Leg Atrophy: what happens when you stop walking?

What is muscle atrophy? 

Muscular atrophy, also known as muscle wasting, involves the weakening and shrinking of muscle tissue¹. The loss of muscle mass and strength is usually due to prolonged inactivity and disuse of leg muscles². Disuse syndrome is a condition that arises from prolonged physical inactivity, leading to the deterioration of body systems³. This phenomenon is particularly noticeable in the legs when we cease walking, as these muscles are accustomed to frequent use. It often happens to people who can’t walk or are on bed rest².

Indeed, when you stop walking or reduce physical activity significantly, your muscles are no longer challenged. By consequence your muscles lose strength and size over time^{2, 3}. In addition, when muscles aren’t used, the brain sends fewer signals to them4,5. This makes the muscles weaker and harder to rebuild when you start moving again^4,5.

Muscle atrophy, defined as the loss of muscle mass and strength, is linked to a range of secondary health issues that significantly impact overall health and quality of life¹. When muscle mass decreases, the body’s basal metabolic rate drops6, meaning fewer calories are burned at rest, making it more difficult to maintain a healthy weight and increasing the risk of metabolic imbalances such as insulin resistance⁷ and impaired glucose homeostasis. Over time, this may increase the risk of developing type 2 diabetes⁶ and obesity⁶. The lower energy expenditure also makes it more challenging to maintain a healthy weight, as excess calories are more likely to be stored as fat. This shift in body composition, with more fat and less muscle, can increase cardiovascular risk⁸, and elevating blood pressure⁸.

Muscle atrophy is also associated with higher risk of fractures due to reduced bone mineral density⁶ and functional disability. Additionally, the loss of muscle mass impairs immune function, as skeletal muscle plays a role in supporting immune responses and overall metabolic health⁹. Mechanistically, factors such as oxidative stress, inflammation, mitochondrial dysfunction, and hormonal imbalances drive muscle atrophy⁹ and its secondary complications. These interconnected pathways highlight why muscle atrophy is not just a localized problem but a systemic health concern, especially in aging populations and those with chronic illnesses

In severe cases, it can lead to long-term disability, impacting not just physical health but also mental and emotional well-being.

Causes of leg atrophy

Understanding the causes and effects of muscle wasting can provide a pathway to prevention and recovery, emphasizing the importance of keeping muscles engaged and active.

1. One of the most common causes of leg atrophy is injury. When a person injures their leg, they may be unable to use it properly for a period of time¹⁰. This lack of use can lead to muscle wasting and atrophy^{2, 3,10}.  
    
2. Certain medical conditions can also lead to leg atrophy. For example, neurological disorders can cause muscle weakness and atrophy in the legs⁶. These conditions affect the nerves and muscles, leading to weakness and wasting of the legs.
    
3. Additionally, lack of physical activity can contribute to leg atrophy². When a person leads a sedentary lifestyle and does not engage in regular exercise, their muscles can weaken and waste away. Encouraging even small amounts of movement can have significant benefits, helping to maintain muscle mass and prevent the broader systemic effects of inactivity¹¹.
    
4. Other potential causes of leg atrophy include malnutrition. Malnutrition can deprive the body of essential nutrients needed for muscle health¹².  It's important to consult with a healthcare professional to determine the underlying cause of leg atrophy and develop an appropriate treatment plan.

What can be the signs of leg atrophy?

Common signs of leg atrophy may include muscle weakness and decreased muscle mass^2,3. In some cases, individuals may also experience pain or discomfort in the affected muscles¹³. The process of muscle atrophy is not just a physical change. It can limit a person's ability to perform daily tasks¹³, reduce their sense of independence, and ultimately affect their mental well-being¹³.

The impact on mental health

A decline in physical abilities often triggers emotional distress, including sadness, frustration, or a sense of hopelessness¹⁴. Many individuals may also grapple with anxiety about their future, health, and growing dependence on others.

Social interaction often becomes more difficult when mobility is limited. As a result, some may begin to withdraw from activities and relationships, increasing their risk of loneliness and emotional isolation¹⁵. This social disconnection can, in turn, intensify symptoms of depression and anxiety¹⁶.

The fear of becoming a burden to others can also be psychologically overwhelming. In some cases, this fear leads individuals to avoid seeking help, even when it’s necessary, potentially worsening their mental health over time.

What can help to regain control

Working with mental health professionals, such as psychologists or counselors, can offer crucial emotional support and guidance. A strong support network of family and friends can also help reduce feelings of isolation and foster a sense of connection. Participating in support groups with others who share similar experiences can bring comfort, understanding, and a sense of community.

Even with limited mobility, engaging in appropriate physical activities can positively impact mood and mental well-being. Exercises such as swimming, chair yoga, or arm workouts can help maintain physical activity levels and promote a sense of vitality.

Setting realistic and achievable goals, no matter how small, can foster a sense of progress, purpose, and empowerment.  

Adapting to a new way of life also offers the opportunity to explore new interests. Whether through learning a new skill, developing a creative passion, or discovering new hobbies, such activities can help individuals rebuild a meaningful sense of identity and fulfillment.

Finally, in some cases, regaining control also involves restoring movement and confidence through medical solutions. Orthotic devices, such as KAFOs, can support this journey by improving stability, encouraging safe movement, and enabling greater independence. To learn more about how these devices work and who they can help, you can read our dedicated article on KAFO orthoses.