Is Obesity a Risk Factor for Tendinopathy?

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.

Edmonton, Alberta