Don’t let muscle mass go to waste

Muscle atrophy, the loss of muscle tissue, can emerge after a period of inactivity.

Published: December, 2020

Age-related muscle loss, called sarcopenia, is a natural part of getting older. But after an injury, illness, or any prolonged period of inactivity, muscle loss can occur faster, leading to muscle atrophy. The consequences are greater weakness, poor balance, and even frailty.

"People older than age 65 are especially vulnerable to muscle atrophy," says Jodi Klein, a physical therapist with Harvard-affiliated Brigham and Women's Hospital. "It can take longer for the body to recover from dramatic muscle loss, but with the right strategy, older adults can protect themselves from muscle atrophy and rebound easier if it occurs, no matter what their age."

Signs of weakness

Muscle atrophy can occur from a disease that primarily affects the muscles, such as polymyositis (an autoimmune inflammatory disease). Diseases that rob the muscles of energy, like cancer and malnutrition, are other causes.

But muscle loss most often is due to physiologic atrophy, which happens when people don't use their muscles enough for an extended period. Besides an injury or surgery, physiologic atrophy can occur because of osteoarthritis, which makes staying active difficult, or a sedentary lifestyle.

Muscle atrophy can lead to

  • weakness in the upper limbs, including trouble raising your arms or reaching for high objects
  • difficulty opening jars, holding a pen, typing on a keyboard, buttoning a shirt, or tying shoelaces
  • muscle twitching and cramps
  • trouble balancing.

Muscle atrophy does not always happen after a physical setback. How a period of downtime affects you depends on your prior health, activity level, and amount of muscle mass. "Men who are regularly active have a much easier time preventing muscle atrophy even if they are off their feet for a while," says Klein.

Still, it doesn't take long for the body to lose what it has gained. A 2015 study in the Journal of Rehabilitation Medicine found that older men who did eight weeks of strength training lost about 25% of their muscle gains after they stopped training for two weeks.

"A sudden stop in activity is like slamming on the brakes and can be quite jarring to the body," says Klein. "Even minor muscle atrophy can cause some loss of strength and movement and make activity more difficult."

Get a head start on recovery

If you know you will be inactive for a stretch — like from an upcoming surgery — then you can work to prevent muscle atrophy. "If you are already active, continue what you are doing," says Jodi Klein, a physical therapist with Harvard's Brigham and Women's Hospital. If you are not a regular exerciser, use this time to get started. "The better shape you are in going into surgery, the better shape you will be coming out, and the less chance you have of enduring muscle loss," says Klein.

Make a move

While you can quickly lose muscle because of physiologic atrophy, you also can get it back. It's best to get advice from your doctor. He or she can recommend an appropriate program to rebuild your lost muscle. This often includes physical therapy, strength training, cardio workouts, flexibility exercises, and a nutrition plan that may increase protein and calories.

There is also much you can do on your own to increase and maintain muscle mass and strength. Almost any activity that works the upper and lower body can help you regain what you have lost.

Weight training is ideal and can include workouts with dumbbells and resistance bands. Other muscle-building exercises include rowing, swimming, walking, and cycling (stationary or regular bike). "Focus on exercises you can do safely and consistently, or better yet, enlist a trainer to create a specialized plan based on your limitations and needs," says Klein.

Keep in mind that you have to take small steps at first, and it may take time to get back to where you were. "But focus on the fact that you are moving," says Klein. "Any activity is always better than no activity."

Image: © Paul Bradbury/Getty Images

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