not what you'd expect if extreme load was straightforwardly harmful in the way you seem to think it is. Regarding your comment on cortisol. Plausibly the relationship between cortisol and behaviour here is bi-directional, as is common with hormones. High testosterone influences me to go to the gym and my workout influences my testosterone, etc.

inglor_cz 2y ago

N == 1, but when I bought a Garmin watch and started doing 10 000 steps every day, all my lower limb joint problems disappeared in two months or so. Nowadays I don't even know which knee used to hurt worse (I am 45). Mind you, I wasn't completely sedentary before, but I guess that Garmin made me move about 40 per cent more.