What to do when the key to your recovery is weight loss
Weight loss can be a key to your recovery
There are many injuries where weight loss will have a positive impact on you and your pain. If you think about the extra load your feet, ankles, knees, hips and lower back need to support when you have an increased body weight, it makes sense that losing weight will take some of the pressure off these areas. Therefore, sometimes loosing weight can make it easier for your injury to rehabilitate and improve.
This is obviously a difficult conversation to have as a physiotherapist with your patient, but it is a conversation that is necessary. We need to have these difficult conversations to help you improve, and believe me they always come from a good and caring place in our heart!
The journey to recovery when weight loss in involved
If weight loss was easy – everyone would be doing it! The issue is that it is a complex journey. When it comes to weight and recovering from an injury there are two things you need to achieve:
1) weight loss
2) increasing physical activity without overloading the injury whilst you are reducing your body weight
This blog will cover a few options that you can consider to help yourself while you are on this journey.
Healthy steps you can take to improve your outcomes
Going it alone is tough when it comes to weight loss but there is help out there!
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Seek guidance from an accredited dietician to see where you can change you diet to aid weight loss
Messier et al (2013) investigated the effects of diet and exercise on knee osteoarthritis in overweight and obese adults. They found that the diet group alone had the greatest weight loss and decrease in knee compressive forces. The saying goes “you can’t out exercise a bad diet”, so whilst it may feel as though exercise is the be all and end all of weight loss, the food you are putting in your mouth has majority to do with it. Your physiotherapist cannot give you advice about your food intake, so this is where an accredited practicing dietician comes in handy. You can see you GP for a referral or do some research for someone near you. The most important thing is that diet needs to be individualised, and it needs to be achievable for you.
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Try a non-weight bearing form of exercise such as deep water running/water aerobics
Deep water running and/or water aerobics are offered at many public swimming pools. Here on the Gold Coast there are classes offered at the pools and also as apart of the Healthy Living Program as apart of Gold Coast City Council so check these out! Exercising in the water with a flotation belt means you can move and get your heart rate up, without the impact and load through your spine or lower limb joints. It is important to discuss whether this form of exercise is suitable with your physiotherapist as sometimes the twisting is not appropriate, but often there are alternatives you can do!
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Try clinical pilates or an exercise session with a physiotherapist or exercise physiologist
Clinical pilates is performed on a pilates reformer. This is spring based exercise on a carriage that moves. Therefore there are many exercises you can perform in a supported position. Read more about our Pilates HERE>>. Clinical Pilates can be great as it is resistance exercise which helps increase muscle mass and can help decrease weight. It is also specific and individualised to you and your injury so you can participate without the risk of making your injury worse. If you are not keen on pilates, having a physiotherapist or exercise physiologist teach you a home exercise program or gym program can be excellent, because they have extra training and knowledge in anatomy and injury rehabilitation, that they can prescribe you an exercise program that will not flare you up and will help you rehab your injury and increase physical activity.
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Discuss with your physiotherapist if you injury is going causing you pain when you exercise, or if you are fearful it will cause pain
Sometimes a small amount of pain can be expected when you are getting back into exercise. If you expect to be completely pain free, sometimes you will never be able to start back moving. So talk to your physiotherapist about whether exercising even if a 1-3/10 pain is reached, is ok. Sometimes just the thought of getting back into exercise or starting some form of physical activity can be scary because you may believe it is going to cause pain. This is when your physiotherapist needs to guide you on what exercises to do and what to expect when you perform them. This will then reduce any fear you have and make getting back into exercise a less scary experience.
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Consistency is key, small bouts over time compared to a large bout here and there
If you have one really good week of exercise, and then two weeks off, you are not going to get anywhere. It’s like the old saying one step forward and two steps back. It is better to do exercise every second day and make it more achievable, than to set your goals too high and burn yourself out, then have to start from square one every month.
If any of these points have resonated with you, please let us know and feel free to get in contact. If you have any questions about the points above, please feel free to email e.georgopoulos@pogophysio.com.au
References
Fernandes L, Hagen KB, Bijlsma JWJ, et al
EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis
Annals of the Rheumatic Diseases 2013;72:1125-1135. doi:10.1136/annrheumdis-2012-202745 // discussed 11 points for non-medication related management of hip and knee pain with a large section on weight loss.
Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, DeVita P, Beavers DP, Hunter DJ, Lyles MF, Eckstein F, Williamson JD, Carr JJ, Guermazi A, Loeser RF. Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among Overweight and Obese Adults With Knee OsteoarthritisThe IDEA Randomized Clinical Trial. JAMA. 2013;310(12):1263–1273. doi:10.1001/jama.2013.277669 // discusses that diet alone had greater decreases in knee compressive forces
Riddle, D. L. and Stratford, P. W. (2013), Body weight changes and corresponding changes in pain and function in persons with symptomatic knee osteoarthritis: A cohort study. Arthritis Care Res, 65: 15–22. doi:10.1002/acr.21692 // >10% body weight loss correlated with important changes in pain and function
Emily Georgopolous (APAM)
Physiotherapist
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