How do I start as a beginner with back and knee pain? I think the knee pain is due to weight 30/F/72kg/UK

ctrowland

New member
I used to be active (going to the gym at least 5 times a week and often doing 1hour + of cardio) every fitness post I’ve said says to lift weights and forget cardio… I don’t know where to begin. I used to have a PT but some of the stuff feels unachievable to me now e.g squats and deadlifts and I am anxious about starting again… how can I start gently but maximise weight loss please? I feel like everything physiologically and physically has declined
 
@ctrowland I would start with a physiotherapist appointment to check out the back and knee pain. They can let you know what is safe and what it is not and give you some exercises to specifically address those issues. I don't know what "posts" you're reading, but cardio is good for your health and good for weight loss. It is very trendy to demonize cardio right now, though.

I would start with walking until after the physiotherapist appointment. Walking is easy on the body and a great way to create a calorie deficit. The only way to lose weight is to be in a calorie deficit. You can do that by increasing your movement or lowering your calories. If you choose to lower your calories, try to swap out higher calorie foods for lower calorie foods like vegetables and fruit so you can still eat lots of volume and feel full. You'll want to start focusing on eating protein. Aim for lean protein with every meal.

Once you're cleared, you can add in weight training. It might be best to hire a PT again if you're comfortable with that. If not, find a program that has progressive overload and fits into your schedule.
 
@dawn16 Thanks for your advice :) I’ve just been discharged from physio for back pain and tight hip flexors following a car accident last August - her advice has been pacing and given me little direction for exercise because she says I need to be “gentle” first - she said light weight with higher reps and swimming but said that I shouldn’t have limitations because I do have full range of movement, it’s just not overdoing it (guilty of this due to frustration) she agrees with me that knee pain is a result of lack of activity and natural aging. With the green light, I’m not sure where to start or full body workouts that are realistic (my abs and core strength is non-existent)
 
@ctrowland I'd be skeptical of any physio telling you that knee pain is due to aging in a healthy (assuming) 30 year old. Typically, a physiotherapist would give you some exercises to address a weak core and the muscles around the knee. Sooo I vote for a second opinion on the physiotherapist. And, of course, make sure it is a physiotherapist and not a chiropractor.

As for a workout routine, it all depends on your goals, available time, and equipment. The r/fitness wiki has a list of popular weight lifting routines. I'm a fan of the 5/3/1 but there are more beginner friendly routines there, too. They are all realistic programs though. They are based off the strength that you currently have so no worries about not having enough strength to start. You do.
 
@dawn16 i super agree, an english physio once told me to just live with my knew pain and then i found a feldekrais exercise that took the SEVEN YEAR pain away in 13min. i had undiagnosed ITBS which just needed knowledgeable stretching to retrain the pathway. nobody in their 30s should have “natural pain” unless they had injury or other mechanical clearly traceable reason. get a second opinion!

also i recommend getting a PT session back home to “come back” to the gym, i just did that as my body changed and i had so much help and confidence boost and a new set of exercised for my body and goals as i am now.
 
@ctrowland some of the best advice is if it hurts stop. test out every exercise start light for reps. gradually add weight and cut back reps. if you feel any odd pains listen to your body and stop that exercise and look for an alternative to build similar muscles. maybe squats hurt but leg extensions dont. or deadlifts hurt but bridges dont. theres always another exercise for a muscle.

also dont skimp on your stretching and strencth drills specific to your pains. if your knees and back are the issues then focus on the drills your physio gave you and also doesnt hurt to look up other ones and implement the as you see fit. over the years ive dealt with various pains and injuries. i adapted this strategy and its worked well for me.

also when you're first starting youll probably be a little sore. keep it light and easy and gradually add in. but the most important thing is to not take extended time off just because you feel sore. if youre really sore on a day get up. do some stretches/dynamic movments. doesnt even have to be weighted. the act of moving and getting the blood moving helps the body recover more than laying and doing nothing.
 
@ctrowland Take 800 mg of ibuprofin 3x a day. If you're still experiencing pain after this, also take 650 mg acetaminophen every 4 hours (take it halfway between your ibuprofin doses).

every fitness post I’ve said says to lift weights and forget cardio…

Those posts are idiots.

How do I start as a beginner with back and knee pain?

It's difficult to answer this question without knowing the kind of pain you're experiencing. Sharp, debilitating "holy crap" pain? Yeah, stop. But if you have general tendonitis / joint soreness then you just keep pushing yourself through it.
 
@leightonh ibuprofin etc arent always the answer. do they stop you from feeling pain yes. but they dont fix the problem or heal the pain. im an advocate of not using pain medicine prior to working out etc due to it numbing your bodies response to pains. ultimately leading to more injuries from overworking an already injured area. the only exceptions i tend to give are for things you absolutely have to get done regardless of pain.

realistically anti inflamatory medicine slows down recovery. inflammation is the bodies way of repairing itself and medicines that reduce it force the body to work slower when repairing. its the same reason putting heat on an injury is better than ice. yes it doesnt alleviate the pain but it heals faster. so in short balance the pain to where its tolerable but dont over medicate. only take if you cant tolerate the pain at that moment.
 
@alan7057 The medical consensus for conservative treatment of soft tissue injuries / pain in a young adult is NSAIDs (short term) + exercise to strengthen muscles / tendons (mid-term) + diet to keep off excess weight (long-term).

If popping some Advil gets him into the gym, then that's a positive.

You can disagree all you want, but I'm going to go with what doctors say.

You're acting like Advil is equivalent to opioids.
 
@leightonh i never said you cant take advil. i said use discretion. while its a drug it doesnt fix injuries. its pain management. and its also a well known fact that inflammation is a naturally occuring part of the body and is how it heals itself. which doctors also agree with. health and medicine isnt an exaxt science. it changea daily and there isnt necessarily a right or wrong answer here. so im not saying youre wrong but funny enough nothing i said was wrong either.

however id always advocate doing things with less drugs if at all possible. people are way to quick to jump to medicine in general.

TL:DR drugs in moderation can be helpful but using less is always best for pain management.
 
@ctrowland Weight loss is probably about 80% diet. But the fitness gives it an edge so to speak. And as someone with mild back knee pain, or used to when over weight, you have to go slowly to build up a tolerance and adapt and recover. That might mean once a week, eventually twice a week, three times a week. At four workouts per week, I am at my limit, my joints dont like it and I'm nearing 40. And that's just 45 mins of cycling.

Basically weight loss plus intense fitness plus not being a teenager equals injuries. So what you want are activities that can measure your progress, like walking or cycling a certain distance, time, etc.

So if you can walk 20 mins without pain, do that. Next week try 25. If that hurts, do 20. Etc.
 
@ctrowland Start with an assessment. Talk to your doctor and make sure there's nothing seriously wrong with your knees and back.

Diet: drink a lot of water. More than you think is likely reasonable. Aim for 5L daily plus whatever you drink while exercising.
Eat a lot of protien. Whatever source you like. Boslter that with vegetables. The rest in carbs. Eat slowly til you're 80% full then stop. Count calories and macros later.

Exercise: start with walking and stretching. That will likely do a lot to benefit your daily pain. Invest in good shoes and a foam roller. Use that lots.
Lifting is great, but it isn't the ONLY answer.

Do that for 6 weeks and reassess.
 
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