When it comes to knee pain though, I’d argue that it’s not bad to be a broken record about one thing anyway. And that’s the single factor that, more than any other, predicts whether you’ll have knee pain.
It’s simple:
Being overweight.
A new meta-analysis of existing studies found that “one-fourth of cases of onset of knee pain could be attributable to being either overweight or obese,” according to researchers at the Arthritis Research UK Primary Care Centre.
That may elicit a yawn from you, especially if you think I’m a bit of a broken record on this subject. But here’s the part I found shocking:
5.1 percent of new knee pain/knee osteoarthritis could be attributed to a previous injury and 24.6 could be attributed to being overweight or obese.Wow! Didn’t see that coming. What a disparity. If anything, I would have expected a previous injury to be a more significant contributor to the onset of knee pain. But it isn’t. And it’s not even close.
If I were an orthopedic doctor, and I had a patient with knee pain who was overweight and who claimed to be serious about doing whatever it takes to get better, I’d say:
“Lose x pounds. That will show that you’re really serious.”
Because if you are serious, and you are overweight, shedding some pounds has to be a No. 1 priority. On this point, the evidence isn’t debatable.
Yes, there is so much food temptation. It can be so hard to lose weight once your exercise options have become limited. I liked your books mention of brown rice & garlic. Brown rice is so much tastier than white rice.
ReplyDeleteI have a question about inflammation. You mention you always backed off when it was suspected. I'm wondering what your inflammation symptoms were? Obvious swelling? Redness? Is ordinary garden variety stiffness & soreness a sign of inflammation? I have read that "motion is lotion" & that you should keep on moving appropriately to get rid of the "garbage". So my two big knee challenges are not to early too much and not to be a "Humpty Dumpty" when my knee is stiff & sore. Thanks for keeping the blog going.
For me, signs of inflammation or signs that I had overdone activity were excessive (more than normal) amounts of burning in my knees, stiffness, swelling (mine was always minor, so I was lucky there), achiness. There's definitely a difficult balancing act though, between backing off and getting in enough movement. I like that "motion is lotion" line -- very true.
DeleteTypo. "Early too much" should read eat too much.
ReplyDeleteHello! :) I'm 19 and I was diagnosed with chondromalacia patellae 2 years ago- since then, I've had some many periods of time when I was pain-free, but sometimes, when I was at my worst, my knees would 'burn' when I'm sitting down, walking and standing up. For the past two months, I joined a gym to lose weight and I started doing lots of squats and using the stationary bike with high resistance because my trainer said that these exercises were 'good for the knees' and were effective to lose weight. My knees always kind of burnt whenever I was doing these exercises, but the pain always subsided the next day. But yeah, anyways, I don't know what I did last week, but after using the stationary bike for a bit longer than usual, my knees were burning so much that I could barely walk- and they've been like this for 4 days already. I don't know what to do, I'm desperate. I thought I was doing well, but then this happened. What should I do in order to lose weight and at the same time save my knees? Thank you in advance! :)
ReplyDeleteHi Jia Le, from my experience so far I'd advise you to stop going to the gym for a while and maybe start going for short walks everyday. Also you can do some knee friendly exercises like quad sets. Some exercises for your core will make you stronger without damaging your knee. For now try to do some planks and bridges 3 times a week.
DeleteAlso...one of the most important things to loose weight is to watch out what you eat... I'd say is more important than going to the gym. Stop eating gluten and dairy, switch to almond milk for example, do not eat bread or processed food, sugars... Eat fruits, vegetables and fish. You can also eat some meat, chicken, nuts... But forget sugars and gluten.
That's what is working for me, I also have chondromalacia.
Hope this helps
Athenea
Oh another thing you could do, from what I know, if you wanna keep doing the stationary bike, do it with no resistance. This way you will improve the synovial fluid thickness and your knee should feel better.
DeleteBe patience... unfortunately this is not an overnight thing!
Athenea is spot on. Forget the squats, start walking, and weight loss is roughly 80% diet. When my knees went south and I could no longer train intensively for 8-14hrs a week, I changed my diet (mostly reduced processed carbs and sugar) and my weight has stayed around 64-65kgs (when I raced, it was about 63kgs). I also swim 2-3x/week, but minimal kicking - small pull buoy between thighs and ankles strapped together with an old bike tube. You can get a really solid 20-30min aerobic workout, doing hard 100m repeats with short rests (30-60sec) inbetween.
