The 5 top reasons obese individuals seek physical therapy

Hello there, Obesity Panacea readers!

Today’s guest post comes courtesy of a good friend of mine, and physiotherapist, Matt Sanchez. Matt and I have been friends since high-school, and also completed our undergraduate degrees together at the University of Western Ontario. Matt is currently the Director of Rehab & Technology at Aim2Walk Rehabilitation Center. Recently, I asked Matt to discuss some of the common musculoskeletal issues that overweight and obese people encounter and he graciously agreed.

So without further ado, here’s Matt!

Peter

——–

If there’s one thing my five years of experience as a Physical Therapist in the community has taught me, it’s that people don’t like pain.  I know, my 6 years in University and 30 years of life should’ve taught me that.  But seriously, the number one orthopaedic complaint I treat involves pain.

But making a Physical Therapy appointment for obesity? That is VERY rare.  In fact, I cannot recall a single case where a client stated the reason for the appointment was obesity.  The reason is almost always pain.  Approximately 1 in 4 people that walk/limp/roll through our clinic’s doors have a body mass index (BMI) of 30 kg/m2 or more.  Their injuries range from low back pain to spinal cord injuries – same as the non-obese population – and there is almost always a complaint of pain.

Nevertheless, some injuries present themselves more than others in the obese population (1).  Let’s take a look at the 5 most common pain-causing injuries in the obese population seen in a physical therapy clinic:

1) Sprains and Strains

These two terms are commonly used interchangeably, but they actually refer to different musculoskeletal injuries.  You strain a muscle or tendon and sprain a ligament.  Now you can correct your friends.

This is a very broad category which is likely why it tops the list.  Muscle, tendon and ligament injuries are quite common and I suspect that many of you have had an injury of this sort in the past.  Sprains/strains can be acute or chronic and can have a plethora of possible causes.  These are very common injuries for weekend-warriors, or people that are not active and attempt moderately strenuous activities using their de-conditioned musculature.

2) Osteoarthritis and joint replacement

Obesity is a known risk factor for osteoarthritis (2) and joint pain has a strong association with body weight. You need not go any further than this blog entry by Peter discussing the effects of excess weight on predicting a younger age for needing a hip or knee replacement.  As Peter mentions though, we can’t jump to the conclusion of arthritis occurring purely due to increased joint load, as there is also a correlation between obesity and hand osteoarthritis (3).

3) Disc Herniation

Disc herniation is another injury associated with obesity, but not necessarily caused by the increased load on the discs between our vertebrae.  Obesity is closely linked with other disc herniation risk factors, such as inactivity, weak abdominal musculature and issues with circulation. Specifically, reduced blood flow through the descending aorta artery means reduced blood flow to the discs making them more likely to be injured.

4) Carpal Tunnel Syndrome

This refers to symptoms created by pressure in the wrist on the median nerve, which supplies feeling and movement to parts of the hand.  Approximately 10% of the general population will be diagnosed with carpal tunnel syndrome, whereas 25% of people classified as obese will get this condition.

5) Rotator Cuff Tendonitis

Pain with overhead movements and lifting using an outstretched arm may indicate rotator cuff pathology.  This injury can be associated with obesity in relation to reduced activity levels, weak supporting musculature, and poor postures adopted during prolonged sitting activities.

If experiencing one of the five injuries reviewed above, or any other pain causing injury, it is best to consult your physiotherapist.  Physiotherapists are specially trained to diagnose, treat and help prevent musculoskeletal injuries and neurological conditions.  You do not require a doctor’s note to see a physiotherapist, and you can find one near you by clicking here.

Matt Sanchez
Email: matt@aim2walk.ca
Blog: www.neurochangers.com
Website:  www.aim2walk.ca
Twitter: @aim2walkPT

References:

(1) Matter, K., Sinclair, S., Hostetler S., Xiang, H. (2007) A Comparison of the Characteristics of Injuries Between Obese and Non-obese Inpatients. Obesity.15: 2384-2390 doi: 10.1038

(2) Felson DT, Chaisson CE: Understanding the relationship between body weight and osteoarthritis.Baillieres Clinical Rheumatology 1997;11:671-681.

(3) Cicuttini FM, Baker JR, Spector TD: The association of obesity with osteoarthritis of the hand and knee in women: a twin study. J.Rheumatol. 1996;23:1221-1226.

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5 Responses to The 5 top reasons obese individuals seek physical therapy

  1. June says:

    As a former-obese person I’ve had to seek out physical therapy for both my knees and pain in my wrist/elbow. Unfortunately, the doctors were entirely unhelpful and told me to “just lose weight” (at that point I had gotten down to 15lbs overweight, significantly less than before and yet was still having problems) and have now restricted my exercise to swimming and upper body lifting. Then again I’m also “blessed” with flat feet, which can contribute to knee problems and am top heavy, which can contribute to carpel tunnel syndrome.

    I’m curious… what do most physical therapists do when patients come in with these problems? Those that I met with gave me the impression that I just have to suck it up and deal with it and there’s no help.

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  2. Mike R says:

    If only 25% of the patients are obese and obesity rates are higher than 30%, doesn’t that imply that the number of obese patients seeking physical therapy is below average?

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  3. Matt Sanchez says:

    Hi June,
    I’m truly disappointed that you have experienced health practitioners that said anything to the tune of “just lose weight” as a treatment for your ailments (especially if it was a PT!)
    Excess body weight MAY be a contributing factor for your different pains, but in every instance I have experienced, a physical therapist should be able to provide an effective treatment plan that does not include a lecture on weight loss. Factors that should be considered: localized muscle weakness, muscle imbalance, muscle tightness, restricted joint mobility, altered biomechanics, posture… The list goes on. If none of these things are addresses, find another therapist!

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  4. Matt Sanchez says:

    Mike, I cannot find any literature stating that obese individuals seek Physical Therapy any more/less than others. My stat that 25% of our clients are obese is an estimate. BMI is not an objective measure that most clinics track, and so I had to take a random sample of 50 active clients, and calculate their BMI from our records. At the time of my calculation, we had 27% of active clients with a BMI level considered in the obese range for their sex. But because clinics have high turnover, this number is likely to fluctuate all year. This number would be different at different clinics as well, based on the type of injuries they cater to (i.e. sports vs work related injuries).

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