137 comments

[ 34.5 ms ] story [ 3395 ms ] thread
This article has a bad "pop science" feel to it. The correlation between grip and survival is probably solid enough, but it's hard to avoid the nagging feeling that people who have a strong grip are probably stronger and healthier overall as well.

The article goes on to recommend grip strengthener and I strongly suspect that better skeletal-muscular health in general should be the goal.

"Strong people are harder to kill than weak people and more useful in general." --Mark Rippetoe.

Yes, real science takes a random group and has some strengthen hands and others do something else and see who has better outcome.
Which is fairly impractical over those timespans and so we mostly have to make do with observational studies and RCTs looking at proxies for the actual outcome of interest and mechanistic reasoning.
Yes I believe you are correct here. So often in medicine we want to just treat the symptoms. It's amazing how hard it is to find doctors who don't end up thinking like this. Personally I haven't been able to figure it out. They're definitely not stupid, but why do so many research papers look at the body in such a way that leads to such prescriptions? Is it because researchers lack the clinical experience to overcome this mistake?

Definitely the advice of increasing one's grip strength is poor on multiple levels. Even if increasing your grip strength leads to a higher-quality life, simply training only the forearm without addressing the entire arm and shoulder and neck all together is not going to be good for ones overall muscular (and nerves, etc) balance.

No way man, the entire medical industry is well aware about the differences between correlation and causation.

Trials to validate medicine heavily involve tactics to check for causation.

What you're reading here is just some journal that identified a correlation and the author of the popular science article can't tell the difference between that and causation.

I think it is probably fair to say that the industry is aware, but most of the practitioners that make up the industry can still be susceptible to the mistake. This is largely true of science, as well.

Note that I don't mean that many practitioners are ignorant of the idea. I mean that they could know it, and still fall to it. "Value based judgements" are still a large thing, after all.

Practitioners just regurgitate the results of said science. They use standard treatments and well-documented techniques without the need to understand the science around the development of those techniques.
I definitely agree with this. When I was a beginner weightlifter, I'd actually grip the bar too tightly. This led to bicep activation when doing bench press, so I had to learn to lighten my grip and focus on activation of my deltoids, pectoral muscle, lats, etc. Even some tricep activation helped too
I generally love Axios, but this does feel more life hacking newsletter than hard news.

But the article does talk about risk of falling too which. seems like a fair logical causation jump that stronger hands = less risk of falling injury. They don't cite that though....

I think they should have used the line from the harvard link they put "these findings highlight the importance of doing regular exercise to maintain strong muscles as you age. "

Yes. The correct take from this article is to change your lifestyle until you have strong hands if you want to live longer, but don't focus on getting strong hands specifically.
Yup. The right lifestyle leads to all sorts of beneficial side effects. I moved off grid about two years ago, and since, have become leaner and fitter than I have been in my entire life, with zero deliberate exercise. I hadn’t considered my hand strength until just now, but it just occurred to me that I’ve had no carpal tunnel symptoms in at least a year, although I still do plenty of typing and fine manual work. I also do a lot of heavy carrying and lifting and digging and all the rest. Prior to this I was a desk jockey, living off processed crap - now, barely a day passes when I don’t find myself doing some kind of manual labour out of necessity. Honestly, it feels great to live like a human is built to live. We just aren’t made for the sedentary lifestyles we typically live in developed countries, and it’s killing us - and advice like “use a hand exerciser” is the absolute epitome of treating the symptom, not the disease.
"Correlation does not imply causation."
OK, maybe there's something to being able to catch yourself when falling, or prevent the fall in the first place through grip strength. But this:

> It's not just bracing yourself. Scientists have linked stronger hands to healthier hearts.

> One study in the American Journal of Preventive Medicine found that higher grip strength was correlated to lower blood pressure, lower blood sugar and higher good cholesterol levels.

Has to just be grip strength correlating with activity level and general health, not grip strength causing any of that.

