Alright, welcome back for the second part of this investigation.
Disclaimers:
-No, I’m not a doctor.
-Yes, I’m going to spoil the movie. Duh.
-Yes, I did research. I will source them.
-No, it’s not going to get dark and depressing.
-Yes, it will be long, buckle up.
-Yes, I’m going to go well in detail.
-Yes, I will share some personal insight as I do suffer from chronic pain myself, my family too, and I’m familiar with manual labor.
-Yes, I have preventively excluded anything that didn’t look pertinent enough in order to save us some time.
So, second part, let’s get a precise diagnosis, shall we?
From my research, a large variety of things can cause you to have bad knees. Many factors can put you more at risk… And sadly, I fear Luigi checks a few of them.
Manual workers and athletes are more likely to be at risk of injuries and conditions provoking chronic pain. They do repetitive movements and put strains on their body. Unfortunately, Luigi is both.
Plumbers often have to work in uncomfortable and awkward postures, since they often work in narrow spaces. It’s common for plumbers to have to be on their knees, as well as to have to do heavy lifting. All those things can injure someone over time. In addition, they might have to work at a height, I am not the one who will teach you that falling from a high place can hurt…
I was surprised, but a plumber's work is not that easy and requires extensive safety training. They’re exposed to a myriad of hazardous substances, and their workplace is often unsanitary, therefore they need to have those vaccines up to date.
Now, the Mario brothers haven’t been plumbers for a long time yet. In the movie, they are just starting their activities. So, Luigi’s job is probably not the cause of his condition, but, he still needs to be careful about it.
But hold up, the brothers were wreckers before that, was it safer? Absolutely. Not.
The work of a wrecker is incredibly dangerous, the list is long: exposure to hazardous substances, fumes, dust; noisy environment; fire, falls (of self, but of debris too), electrical hazards; vibration produced by heavy machinery, said heavy machinery being dangerous in and of itself, heavy lifting… I’m gonna stop there, you get the picture.
Personal insight: I worked in the wood and metal industry, and our machines are laughable compared to a jackhammer. Yet I knew full well that I needed to be very focused while operating them. A lathe is no joke. Yet, as you get used to those machines, you lose your vigilance. After all, you work with them every day, they stop looking scary and dangerous quickly… and that’s when accidents happen. Plus a machine can always malfunction, depending on whether or not it's being well maintained.
Papa Mario is right about being worried for his kids' future, but switching jobs was a good move for their safety.
But that’s not all my friends… Both brothers are into sports… Without even referring to the games, we can confirm this with the movie. @pianokantzart analyzed the brother’s room and it shows two baseball bats and a tennis racket. Granted, the racket is red, but with the bond the brothers have, I don’t think Mario plays alone…
Both of those sports are strenuous for the body, especially tennis. Injuries are fairly common.
From stress fracture, tendinitis, and osteoarthritis of the knee, to sprain and strain, passing by ligament injuries and torn meniscus. Baseball seems safer for your knees, yet it’s possible to get overuse-related injuries due to the squatting posture of the catcher.
So to summarize, we have a few possibilities: arthritis, overuse of the joint, and injuries. Relax, it’s not as bad as it sounds, I promise. But let's break it down.
First, arthritis:
Essentially, everyone has it or will likely experience it at some point in their life, but not to the same extent. Two types of arthritis are interesting for us in this case: osteoarthritis and rheumatoid. To better follow my explications on the topic, here is a diagram of what a knee looks like inside.
Osteoarthritis means that the cartilage of the bones is breaking down. Which, in a knee, represents the articular cartilage on the diagram. It acts as a protective cushion that protects the joint from the bone’s friction during movements. The only problem is that this cushion wears down with age and use.
Most people will develop this form of arthritis as they grow old. Yet it can be influenced by someone’s activities, someone’s body weight, gender assigned at birth, and if they smoke. Arthritis has multiple states of severity and is a degenerative condition. Meaning it only worsens and doesn’t heal. Despite, it can be manageable, it is possible to slow down its progression and find solutions to its symptoms. With the absence of cartilage to protect the bones from scraping at each other, they can get damaged and misshapen. In its less severe form, it only creates pain, a bit of stiffness, and inflammation.
