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Medical Edge Newspaper Column from Mayo Clinic

HOW CAN I START A WEIGHT-LOSS REGIMEN IF I HAVE SORE KNEES?

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.)

— Non-impact 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

Additional Resources:
Orthopedics
Appointment Information
Starting an Exercise Program

READERS: Germs. You can’t see them, but they can be found most anywhere. And a small percentage of those germs, which include bacteria, viruses, molds and yeast, can cause disease.

Mayo Clinic Women’s HealthSource offers some ways to protect against pesky germs that could cause illness.

— Wash your hands often. Soap and water are the old standbys for keeping hands clean. When that’s not an option, use an alcohol-based gel. They work as well or better than a 15-second scrub with soap and water. Choose a gel with at least 50 percent alcohol.

— Keep dirty hands away from your face. Most germs can’t penetrate intact skin. You provide an open door into your body when germ-laden hands touch the mouth and eyes.

— Remember food safety. Wash fresh fruits and vegetables, cook eggs and meat thoroughly. Avoid raw or unpasteurized animal or dairy products.

— Avoid close contact with people who are sick. Although most people are wary of the germs sent into the air when someone coughs or sneezes, those germs are cleared from the air fairly quickly. The bigger concern is germs that settle out of a cough or sneeze onto surfaces, or germs picked up by direct contact with someone who is ill.

— Keep current on immunizations. If you’re over 65, specific vaccines, such as for pneumonia, are recommended. An annual flu shot is advisable, too.

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.