Why do I still have joint pain after losing weight?

Did your doctor sit you down and tell you that your pain would go away if you would just lose the weight?

Did you feel like your knees must be painful because you needed to lose 30 pounds or more?

Did you figure that your low back pain would improve if you lost that beer belly?

Did you work so hard to lose the weight in hopes that you would feel better, but are frustrated because everything still hurts the same….or it hurts even worse?

You are not alone!!  Many, many times in my career, I have had patients come into physical therapy as a “last resort” for their knee, low back or hip pain.  Why would PT be a last resort?  In every case, these patients were told by their doctor or heard from somewhere that all of their pain was due to their excess weight and that there was no way that they were going to get better unless they lost the weight.  So what did they do?  Instead of coming to PT first, they were promised that once they lost that 20, 30, 50 pounds, or more, that they would magically feel better, so they didn’t need PT!

I would say that at least 90% of these patients broke down and cried during the first visit.  Not because of pain, but due to pure frustration from putting in so much effort, time, money and self-control just to feel the same or worse than they did before.  Luckily, in most of these cases, the pain was very treatable – the patients had just gone a little out-of-order in regards to treating the pain alongside the weight loss.

I’ve come up with my own theory as to why this happens – fat and increased weight provide a certain amount of joint stability in their own way.  We are used to hearing about muscles, ligaments, tendons, capsules and fascia providing the support for our joints, but the compression of the extra fat and tissue may also be providing support.  Think about how one of those neoprene knee braces work – they’re basically just adding pressure and compression to the tissues around the joint which gives the sense of added stability.  In some ways, fat and extra tissue may also do the same thing, as the fat is like a cushion between the skin, fascia, muscles, bones, joints (and other structures) and it exerts some kind of force on everything around it.  If you lose this cushion and mild compression once you have accomplished weight-loss, everything around where that fat used to be is somewhat stretched out and gets saggy.  Now everything that was holding that joint in place is loosey-goosey and even though the joint may not have been in a great position before the weight-loss, now it has almost no support and it hasn’t been retrained to function in this new environment.

How do you prevent this from happening???  You see your friendly physical therapist DURING your weight-loss journey and they can help you build muscle, strength, stability, flexibility and balance along with your body’s changes!  As weight-loss is happening, the muscles, joints, fascia and other structures are going to be in a state of constant flux – trying to keep up with the new angles and mechanics.  Everything in your body is going to need to be “re-educated,” as the old ways of functioning are not going to work anymore.  Imagine the spine of a person with a big beer belly – it’s constantly being pulled forward by the weight in the front belly area and it accommodates to this over time.  Now imagine that this person cleans up their diet and loses 30 pounds from their stomach – that’s a lot less force pulling forward on the low back!  But if the person did not work on strengthening and tightening their stretched out abdominal muscles during the weight-loss process, there is now a spine that’s just wobbling away in the wind.  It doesn’t have the pull from the belly weight, but it also doesn’t have stability from a strong core, so essentially – IT’S GOT NOTHING!  No wonder it hurts just as bad, if not worse than before the weight-loss.

This same principle applies to everything in the body – the spine, pelvis, knees, hips, ankles…etc.  If you don’t teach your body how to function in it’s “new normal” then it will provide you less and less support and continue down the painful path.  So even if you’ve lost the weight and are in this predicament, don’t give up yet!  It may take a bit longer, as you’ve already lost all of the “stability” that the extra fat and tissue was providing and things are stretched out.  Never fear!  Physical therapists are THE specialists in finding people’s individual areas of imbalance and teaching them how to re-educate themselves and their bodies to restore function and live with less pain.

So I know what you’re thinking…what exercises can I do right now?

I would usually link some exercise videos or give some suggestions for people to try, but in this case that could be dangerous.  Due to individual differences with pain, muscle weakness and tightness, balance issues, etc, anyone in this situation should consult a physical therapist that can really focus on giving them one-on-one evaluation and exercise prescription.  Not everyone will benefit from the same exercises, and some exercises could even cause more pain or injury in certain people.  When we are “re-educating” muscles, a skilled physical therapist should be with you and feeling for proper muscle contraction, giving you specific cues (both verbally and hands-on) and prescribing repetitions that are customized to you and your individual needs.

Solstice Physical Therapy specializes in one-on-one, private physical therapy – just the patient and the therapist in a treatment room for at least 60-minute sessions.  This means that there are no distractions for both the patient and the therapist and we are focused on you, your individual needs and goals, and we are able to figure out what exercises and hands-on techniques will improve your unique situation.  It’s a truly different physical therapy experience and our patients improve much quicker than in the traditional physical therapy model.  Please contact us with any questions or to set-up an initial consult, we look forward to helping you live your best life!

Solstice Physical Therapy.  12365 Huron Street #1800, Westminster, CO 80234.  (720) 369-7738

www.SolsticePhysicalTherapy.com

**This is not to be considered medical advice, please contact a physical therapist or other healthcare professional for more information.  All content on lisawilcoxpt.com is created for informational purposes only and is not to be taken as medical advice, treatment or diagnosis.