The Crisis of Physical Health in the United States
In a country known for innovation, economic strength, and cultural influence, the physical health of its citizens tells a much different story. The United States faces a growing crisis of inactivity, chronic disease, and musculoskeletal disability that is not only impacting individual lives but also straining the healthcare system and workforce. Despite the wealth of medical advancements, our nation is sicker and more physically limited than ever before.
Leading Causes of Death in the U.S.
According to the Centers for Disease Control and Prevention (CDC), the leading causes of death in the U.S. are predominantly lifestyle-related chronic diseases. In 2022, the top five causes were:
Heart Disease (695,547 deaths)
Cancer (605,213 deaths)
Unintentional Injuries (224,935 deaths)
Chronic Lower Respiratory Diseases (152,657 deaths)
Stroke (150,005 deaths)
Many of these conditions are influenced by lifestyle factors such as diet, exercise, and overall physical activity.
The Role of Physical Inactivity in Co-Morbidities
Physical inactivity is a major contributor to these chronic diseases. The CDC reports that only 28% of Americans meet the recommended physical activity guidelines, which include at least 150 minutes of moderate-intensity exercise per week. The consequences of this sedentary lifestyle are staggering:
Obesity: Over 42% of U.S. adults are classified as obese, a key risk factor for heart disease, diabetes, and some cancers.
Diabetes: Nearly 38 million Americans have diabetes, a condition strongly linked to inactivity and poor metabolic health.
Hypertension: About 47% of U.S. adults have high blood pressure, significantly increasing their risk for heart attack and stroke.
Musculoskeletal Disability and Its Economic Impact
Beyond chronic disease, inactivity and poor physical fitness contribute to significant musculoskeletal disability. Low back pain, osteoarthritis, and other musculoskeletal disorders are among the leading causes of disability in the U.S. The Global Burden of Disease Study ranks low back pain as the top cause of years lived with disability (YLDs) worldwide. In the U.S. alone:
Over 50 million adults suffer from chronic pain, with musculoskeletal pain being a primary driver.
Workplace injuries and musculoskeletal disorders account for $50 billion in direct costs annually.
Lost productivity due to physical disability costs the U.S. economy hundreds of billions of dollars each year.
A Paradox of Modern Healthcare
What makes this crisis even more alarming is that we now have more physical therapists, gyms, medications, surgeries, and advanced imaging techniques than ever before—yet these problems continue to escalate. How can it be that with more access to fitness facilities, rehabilitation specialists, and cutting-edge medical interventions, our physical health is deteriorating?
The issue lies in how we approach health and movement. Rather than prioritizing proactive physical resilience, our culture has shifted toward reactive medical treatment—relying on pills, procedures, and passive interventions rather than consistent movement, strength training, and preventive care. The increase in healthcare resources should correlate with better health outcomes, yet our dependency on external fixes without addressing foundational physical activity only perpetuates the cycle of disease and disability.
Further compounding the problem is the biomedical approach to pain, which often reduces complex musculoskeletal conditions to isolated structural issues rather than addressing movement, strength, and resilience. Many individuals receive misguided advice that convinces them of their fragility—reinforcing the belief that they must avoid activity and rely on medications, imaging, or passive treatments to “fix” them. This not only creates dependency on ineffective long-term interventions but also diminishes self-efficacy, leading people to believe they are incapable of regaining strength and function on their own.
The Fundamental Misunderstanding of Pain
A major driver of this crisis is our fundamental misunderstanding of pain, largely shaped by the biomedical model. Many people are taught that pain equals damage, leading them to believe that discomfort or injury is a sign of irreversible harm. This belief is reinforced by over-reliance on medical imaging, despite decades of research demonstrating that abnormal findings on MRIs and X-rays are often present in people without any pain at all. Studies show that:
Over 50% of asymptomatic adults have disc degeneration or bulges on spinal MRIs.
Meniscal tears in the knee are common in people without knee pain.
Rotator cuff tears are frequently found in shoulders of pain-free individuals.
On the other hand, many people experience chronic pain despite having completely normal imaging, highlighting the complexity of pain beyond structural findings. The biomedical model fails to account for the role of the nervous system, psychological factors, and movement variability in pain perception, leading to unnecessary fear and avoidance behaviors.
The Psychological Impact of Pain Beliefs
Misconceptions about pain don’t just influence medical treatment; they directly impact how people live their lives. Research has identified several key psychological factors that contribute to prolonged disability and suffering:
Fear-Avoidance Beliefs: People who believe that movement will cause further damage tend to avoid activity, leading to deconditioning and more pain.