DeleteHi TriAgain,
DeleteThanks for mentioning about the putting a bouy between thighs for arms-only swimming. That's a great idea! In the past I've tried arms-only swimming but my legs and lower body were just too much of a drag. Literally and figuratively. So. Next time I'm at the pool for gentle knee water therapy, after those exercises i will try the idea of a bouy between thighs for arms-only swimming for a cardio workout.
- K Star (formerly known as Knee Pain)
Some good suggestions here, Jia Le. My guess is the stationary bike with high resistance was maybe not a good idea, and it finally caught up with you. But the fact that you were able to do exercise that intense should bode well for your chances of healing. You might try dialing back on the bike, maybe low or no resistance (or if biking doesn't work for you anymore, perhaps slow walking can help). Good luck.
DeleteK Star, you definitely need the bouy or it is too hard. My past triathlon coach (the one probably responsible for the sorry state of my knees today as a result of his big-gear grinding windtrainer sessions) also used to get me to swim with legs tied together, but no bouy. Unless you have an incredibly strong core to keep your legs up, they sink and drag and it is extremely hard to swim. Would be no fun at all in the context of knee rehab which is hard enough as it is!
DeleteHi TriAgain,
DeleteI was all set to try the bouy idea, but then I sustained an upper body injury and have been unable to use my arms to swim. Good grief. How ridiculous! So.... since February my eagerness to try this swimming with bouy idea has just increased!
- K Star
Also, I'll comment that if your knees are too bad to exercise, it is def possible to lose weight just by controlling your food intake.
ReplyDeleteAlso, if your upper body is healthy enough, it can help you achieve weight loss goals by doing upper body strength training, abs, and back. No knees required! :)
- K Star (former known as Knee Pain)
Yes actually this is so true, I wanted to add that since I started with my knee pain I decided to follow a better diet. More vegetables, fish, protein supplements, fruits etc... I'm basically not eating sugars (well from time to time I do it dark chocolate or some honey but it is not part of my routine), nor pasta, bread, cereals...
DeleteMy objective was not to loose weight at all, but I did it, and no matter what I can't put on weight! I've lost 6 or 7 kg... And I'm eating well, I eat a lot actually, but just 'good stuff' :)
Give it a try.
Best
Athenea
I am hoping to have learnt something valuable from this set back. I saw the pain researcher/ physical therapist Lorimer Mosely speaking on a TV program called "Ouch" He has a great TED talk that I did not pay enough attention to. It seems that after tissue damage has healed, pain can continue because our brain interprets the signals it is getting about our activities as "dangerous.activity going on here" .
ReplyDeleteWhen I walked for 10 minutes, used the total trainer, used my medi pedaller, I was anxious about the outcome. My brain was expecting danger. I got stiff & sore.
There is a psychology 101 experiment called "Facial Feedback" The research involved putting a pencil between participants teeth so their faces had a smile arrangement of muscles. Results? The mood of the experiment participants improved. The theory is, that if your smile muscles are activated, your brain thinks you must be happy. (And hence not in danger) So my new plan is to have a smile on my face when I walk or exercise & to make positive statements to myself about how good movement is for me. Lots of repetitions of "move to improve"
Further thoughts. I need to add that Lorimer Mosely says that the pain is real and not to be ignored. He says a key to recovery is gentle exercise and a little more each day.
ReplyDeleteI have come to think that my brain has been tricked into thinking that my exercises are doing further tissue damage. When in actual fact, there is lots of anxiety about doing too much that my brain interprets as danger, pain warning needed here. My plan is to try to build up to 3x 5 minute sessions of walking per day. ( with walkarounds, medipedaller, pool tailgates as incidental)
I'd like to add that when you are training to heal tissues such as patellar tendon or cartilage, it is normal to have some symptoms (minor pain) after exercise. The general trend should be of improvement though. I'd like to try meditation ... Never done it before so I guess it will take me a while but I believe it can positively influence my mood and help to stay more calm and focused.
ReplyDeleteAthenea
I work with people on my job. I noticed that when I have a pleasant conversation knee pain is less. When conversation is tiring and boring, the pain is stronger.
ReplyDeleteTherefore, in my experience, mood influence on knee pain is significant.
