The Role of Body Weight in Injury Development

Being overweight is often an overlooked causative factor of injury. Yet it is important for people carrying an injury, ‘niggle’, or experiencing pain of some musculo-skeletal origin, to realise that any surplus weight they are carrying on their body, will result in increased and often avoidable loading of the body’s tissues.

The Frame Weight Concept

In clinical practice rather than referring to this extra weight as being extra ‘body weight’ I prefer to use the more diplomatic phrase ‘frame weight’. One of the definitions of a frame is ‘the way in which something is put together’. In terms of our bodies the bulk and mass of muscle, fat, and other tissues sitting on our skeletons is the way we ‘are put together’. Collectively this tissue bulk and our skeletons sum to give us our total frame weight.

In practice I spend substantial time sensitively educating injured people that their body weight may be a contributing factor their injury development. I have found that most people carrying an injury are unaware of the impact that their extra or surplus kilograms have on their body. They tend to not consider how the extra weight they are carrying has contributed to the development of their pain and injury. They will likely also not compute how their frame weight will either aid or hinder their rate of recovery from their injury and pain.The discovery of a person’s ideal frame weight affords them a host of benefits not only related to their injury and pain but also their general health and well-being.

The ‘frame weight’ concept is not a researched theory. It is likewise not a concept that is taught throughout physiotherapy training at university, or to my knowledge any other medical university program. Rather the frame weight concept is an observation that I have made throughout the years of my clinical practice as a physiotherapist.

Everybody has a different body, a unique body. There are no two bodies the exact same. As a result I believe that every body’s body (not a typo) has a set operating body weight, or body weight range at which they are designed to optimally function. If the individual operates within this ideal range of weight they will experience improved performance due to improved efficiency of movement. The individual will also experience less injuries as a result of lessened adverse loading on the joints and tissues. This applies to all injuries including lower back pain, and the development of joint osteoarthritis in weight bearing joints such as the hips, knees, and feet.

I believe that this ideal frame weight range is a genetically determined physical attribute. My thoughts are that a set operating weight range is ‘hard wired’ into the DNA of every human. I believe all human beings are born with a weight that their fully matured body should grow to. If the adult body can operate at a weight range in tune with their ideal frame weight the body will tend to be re operating free from adverse joint and limb loading. The body will be operating with ease and efficiency as it was designed to do.

In effect this frame weight range is like a ‘set point’ of a thermostat. The set point controls the temperature of the room, while the set point of our body weight largely determines the effectiveness of our human movements. This set point may be a number or it may in fact be a range of weight. Given that there is no defined way other than trial and error to find your ideal frame weight I lean more towards the more achievable concept of discovering your ideal frame weight range as opposed to a defined specific number.

The effects of additional frame weight 

A person who is carrying surplus kilograms to what their body is ‘designed to carry’ will be subject to extra stresses and loads. The loading that results from this excess weight tends to be adverse in nature. The body’s skeleton, muscles, connective tissues, ligaments, and tendons are put under extra strain by the surplus body weight.

For example imagine a lower back pain sufferer that has an extra 10 kilograms on their frame. That is akin to putting a 10 kilogram weight in your pocket and going about the activities of the day-sitting, driving, lifting, to name a few.  The person’s tissues and skeleton has been designed to withstand a certain range of frame weight. The gap between the frame weight it is designed to carry, and the frame weight the body is carrying equates to the gap of additional and adverse loading. It’s where many problems in terms of injury contribution can emanate from.

Don’t Dodge It

Many health practitioners avoid conversations about surplus body weight because of the sensitivity and perceived awkwardness that may result. Discussing surplus body weight is never an easy conversation to have in the physiotherapy consulting room.  Whenever I am tempted to ‘dodge’ the topic of body weight for an injured runner (or general injured client) I remind myself that my job is to be effective and deliver on the outcome that I am being engaged to deliver on. My role is not to be just liked by my client. There is a huge difference between being liked and being effective. The two however don’t need to be mutually exclusive when the practitioner is sensitive and caring in their approach.

A person’s recovery from injury will be delayed if they are carrying surplus body weight. If all other injury contributory factors are addressed through an injury rehabilitation program but the excess frame weight is not addressed, then the runner remains at risk of further injury or re-aggravation.

Being under your ideal frame weight can also create challenges for the body. Although the effects of being under your ideal frame weight are less deleterious to a runner’s quest to run pain, fast, and injury free, than being in surplus of your frame weight is. Conditions such as osteopenia (loss of bone mineral density), and amonhorrea (female runners losing their regular menstrual cycle) can be the result of running with a frame weight less than the set weight range.

