By Carl Green 
 
In this 9th edition of my musculoskeletal series, we will consider the causes and effects of physical deconditioning and obesity, and how physiotherapy can help. In today's fast-paced world, sedentary lifestyles and unhealthy eating habits have led to a significant rise in physical deconditioning and obesity. 

Physical Deconditioning 

Physical deconditioning, also referred to as detraining, is a decline in physical fitness, strength, and overall functional capacity due to prolonged periods of inactivity or reduced physical activity. This often happens when individuals lead sedentary lifestyles, with no daily or weekly work or hobbies to challenge their personal fitness levels. This decline in physical capabilities can lead to difficulties in performing everyday tasks and increase vulnerability to various health issues. 
 
Muscle atrophy (which involves the loss of muscle mass and strength), reduced cardiovascular endurance, impaired flexibility, decreased bone density, and a heightened risk of injuries are associated with physical deconditioning. Essentially, the body adapts to the decreased demands of physical activity by reducing its physiological functions, resulting in reduced overall fitness. It's important to note that physical deconditioning is a reversible process, and with the right exercises and lifestyle changes, individuals can regain lost fitness levels and improve their overall health. 

Obesity 

Obesity is a medical condition characterised by the excessive accumulation of body fat, which poses significant health risks. Body weight in proportion to height is typically assessed using an individual's body mass index (BMI), by dividing their weight in kilograms by the square of their height in metres. An individual with a BMI of 18-25 is considered “normal”, 25-30 is considered overweight, 30-35 is considered obese and 35+ is considered morbidly obese. 
 
BMI offers a fast and easy categorisation method, however it should be used as a guideline and one part of a clinician’s assessment. For example some individuals, especially those with large muscles, may be “heavier” despite having average to low body fat, and could therefore be categorised as overweight or obese using BMI, but actually be very healthy. There are other more accurate ways to assess body fat percentage but they can be more variable and time consuming. 
 
The root causes of obesity often involve a complex interplay between genetic, environmental, behavioural, and hormonal factors. Energy and nutrition balance is a key component to effective weight management. If nutrients and energy consumed exceeds the body’s needs, this leads to excess being stored as body fat or excreted. This imbalance can be exacerbated by factors like genetics, which influence metabolism and fat storage, as well as behaviours and societal factors that promote unhealthy eating and sedentary lifestyles. 
 
The health implications of obesity are significant and wide-ranging. It increases the risk of chronic conditions such as type 2 diabetes, cardiovascular diseases (including heart disease and stroke), joint problems (like osteoarthritis due to excess stress on joints), respiratory issues (including reduced lung function and conditions like sleep apnea), and even some cancers. 

Interconnection of Physical Deconditioning and Obesity 

Physical deconditioning and obesity are often intertwined, creating a harmful cycle. A sedentary lifestyle and lack of exercise lead to deconditioning, weakening muscles and cardiovascular fitness, promoting weight gain and obesity. This excess weight strains the body, making physical activity even harder and worsening deconditioning. This interconnected relationship forms a challenging loop that significantly affects an individual's health and well-being. 

Physiotherapy's Role 

Physiotherapy offers a comprehensive and scientific approach to tackling physical deconditioning and obesity through designing personalised strategies for each individual. These customised strategies often include tailored exercise plans that gradually enhance strength, flexibility, and cardiovascular fitness. Rehabilitation after injuries or surgeries is facilitated, ensuring a safe return to physical activity and preventing further decline. Educating individuals about the importance of regular physical activity, proper body mechanics, healthy lifestyles and making informed dietary choices can also play a vital role in preventing both physical deconditioning and obesity. Consistency in adhering to recommended exercise plans and adopting sustainable lifestyle changes is essential for success. Therefore, having professionals like ourselves work with you to create agreed practical, sustainable and efficient plans to maximise your likelihood to remain consistent and succeed. 
 
I am especially interested in deconditioning and obesity, having been a personal trainer for 10 years before becoming a physiotherapist. I also wrote my dissertation on the subject during my first degree in sports science and human biology, where I covered modules on nutrition, body composition, and exercise physiology, amongst many other subjects. 
What's next? 
If you have any questions or are interested in our support, please get in touch with us at Colchester Physiotherapy and Sports Injuries Clinic, and myself (Carl Green) or my physiotherapist colleagues Craig Fowlie or Jane Marr will do all we can to help you. 
 
Also, please get in touch if you have seen this and would like us to cover other topics or questions in future posts. 
 
The next instalment in this musculoskeletal conditions series will be on “nerve irritations and compressions”, so check back in for that or follow us on social media to see when it is published. 
Get in touch with the team here at Colchester Physiotherapy and Sports Injury Clinic for honest advice and recommendations! 

Author 

Carl Green 

Carl is a Specialist Musculoskeletal Physiotherapist, Sports Science and Human Biology graduate, former Lecturer in Sport and Exercise, Personal Trainer, and Sports Massage Therapist. 
 
He has worked as a Physio within the NHS at a senior level, sports injury clinics, his own practice, stroke rehabilitation, occupational health and chronic pain. Carl also has first hand experience of acute and chronic injuries, pain, surgery, and disability, giving him a deeper understanding how these can affect us both physically and psychologically. 
 
He started his career in health and fitness in 2002. Empowering people to achieve their goals, overcome challenges, and reduce future problems through lifestyle/behaviour change and exercise has continued to be a big part of his approach as a Physio. 
 
Carl has tried many sports, but mainly focused on rugby, gym training, running (5k to half marathon), and Muay Thai Boxing. He also enjoys snowboarding, home gym training, teaching his dog tricks and playing fetch, covering songs on his guitar, and has recently taken up archery. 
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