Building a Body That Walks for a Lifetime! Basic Knowledge of Orthopedic Life Course and Preventive Medicine
Introduction: The Importance of the Life Course
I would like to talk about "Orthopedics" and "Preventive Medicine for the Body." There is a concept called Shinshin-Ichinyo (the unity of mind and body). For example, if the brain is tired, the body feels tired, and conversely, if the body is tired, the mind feels exhausted. Mood disorders or depression are deeply related to physical pain, and sometimes similar medications are used for treatment. In the fields of insurance and welfare, it is often observed that "the mind and body are intimately connected." If the mind weakens, the body stops moving; if the body stops moving, the mind becomes depressed.
In this article, looking ahead at the long journey of life (the life course), I will explain the physical changes you need to know and the countermeasures to take in order to "keep walking on your own two feet for a lifetime."
1. The Basics of Preventive Medicine: "Winning Without Fighting"
First, "prevention" in medicine can be broadly divided into three categories:
Primary Prevention: Preventing disease from occurring (Health promotion, vaccinations, etc.)
Secondary Prevention: Detecting and treating disease early (Health checkups, etc.)
Tertiary Prevention: Preventing recurrence or deterioration (Rehabilitation, return to society)
You might retort, "Isn't secondary prevention already dealing with a disease?" but that is not the important point here. In Sun Tzu's The Art of War, there are phrases like "To win without fighting is best" and "First, put yourself in a position where you cannot be defeated, and then wait for an opportunity to defeat the enemy." Medicine is the same. Instead of treating an injury after it happens, the greatest victory is to build a body that doesn't get injured in the first place, or a body that doesn't suffer lasting aftereffects.
2. Life Milestones: How the Body Changes
It is said that the peak of human organs and functions is roughly around 20 years old (18–22 years old). After that, the body changes as it carves out its history. Let's organize the "turning points of the body" from a psychiatrist's perspective.
[Late 20s] All-nighters become tough There used to be an era in Japan where people asked, "Can you fight for 24 hours?" (referring to corporate workaholism), but that was just forcing the body to move in a kind of excited (manic) state. Even if the brain is motivated, physically and physiologically, forcing yourself to pull all-nighters becomes ineffective from the late 20s onwards.
[Age 35] The biggest turning point in life Age 35 is a major milestone, both medically and socially.
Historical Background: Buddha attained enlightenment at 35. In ancient Greece, it was considered the appropriate age for marriage. It is the line where one transitions from "the youth" to "the elders."
Physical Changes: Items that fall outside the standard range in blood tests begin to appear here and there. Recovery power (homeostasis) declines, and not just all-nighters, but even slight overexertion starts to affect you the next day.
Brain Changes: While "brain processing speed (specs)" begins to drop, "experience" and "patience" are acquired in return. This corresponds to Confucius's saying, "At thirty, I stood firm."
[Age 40–45] Signs of aging become visible
Age 40: Especially for men, the belly starts to stick out (Metabolic Syndrome).
Age 45: "Presbyopia" (farsightedness due to aging) begins almost as if a timer had been set. Regardless of whether you strained your eyes or not, it arrives as a physiological change.
[Age 50] Transition to the Second Life Women reach menopause, and menopausal symptoms become prominent. Male menopause also exists. Just as the warlord Oda Nobunaga danced and sang "Life is 50 years (from the play Atsumori)," this age was once considered a standard lifespan in pre-modern times. In the modern era, we have to live another 30 or 40 years from this point. If you continue to work in your 50s the same way you did when you were young, your mind and body may not keep up, risking "true clinical depression." This is the time when "skills to slack off moderately" and a "shift in work style" are necessary.
3. The Dilemma of Youthful "Recklessness" vs. "Savings"
Training your body when you are young becomes "health savings" for when you reach middle and old age. If you increase muscle and bone density, you will be more resilient to upsets caused by seasonal changes.
However, "too much recklessness" becomes a debt. The human body remembers the damage it receives. Injuries and overuse in youth become "old wounds," causing pain when forgotten or becoming the cause of osteoarthritis later in life.
That said, is it correct to "spend your youth quietly for the sake of old age"? Not necessarily. There are experiences you can only have when you are young, where you "burn your life force" to build achievements or status; otherwise, you might reach a dead end socially. "Live short and thick (intense)" or "Live thin and long"? There is no single correct answer, but it is important to know how your body will change and then choose whether or not to take the risk.
4. Why is "Orthopedic" Prevention Necessary?
Specific diseases designated by the government include lifestyle diseases like cancer and diabetes, but orthopedic diseases (locomotor disorders) are still underdeveloped in the field of preventive medicine. However, what significantly lowers QOL (Quality of Life) in old age is actually "becoming unable to move."
Locomotive syndrome, Sarcopenia (muscle loss), Frailty
These conditions often cannot be cured simply by taking medicine, and once the structure breaks, it is often irreversible (cannot return to its original state). Just as we prevent cavities by brushing our teeth, we need to take care of our "bones and muscles" from a young age.
5. Conclusion: Humans Ultimately Face "Physical/Mechanical" Problems
When using a PC, the mechanical parts are often the first to break. It may be similar for humans; the mechanical parts—the physical parts—break first, becoming the rate-limiting step (bottleneck) for ADL (Activities of Daily Living), QOL, healthy life expectancy, and disability-free life expectancy. Ultimately, it might be safe to say that what defines a human being in the end is their "physical and mechanical structure."
Heart/Blood Vessels: Deterioration of the muscle called the pump and the tubes called pipes.
Lungs: If the precise filters called alveoli break, they do not regenerate (e.g., Emphysema).
Kidneys: If the filters of the filtration device clog, it is the end.
Locomotor System: Without muscles, the commands from the brain cannot be executed.
As dementia progresses and brain function declines, one becomes unable to even issue basic movement commands like "eat" or "walk." However, even if the brain is healthy, if the "drive system" (legs and loins) breaks, a human cannot move, and from there, systemic decline accelerates instantly.
"If you can't walk, it's over." This may sound a bit extreme, but maintaining the ability to walk on your own feet is the strongest preventive medicine and the key to maintaining mental health. In the era of the 100-year life, how will you maintain this "biological machine" to use it until the very end? It is never a loss to have this perspective starting now.
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