On the other hand , the best pain killer for knee pain is beer. When I drink two or three beers, there is no pain at all. I think this is only partly related to alcohol. Whiskey or wine do not have such an effect on my knee pain level.
Goran
Same here! I experienced a lot of stress last year, and my knees went from bad to worse despite not doing anything else than slow walking.
DeleteWhen I started the hydrotherapy, I decided to make it as much fun as possible, there is a group of people with various ailments but all are in a brilliant mood despite the pain. And I'm having such fun, my knees feel better almost instantly. Same when I am on holidays, relaxed, with people I love.
I don't really drink much, a half glass every now and then, so I wouldn't really know the effect on the cartilage, but alcohol destroys cells so I can't see how this can have a positive outcome? Or may be it's just the feelgood and relaxing feeling that are at work here?
I stopped drinking alcohol when my knee pain started. Actually I remember it was my bday and my pain was not really strong at that time so I had a few drinks and enjoyed so much the night. BUT the next day I wanted to kill myself, not only for the hangover but for the horrible inflammation and pain I had in my knee.
ReplyDeleteSo I'm not drinking at all at the moment... That is my personal experience but I think alcohol promotes inflammation so I'd not advise people to drink ;)
It was not my intention to promote alcohol as the wounded soldier does not promote morphine. But if alcohol, at least for the short time, make you feel normal, I'm not against it, especially on certain occasions, such as birthdays...
ReplyDeleteI also feel more pain after drink but I think it is also caused by the greater freedom of movement because you do not feel the pain and do what you should not do.
Goran
Experiencing Knee pain has really messed with my mind these last 3 years. There is a whole mix of disappointment, anxiety, frustration. In short lots of negative stuff. I have spent a lot of time finding out about mindfulness and I try to do mindfulness meditation every day. John Kabat Zinn is a great resource for mindfulness & you tube have some clips where he demonstrates meditation practices. Also Diana Weston. My tee total phase is back to a small glass of wine per day.
ReplyDeleteDon't drink booze. Don't have the space here nor the inclination to explain why. You'll have to trust me- No booze helps heal the knees. Even if not drinking only helps 5%, that's 5% toward your cure. That's how I think about my cartilage: all the right moves add up. a % here and a % there, to as close to 100% healing as possible. I still have 20% to go. I may never get to the promise land, but I am 10X better today than a year ago. And 15X better than 2 years ago when my MD's were writing me off as an old car. I think Richard has demonstrated that cartilage can heal, but we all have to discover our own unique risk factors and add in our variables for cure.
ReplyDeleteOne last quick point. I think I remember reading about young females, hormones and a possible relationship to chondromalacia. Might be worth looking into.
Good luck to everyone healing their knees, R-X
So many of the above comments strike a chord in my case - the brain tricking you into pain (why can I go fishing for 6hrs walking over rough ground with minimal negative effect, but 10 mins of easy spinning = pain the next day), worse when bored, better with beer, messes up your mind (I really must try meditation - I remember it helped Richard).
ReplyDeleteHaving a bad flare up over the past few days. Why? No idea.
It is so hard to understand the symptoms. They are driving me crazy. I keep a journal and all but still ... sometimes it makes no sense.
DeleteMy coach says in less than a year I'll be dancing again but I think she is being too optimistic!! :S
I stopped my knee journal because I was concerned it made me dwell on the pain too much and like you, it was making no sense.
DeleteI've had another flare up since Sunday evening - brought on I think by squatting down and up a few times to release fish back into the water while fishing (I always release the fish I catch!). All weekend my knees were really good, even after doing lots of jobs around the house (vacume. mop, up a ladder cleaning windows), walking, swimming in the dam etc. Then just a few stupid little crouches and down it goes. It sure does drive you crazy.
I hope your recover from the flare up soon! What I don't understand is for example why today I squat and I have no pain, few days later I squat and I have pain.
DeleteSometimes you can say ok, you have been walking more, or doing other things etc so that is the reason, but without having changed your routine at all, how do you explain it...? It's hard to know!
At the moment I'm really worried because my left knee doesn't seem to improve at all, whereas the right one is doing great... And I have followed the same recovery program for both..
Anyway, let's wait and see!
Athenea.
Nerves are tricky. In 20 months of my pain I didn't manage to understand patterns. It's extremely frustrating. Last 10 days my pain is stronger. I'm considering another orthokine treatment.
ReplyDeleteGoran