Q&A Wednesday: My Knees Hurt When I Work Out!

Q: Hello Erika,

How are you? I respect you for giving out the information that you have for us women. I just had a few questions for you.

Every year I say I am going to eat right and lose weight and I don’t. I have gained so much weight through the years that now every time I do get on the treadmill my knees hurt. They hurt so bad that when I lay down at night they throb inside. I know it has to do with the excess weight I have gained in my legs and around my knees. What kind of exercise do you suggest for this and did you go through this also?

Of all the things I went through, I didn’t go through this. I started out walking, and didn’t start toying with the idea of running until maybe 50lbs in. Running hurt, and I wasn’t about that pain life to begin with.

A frustrating factor of weight gain over the years is the impact it has on your joints. Your hips, knees, and ankles all take a beating trying to keep you upright without enough muscle to help get the job done and, when combined with a poor diet, ultimately can make the joint and the bone brittle and in need of surgical care.

That being said, when it comes to trying to lose weight before it gets to that point, you have to be careful. If your approach to weight loss prioritizes exercise in a “by any means necessary” kind of fashion, the larger you are the more you can jeopardize your joint health.

Imagine you’re driving a car with no shock absorbents over a pothole-filled road. You’re going to feel every bump deep down in your soul, right? Now, throw some poor quality shock absorbents on that car. Not only are you going to still feel every bump, though not as much as without any shock absorbents at all, but your shocks aren’t going to prevent any damage to the rest of your car. Soon, your bumpers going to start hanging low and wobbling to and fro. Your interior’s going to be falling apart, too. It’s just too difficult to keep everything in place and structurally sound when it’s constantly taking a beating.

Now, think of a car with high quality top dollar shock absorbents. It’s a smooth ride, you feel virtually nothing in comparison to before, and you’re thankful that your head doesn’t hurt so much by the end of the ride. Your car’s not falling apart after months of crappy shocks, so it’s easier and cheaper to keep your car in good health.

Shocks to a car are essentially the exact same as joints to a human body.

With every jump, your body absorbs the force necessary to keep you from collapsing into the earth like Michael Jackson in that puddle of glitter from the Remember the Time video. (Don’t look at me like that—it’s the only way I can explain it! LOL)

And, at every joint, the amount of force is lessened—your toes, your ankles, your knees, with your hips absorbing the largest amount of force and preventing it from going upwards to your skull. (Remember—people who take force head on, like football players, develop brain injury after enough time, and taking too much force at one time causes concussions. Your body has evolved to protect you from the traditional form of internalized force to help you avoid these kinds of consequences.)

Joints are protected by muscle in both helping with force absorption and keeping you from collapsing into the floor by flexing to help slow down or stop a fall, while also helping you brace yourself if you do fall as well as helping you get up if you do. Without muscle, your joints take even more of a beating.

It’s also worth noting, while I’m nerding out on joint health, that people who go on very low calorie diets with the intended goal of losing body mass often a) lose muscle mass as well as b) negatively impact their bone health, thereby guaranteeing poor joint health, a lack of muscle mass to ensure good quality of life, and brittle bones in their 40s and beyond.

This is important stuff. Clearly.

Those of us who are trying to lose weight and are also a bit on the larger side run the risk of harming our joints in trying to do too much at once. High impact exercises, like burpees or running can really put a hurting on you if you’ve got joint issues and, after enough time, can cause joint issues if you’re not both smart and careful.

Do I have tips for handling this? Of course I do.

1. Gravitate towards low-impact and high-energy activity for a while. There’s a reason why I started taking spin classes as my first exercises post-baby. I wanted something that would let me slow-roll my way back into being active, and give my joints time to get used to me being active at this size, while also getting me used to activating my muscles in a way that supports proper form.

Spin classes are great, but often not free (or cheap.) But know what is? Walking! Power walking, at that.

Whereas running requires you leaping into the air and crashing back down into the ground, walking encourages you to use your joints without the leaping. This not only strengthens the muscles around your joints, but also helps you burn the necessary calories to achieve your weight loss goal.

Anything that keeps your feet on the floor—or a comparable service—without a bunch of you bouncing around on the ground is good. Elliptical trainers, ab gliders, rowing machines…all very helpful. If those are too much, then just stick to walking on a treadmill with incline modifications, or—my personal favorite—walking outdoors.

2. Skip the super-low calorie diets. Joint health is muscle health, and muscle health is joint health. If you show me healthy joints in the absence of sufficient muscle mass, and I’ll tell you I’m looking at someone who will have joint problems in the near future.

Because super-low calorie diets are the enemy of muscle mass—especially if you’re tall—you’re going to want to leave those behind. Strong joints are strong because they are properly supported, and you develop and maintain that through having a diet that keeps your properly nourished and…

3. Strength training. You should find a low-impact activity that will help you burn calories while also not damaging your joints, but you also need to incorporate strength training into your diet to help make sure you’re also developing muscle, even if it’s only developing slowly but surely.

Moves like squats and other lower-body-focused moves are important, but if you’ve had joint issues in the past, start by doing them assisted. Repeatedly sitting down onto a chair and getting back up is a squat move. It counts. Squatting while holding onto a banister, rail, or table side is still a squat. It helps you develop the full body strength to prepare you to squat unassisted and developing better joint protection.

3. Avoid [most] machines [if you can]. As much as I love my spin bike, it can’t be the only exercise I do. And, as much as I recommend bikes and ellipticals and other kinds of equipment that are no-impact, they can’t be the only exercise you do, either. The treadmill hurt because it’s still a high impact activity on a machine that’s forcing your body to keep moving and, because you like a challenge even though it hurts, you take it on.

If you want to walk, walk outside. If that’s not possible—trust me, I understand—then use the treadmill. If you’re going to do the treadmill, keep the speed below 3mph and simply increase the incline.

The same goes for the weight machines, too—if you can, find a way to do your moves with free weights instead of machines. Machines often require you to sit instead of stand or squat, two things that would help you strengthen the muscles around your joints—back, thighs, calves—and keep you growing strong.

5. Consider a support brace. A knee brace helps your joints feel more supported, and allows you to take greater risks in movement, thereby encouraging development in the muscles that support those areas. One of my favorite knee braces to recommend, by Witkeen, makes a huge difference in how your knees feel during exercise. (And, if you decide to purchase it, consider using my link! Amazon pays me a few coins for referring you to their product!)

5. Foam roll and stretch. Basically, keep your pre- and post-training self care on point. Training will be hard, and will likely leave you sore. Trying to live your life while feeling sore in your lower body can not only discourage you from continuing on in your training, but it can also encourage bad habits, poor form, and improper development of your muscles. Read my post on foam rolling, and stay posted for my series on flexibility.

All in all, if you follow these tips, you’ll get closer to achieving your goals and stop the joint pain. Exercise isn’t a lost cause—just keep it low and slow, focus on changing your diet and making sure you’re maintaining a caloric deficit, and you’ll be good to go. As I always say, your body—and your joints!—will thank you for it!