When You Can’t Blame Your Knee Pain on Your Weight

Do you have knee pain and have been told by your doctor it is because you need to lose weight?

Lean in. I have a secret for you: your weight probably isn’t the problem.  You can let yourself off the hook.

I’ve been in practice for about 18 years, and knee pain is a frequent complaint among people of all sizes. Despite this, it is not uncommon for a person who is technically overweight to come in and explain they have knee pain because s/he weighs too much. Very often this is what they have been told by their physician.

Usually the conversation goes something like this:

Me: “What can I do for you today?”

Client: “I am here to see if you can help me with my knee pain. I know really I have to lose weight. That’s what my doctor says.”

Me: “Is the pain in both knees?”

Client: “Yes, but the right/left one is worse.”

(Insert the sound of screeching brakes here.)

Hold up.  If the pain is worse on one side or only present on one side, immediately you can rule out your weight as the primary cause. Immediately. If it is only your body weight that is the problem, both knees would hurt equally.  After all, how much weight is the other knee carrying?

Something else is going on.  The question is what’s the difference between the knees that accounts for the pain?

Sometimes there has been a previous injury to the knee. Other times (many, many times) in my experience, there is a misalignment of the knee(s). Your knee joint is designed to function without pain when the bones of your legs are properly aligned. If the bones are not lined up correctly, this creates wear and tear on the tissue which results in inflammation and pain.

If your body is misaligned this happens no matter what you weigh.

On the flip side, you can weigh a lot, and if your knees are functional you can be without pain, even with lots of activity. Please consider NFL offensive linemen as examples. They are very large gentlemen, no? But their knees do lots of strenuous things for them despite their weight.  What’s the difference?  Strength and functionality.

“But I swear my knees hurt less when I lose weight.”

Sometimes people will say that their knees hurt less if they lose a few pounds. I have no doubt this is true because more weight is essentially more stress on a dysfunctional joint system. The essential problem, however, remains the dysfunctional joint system, not the weight.

It’s actually a bit like a dysfunctional relationship. Relationships that are strong and healthy can take some stress. Financial, family, and health issues are all stressors, but a relationship that is in good shape provides support. In fact, life difficulties can make a relationship stronger and bring two people closer together if the basic framework is healthy. Unhealthy relationships, on the other hand, crumble under pressure. When life gets tough, the cracks start to show.

Just like with a relationship, the issue isn’t the stress, it’s the health of the overall system. If you haven’t removed the root cause of the problem, and the weakness will crop up again next time it bumps up against a different stressor.

And, like the rest of life, it’s nearly impossible to avoid stressors forever.

Where your knees are concerned, maybe that’s climbing the stairs, or going for a hike, or riding your bicycle, or playing with your kids/grandkids. Probably at some point it will be an activity that you really enjoy.

A misaligned joint has a narrow margin for error and you are bound to bump up against its limitations again eventually, regardless of your size.  And unfortunately that can really diminish your quality of life and restrict the things you can do without pain.

You can lose weight, but your knees (or back or hips or ankles) will still need to be fixed for your long-term health.

How do I know if my alignment is off?

Here are some potential clues that suggest a misalignment.

1. When you look at your knees in the mirror, your knee caps do not face the same direction.
2. When you look at your knees in the mirror, your knee caps do not point straight ahead but outward or inward.
3. When you look at your legs in the mirror, your feet are turned outward or inward rather than straight ahead.
4. When you close your eyes and pay attention to your feet, you notice more weight on one side than the other.
5. When you close your eyes and march in place for 30 seconds, you open your eyes to discover you have marched in a circle.
6. When you pay attention to your weight distribution on your feet, the weight is on the inside or outside of your foot rather than over the center. (This distribution might also might be different from foot to foot.)
7. Your pant legs always seem different lengths.
8. One shoulder is higher than another.

In my office I do other evaluations for your posture, but any of these easy things to notice can tip you off that something is amiss with your alignment.

So, how do you fix it?

Simply put, a misaligned joint means a bone is not where it is supposed to be. A bone has moved and stayed there. How do bones move normally? Yep, that’s right, your muscles. Your muscles move your bones, and if something is chronically out of place you have to look at what is happening with the muscles of your body.

There are lots of ways muscles can be imbalanced, but an individualized selection of exercises and stretches that take into account the alignment of your whole body can keep you strong and functional while you are out and about living your life.

Realigning and strengthening the joint means that you address the underlying cause so you can enjoy a wide range of activities and movements, regardless of your weight. And when your joint is in a healthy position, your body gets stronger with activity.

Please don’t miss the solution to your knee pain because you are busy pursuing weight loss. You could be spending your energy making your joints strong and functional so you can be active without pain.

Just like a relationship, you can make the system healthy so it gets stronger and thrives under pressure and demand.

Do you relate to this article? Curious if you could benefit from an integrative therapy plan? Contact me for a consultation if you want to discover the root of your pain, uncover blockages to healing, and create an action plan to finally solve it.