Is it an injury or just wear and tear?

What is Causing Symptoms?

The central part of our jobs as physios is to work out what is causing our patient’s symptoms.  We need to determine if symptoms relate to an acute injury, or are they part of an aging process (wear and tear) that has now reached a stage where activity is challenging and pain is occurring?

Don’t Scans Show what the Problem is?

Clinicians can’t rely on scans alone as they don’t tell us what is causing pain.  The whole patient picture must be considered, which includes an understanding of what is normal for age, what activities are affected and what the patient wants to return to.  If a knee MRI shows a cartilage tear, it doesn’t mean that repairing or trimming the cartilage will allow the patient to return to pain-free running.

Each day we get older, and regardless of how good we feel on the outside,  our bodies are changing underneath.  Many studies show that a high proportion of us have some form of pathology on X-ray, ultrasound, CT or MRI even though we don’t have symptoms.  Almost 50 % of us have knee meniscal tears on scans at 50 years of age with no pain or issue.  Low back disc bulges are prevalent in about 60% of us at 50 years of age.

This makes it all the trickier to determine when a patient presents to us if it is a pre-existing issue or whether it is something that they have recently done.  This is important because it can influence how we approach the injury and treat it.  Generally, our bodies have a remarkable ability to repair themselves, and many injuries will improve by themselves with time.  Sometimes, intervention is required to assist the recovery process.

You Can Improve Symptoms arising from Wear and Tear.

One of my longer-term patients has major tears in 3 of the main tendons in her shoulder.  Big tendon tears are problematic but common in the 60 plus age group.  However, with careful strength training and high motivation, my patient’s shoulder improved significantly, and she was able to function and return to dragon boat racing without needing surgery.   If we re-scanned her shoulder, the tears would still be there.  However, we can improve, participate, and function well even when our bodies show significant wear and tear on scans.

Strength Training is the Key to Keeping Aging Bodies Active

We lose 8-10 % of our strength per decade after the age of 40.

One of the best things you can do to prevent or improve symptoms that arise from the normal aging process is to participate in regular muscle-strengthening exercise sessions at least twice a week.  Even simple tasks like getting out of a chair become easier if our leg strength is maintained.  It all takes effort.  As the saying states, “Live stronger, live longer”.

Post by Physiotherapist Mark Nagel