Pain Catastrophizing: Exaggerated negative thoughts about pain, such as believing it will never improve or that it indicates serious harm, are linked to worse outcomes and prolonged disability.
Pain Self-Efficacy: A person’s belief in their ability to manage and function despite pain is one of the strongest predictors of recovery. Low self-efficacy leads to reliance on passive treatments and avoidance of movement.
Hypervigilance: Constantly monitoring and fearing pain can heighten sensitivity to discomfort, reinforcing the experience of suffering rather than promoting adaptation.
The Lived Consequences of This Crisis
The impact of this systemic failure extends beyond statistics—it affects how people experience life itself. The fear of movement, instilled by misguided medical advice and cultural narratives around fragility, leads many to live life on the sidelines. Rather than seeing the body as adaptable and resilient, individuals come to believe they are broken, fragile, and in need of constant protection.
This mindset fosters unnecessary limitations, where people avoid activities they are fully capable of adapting to, missing out on meaningful experiences that contribute to a fulfilling life. Whether it’s playing with their children, engaging in recreational sports, hiking, or even performing basic household tasks, the fear of pain and re-injury keeps them inactive. The world, rather than being a place of opportunity and engagement, becomes a landscape of threats to be avoided.
The true cost of this crisis is not just measured in dollars spent on healthcare but in lives not fully lived—in the memories unmade, the adventures untaken, and the quiet resignation that movement, strength, and capability are things of the past.
Societal Shifts and Their Impact on Physical Health
Beyond the medical and psychological factors contributing to this crisis, broader societal changes have also played a crucial role in shaping the decline of physical well-being. Over the past several decades, the way we live, work, and eat has drastically changed, often at the expense of our health.
Beyond the medical and psychological factors contributing to this crisis, broader societal changes have also played a crucial role in shaping the decline of physical well-being. Over the past several decades, the way we live, work, and eat has drastically changed, often at the expense of our health.
Decline in Physical Labor: The modern workforce has shifted away from physically demanding jobs to more sedentary roles. Automation, mechanization, and digital workspaces have drastically reduced the amount of daily movement required for survival. Where past generations naturally incorporated strength and endurance into their work, today's workforce is largely desk-bound, reducing overall activity levels.
Technological Efficiency & Convenience: Advancements in technology have made life more efficient but also less physically demanding. Tasks that once required manual effort—like washing dishes, mowing the lawn, or even grocery shopping—can now be done with minimal exertion. The rise of rideshare services, delivery apps, and remote work has only accelerated this trend, further disconnecting people from regular movement.
Changes in Food Quality & Quantity: The modern diet has also shifted dramatically. The accessibility of ultra-processed foods, excessive sugar consumption, and high-calorie, nutrient-poor meals have contributed to widespread metabolic dysfunction. Despite increased awareness of nutrition, food marketing, busy lifestyles, and the affordability of unhealthy options continue to drive poor dietary choices, exacerbating obesity and chronic disease.
Deteriorating Mental Health: The rise of anxiety, depression, and chronic stress plays a significant role in physical health. Research has shown that mental well-being and physical activity are deeply connected. However, increasing societal pressures, social media influence, economic stressors, and a lack of community engagement have contributed to declining mental health. Anxiety and depression are often associated with reduced motivation for exercise, increased pain perception, and further disengagement from physical activity.
Social Isolation & Mental Health Decline: The rise of social media, remote work, and urban sprawl has contributed to increased social isolation. Humans are inherently social beings, and a lack of meaningful social connections is associated with increased rates of depression, anxiety, and even physical health decline. Studies show that loneliness is as detrimental to health as smoking or obesity, yet fewer people are engaging in communal activities that foster movement and resilience. The combination of sedentary lifestyles and diminished social support creates a reinforcing loop where physical inactivity and mental health struggles feed into one another.
These societal shifts, combined with the flawed medical approach to pain and movement, have created an environment where physical inactivity and chronic disease are not just common but expected.
A Shift Toward the Biopsychosocial Model of Pain
As our understanding of pain evolves, there has been a growing movement toward the biopsychosocial model, which recognizes that pain is not solely a product of structural damage but rather a complex interaction of biological, psychological, and social factors. Unlike the reductionist biomedical model, which focuses primarily on physical abnormalities, the biopsychosocial model acknowledges the profound impact of beliefs, emotions, behaviors, and social context on pain perception and recovery.