These extra kilograms on somebody’s frame are not only relevant for the onset, management, and recovery from running related injuries, but the consequences of carrying surplus weight extend to general health and well-being. It is well documented that surplus body weight markedly increases the risk of lifestyle diseases such as cardiac events, type -two diabetes, and stroke. Being overweight is also one of the major drivers for lower back pain.

Discovering Your Ideal Frame Weight

Unfortunately there is no easy way to calculate or discover your ideal frame weight. There is no formula that produces the range of body weight or the ‘magic’ set weight point you need to operate at or within.

There are two methods I recommend my clients use in order to arrive at an initial ideal frame weight. The two methods are:

1. Think back to a time when you were pain and injury free. You had no or very little day to day aches or pains. Perhaps you weren’t running in your past but that doesn’t matter. Reflect on a time when you physically felt healthy and well. Don’t over-analyze or complicate the reflection by rationalizing things like your fitness, age, or lifestyle. Just recall the time when you were uninjured and strong. Now see if you can recall the body weight you were at that stage. The chances are that this body weight is close to your ideal frame weight. Typically with the kilogram creep experienced by most people with the passing of the years this weight will be anywhere from 5 kilograms to up to 30 kilograms less than their current body weight.

2. Start to record your body weight and match it to your pain and injury profile. This is not a quick or overnight exercise but rather a commitment to stick to over the course of one to three years. Because of the required time-course for such an analysis most people prefer to reflect on their past to arrive at their approximate ideal frame weight.

Whatever method you use, make it your aim to start to work your way towards the approximate frame weight. Don’t procrastinate start today. Remember there are no overnight shortcuts that will get you to where you want to go. I suggest just start by making some seemingly small daily choices that over time will sum to something significant.

There has been much written on body weight management. I suggest looking for resources that may help you or if necessary engaging professional help. Rather than enter a space that is outside of my professional scope of practice and expertise I thought it would be more useful if  I shared with you several tips that I have found to help my journey of maintaining my body weight close to my ideal frame weight. It’s never ‘perfect’ but I have found the below tips to have been helpful in being consistent with my body or frame weight.

Frame Weight Tips

To get you started on your journey towards your ideal frame weight try some of the following tips:

• Break your day into quarters. For example if you wake at 6AM and go to bed at 10PM that is a 16hr day. The quarters would be 6-10AM, 10AM-2PM, 2PM-6PM, and 6PM-10PM. Rather than attempting to make wise food choices over the course of entire day break it into smaller segments (quarters). You will have more control and motivation to make wise choices during each quarter than you will over the course of the entire day.
• Avoid eating when you are tired. Fatigue can be a real trigger for over indulging.
• Cut out one coffee a day.
• Drink mineral water as a treat as opposed to drinking high calorie soft drinks.
• Substitute high sugar drinks such as fruit juice for water.
• Have more salads than calorie rich meals.
• Decreasing size of protein ingestion. Try limiting protein intake to portions that are the size of the palm of your hand.
• Being aware of visual cues with our eating. For example smaller plates will mean smaller calorie ingestion, and taller skinnier glasses will ensure you drink less.
• Place nutritious foods at eye level in your fridge and pantry. What you see first and the most you will tend to eat the most of.
• Progressively reduce the size of your meals and portion sizes. Replace your standard dinner plate size with smaller plate size.
• Don’t fear hunger pains. They do not escalate until you are rolling on the ground clutching your stomach. Rather they actually go away. Few people ever push through the sensation of needing to eat to discover this.
• Chew your food fully before swallowing. Not only does this habit significantly improve digestion it also creates a margin of time for the ‘full reflex’ to be sent to your brain.
• Reduce or eliminate your intake of bread. Bread is heavily packed with calories.

Don’t make your effort to return to your ideal frame weight too stringent and rigid. Just pick two or three of the above and monitor your progress over time. You will be amazed at the results that wise and small daily choices can produce.

Hopefully after reading this post you have a greater appreciation of the need to ‘stay in shape’ in terms of not just our overall ‘health and well-being’ but specifically with regards to the rehabilitation of existing injuries such as lower back pain, or the prevention of overuse or ‘wear and tear’ injuries such as osteoarthritis of the lower limb major joints such as the knees and hips.

If you have any questions or feedback please feel free to leave your comments in the comments box below.

PAIN-FREE. PERFORM. PROLONG 

BRAD BEER (APAM)

Physiotherapist, Author ‘You CAN Run Pain Free!‘, Founder POGO Physio

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