In the worse stages, it can create painful deformities and it can lock someone’s joints in place, bones potentially fusing together. Don’t worry tho, that’s the worst-case scenario (it's not the case for Luigi).
The pain and stiffness caused by it mostly come and go depending on the weather, someone’s activities, someone’s overall health and stress level.
Rheumatoid arthritis on the other hand is autoimmune. It’s the same as Osteoarthritis, but it's due to genetics. Autoimmune means that the body is attacking itself and causing damage. It can start early in your life.
Ok, now that we see what it is, does Luigi have that? Maybe…
Arthritis is consistent with his struggles: knee pain, check; stiffness, check (since Luigi is cautious in his moves). He also checks some risk factors since his activities are strenuous on his knee. But, we can’t tell by what we see in the movie if he’s experiencing inflammation, and we do not hear his knees “clicking” either. Joint becoming noisy is commonplace for people with arthritis.
I think we can safely exclude the Rheumatoid kind of arthritis with two arguments:
It doesn’t look like Luigi's condition is genetic. Luigi is the only one in his family we see exhibiting symptoms (based on what we see. Maybe Papa Mario and his brother could be affected but we just don’t have evidence suggesting so). Plus Mario doesn’t seem affected either. Thus the likelihood of his condition being genetic and only Luigi being affected by it is rather low.
Luigi only suffers in his knees, and rheumatoid arthritis typically affects multiple joints. Osteoarthritis can be specifically observed in one joint and not the others, being the result of an injury.
But what about EDS?
As explained by @griffinsystem, Luigi could have EDS, I encourage you to read the posts I’m referencing here.
EDS is, roughly simplified, a genetic disorder that affects the collagen and connective tissues in your body. It’s characterized by hyper-mobility in joints, resulting in injuries (there is a reason why your joints have a range of motion and why you shouldn’t exceed it). It also causes people to get stretchier and more fragile skin (resulting in injury, and heavy scarring). I like this diagnosis, but we have some issues with it:
From what we see, there’s no sign of other family members having it too. Just like for Rheumatoid arthritis, I don’t have enough evidence to validate this component.
Luigi doesn’t exhibit hypermobility or fragile skin. I mean, not more than any other character in the movie.
And again he wouldn’t be affected only in his knees.
The lack of evidence doesn’t mean it’s not possible. It’s simply not where my investigation is leading me. But let's not throw it out the window because EDS is a risk factor for Arthritis.
I think we need to dig deeper into the other possible causes for Luigi’s pain before concluding…
Second, overuse of the joints:
If you do too much sport or physical activities, too often, too quickly, without enough rest, if you push yourself, you will be prone to get hurt. Putting too much strain on your joints, and doing repetitive movements for long periods will wear your cartilage down quicker than it would… We already addressed that.
Furthermore, you can get a stress fracture. Generally, it’s not a broken bone per se, it’s more like a crack in the bone. It sustained too much pressure and it got damaged. Stress and exhaustion increase your likelihood to sustain one (as I learned myself…). Manual labor and sports multiply your risk of getting one, ie: if you push yourself too much during training/train too often and don’t allow your body to rest.
Although it shouldn’t be too much trouble, if you listen to your body and let it heal (and that can be a long road), you should be fine, although the area will forever stay weakened. Usually in the knees, that means you shouldn't run or walk very long distances, or jump much, or else it might reopen the fracture. Now it is a case a by case type of thing, some people can be fine, but others might need to pay more attention.
This could be a potential diagnosis for Luigi, it could explain his overall “weaker” physical abilities compared to his brother, as well as the cautions he takes when he does follow him. He might need to be more cautious to protect his body. But a stress fracture should not result in chronic pain if healed correctly.
Uh, side note: I don’t mean that disabled people and those who experience chronic pain are weaker physically. I mean that those conditions have consequences for someone.
Third, injuries:
Those injuries are not fun and I’m not going to describe them graphically. Earlier I mentioned how high-impact sports were more risky for your knee. That’s because the shocks mean your joints have to sustain strong, sudden force against them. Over and over and over… So running and jumping… hum…Mario should watch out, just saying.
