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Author Topic: HELP - Continue to exercise & lose wt or save what's left of knee cartilage??  (Read 9660 times)

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Offline olga23

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Hobson's choice, of course >:(  I'm over female , over 50 (& yesterday my knee specialist quoth I'm TOO YOUNG for TKR ::) ) about 40 lbs overweight (after losing 40 more & plateauing for last 2 yrs - it's later than you think dept...)  The only way I've been able to maintain even my current obesity is via 1200 cal/day diet (MOST of the time ;D) + 60 - 90 min. day weight-bearing exercise (walking, elliptical, mini trampoline.)  Yesterday my joint doc said my OA was now severe & I should immediately desist from all weight-bearing exercise - he recommends the standard swimming/water activities & biking, but I'm no swimmer & it's very inconvenient to get to a pool, anyway; & biking has never helped me reduce my weight, although I do own a staionary bike.  As I'm in menopause, I'm concerned about heart disease (have borderline hi cholesterol & blood pressure, but taking no meds, was relying on exercise to reduce these counts along w/weight) & cancer  (breast cancer in family -  exercise reduces that risk, so "they" say.)  The doc has no other advice for me (I'd gone to see him as I suddenly became unable to bear my full weight on my left (worse) leg & am now (for 5 wks) moving with a shuffling limp (but can do the elliptical  fine!)  As apparently, a TKR is in my future at some point, I'm tempted to ignore unhelpful doc & focus on fast weight loss via more stringent diet & my usual weight-bearing exercises, as the left knee (at least)  is now apparently shot, so why not sacrifice what's left of that knee to try to get the rest of my system in better shape.  Comments welcomed!

Offline Nettan

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I would go find a doc who can do a TKR on you. This sounds really ridiculous.
I mean you need to move around to loose weight for your health, but he says you can't cause you need to save your leg. Look around and find someone who can and will help you. I'm sure you can have a TKR already know, lots of people are younger when they get them. Well done of you loosing the weight.
Wish you best of luck !!

HUGS NETTAN  8)
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline olga23

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Hi Nettan & many thanks for response.  I called & left a message for this knee doc re the age that is "old enuff" for TKR, but no reply from him yet.  As with most terrified  :o  patients, I'd MUCH prefer to delay TKR to the max, but only if I can regain a more normal gait - this shuffle is painful & very tiring (as well as totally humbling, when I realize I'd never previously considered how painful, exhausting, etc., ambulation is for those with permanent lower limb issues.) I sure would like to know if others with progressing OA have been told to avoid weight-bearing exercises to save their cartilage - this totally flies in the face of info I'd earlier received from other docs & in published reports re the many benefits of moderate exercise on OA.  (Oh, yeah - to state as I did in my first post that I am "over female"  :D was definitely a typo - EstrogenDepletion is my middle name!)

Offline BikeRider

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Make sure the 1200 calories that you eat are GOOD calories. Cut out ALL sodas. Drink water. Diet drinks don't work. If you need the fizz, get the flavored seltzer waters. I drink them and it satisfies the need for fizz. Also, get a good exercise bike, not a cheap one. Get something with some computer feedback so you can set goals and see improvement. And the computer controls the resistance. And don't kid yourself. People that are fat are fat because they are doing the wrong things. Eating the wrong things and too much of it. Losing weight and keeping it off can be very hard.  If you want to lose weight, you will find a way. My patella was shattered over a year ago. I kept from gaining weight by being very careful what I ate until I could get my activity level back up. Now I am back riding a bicycle. I can no longer run ever again, so my bicycle is all I have. I too am not much on swimming. Mainly because it is too hard to get over to a pool. My cycling I can do when I want. I use my road bike on a set of rollers when the weather is bad and I can't ride outdoors. Rollers are tricky, so stick to an exercise bike. But get a good one. A recumbant works good.

Offline Natalie.D

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Hi,

I'm in pretty much the same situation as yourself but I'm only 38.  I have been told that I'm too young for TKRs although the knees are at the stage where they need one!  However, since the OS said that its pretty much as bad as its going to get I decided to go for the exercising, BUT I have modified a lot of the exercises to create the least amount of pain.  I don't like swimming much so have settled on normal walking on my treadmill, about 1 mile every night, I also have a trampette but find that I cannot jump on it but what I can do is sit at the side of it with my feet on the floor and push with my quads and bounce my behind on the trampolene (I hope that makes sense), I was amazed at how tiring it was and how much it works my quads.  I also bought a mini bike which is just like the pedal section of the bike, I sit on an upright chair (dining chair) and pedal for about 4 miles every night, I originally wasn't really trying to lose weight I was more concentrating on strengthening up the muscles but I'm finding that I'm losing weight anyway which is an added bonus.  Some days I know I've overdone things and have trouble walking for a day or two afterwards so I just wait until the pain is bearable again and take it slower for the first couple of days, for me, doing even a little is better than what I was doing before - nothing  :-\ and although I'm in a bit more pain than I was I'm just gritting my teeth and exercising anyway because, for me, I can't really do any more damage than is already there and if I can strengthen up the muscles and lose a bit of weight then its obviously going to benefit the knees with less pressure on them and stronger muscles to support them!  Good luck with the continued weight loss.

