Medical Edge Newspaper Column

How Can I Start A Weight-Loss Regimen If I Have
Sore Knees?

Nov. 21, 2005
DEAR MAYO CLINIC:
I'm 48 years old, overweight and very out of shape. I had knee-repair surgery about two years ago and have never fully recovered. I want to exercise, but most activities hurt my knees. Could you make some suggestions of how to get started with an exercise program? -- Grand Forks, N.D.

ANSWER:
Because of your knee pain, I'd suggest you start by enlisting some help. Schedule an evaluation with an orthopedist or physical medicine and rehabilitation physician, who can recommend exercises to help strengthen your knees and minimize pain. You'll also learn how to care for your knees during and after exercise, by wearing a brace or applying ice.

I'd also recommend that you work with a physical therapist or personal trainer to get started. It's important that you exercise and use gym equipment correctly and safely to avoid injury to your knee.

Working with your therapist or trainer, write down your goals and a plan. Be realistic. Start small and gradually increase the time and effort you expend. Most people start too hard, get discouraged or sore, and lose motivation. Ideally, you'll eventually want to do aerobic activities that get your heart rate up three or four times a week and strength training two or three times a week. Your plan will likely include:

• Aquatic exercise: Walking in the water, water aerobics or swimming can help you build up strength and cardiovascular fitness. These activities are also easy on the knees. (One caveat: If you are trying to lose weight, aquatic exercise doesn't seem to help weight loss as much as other types of exercise.)

• Nonimpact aerobics: Stair steppers, elliptical trainers, bicycling and stationary bicycles are generally well tolerated and are good options.

• Low-impact aerobics: As your knee strengthens, you can advance to walking on a treadmill or outside.

It's great that you are ready to increase your physical activity. If you regularly do aerobic and strengthening activities, your program can help with weight loss as well as reduce the risk of heart disease, diabetes, hypertension and some cancers. An added benefit: Your knee will likely feel better, too.

-- Jay Smith, M.D., Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minn. Dr. Smith is the co-author of "Mayo Clinic Fitness for Everybody."