I hear this all the time – “I am trying to lose weight – but I can’t exercise because my knee hurts.” It’s like a never ending cycle that needs to be broken!

It is not uncommon for patients to embark on a weight loss exercise regimen that results in a knee injury or knee pain. More than 36% of adults and 17% of children in the US are obese, which is a far too common problem. In order to attack this problem, we need to eat better and exercise more. Many patients make a good conscious decision to do this, but increased activity can often result in knee pain leaving them unable to continue to obtain their weight loss goals.

The good news is that the “cycle” can be broken. More often than not, the knee pain can be treated without surgery. Obesity causes increased load on the muscles and joints. The knee joint feels 5 times body weight each step we take – so a weight loss of even 5 lbs can feel like a 25 lb weight loss to your knee. Working with patients to achieve their weight loss goals will eventually reduce their knee pain, as well as result in many other health benefits.

We can help by identifying the cause of the knee pain and work with you to determine a treatment plan to keep you moving.

Were you doing too much too fast?
Do you need to work on some strengthening of your core or proximal muscles?
Would you benefit from formal physical therapy?
Would cross training or a modified exercise plan be beneficial to avoid overuse injury/pain?
Is there a brace that would be helpful?
Would an anti-inflammatory medicine help?

There is usually not a quick fix to knee pain, but the best evidence we have to make your knees “feel better”─ whether you are struggling with osteoarthritis, anterior knee pain, tendonitis, or a meniscal problem ─ is weight loss. Weight loss will result in less knee pain! So stay motivated! We are here to cheer you on!

Brigham & Women’s Hospital
Boston, Massachusetts

17 comments

  1. Mahum

    I need your help.. Suggest me some exercises I can do for loosing weight cz I have been suffering from knee sprain.. I can’t even walk fast.

  2. Mary D Lee

    Hello I’m bone to bone can’t run no more what can I do to exercise .Help please

  3. Elizabeth Matzkin, MD

    Mary:
    When you have advanced arthritis – some exercises may be harder to
    participate in. I recommend swimming, biking or walking. Swimming is a
    great way to get some aerobic activity and lose weight – which will in
    turn benefit your knees. Strengthening is also important. Talk to your
    health care provider or orthopedic surgeon for more specific
    recommendations in and around your area.
    Keep moving,
    Elizabeth Matzkin, MD

  4. Caitlin

    I had a sports related injury to my knee years ago. When I had the injury, I was not overweight. After being unable to exercise for almost a year, as well as continuing to eat like an athlete, I gained a significant amount of weight. As the knee started to heal, I lost almost half of it, but am still having problems with my knee. It pops, and slides to left (the inside) and then pops back and immediately swells to twice it’s original size. Each time I approach my doctor about it, she continues to push losing weight and will not refer me to a specialist. Is the end all be all of my knee problems? Will my previously injured knee magically stop popping out if I keep losing more weight? Or do I need a new PCP? I would really appreciate any help I can get, because I’m seriously tired of paying money for some woman to tell me I’m fat when I’m doing everything in my power, and successfully I might add, to lose weight.

    • Elizabeth Matzkin, MD

      First of all congratulations on your weight loss and persistence to continue to want to live a happy and active life.

      If your knee is popping and swelling – you should certainly be evaluated by an orthopedic specialist. Mechanical symptoms (popping/catching) and swelling are usually indicative of some internal problem in your knee such as a cartilage, meniscus or ligamentous injury.

  5. C

    Hi there,

    First of all, thank you for this article. It’s nice to hear from a doctor who gets it! I wonder if you can provide some guidance for me (if you have the time!)? Here is my situation:

    A few years ago, I was diagnosed with patellar-femoral syndrome in both of my knees. This had been an ongoing issue for a little over 10 years (not sure if this is related, but I had torn the miniscus in both knees — most likely (locking knees) according to a physical therapist; this went undiagnosed and untreated — immediately prior to this knee pain). I was at a healthy weight and was very active. I loved to hike and could do so, but only if I wore store-bought supports. I finally saw a sports medicine doctor who diagnosed this issue and began treatment. We tried two different physical therapists. The first one was extremely passive and unfortunately, it made my knees infinitely worse. I could hardly walk up the stairs to my apartment. My doctor also tried steroids (no effect) and a better brace. The second therapist decided to try a more aggressive plan. This actually was really starting to work, until we pushed it a little too far towards the end and set me back to square one. My knees healed enough so I can walk normal amounts without too much pain.

