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!
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.
(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.