Have you tried hydrotherapy?  I'm doing 2 x 1 hour sessions a week at the local hospital (I had to get referred by my PT) but it really is working wonders for me because in the pool you have no weight on your joints and I can do a whole range of exercises that I can't do on dry land.  It might be a good option for you, even though you say its difficult to get to a pool, if its at all possible I would certainly recommend trying it.

Natalie.
« Last Edit: October 16, 2006, 01:45:12 PM by Natalie.D »
Dislocations since age 12
Trochlear Dysplasia
Maltracking
Hypermobile
LR/MR-failed
TTT, LR, MR L knee 95-Success
TTT, LR, MR R 02-Success
Screws out
Partial tear ACL
Severe end stage OA
4 Debridements
Partial Meniscectomy
Failed Microfracture
11mm Defect LFC
Bone Spurs, Kissing Lesions

Offline WhiteH2OWoman

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Olga, I hear you, believe me, and I'm in a similar situation.  I'm a lifelong athlete, former long-distance runner and competitive weight lifter.  I'm female, 48 years old, and I'm scheduled for TKR on November 20th--8 days from NOW!

The biggest mistake I made when I transitioned from being a competitive marathon runner was to allow my weight to drift up from 114 lbs to 120, then 130, then 140, then 150...sure, it's mainly muscle, but it's all weight to my poor knee.  Fat or muscle, extra pounds are still extra pounds to your knees.  Bodybuilders suffer as many knee problems as obese people--extra weight on the knee is extra weight on the knee, period.

At one point, I hit the 170's.  Then I lost 20 pounds.  8 months ago, I was 150.  But then my knee got so bad I had to cut back on walking & biking and so I've gained 20 pounds in the last 8 months. 

I had to give up running 2 years ago on doctor's orders.  At the time he told me to get my weight down to 125-130 and I simply did not do it.

I used to run a personal fitness training business.  My best advice to you is this:

1. Make the effort to drive to that pool and swim, even if you don't like it.  It will get your cardiovascular system in shape.

2. No, do NOT do weight-bearing exercise if your doctor told you not to.  There's more here at stake than just that bad knee--you may be stressing out your OTHER knee, too, and both hips.

3. Stay on your diet, and walk as you are able.  Lift light weights, high repetitions.

4.  Have that TKR and recover--do everything they say, and continue your diet and swimming.

Here is my motivation and yours to lose weight:  if we don't, we can look forward to having the other knee done and probably both hips within 5 years.  As you know, that is very painful and expensive.  And if you run your own business like I do, you don't make money when you're out sick.

Use this for motivation!

Another powerful motivator for me is the growing shortage of orthopedics in the US.  It's already at the point that you have to wait weeks for an appointment, the waiting rooms are always full, there's always a long wait once you're there, and the doc is so busy he only sees you for about 2 minutes, tops.

And it's only going to get worse as more and more Baby Boomers go in for knee and hip replacements, particularly since public acceptance of joint replacements grows...more and more people will demand them.  The docs will be swamped. 

MUCH better to lose the weight now and stay OUT of the doc's crowded office!

Offline olga23

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Hi & Happy Thanksgiving - no diet being followed today, I admit ;D  Thank you all for your informative & helpful replies.  Since I wrote the original message, I've become a regular (if reluctant) "water walker" at the YMCA, to the point of wearing the skin off the balls of my feet (typical - I tend to overdo everything or do nuthin'!) & have also received knee acupuncture (which has truly amazed me with its pain-relieving ability, much greater than any med/Synvisc injection/arthritis rub, etc.,  that I've experimented with for the last 10 yrs.)  I now find that when I use my elliptical, I'm in pain, so have pretty much set aside all weight-bearing exercise, but do use my ancient stationary bike twice daily, for 30 mins. each session.  I have one more question - does swimming or other hydrotherapy actually improve arthritis &/or its pain, or does it simply allow one to do exercises that are impossible on land?  For the last 10 days, I've been unable to get to the pool & my acupuncturist is on vacation -  & my knees are suddenly very painful once again, despite biking & daily PT exercises.