    I moved back to my home state and into a rural area. My daily activity definitely decreased; especially in the winters. But, I still made time to work out on the treadmill to compensate (~4 miles/day, 4-6 days/week). I ended up getting hypothryoidism that went undiagnosed and untreated for nearly two years. I gained 70 pounds from that. I’ve been on medication for about a year now and my thyroid is healthy. But, I have not lost much weight — 8 or 9lbs in the last six months. In the past, exercise always seemed to be the only thing that has worked for me. I’m a bit of a health nut and I eat very well. I eat between 12-1300 calories per day and am a bean-loving vegetarian. My knees are extremely fragile right now and are sometimes set off by merely stepping incorrectly, or just seemingly at random. My knee braces don’t fit me anymore, either :(. At this time, I also don’t have regular access to a pool for that kind of low-impact exercise.

    Do you think I would benefit from another round of physical therapy, even at this weight? Do you have any other suggestions at what I might do? I really appreciate any advice!

    • Dr. Elizabeth Matzkin

      I would certainly recommend being re-evaluated by an orthopaedic surgeon or sports medicine physician in your new location. Physical therapy and proximal muscle strengthening (hip flexors, abductors and quadriceps) would certainly be beneficial. Walking or riding a stationary bike would be a good way to start increasing your exercise and working on weight loss. Start slowly and increase little by little each week. The only good evidence we have to ease knee pain that is secondary to early arthritis or patellofemoral pain is weight loss, keeping proximal muscles strong and exercise. This will take time and effort. If you are diligent—you should start to see some results in 6-8 weeks. Good Luck.

  6. tinaleger

    i reallyneedhelpwithmyknees iam having averyroughtimewiththem

  7. Riyana Vatyani

    Thank you for the info. Really an informative and helpful article. will surely share this. looking forward for more articles like this. Thank you once again. i also read few articles which were helpful to me when i was on weight loss program… “http://medicaldice.com/tag/weight-loss/”

  8. Rubina Naz @ Diet Plan

    I could have sworn I’ve been to this website before but after browsing through some of the post I realized it’s new to me. I really like this blog on motivation weight loss tips . Your blog really attrack a lot to me. I got many information here. Thank you! Keep up the great work!

  9. Beth Adams

    I wish you were my doctor. You have a lot more tact than mine. My problem is my knee locks — very painfully. And I used to do 3-4 miles a day on the elliptical until I got out of the car too suddenly one day and tore my calf. I had a Baker’s cyst that burst and the MRI showed slight arthritis (I’m 50) and about a 3 inch tear in my calf. That was in late 2014. Since then, I’ve had no less than 20 incidents of very painful locking of my knee — xray shows nothing, but it continues to happen. And it happens intermittently —- every 2-3 months. It’s very frustrating to be told again and again to just exercise more. I’m not grossly obese. I do sit at a desk job all day and I have hbp which causes edema. But again, my doctor gave me nothing — no suggestions, no solutions or sympathy for the very painful locking, just an order to exercise.

  10. Joyce Norris

    I had a total knee replacement and need safe exercises to lose weight

  11. kaleem

    Thank you for the info. An informative and helpful article. Will surely share this. Looking forward to more articles like this. Thank you once again. I also read few articles which were helpful to me when I was on weight loss program…

  12. Manisha Sharma

    Hello I’m 21 and I’m around 85kgs I’ve been working out regularly but couldn’t lose weight to be honest I haven’t been following my diet strictly. Now my knee hurts and I can’t workout I thought taking a few days break might fix the pain but it still hurts even after a week of rest. Please advice me what to do thank you

  13. NickA

    Thank you for the great article. For various reasons I had suspected that, absent other problems, losing weight would help reduce knee pain. In losing weight thus far, I have already noticed a reduction in pain and looking forward to even less. I wonder, though, if building up the muscles around the knee may have a complimentary effect to the weight loss in terms of knee pain. This is not discussed. Given the amount of pain I was in, I could not run, jog, or really walk very far. But I discovered that a properly configured spin bike produced absolutely zero knee pain. Pleasantly surprised, I now average 70 miles a week and the pain lessens noticeably every week. You mention bicycling in your article which, given the deep cycles you put your knee through when pedaling, seems counterintuitive and had been of concern. Again, thank you for putting these concerns to rest.

  14. Rachael

    Hello!
    I had been an athlete many years ago and suffered from knee pain. The orthopedist told me my knee caps slide around because I have loose cartilage. He recommended some exercises to strengthen the muscles around my knee. I have to admit I haven’t done them for some time but will resume the routine once again. My other issue is that I hyper extend my knees back when I lock them. As much as I try to keep soft knees during exercise, I wonder if knee braces would prevent this hyper extension, or help in any way? I’ve read that wearing knee braces without an evaluation may do more harm than good. So I though I may ask before buying and potentially exacerbating the problem!
    Thank you in advance.

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