Saturday, January 12, 2013

What’s the One Piece of Advice That All Knee Pain Doctors and Experts Agree On? (Part I)

Occasionally, as I’ve noted before, I get a taste of how confusing it must be for a new knee pain sufferer seeking relief. Chase a few helpful-looking links on the Internet and your head will be set awhirl.

Stretching should be part of a program to beat knee pain! Stretching is useless! Take glucosamine for proven relief! Glucosamine is a placebo! Ice your knees to subdue inflammation! Inflammation is good; it’s a necessary part of the healing process! Strengthen your quads! Don’t worry about strengthening your quads!

Then you have the many unorthodox methods for overcoming knee pain, from acupuncture to squeezing an inflatable ball between your knees while sitting. And, even when a piece of advice seems to be consistent across practically all web sites (you need to move!), there’s much disagreement on how to interpret this in practice (what kind of movement? how much?)

So, considering the welter of conflicting, confusing signals about how to treat your bad knees, when there’s a bit of simple advice that’s easy to interpret that everyone agrees upon, shouldn’t we sit up and take special notice?

I would certainly think so.

At this point, I hope I’ve piqued your curiosity. The idea behind the buildup of suspense is to engage you the reader in really thinking about, “What can this be? And why doesn’t everyone do it?”

Because, once I draw back the curtain, you’ll probably react with a deflated, “Oh, he means that.”

So here goes.

100 percent of everyone out there agrees, for relief from knee pain ...

Lose weight.

Okay. I’m imagining the hue and cry already. Some of you are probably protesting: But I’m not overweight! Doesn’t apply to me!

My guess, however, is that it does. As I’ve said before, I think more than 90 percent of knee pain sufferers (and maybe more than 99 percent) could benefit from losing at least a little weight. I was skinny when I battled knee pain. Still, I forced myself to shed about three pounds. And I think it helped.

Knees are extraordinary in many ways, but one of the most remarkable has to be how knee cartilage has evolved so many mechanisms for surviving and thriving based on mechanical feedback, i.e., based on forces and pressures exerted on it. And that’s going to be influenced by how much you weigh. That’s not a conjecture on my part. That’s simple physics.

Here’s a quote I recently came across from orthopedic surgeon Ronan Banim that starkly (and effectively) summarizes the problem:
In clinics we are seeing knees that are literally being crushed by excess weight.
How's that for graphic imagery?

Next week, it’s time for the evidence. I’ll provide a roundup that further illustrates why losing weight = a smart way to start addressing that knee pain that’s been bothering you for so long.


  1. Thanks so much for the reminder, Richard! As a marathon runner, I am thin - but your own experience with losing just 3 lbs. is good to know! Thanks again for helping us, and your blogs are a weekly dose of encouragement. ~Theresa

  2. I used to think it would be too hard to lose weight without being able to walk, run, bike, etc. It turns out that what you eat plays a much bigger factor into losing weight than exercise.
    A little packet of hot chocolate mix may seem small, but if that packet is 100 calories, the typical person would need to walk 1 mile to burn those 100 calories. It's far more efficient to just not eat the hot cocoa packet and have hot tea instead which has zero calories.

    I was able to lose 30 pounds with nearly zero exercise (due to knee pain) other than just moving around to live my life. The body burns calories just by doing regular body functions such as breathing and circulaton. The rate that you burn calories just by being alive is called your basal metabolic rate (BMR). BMR doesn't include the energy it takes to move around for regular daily functions such as getting dressed, going to work, buying groceries, etc. So, even If you can't exercise, you can still lose weight by eating fewer calories than you burn via your BMR plus any movement. For example, I can't move around a lot due to knee pain and it's estimated I burn 1800 calories per day. So, my goal when losing weight is to eat less than that per day, such as 1200 calories. (while also adhering to smart nutritional choices in order to stay healthy and have energy.)

    The tricky part is coming to realize how many calories are in everything. Something can look small and innocent, and yet have a lot of calories. For example, if i learn that a certain muffin i love has 300 calories and realize that is 25% of my ideal daily caloric intake, i may decide to spend my 300 calories with a different eating choice such as 2 small chicken apple sausages mixed with cooked cauliflower, onions & broccoli sprinkled with a bit of low fat cheese. Mmm!

    One way you can help yourself burn more calories without traditional aerobic exercise is by building muscle such as doing strength training for upper body and core/abs. This helps burn calories in 2 ways: you burn calories by doing the strength training itself and then also you burn more calories in general because muscles burns more calories than fat even at rest.

    Personally, I joined a particular diet program to help guide me in my weight loss journey and for me it was worth it because I had such great results.... Even without exercise! So, if you've tried and tried to lose weight on your own without results, consider looking into weight loss programs and find one that you feel will work for you and your lifestyle.

    But, anyway, I mainly just want to encourage people that it IS possible to lose weight even with knee pain that prevents you from much aerobic exercise -- even walking.

    1. Some great ideas here, Knee Pain! Thanks for weighing in -- um, so to speak. :)

  3. By the way, to find out how many calories you burn per day, google "Calories per day calculator" and you'll see a bunch of search results. Use a calculator that lets you plug in your approximate activity level.