(comment deleted)
Well, it doesn't have to be that abstract. Muscles in the peripheral limbs, particularly the lower leg but also the forearm, are important in returning venous blood to the heart. In fact, the gastrocnemius (calf muscle) has been referred to as the "second heart":

https://veinatlanta.com/your-second-heart/

I wonder if grip strength could indicate nervous system health, which might have heart effects.

I'm not a doctor but I am deeply sceptical of any study involving extracting statistical insights from (very complex) humans.

That would definitely explain the large numbers of feisty old Judoka I meet around the world. Anecdotally, there seems to be a higher percentage of healthy older individuals doing Judo than the general population, but I guess the unhealthy ones wouldn't still be at it, so it self selects for that trait.

Judo practitioners might be a good population to study for this effect, if you could find the individuals that started and track them all, including the dropouts. It would have common traits of strong grip AND muscle memory of how to fall properly, which could be a confounding factor.

Also, playing golf adds 5 years to your life expectancy [1]. I kid you not. Start playing today, and you’ll live years longer. This has nothing to do with the fact that most golf players are really wealthy, and so they have access to way better healthcare, nutrition, and lifestyle than the rest of us.

Said differently, correlation does not imply causation.

[1] https://www.golfandhealth.org/news/golfers-longevity/?amp_ma...

Decided to take up golf. Now I can’t feel my leg.
They claim that was adjusted for socioeconomic status.

Rather than being a matter of better access to health care etc, I suspect a reverse causation -- people who are in poor health are less likely to go out to the golf course. The same applies to Vitamin D, taking international flights, and reading books, all of which are correlated with reduced death rates.

Thank you. They always make it sound like X helps you lenghten your life. But it's always the case the X is a symptom of a healthy life, not the cause of it.

Strong hands is probably a result of exercise and leading a healthy life which leads to higher life expectancy. Meaning exercise and leading a healthy life is the cause of strong hands and higher life expectancy.

Golf industry says golf lengthens your life. Hand grip industry says strong hands lengthen life. Can't help but be a little bit cynical the older I get.

I would imagine few people with a strong grip have everything else in their body weak.

So a strong grip might correlate with strong everything else. By the way, strong hands are controlled by strings and pulleys - it's really just strong forearm muscles.

It would be interesting if the study was for people with JUST a strong grip, like folks who were always in a chair.

I remember reading of another study where people who were pear-shaped were healthier than people who were round. Turns out that people put on weight at the waist first, and as they put on more weight, it moves to the chest and shoulders, so...

Here's a metastudy of 26 studies of the results of handgrip training on systolic blood pressure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292032/.

The results were that handgrip training for at least 4 weeks reduced blood pressure by around 5 mmHg. Which yes, could lengthen some lives.

Assuming that correlations are spurious is as poor an approach as assuming they are not.

Without understanding of a mechanism we're still talking about correlation, though. Just one backed up by a metastudy.
I saw a study like that a year or two ago. It wasn't just correlation, they did an actual clinical trial. They measured BP before intervention, had people do a specific exercise to increase hand strength, had a control group, and measured everybody afterwards.
Not knowing the cause doesn’t mean much, in terms of valid association, unless the effect deviates as people adopt the correlating behavior. If we don’t know the mechanism but it continues to produce the same result absent other unrelated factors, it’s likely in the chain or determining factors.
Isn't that a hint at a more general trick ? anything that improve blood pressure should be done a bit ?
Similarly, a diagnosis of in situ prostate cancer means you'll have less risk of dying[1] over the next ten years compared to the rest of your age and race group. Totally not because men who catch these cancers early have good health insurance, regularly see their doctor, and keep up with screening procedures, plus all the other behaviors associated with those personality types.

[1] If you look at the U.S. national statistics, net cancer survival rates top out at 100%. That's because their algorithm doesn't allow any negative values for risk. I think that's enforcing a belief on the data, so I've always calculated it differently. People diagnosed with in situ prostate cancer, in situ testicle cancer, and (IIRC) in situ melanoma all have better survival chances than their peers. Unsurprisingly, all are screenable and easily treated if caught early.