A sprain is an injury to the ligament. A strain is an injury to a tendon/ muscle (the more you know). Although the implications of a sprain are about the same as a strain… It’s painful, creates swelling, and creates difficulties to walk. Depending on how the injury occurred, it can result in torn cartilage too.
Tearing a ligament, or a tendon inside your knee is quite prevailing in tennis. It’s caused by a shock, a fall, or a sudden change in direction. Those are the injury that makes your knee go “pop”, it's generally the ACL (anterior cruciate ligament on the diagram). It’s painful and it requires a lot of rest, with ice, and physical therapy. It can call for a brace during activities to protect the weakened joint. But in the worst case, surgery can be necessary to repair the torn ligament.
A fracture of the kneecap or a dislocation can happen when you mix weight bearing with twisting. You either need a cast or surgery, or both. Surgery might mean putting stuff back together but also having metal plates or screws or pins installed. If you need a cast, you’re going to have fun spending a few weeks of your life unable to bend your knee at all, from what I heard it's not comfortable. Those often result in stiffness and chronic pain after it’s healed, as well as muscle weakness for a while.
Little personal insight: One of my friends had a dislocated knee in her teen years. She’s fine now, she had surgery and has now metal screws in her knee. It hurts when she takes long walks, she is a bit slower with that leg, and she sometimes gets stuck in position. It doesn’t bother her too much tho.
Despite this diagnosis sounding fairly plausible for Luigi, we do not get a good look at Luigi’s knees during the movie. Therefore we can’t know if he had surgery or any type of scars around his knees. We have no evidence of that. And that’s for the best, let's assume that since we do not see it, it does not exist. In the same category: we don’t see Luigi using any type of brace or splint, during the movie, except taking support for his knees, being careful and preventive.
Conclusion:
Overall, we have multiple possible diagnoses, but with the pieces of evidence we have and what we see in the movie, we shall not assume the worse. Although, individuals who experience chronic pain don’t generally have the same pain scale as everyone. Luigi could be in a lot of pain and it wouldn’t be visible, because he is used to it. Someone 8/10 can be the 5/10 of someone with chronic pain. He also reminded me that not all disabilities are visible and that being disabled doesn’t mean being weak.
Based on the pieces of evidence we have, I think our most reasonable diagnosis of Luigi's condition would be that he suffers from the consequences of a knee injury. Maybe a fall or a wrong move during either sport or work?
With this amount of risks involved, and Luigi being clumsy, it’s possible he got hurt while working as a wrecker.
We could extrapolate that Spike’s insult against Luigi when they meet at the dinner would be a hint towards this hypothesis.
When a working place accident happens, you need to report it. It's a hassle and has many legal implications. This can look very bad for a boss, especially if the workplace wasn’t safe to begin with. And from what I have seen during my time in manual labor… All the safety precautions are rarely respected. To be fair, once you are accustomed to your work and confident in what you are doing, those precautions can be bothering, make you lose time, and get in your way… So both parties can be at fault.
I wouldn’t be surprised if Mario and Luigi caused Spike some legal trouble…
Anyway. To give a more precise diagnosis: I’m rooting for either overuse of his joint, resulting in a beginning of osteoarthritis; or a ligament injury, like a sprain that would have left some consequences.
Alright, we got a diagnosis, but what does it mean? What are the implications for Luigi? Is he disabled?
I would like to address first that chronic pain doesn’t always mean disability. This comes from an exchange I’ve had with @griffinsystem, Tim pointed out I showed misconceptions about disability in my part One and he is right.
Some chronic pain is considered a disability because of its impact on the individual’s ability to perform daily activities. It depends on the pain severity, its duration, and the limitations it imposes.
As a consequence, Luigi's chronic pain can be managed, with or without medication. He probably requires to rest more, to not push himself. It can very well make him less agile and strong than his brother because he would need to be more prudent with his body to not injure it anymore. Maybe, Luigi could still be in recovery. Also, Luigi could have better days than others, experiencing more or less pain. We could guess (and hope) that the scene where the brothers run to get to their first job is an example of a bad day for Luigi since it’s the only moment he complains about it during the film.
At the end of the movie, he jumps on platforms with Mario, and although he still behaves with apparent vigilance, more than his brother at least, he doesn’t seem to be in pain. See how he goes for easier jumps than Mario?
