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PHYSICAL THERAPY AND WEIGHT MANAGEMENT

by / Saturday, 21 April 2018 / Published in Articles, Physical Therapy

THE EPIDEMIC
Obesity in America has steadily and unfortunately been on the rise. Current studies would indicate that more than 1/3 of adults and 17% of youth are obese, which is standardly measured via body mass index (BMI) of greater than 30. To confront this alarming trend, obesity has been increasingly studied over the years. This research shows a direct correlation with serious health risks such as: heart disease, type II diabetes, growth changes, musculoskeletal changes, hormone imbalances, emotional, phycological stress, orthopedic injuries, and generalized decreased quality of life.

Although obesity can be minimally affected by several unmodifiable risk factors such as hormone imbalances and ethnic background, there are several modifiable factors that we have complete control over. These include increased activity level and nutrition. Even small changes in these risk factors have positive lasting effects in improving one’s overall BMI and health.

ACTIVITY LEVELS NEEDED
Several current studies have concluded that appropriate increases in activity level will reduce the side effects of a sedentary lifestyle such as obesity and orthopedic injuries. Many of us struggle with making lasting weight changes, as clearly seen by the ever growing market of weight loss products. Contributing to that difficulty could be a lack of knowledge on how to improve our activity level, injuries or lack of resources.

Proper education on why exercise is needed and how to safely exercise are key components to successful change. An active lifestyle should involve both anaerobic and aerobic exercising which includes resistance training, cardiovascular training, and adequate time for tissue healing. The ideal ratio of these vary from individual to individual and the preferred styles differ drastically. A good general outline provided by the ACSM (American College of Sports Medicine) recommends that the average adult should exercise for 150 minutes a week of moderate-intensity exercise or 30-60 minutes a day to improve overall health.

The ACSM further specifies that 3 days a week should be cardiovascular training and 2 days a week should be moderate intensity resistance training on major muscle groups of the body. These exercises should be performed in at least 10-minute intervals of continuous exercise and sequenced in super set fashion. The term “super set” signifies when an antagonist muscle exercise is performed directly after an agonist exercise. As an example, one set of bicep curls is performed directly after a set of triceps extension. This sequence of exercising leads to far better strength gains and outcomes with exercise training.

WHEN IS PHYSICAL THERAPY APPROPRIATE IN WEIGHT MANAGEMENT
Doctors of Physical Therapy are experts in the areas of the human body, human physiology, how it relates to safe and effective exercise and how this leads to overall wellness. This specialized knowledge makes them a trusted resource in the fight against all stages of obesity.

Stage I-Obesity prevention: In this stage prevention is used for an individual that is found to be at high risk for obesity or is trending towards obesity. A physical therapist can help these individuals by helping create a lifestyle change and exercise plan to decrease BMI levels. This is different than just going to the gym. This change requires exercises tailored specifically for the individual at an optimal load so that all systems of the body can benefit from exercise. This stage is the best stage to create a change so that negative secondary effects can be avoided.

Stage II- Current Obesity: A physical therapist will perform a detailed examination of what the patient is lacking as well as what they truly need. This includes screening all the systems of the body and monitoring how the patient responds to specific movements. If the individual has been sedentary for a long period of time the range of loads tolerated will be narrower than normal healthy individuals. Often people get deterred from changing their activity level because they do not apply the correct loads at the correct times which leads to pain or not getting the desired results. Making sure the right loads are applied is crucial in order to avoid any adverse reactions and unnecessary injury. If an individual is in this stage it is important to create a detailed plan on how they can make a change and have someone hold them accountable to a specific frequency and duration of exercise.

When health care professionals such as primary care providers, dietitians, and physical therapists combine their efforts and expertise, the success of obesity intervention is considerably higher.

Stage III- Orthopedic Injury: This is a subcategory of stage 2 wherein secondary complications begin to arise. Obese individuals are often dealing with secondary complications such as fatigue, arthritis, tendinosis (tendon break down), muscle strain/ fatigue, due to increased stress on the bones, muscles, and ligaments from the increased weight and/or compensatory movements.

These secondary complications often create pain and increase the difficulty to exercise without increasing pain in other parts of the body. Discouragement to enjoy exercise sets in at high levels here. Physical therapists have the knowledge and skills tailored to assist with these ailments and can safely adapt and progress exercises in a way that can help exercise become enjoyable, decrease secondary complications, and avoid any improper loads or stresses which can lead to additional injuries.

CONCLUSION
Appropriate modifications to increase the activity level and incorporate healthy habits are key factors needed to both avoid and treat obesity. Involving a physical therapist in the intervention of obesity can greatly help in applying the appropriate principles of exercise within the recommended moderate-intensity prescription of 30-60 minutes per day. Their involvement can minimize injury or adverse reactions to exercise through proper tissue loading, warm-up/cool down, frequency and duration, mode/type of exercise, and sequencing of resistance exercise. Call us today at one of our clinic locations to schedule for treatment or referral. Please visit wrightpt.com for questions and contact information.

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