Tuesday, July 28, 2009

How to Lose Weight with Knee Arthritis

There is a large amount of evidence that proves losing weight decreases knee pain in those suffering from osteoarthritis.
Unfortunately, it is the pain itself that is usually responsible for weight gain.

It is natural to want to avoid pain, so arthritis leads to decreasing activity levels. This often happens slowly at first but before you know it the pounds are on and they don't want to go anywhere. These extra pounds put more strain through the knee and lead to more pain, completing the vicious cycle.

So how do you break out of the downward spiral of pain and weight gain?

Firstly lets start with a good amount of common sense. Weight loss is difficult with two fully functional legs that are pain-free. In order to achieve weight loss with arthritis you need to formulate a plan and stick to it.

Weight gain occurs when the fuel going into us is not matched by the work that we do. To lose weight we need to use up more energy than we provide ourselves. This needs to be achieve by limiting what goes in, and increasing the work we do, removing stored fuel from our bodies.

A quick word on dieting: What is required is a lifestyle change towards healthier food. You can forget fad diets or anything targeting rapid weight loss. Health Magazine published a list of the Top 10 Healthiest Weight loss plans. A panel of doctors, scientists and nutritionists rated over 60 programs to find the overall best. The winner was the Structure House weight loss program that educates to achieve lasting results. As you can pick up the book for around $10 (see link in side panel under 'I recommend') this should be the limit of your outlay on the dieting side. Anything costing hundreds of dollars should be avoided as it is usually all marketing and no science.

OK, so you are on the way to eating better. Now the hard part. How do you exercise with knees that cause so much pain?

Here are my tips:

  • Avoid any exercise that increases your pain. We want to increase overall activity. If you have a major flare-up and don't walk for 2 days you will do less not more. You will not be able to 'push through' the pain. It doesn't work that way.
  • Start gently. Measure how much you walk each day over a few days (a pedometer is great for this) then gradually increase. You don't have to start off with any specific knee exercises. Just try and walk more.
  • Don't be rigid in your activity. You want the average activity to go up each week. If you are having a bad day with strong pain, take it easy and make it up when things are better. Forcing yourself to walk a mile on a bad day causes flare-ups and usually results in you quitting the exercise program.
  • Consider water. Exercise in water reduces stress on weight bearing joints. This means you can do more work without increasing pain. Even if you can't swim, waist deep water has some benefit, chest high water more.
  • Work the arms. Although increasing thigh muscle strength is of benefit to knees also, for the purpose of losing weight, your body doesn't care where the work is done. Burn off more energy than you put in and your pounds disappear.
  • Use whatever helps. If your pain is less in the middle of the day do your exercise then. If painkillers are effective for you, do your exercise an hour after taking your pills. If you are stiff and in pain first thing in the morning avoid exercise at this time and ease yourself into the day. Consider a knee brace or support if it helps you do more.
These are just a few ideas to get you started. It is also a great idea to combine a weight loss program with specific exercises to build the quadriceps muscle as this also helps decrease pain. Finding the right one (that doesn't cause a flare-up) takes a bit of trial and error. A Physical Therapist is helpful here to guide you through the process. The will know 20 or 30 different ways to exercise your quads. One of them will work for you.

Now we have covered food and exercise all you need is a large dose of motivation with a bit of commitment thrown in. Always the toughest two ingredients to sustain.

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