From Broken Bodies to Active Lives: Rethinking How We Talk About Osteoarthritis
Dear Readers,
What if the way we talk about osteoarthritis is just as important as the way we treat it?
A thought-provoking 3-part editorial published in the Journal of Orthopaedic & Sports Physical Therapy asks us to reflect on exactly that. The series—“Broken Machines or Active Bodies?”—challenges some of the deeply ingrained language and assumptions surrounding osteoarthritis (OA), and shows how our words can shape a patient’s beliefs, choices, and outcomes.
The Problem: Language That Limits
We’ve all heard (and perhaps used) phrases like:
“Bone on bone” “Wear and tear” “You’ve got an old knee”
These metaphors frame joints as faulty parts on a machine. They reinforce the idea that aging equals damage, that movement is risky, and that surgery is inevitable.
The result? People stop moving. They stop believing in their ability to help themselves. That’s not a treatment plan—that’s a trap.
Alternative?? Empowerment over Fear
The authors encourage us to flip the narrative. Re-framing OA with constructive, function-focused, can-do language. Such as,
“Sore but safe” – Movement may be uncomfortable, but it’s not harmful. “Strong joints adapt to load” – Rather than breaking down, our bodies learn and change. “You’re not broken” – You’re capable, resilient, and can improve.
It’s not about sugar-coating pain. It’s about acknowledging personal challenges while fostering empowerment and restoring belief.
5 Practical Shifts You Can Make in Clinic
From the final part of the series, here are five evidence-based strategies clinicians can adopt:
Adopt a whole-person approach – Sleep, stress, social context, and beliefs all influence joint health Avoid mechanical metaphors – instead of “wear and tear,” try “joints are strong and designed to move.” Align actions with words – Our behaviour should support, not undermine, the message that “Movement is Medicine” Promote consistent messages – across all clinicians, written material, and online content. Be a coach, not a fixer – help people build skills and confidence, not dependency.
Why This Matters at HealthPlus
At HealthPlus, we see OA not as a dead end—but as a chance to change lanes. We believe in coaching, not catastrophising. In movement, not fear. In shifting the focus from pathology to possibility.
Let’s keep building a culture where language helps, not harms
With Hope,The HealthPlus Team
Reference:
Bunzli, S. et al. (2023). Broken Machines or Active Bodies? Parts 1–3. J Orthop Sports Phys Ther, 53(5–7).
Part 1: https://doi.org/10.2519/jospt.2023.11879
Part 2: https://doi.org/10.2519/jospt.2023.11880
Part 3: https://doi.org/10.2519/jospt.2023.11881
