PREVENTING MUSCLE LOSS WHEN INJURED

Injuries, illness, and surgery can lead to an extended period of immobility. As patients sit or lie down and recover, and this lack of movement results in muscle loss. After recovery, the patient may struggle to return to normal activities due to atrophy. Physical therapy before and after immobility can help patients restore muscle strength.

Immobility leads to muscle atrophy due to several physiological occurrences such as loss of muscle mass, strength, metabolic rate, insulin sensitivity and an increase in fat within muscle tissue.   Studies have indicated that nearly everything in the body is adversely effected including bones and tendons (connective tissue).  These same studies report that muscle tissue is the most effected and degrades at a faster pace than the other tissue.  To make matters worse, the loss in muscle size is bad enough but the loss of strength occurs at a rate that has been measured to be 3x the pace of size loss.  Following immobility it is critical to restore the strength and size (not always a 100% correlation between size and strength) of the muscles in the involved area.  If these factors are not addressed, the body will be able to return to a functional level, but a great deal of modification will take place.

The best practice is to attempt to prevent muscle loss in size and strength before it happens.  This involves “pre-hab,” a complete rehabilitation programs that focuses on strengthening the involved body part(s) before the period of immobility occurs.  For instance, before a surgical procedure, a patient may follow pre-hab protocols An example of this would be a pre-hab program for a surgical procedure.  These programs have been successful at reducing the rehabilitation time that is need during the post-immobility period.

Dietary needs should be considered when someone is going to be immobilized for a period of time.  Eating the proper types of food can help to reduce the negative effects of immobilization. An increase in protein can provide the foundation for muscle development.  Amino acid (protein) levels need to be at an adequate level for muscle tissue development. In the early phase of immobilization the body does not use the available protein in the system and the lack of protein use is most likely the reason the muscle loses so much size and strength almost immediately when it is immobile.

At times, some people lose their appetite or try to conscientiously curb their appetite in fear of gaining weight while they are “out of action.”  Unfortunately, this can lead to a host of issues and building muscle mass is one of them.  Taking supplements such as easily digestible protein powder with leucine is recommended.

Utilizing therapeutic neuromuscular electrical stimulation (NMES) has been shown to help reduce the loss of muscle tissue.  The muscles of the body have two primary types of cells, fast twitch and slow twitch.  Fast twitch are most affected by immobility and will lose size and strength before the slow twitch fibers.  Fortunately, the NMES stimulates the fast twitch before the slow twitch, therefore the electrical stimulation “targets” the muscle cells that are most affected by immobilization.

Cross training can help maintain overall fitness during a period of immobilization.  Some studies have reported positive results when the opposite or contralateral joint is “trained” during the immobilization time.  The results indicate less of a loss of size and strength of the muscles in the immobilized joint.

Immobilization is required in many instances to allow the healing process to occur, but it can have detrimental effects on the body.  Preparing for the immobilization properly can help reduce muscle loss and other negative effects.  If a situation arises that produces the need for immobility, there are several ways to limit the muscle loss that occurs.  Seek the treatment of a Physical Therapist to help with a program that will limit the muscle loss and help to regain the strength and function of the involved body part.