Saturday, January 19, 2013

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

Last week I revealed (to a chorus of groans, I’m sure) that the one, simple thing that everyone agrees on for reducing knee pain is:

Lose weight.

This week, I’m going to provide more evidence (I say “more” because I’ve already visited this topic, here and here, bearing lots of evidence.) But the “lose weight” message is important enough to merit periodic revisits.

So here you have yet more proof, in round-up fashion:

* A report published in the August 2009 issue of the periodical Radiology linked obesity with the rapid progression of knee osteoarthritis and cartilage loss.

All 336 subjects, though overweight, started out with minimal or no loss of knee cartilage. During the 30 months they were monitored, one-fifth of the patients lost cartilage slowly and 5.8 percent lost it rapidly. For every 1 point increase in body mass index, the risk of rapid cartilage loss jumped by 11 percent.

* A 16-week diet that included protein shakes and soups helped people lose weight, lessening joint pain, according to findings published in the December 21, 2011, issue of the European Journal of Clinical Nutrition.

The 175 obese people in the study lost an average of 26 lbs. in the first eight weeks. Dropping all that weight had a significant impact; it “helped more than 60 percent of the participants reduce their knee pain and improved their ability to walk.”

* Another study looked at morbidly obese patients who underwent surgery (such as bariatric) to spur weight loss. A year later, they had lost almost 51 lbs. on average and reported significant improvement in knee function and less pain.

* A higher BMI means more knee pain among women -- whether or not they have osteoarthritis -- according to a study published July 7, 2011, in Arthritis Care & Research.

The 594 women who took part were examined over 14 years. “Significant predictors” of pain were found to be greater initial weight and weight gain. (Curiously, the relationship applied only to patients with pain in both knees, not just one.)

* A study of 20 morbidly obese youngsters, average age 14.2 years old, showed that each had a cartilage lesion in at least one knee region, as indicated by MRI.

The defects (surprising in adolescent children) were similar to those found in victims of “various accidents” or in older people.

It was unclear, at least at the time of this 2005 report, whether the cartilage damage was due simply to mechanical overload or whether metabolic factors might also be to blame.

* And, just in, published December 27 in Arthritis Care & Research:

196 subjects (from 25 to 60 years old) were split into three groups: those who lost 5 percent or more weight during two years, those who gained 5 percent or more and those whose weight remained stable (everyone in between).

Those who put on extra pounds reported stiffer, more painful, worse-functioning knees, whereas those shed weight boasted of the opposite.

So there you have it.

Evidence -- pretty much overwhelming at that -- that losing weight is one of the smartest things you can do to beat knee pain.


  1. If someone is not obese, they may think that these studies don't really supply to them.

    But, if you google "BMI chart," you can see that even within the healthy BMI range there is range of 30-35 pounds. 30 pounds is a LOT! For example, 4 cubes of butter = 1 pound, so imagine walking around all day with a backpack full of 120 cubes of butter in it! Or, a backpack full of approximately 35 cans of soda.

    So, even if you are not obese or overweight, there could still be room to shed some pounds.

  2. What if you have very low body fat but you are still on the upper end (or a little beyond) the normal body mass index due to naturally more muscle mass on both legs and upper body?

    1. Well, obviously I can't see what you look like, and it could be that you have no fat to lose, only muscle mass. But -- my experience has been that most people tend to overestimate how much of their extra poundage is muscle and underestimate how much is fat. I'm not saying you have a lot to lose, but you may have a few pounds. Only you (or a therapist with a caliper) can answer that. :) Good luck!

  3. Hey there. My comment was about folks like me who had a healthy BMI but still had room to lose fat.

    I don't know what to tell someone who already has very low body fat except for congratulations! :)

    Personally, my goal is to actually grow more muscle at this point. Even though muscle weighs more than fat, but, that's my personal choice as a way to be fit.