Even worse, you'll likely have spent these five years on the golf course.
They hypothesize two reasonable mechanisms for increasing health:

>Stronger hands grip tighter to prevent falls — and brace stronger when you tumble.

>Grip strength is especially important for those older adults who use canes, walkers or handrails or need assistance getting out of chairs, says David Bellar, a kinesiologist at UNC Charlotte.

Care to say anything about that?

Is there a study that looks at grip strength vs falls? As is, grip strength could be a result of exercise which obviously improves health outcomes.
Eating caviar frequently is also strongly correlated with increased personal wealth - start eating as much as you can to get rich!
The page you linked should but doesn't reference the actual study. The mortality reduction from non-golfers changed according to golf handicap not just according to playing golf.

"Golf: a game of life and death – reduced mortality in Swedish golf players" by B. Farahmand, G. Broman, U. De Faire, D. Vågerö, A. Ahlbom.

"Golfers with the lowest handicap (the most skilled players) had the lowest mortality; SMR=0.53 (95% CI: 0.41–0.67) compared with 0.68 (95% CI: 0.61–0.75) for those with the highest handicap. While we cannot conclude with certainty that all the 40% decreased mortality rates are explained by the physical activity associated with playing golf, we conclude that most likely this is part of the explanation. To put the observed mortality reduction in context, it may be noted that a 40% reduction of mortality rates corresponds to an increase in life expectancy of about 5 years." [1]

[1] https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0838...

(comment deleted)
Might be just from the social aspects of it.
Yep, you read this as being a correlation-causation fallacy. You are being nerd-sniped, and it worked. Don't let that put you off doing arm and hand exercises. I recommend kettlebells.
No, people with strong hands tend to live longer.
The correlation is probably between strong wrist muscles and general fitness, i.e. exercise or strength training, and longevity.
While the website seems very fluff, the concept of hand health can't be overstressed.

Keep care of your hands and wrists. If you feel pain or discomfort, stiffness etc figure out why and fix it. Whether it's keyboard/desk etc change. Or taking breaks and stretching.

Those suffering later stages of hand/wrist strain or wear... look into: wrist straps, wax baths, heated 'wax gloves'

I’m slightly embarrassed to admit that, in late and just post college, my wrist pain was so bad that I used to have to ice my wrists at night and take ibuprofen to be able to sleep. It didn’t occur to me at the time that I needed to do anything about it.

Eventually a colleague noticed and took me aside and gave my a clue-by-four to the head. 30 years later, pain-free and still in the industry, due in no small part to a Kinesis keyboard.

I credit the Kinesis keyboard for saving my career. I still have wrist and hand issues but nothing as bad as the years before Kinesis.
/r/hailcorporate this guys are just promoting some products backed with pseudo science BS
Bob: "You know I used to think correlation implied causation, but I took this Statistics class but know I know that's not true."

Jeff: "Wow it sounds like that class really helped you"

Bob: "Maybe!"

Credit goes to XKCD

Haha... Attending the statistics class is the most likely explanation for the mental change.
The XKCD article is a misnomer. Causation is actually verified.

   1. You measure a population about whether they know about a fact. You find most people don't know it.

   2. You introduce a statistics class to that population that teaches said fact.

   3. You measure the population after the class and you find most now people know about said fact.
That is literally proving Causation. But you'll see there's a trick in my wording. If I didn't deliberately introduce that class to a population, and I simply observed an existing population that took that class... well, then in that case I cannot prove causation.

However the character that was asked the question in the XKCD comic, deliberately introduced the statistics class on himself. This deliberate act changes the experiment. HE himself is the experimenter and he controls the parameters and thus he has the knowledge needed to verify causation.

The person who asked the question cannot verify causation, but the person the question was asked too, CAN verify it.

I get the humor behind the comic. But it is technically wrong. Causation is verified. All causative experiments are run this way.