Appreciation of Psychosocial Variables
Pain is not just a signal from the body; it is a lived experience shaped by multiple factors. Fear, anxiety, social support, and past experiences all play a critical role in determining how a person perceives and responds to pain. Studies have shown that individuals with strong self-efficacy and positive coping strategies tend to recover faster, while those who experience pain catastrophizing, fear-avoidance behaviors, and social isolation are at a much higher risk of chronic pain and disability.
Expanding the Field of Affordances
A key concept in this shift is the idea of affordances, or the opportunities for movement and interaction that an individual perceives within their environment. When people believe they are fragile or incapable, their world shrinks—they see fewer opportunities to engage in meaningful physical activities, and their affordances diminish. The goal of modern rehabilitation should not be merely to “fix” isolated impairments but rather to expand a person’s affordances, enabling them to engage with the world in a more meaningful, confident, and unrestricted way.
Moving Beyond a Reductionist View of the Body
The traditional approach to pain and rehabilitation has often been overly mechanical, viewing the body as a machine that breaks down and requires repairs. This perspective has led to an excessive focus on imaging findings, passive treatments, and quick fixes rather than addressing movement capacity, adaptability, and long-term resilience. A more holistic approach acknowledges that pain is not simply a defect to be corrected but a complex experience influenced by a person’s entire life context.
Principles That Improve Affordances
To truly improve physical well-being and reduce unnecessary disability, we must emphasize foundational principles that enhance a person’s capacity to move and engage with life:
Strength: Building muscle and overall physical capacity increases resilience to stress and reduces injury risk.
Mobility: Maintaining functional ranges of motion allows for confident movement and prevents compensatory patterns that lead to discomfort.
Endurance: A well-conditioned body is more capable of sustained activity, reducing fatigue-related pain and limitations.
Confidence: Psychological resilience and self-efficacy help individuals trust their bodies and challenge perceived limitations.
Community: Social support and engagement in group activities enhance motivation, consistency, and overall well-being.
By prioritizing these principles, we can move beyond outdated paradigms of pain management and begin to restore people’s ability to live full, active, and meaningful lives.
Our Model of Rehab and Fitness: A Holistic Approach
Recognizing the flaws in traditional healthcare and fitness paradigms, our approach integrates a wide variety of services designed to emphasize movement, resilience, and empowerment. Our model includes:
Physical Therapy & Chiropractic Care: Evidence-based rehabilitation that prioritizes active recovery, movement retraining, and long-term resilience rather than reliance on passive treatments.
1:1 Personal Training: Tailored coaching to help individuals build strength, mobility, and confidence in movement through individualized programs.
Small Group Training: A balance between personalized coaching and community support, fostering accountability and skill development.
Group Classes: Structured fitness classes that encourage consistent movement, strength, and endurance within a supportive environment.
Open Gym Access: Providing members with access to high-quality equipment, allowing them to take ownership of their health and fitness journey.
A Simple Yet Effective Approach: Integrating Rehab and Fitness
A well-designed fitness program that considers an individual's history of injury and pain is the key mechanism by which we address all these principles. This is where the expertise of our physical therapists and chiropractors comes into play. Rather than forcing a one-size-fits-all approach, our model seamlessly integrates rehabilitation and fitness, ensuring that each person has an entry point that is both safe and effective. By blending clinical expertise with progressive, adaptable training programs, we create an environment where individuals can build strength, mobility, endurance, and confidence without fear of injury or setback.
This approach is simple yet incredibly effective. It acknowledges that movement is not something to fear but something to refine and enhance over time. By layering evidence-based rehab principles into training programs, we ensure that every individual, whether recovering from pain or looking to optimize performance, can progressively increase their affordances—their ability to interact with and navigate the world with freedom and resilience.
A Community That Embodies These Principles
More than just a facility, our model fosters a community that lives by these principles. Every service we provide is rooted in the philosophy of improving affordances, increasing confidence, and creating an environment where movement is seen as an opportunity rather than a threat. By reinforcing strength, mobility, endurance, confidence, and community, we help individuals break free from the limitations imposed by outdated medical models and regain control over their health and well-being.
The Urgent Need for Change
The data paints a grim reality: America has a physical well-being problem. Chronic disease, inactivity, and musculoskeletal disability are deeply intertwined, yet preventable. Our reliance on reactive medical treatment rather than proactive physical health solutions is failing us. If we do not shift our focus toward movement, strength, and resilience, we will continue to see rising healthcare costs, declining quality of life, and an overall weaker population.
The solution lies in reframing how we view health—not as something managed in a doctor’s office but as a personal, daily practice of movement and strength. Our future depends on it.
