Friday, October 21, 2011

If You're Overweight and Have Knee Pain, You Need to Read This

Below are my top four recommendations for people who are overweight and who suffer from chronic knee pain:

1. Lose weight.

2. Lose weight.

3. Lose weight.

4. Lose weight.

No, I'm not trying to be clever here.

I'm convinced that controlling one's weight is critically important for overcoming knee pain. It's not an instant miracle cure -- after losing 30 pounds, you may not be able to leap up and shout, "Hallelujah, I'm healed" (you still need to work at it), but you'll be in a much better position to succeed.

If you don't believe that excess weight can have a huge effect on knee health, well, there's the anecdotal evidence.

For example, take a look at the picture below that ran with a newspaper article about aging baby boomers and knee surgery. This woman had a total knee replacement. Does anything jump out at you?

Obviously, she's nowhere near her ideal weight.

Here's another bit of anecdotal evidence to mull over: some months ago, while browsing the comment section below an Internet article about knee problems, I was struck by a remark posted by an orthopedic doctor. His comment went something like this: "In all my years of practice, I've never had a patient who had osteoarthritis of the knee who was also thin."

Of course there are thin people with knee pain and/or osteoarthritis (I was the former). But the fact that a doctor who sees dozens of patients a week would make such a comment tells you that they're more the exception than the rule.

The relationship between carrying around too much weight and knee problems doesn't surprise me. During my research for Saving My Knees, I was impressed by how human knee cartilage has made a lot of neat adaptations -- related to obtaining nutrients, dumping waste products, growing stronger -- based on movement and load (i.e., weight). The right amount of loading encourages the tissue to strengthen. Excessive load starts to break it down.

Researchers know this weight-knee pain link exists. During my recovery, while reviewing scientific studies about knee cartilage, I noticed the first thing that researchers did when organizing the results was separate the heavy subjects (higher BMI) from the thin ones. Which is basically a way of acknowledging that of course extra pounds put you at higher risk, so to keep the results relatively clean (and unskewed by this variable), the large people should be segregated out.

What if you can't lose weight? A while back I read a complaint from a girl with knee pain that went like this: "Don't tell me to lose weight! Every time I try to exercise in order to lose weight, my knees hurt!"

Ahem. Reality check. While it's certainly easier to lose weight through vigorous exercise, the best exercise is the one you don't do: repeatedly raising your hand to your mouth to insert food. Eat smarter, better, healthier, and you can lose weight. I managed to do so while living in Hong Kong, and that was at a time when I really had no extra weight to lose.


  1. I already wrote about weight loss on one of Richard's other posts about weight, but I'll do a summary here in case it helps anyone reading this blog.

    I myself did lose 30 pounds with no exercise so I can tell you as a fact that it is possible. I couldn't do cardio due to knee pain -- no, not even swimming. Even with bad knees, people can still do upper body and abdominal strength training ... But I but had to cease due to an injury.

    Weight loss is not easy! Even people who have healthy knees and can do cardio find weight loss a challenge. It takes a lot of focus and commitment day after day after day. But, it is possible -- and not being able to do cardio is NOT a deal breaker.

    I had first tried to lose weight by buying a book, or two, or three abouT eating differently to lose weight. If you succeed in losing weight in that manner, congratulations! Personally, I did not succeed that way so started looking for other options and signed on to a specific diet program and I'm happy to say it worked for me! Being part of a program gave me access to couselors who can guide my process and make sure I'm losing weight in a nutritionally safe manner. Being part of a program also get me access to a community of others going through the same struggles and it was helpful to be able to share and learn from each other.

    I don't say the program I chose because I don't want to sound like a commercial. But, there are many programs out there. Some have guidance counselors who you can talk to on the phone or in meetings. Some have online materials and discussion groups. Some have food that you buy from them. But they ALL work on the principle of eating less calories than you expend.... Which is simple in principle but challenging to execute day after day after da after day for weeks and months.

    My main point is to encourage anyone reading this blog that YES it is possible to lose weight even if you can't do cardio exercise due to bad knees.

    1. I forgot to add this!

      In January, I reached my target weight. Knee still giving me pain and problems. No miracle cure ...yet!

      In March, I embarked on yet another focused and determined effort to heal my knee. Amazingly.... It seemed to work better than any of my previous attempts! My knee got better and better in tiny tiny tiny bits of progress. I did still have a few setbacks but nothing major. Now it is August and I can walk without pain, bike 20 miles without pain! It's amazing!!

      Was the weight loss a major factor in this new found success?? I don't know. My knee therapy efforts starting in March included some new things I hadn't tried before including gentle movements in water while floating in the deep end and also journaling. I feel that my lighter body weight did contribute to my new found success but would not have led to healing on its own.

  2. This is great, Knee Pain. I'm very happy for you. It sounds like you're winning the battle. Congrats!

  3. knee pain. I too have a bad knee, I am losing weight, I walk on a treadmill about two miles three to four times a week. I am hoping as I lose weight, it may not take away all my pain. But it does help stamina and flexibility. A lot.
    I think it is great your doing so well.

  4. I know for a fact my knee pain is due to my weight. I yoyo and I know when I exercise it gets better as I lose the weight and my intensity can get higher when I'm not in pain and my body is lighter.

  5. Your fat deal with it.

    1. And you're a loser trolling a knee pain page at 2:44 am. Someone needs a life or a significant other I'm guessing.

    2. I think you'll find the word is "you're", troll.

    3. I think the truth is your most probably obese yourself and you haven't seen your dick for years and your frustrated come on admit it

    4. Agree. This is a test to check unhealthy overweight. Stand straight, just bend your head down without bending neck. Can you see your "D". Over weight will see their tummy but not below. Some time you may be little over weight but have muscular tummy stuck in.

  6. I am at 246# 5'8...I WAS at 285. Losing 40 lbs took almost a year. I still have 81 to lose.
    Decided to get more physical and began hiking and playing soccer. Big Mistake. Torn ACL. Very discouraged :( currently awaiting surgery and swimming a lot. Treadmill was greatly discouraged. My goal is to get back into soccer and hiking by next year. Meanwhile scared Ill lose my momentum and willpower