How long is the California coastline?

How long is the California coastline? It depends on who you ask. If you were to ask the California Research Service, they would say 840 miles. If you were to ask the National Oceanic and Atmospheric Administration, they would say 3,427 miles. The disparity is not the product of error, but instead the result of each organizations method of measuring. If you measure the coastline using a mile long ruler, you’re going to get a much smaller coastline then if you were to measure using a 12 inch ruler. The smaller ruler will record more detail, thus the resultant length will be much larger. The amount of detail that is optimal will differ depending on the application.

The size of the constant (coastline distance) changes depending on the specificity of measurement. A very similar concept holds true when we are discussing complex ideas and information. A complex idea becomes less true as its description is simplified. 

How does this relate to your understanding of health? It’s simple. Medicine, health and fitness are complex topics. Healthcare and fitness practitioners spend their careers developing their knowledge and understanding of the human body. When they have to explain concepts to patients or clients, theres a need to simplify the information for the patient and/or client to understand it. When sacrificing accuracy in the interest of simplicity, it’s imperative to be aware that relevant information was left out in order to improve understanding. 

The question then becomes, what details are we willing to give up in order to make complex issues understandable? For example, If a physical therapist tells their patient that their back pain is due to their “disc being out of place”, is this harmful? The answer is likely yes. While it is a simple and easy way to give the patient a reason for their pain, it’s a grossly false statement and leads the patient to believe their back is fragile. This will negatively affect the patient’s outcomes. 

If a therapist tells a patient their back may hurt because of impaired lumbar spine neuromuscular control leading to increased compressive and possible shear forces on the facet joints which results in nociception and over time has increased central sensitization and fear avoidance behaviors, is this helpful? Probably not. It’s important to find a balance. Healthcare and fitness practitioners should educate their clients with the most accurate information that said client can understand.

Another example of the disconnect can be seen with the common health related myth that running is bad for your knees. While this idea could be true for a particular subset of patients, it is not true for the general population. The correct answer requires context and detail. Those who perpetuate this myth have chosen to sacrifice accuracy in the interest of simplicity. While this isn’t inherently harmful, it becomes harmful when the idea becomes “common knowledge” and the false idea is widely accepted. 

When complex topics are simplified, they become less true. Truth requires accuracy, and accuracy requires detail. While there is utility in making complex issues digestible for a layperson, it is important to remain aware of the simplifications.