According to a paper by Malachy McHugh from the Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, US, published in the latest issue of the British Journal of Sports Medicine, overweight and obese adolescents are more than twice as likely to be injured in sports and other physical activities compared with non-overweight and non-obese adolescents. Moreover, obese adolescent athletes are more than three times as likely to sustain an ankle sprain compared with normal weight adolescent athletes.

The increased risk of injury associated with being overweight or obese may in part be due to low physical activity levels and therefore promotion of physical activity for children can provide neuromuscular training that may be beneficial in decreasing injury risk associated with general play and sports. In addition, specific neuromuscular training interventions, such as balance training, may also help reduce the risk of injury associated with overweight and obesity.

Importantly, injured overweight young athletes tend to have more prolonged recovery periods than non-overweight young athletes.

According to McHugh, early aggressive treatment of swelling with physical modalities, prolonged non-weight bearing, limited period of immobilization, and regular repetitive passive joint motion are all indicated for the overweight young athlete with a lower extremity joint injury.

AMS
Frankfurt, Germany

Without question, people carrying extra weight are at high risk for mechanical injury to their musculoskeletal system and need to be careful when attempting any form of physical activity to not inadvertently promote injury and subsequent immobility with all its detrimental consequences for further weight gain and loss of fitness.

Apart from the excess mechanical pressures on the joints and ligaments, new research suggests that obesity may also play an important, hitherto largely unrecognized role, in tendinopathies, a common painful condition that affects the tendons rather than the joints. (Tedons are the ligament-like structures that attach muscles to bone and are thus the key tissues responsible for transferring muscle strength to the skeletal system.)

In a systematic review published in this month’s issue of Arthritis and Rheumatism, James Gaida and colleagues from Deakin University, Melbourne, Australia, examined studies that compared adiposity between subjects with and without tendon injury or examined adiposity as a predictor of conservative treatment success.

They identified 4 longitudinal cohorts, 14 cross-sectional studies, 8 case-control studies, and 2 interventional studies (28 in total), providing a total of 19,949 individuals.

Overall, the studies suggest a substantially increased risk for tendon injury associated with obesity, although there was some heterogeneity in study findings depending on study populations and mode of assessment.

This finding has some important implications:

1) it would be interesting to see if obesity treatment can indeed reduce the risk of tendon injury;

2) clinicians making exercise recommendations to individuals with excess weight must be fully aware of the increased potential for tendon injury and design exercise routines with this in mind.

Anyone, who has experienced tendon injury is well aware that once established, this condition is notoriously hard to treat and often results in chronic pain ultimately reducing mobility and thus further increasing the potential for weight gain.

Another good reason, why exercise professionals working with obese clients (as blogged before) need a sound understanding not just of exercise physiology but also of musculoskeletal pathology.

AMS
Edmonton, Alberta