(comment deleted)
(comment deleted)
This is probably true among free soloists (rock climbing without a rope)
Regular mountain/rock climbing is probably a great way to improve your grip strength. Of course, regular outdoor climbing (even with a rope) may not reduce your lifetime risk of death from falling.
It's an old study, but correlation doesn't prove causation. It turns out that people who have pore hand/grip strength are more likely to fall, or have a type of life that leads to higher chance of death.

This is a very complicated cause/effect to figure out, even for top-class physical therapists.

Also possible that if you have good grip strength then you have good muscular balance and innervation, vascularity, and motor neuron balance (extensor/flexor), which possibly leads to better overall health, including heart health.

Honestly, I have no idea. But that's the point. Neither do experts who spend decades in this field. It's far too complex to study through these types of lenses. This is often why clinical practice still does better than science in this field. It's complicated as hell and many traditional scientists think they can study the musculoskeletal system this way, when the top doctors learn most of their skills through clinical trial-and-error. Still in 2022.

Just to attempt to be thorough, and reiterate that honestly I don't know the answer, but good grip strength may be something comes from good overall muscular and nervous system health, not the other way around.

It interests me how far we have come in technology, but how little we know how to apply it to certain kinds of medicine.

Just as an anecdote, I have been spending thousands of hours in physical therapy, and have visited doctors all over. One thing I have learned is that many great doctors used to read tonnes of research papers early in their career, but over time gravitated more towards their clinical experience in building their tree of knowledge. From what I have heard, the science is just too vague and difficult in this field and so as tempting as it is to want to apply the scientific framework around this field (I'm talking specifically about physical therapy here, not necessarily other areas of medicine where I know far less about), it ends up being more effective to build up ones intuition off of a strong clinical practice and then to look at the science afterwards in order to calibrate and filter through those experiences.

A bit of a tangent, but something I also find to be interesting is how poor the feedback mechanisms are in a lot of medicine. Most patients don't follow their prescribed homework, and many surgeons don't even get to see the long-term outcomes of their patients' surgery. Or when they do they are measuring some variables that don't give enough of an overall view of the person's body or overall health.

Anyways, I'm done rambling for now :P. I hope we can curtail the upcoming health crisis we are going to have with our and our childrens' postures and poor body mechanics.

"Most patients don't follow their prescribed homework, and many surgeons don't even get to see the long-term outcomes of their patients' surgery."

I had some problems after sports accidents and after an odysee to different surgeons and co. and an operation, I came to the conclusion, that the lowly, but very experienced physical therapists, offered the best advice for me. Because they actually work closely with the patients in the long run and see what works. But since they are not academics, it seems their opinions are usually not very well regarded and do not move up the chain (at least here in germany, but I can imagine it is the same all around the world).

To be frank, most doctors don't perform the same exercise that they recommend to their patients themselves. Leading by example should be a thing.

I am now in care of a fit doctor who, though being over 50, is slim and obviously active. It is a huge difference from my previous doctor who was visibly overweight even though 10 years younger than me, and from the yet previous doctor who tipped the scale at at least 350 pounds. (That one died of Covid after spending 6 weeks in the ICU. Wasn't yet sixty.)

If the fit doctor recommends me something from her own experience (in her case, the Sun Salutation), I will know that it works.

" good grip strength may be something comes from good overall muscular and nervous system health"

There probably is a circular relationship. Enough physical activity leads to better cardovascular health and stronger muscles. Those lead to good grip strength, which is just the best measurable element of overall physical strength. Stronger people have more capacity for exercise and will engage in more physical activity, which leads to better health etc. One day, some equilibrium is reached, but this equilibrium is much better than in sedentary people. This equilibrium lowers your risk of heart disease, the worst of modern age killers.

Also, if you spend time outdoors (and a lot of physical activity is done outdoors in favorable climates), your immune system gets training, too. And immune system is what seems to be protecting us from cancer, the second worst of modern age killers.

>This is a very complicated cause/effect to figure out, even for top-class physical therapists.

