In this post we discuss whether overuse or underuse is the best way to think about musculoskeletal (MSK) issues, through the lens of cardiac rehabilitation.
In the 1950s heart attacks were thought to be caused by ‘overuse’ of the heart.
If you saw somebody jogging you’d think they had a death wish.
Patients were routinely recommended bed rest for long periods to help recovery.
Now of course, we understand that in most cases, heart attacks are caused by chronic underuse.
There are parallels here with our current approach to MSK care.
Overuse or underuse?
Ask yourself, is the biggest issue in society overuse or underuse of our muscles? Look around and that’s fairly easy to answer.
Why, then, is so much of MSK care focused on reducing muscular tension rather than addressing weakness?
We’ve built entire industries around this goal—think massage, trigger point therapy, cupping, stretching, yoga, foam rolling, massage guns… the list goes on.
And yet the application of the actual solution, exercise, remains poorly understood.
Take any person off the street who is experiencing muscle pain or discomfort, apply exercise in a sensible manner, and they will feel better.
Plus they get a host of other benefits that lying on a table can’t provide.
With scarcer resources and an ageing population, this seems like a shift in perspective that needs to happen sooner rather than later.