I had my left knee replaced four years ago. After many setbacks and four knee operations, I am finally getting my life back on track. However, I have put on a lot of weight: now 23st 10lb, I badly need some sort of direction. Can you help?
I am sure you understand very well that you need to lose weight for the sake of your knees. And that you will need to work hard on developing and keeping strong leg and knee muscles for the rest of your life. As these two tasks make the difference between independence vs pain and disability, consider the effort it will undoubtedly take as a major investment in your future happiness.
Gather around you as much practical support as you can. Through your GP or privately, get yourself to a nutritionist to write you an eating plan. Discuss weight-loss medication with the GP. For very overweight people a combined approach of drugs, exercise and diet is usually best. But the guidelines for being offered pills are strict, and many GPs will expect you to lose the first vital pounds through your own efforts. Be clear: the drugs will not work without lifestyle changes, too.
Also ask your GP to recommend you for a local “exercise on referral” gym place, where you will be set up with a supervised programme and probably some group encouragement. If this is not available, seek out a friend who is really committed to getting fit and join the gym together, with a pledge to help each other achieve your fitness goals.
Don’t just think “exercise”, but “activity” and “fun”: a twice weekly gym visit followed by five days of being a couch potato is useless. Take every small opportunity to get up out of a chair, walk places, use energy every hour of every day. Find a hobby, pastime or volunteer work that will get you out of the house regularly and make you feel happy.
At first, I suggest you focus your gym efforts on the stationary bike, walking in deep water, and doing exercises set by a physio or advanced fitness instructor to strengthen your legs. In the water, you can push yourself hard without worrying about harming your knee. Consider buying a “rebounder” (mini trampoline) for home use, and do “bouncy walking” on it (not jumping!) for, eg, five minutes a couple of times every day.
When you get fit enough to add outdoor walks to your régime, try Nordic walking poles; these reduce the load on your knees very effectively, helping you to stride out and walk for longer.
Set monthly goals, not just for weight loss but other achievements, too. This is a long-term venture in which there will be phases when progress seems to stop completely. This is normal: don’t be tempted to give up. Keep a diary and progress chart (take photos) to remind yourself, when you lose heart, where you have come from, what you have overcome already and how much more you know you can achieve.