Have you ever wondered what kind of experiment is needed to be run in order to verify causation?

I see people say "correlation does not equal causation." And they never wonder, well what exactly is causation and how can science attempt to verify it at all? One person even told me that causation is impossible to verify. He's right on a technical level. If you want to be very pedantic science cannot prove anything to be true. But pedantry aside experimental methods to "prove" causation are very real and used extensively in the medical industry. All the medicine you put in your body (including the covid vaccine) is verified to be effective from a causative standpoint.

That being said the experiment to test for whether or not hand/grip and strength causatively effects life span is quite trivial in terms of planning out what has to be done. The study could take a while but we've done other studies that have lasted longer and are far more complicated.

Simply select a random group of people and put half of them on a daily plan to increase grip strength. If the half that was put on a daily plan generally lives longer than the other half of people who weren't put on a plan you have verified causation. The key to proving causation is to have the experimenters hand controlling the causative factor rather than observing it.

This technique can (and often is) used to produce raw science directly from clinical practice. The term for this is called "clinical trials"

Not necessarily. It's possible that the group that works on increasing their grip strength will also become healthier overall in other ways. The grip strength exercises might motivate them to do other things that are good for them, body their mood, etc.
I am describing the technical way of verifying causation. This is how it's done in formal science. I'm not making this stuff up.

>The grip strength exercises might motivate them to do other things that are good for them, body their mood, etc.

Grip strength is still the causative factor here. It "causes" people to be motivated which in turn causes people to live longer. It literally supports the articles main point.

People are saying that correlation does not equal causation and that training for grip strength will not increase your lifespan.

However if the scenario you describe above is true. Then training for grip strength DOES increase your lifespan. Causation verified. The article is then completely correct. Think about it.

I get where you're coming from though. Being born has a causative association with having a longer life span than not being born. The connection is technically causative but you want to find a more direct source that is lower on the chain of causation.

Let's have a worldwide day of workout, grip hanging, slow dead lift, taichi. And enjoy 8 Billion man hours of calmer cardiovascular systems.
Guys guys, the whole article was written just to feed traffic to the website selling the hand exercise devices, including the scam powerball thing, which was a cool product when it came out, but for years has had such poor quality control that the devices always stop working after about two hours of use.
(comment deleted)
Anecdata: the older pianists and organists who I know are doing well, and it isn't because they are better at catching themselves when they fall.
what do you think is the causative factor?
For cavemen or office workers?
> Scientists have linked stronger hands to healthier hearts.

Erm, correlation is not causation, it's probably BECAUSE you have a healthy heart that you have a good grip on your hands. I can't believe it's not obvious to the author.

I had a friend who worked in assisted living centers, and saw a number of deaths related to falling. The one thing he noticed about those that fell most frequently was that they still drank alcohol. Anecdata from someone in the field, but it was a stark reminder that people who get to an infirm stage in life are still just people, with all the same vices as before.
I dunno. I can squeeze Iron Mind #3 - but I don't consider myself that healthy, it's just a habit I've had. (Oh, I can squeeze it only with my right hand, my left is 2.5, almost to 3).
It’s hard to work your hands for strength without working other significant muscle groups at the same time—like hanging from things or picking things up.

Likewise, it’s hard to work on muscular strength without also increasing your hand strength. To lift weights, your hands have to grip the weight.

So, there is a pretty strong correlation with overall health.

The one thing I’ll say is that hand strength is hard to get back if you let it fade. The muscles don’t grow very fast or very much, and you need strong tendons (which grow even more slowly) to transmit the strength to your actual fingers. So again, if you’re able to increase hand strength, you’ve probably got some other positive correlations like “works out regularly” and “cares about functional health.”

That's a strange title. Regarding falling. One of the most important things is to sit or lay down immediately when you feel bad, like nausea for example. I understand the fall can be sudden. But sometimes people have a couple of seconds to react and they look for a something nearby to hold on. But then they pass out and fall.