Offline Natalie.D

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I find that doing the hydro helps get things moving and strengthens up the muscles which in turn reduces the pain a little if the knee is stronger, I think the warm water helps relax the muscles too and that helps ease the pain a little.  Have you tried applying a heat pad to your knees (as long as you don't have any swelling)?  I find that applying heat works wonders for me and I plug myself in to my heat pad every night.  It might be worth a try.  Glad you're getting some relief with the acupuncture.

Natalie.
Dislocations since age 12
Trochlear Dysplasia
Maltracking
Hypermobile
LR/MR-failed
TTT, LR, MR L knee 95-Success
TTT, LR, MR R 02-Success
Screws out
Partial tear ACL
Severe end stage OA
4 Debridements
Partial Meniscectomy
Failed Microfracture
11mm Defect LFC
Bone Spurs, Kissing Lesions

Offline aliasgrace26

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I find it difficult to do any aqua exercises in shallow water, as the impact from my feet hitting the bottom of the pool caused my knee to hurt far worse after a few weeks...Also, my feet began to ache, too. I now stick to cool water aqua classes, in which I wear an aqua belt to stay afloat and do aerobics routines. I tend to take the classes at 6 a.m., so it's a struggle entering the chilly water, but it creates a nice, cool environment for my knee. Some prefer warmer water for their knees, though, which does make sense.

The elliptical machine can cause issues with body alignment, according to my chiropractor. She said the reason why people burn more calories on it than doing other activity is b/c it forces your body out of its natural stance. It makes your legs/feet/knees further apart, and can therefore cause more pressure on the lower body. I WAY overdid it with my elliptical machine for about a year, and believe that is what caused the return of my knee pain, stiffness, and scar tissue...
Tibigal platea fx. 12/98
Subsequent poor medical care that did not detect fx. immediately
Rigorous PT once fx. was diagnosed
Arthroscopy in 11/99 to trim plica and remove scar tissue
Chronic pain for 5 years, then a reprieve for 3
Return of pain/stiffness 2/07, in pain mgt., awaiting answers

Offline UK Girl !

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Hi Olga

If I were you I would see a nutritionist because if you are really only eating 1200 cals and doing all that exercise then you body is probably in starvation mode - you need to eat for your body to work and burn cals properly. 

A tkr should not be age related - but need related!
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline JMCDERMO

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Hi,

I'm in pretty much the same situation as yourself but I'm only 38.  I have been told that I'm too young for TKRs although the knees are at the stage where they need one!  However, since the OS said that its pretty much as bad as its going to get I decided to go for the exercising, BUT I have modified a lot of the exercises to create the least amount of pain.  I don't like swimming much so have settled on normal walking on my treadmill, about 1 mile every night, I also have a trampette but find that I cannot jump on it but what I can do is sit at the side of it with my feet on the floor and push with my quads and bounce my behind on the trampolene (I hope that makes sense), I was amazed at how tiring it was and how much it works my quads.  I also bought a mini bike which is just like the pedal section of the bike, I sit on an upright chair (dining chair) and pedal for about 4 miles every night, I originally wasn't really trying to lose weight I was more concentrating on strengthening up the muscles but I'm finding that I'm losing weight anyway which is an added bonus.  Some days I know I've overdone things and have trouble walking for a day or two afterwards so I just wait until the pain is bearable again and take it slower for the first couple of days, for me, doing even a little is better than what I was doing before - nothing  :-\ and although I'm in a bit more pain than I was I'm just gritting my teeth and exercising anyway because, for me, I can't really do any more damage than is already there and if I can strengthen up the muscles and lose a bit of weight then its obviously going to benefit the knees with less pressure on them and stronger muscles to support them!  Good luck with the continued weight loss.

Have you tried hydrotherapy?  I'm doing 2 x 1 hour sessions a week at the local hospital (I had to get referred by my PT) but it really is working wonders for me because in the pool you have no weight on your joints and I can do a whole range of exercises that I can't do on dry land.  It might be a good option for you, even though you say its difficult to get to a pool, if its at all possible I would certainly recommend trying it.

Natalie.
Left knee meniscus removal at age 11.
Arthritis all over, especially in left knee, which is rapidly deteriorating.

Offline JMCDERMO

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Sorry  Natalie and everyone else,

I pushed the button by mistake. I just wanted to thank Natalie for the great exercise ideas.  I have struggled with my weight all my life and now that my knee has gotten much worse, so has my physical activity declined.  I would love to know about any ideas people have about getting the best fat burning cardio type exercise with little to no stress on the knees. 
Left knee meniscus removal at age 11.
Arthritis all over, especially in left knee, which is rapidly deteriorating.















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