Bonus theory: the mushroom kingdom could be life-changing for him and his condition.
Injuries in the mushroom kingdom are almost inexistent. I mean, look at all the brothers do during the movie, and the only consequence is a pack of ice used approximatively 10min by Mario after a fight with a freaking monkey. DK is hella strong and beat Mario up, yet Mario is fine. In the real world, all of his bones would have been crushed, DK would have obliterated the man. Heck, he'd be gone! And Luigi would have been badly burnt with all of that lava and heat exposure. But they are fine. In fact, the only time the brothers get injured is in Brooklyn.
So with that, we could hope that the mushroom kingdom would have a positive influence on Luigi’s health. Maybe even be capable of healing him.
So, there you have it, my two cents on Luigi’s knees.
Thank you a lot for reading, I hope it wasn’t too long or too boring, especially with the medical breaks down I did.
Thank you for all the positive reactions I got with part one, it means a lot to me.
Here are my sources:
Images and gifs: 1 | 2
Medical sources: Knee pain, 2 , chronic pain vs disablitiy, ligament injuries, stress fracture, kneecap fracture, dislocation of the knee; EDS, EDS 2; arthritis, arthritis 2, rheumatoid arthritis,
Risk factors: Tenis injuries, baseball injuries, plumber working hazard, wreacker working hazard 1 and 2.
@pianokantzart's breakdown of the brother's room.
@griffinsystem's posts 1 and 2; Our exchange on disability.
So I was a fan of Paper Mario from the beginning. I loved Mario RPG so much as a kid, so that when they came out with a new RPG-style Mario game on the N64 I jumped right to that, and then TTYD after that. Super Paper Mario was a game I'd been looking forward to for over a year by the time my household got a Wii, and that was the first game we got for it. I was obsessed with the story and played the game as often as I could between classes because I just had to see how it ended.
When I finally beat it I felt... sad. I didn't like the ending. I cried. But also I was so bummed out by it that I didn't stay to the end of the credits so I didn't see the final scene of Blumiere and Timpani standing together on the hill, so it felt like they just died or something and feeling otherwise was wishful thinking. But even after I saw that, I didn't feel satisfied. I get that it was thematically appropriate, and I could appreciate that, but a story I'd loved so much left me feeling so hollow. (I actually love the canon ending now and it doesn't make me feel bad, so the fanfic accomplished its original goal.)
So I did what anyone unsatisfied with canon material would do: I turned to fanfiction. The one that left the biggest impact on me was LazloTitan's "Odium and Love." I actually don't remember anything about it at this point, but at the time I loved it. And I thought about what I would do if I were going to continue the story my own way.
I love cartoons. At the time, I was really interested in TV series that were based on animated films and took place after the movie ended, such as Disney's Aladdin or All Dogs Go to Heaven: The Series. And I decided I could get all of my bad feelings out by writing a few stories that took place after the game like it was one of those shows. I asked myself what would that look like? What might the characters be doing?
The last piece of inspiration came from Mimi's line at the ending scene, when she said, "He's right, Nassy! We still have each other! We can still build the count's world! So, c'mon! Big smile!" The story would then be about them, trying to build a world of love that the Count had wished for. So I put together a scenario of that happening.
(As an aside, I do have all of the events for how Bleck returned, why Dimenio is alive, and the other loose ends planned out, even though it hasn't come out in the stories yet.)
come here I'm just a normal Mario game there's nothing to be afraid of I'm not going to permanently alter your brain chemistry and how you view the world I promise.
THERE IS A VERY OBVIOUS MARIO/BLECK PARALLEL THAT NOBODY EVER TALKS ABOUT 😆
Count Bleck is not just an antagonist, he also serves as a kind of foil for Mario’s character, by illustrating the different ways the two deal with a similar situation (namely losing the girl they love). While the focus of the story is on Bleck, it’s often overlooked how Mario has been through hell and back (literally) in chapters 6, 7 and 8, and by this point he’s been through a series of losses at least comparable to Bleck’s. Each protagonist has a ‘foil’ villain to face in the last gauntlet, and Mario facing Bleck is no exception—instead of becoming bitter in despair, he quietly shows his strength of character even when his friends are gone: and THATS why he’s the hero 👏
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