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The Overlap Between Knee Pain & Obesity

Obesity is defined by Merriam-Webster’s as a condition characterized by the excessive accumulation and storage of fat in the body. According to the Centers for Disease Control and Prevention, over one third of Americans (36.5%) of U.S. adults suffer with obesity. Understandably, those dealing with obesity find that it affects many aspects of their life. One issue that may be overlooked is the impact this extra weight can have on the joints in the body, particularly resulting in knee pain.

The Structure of the Knee

Each ligament serves a different purpose. For instance:

  • The anterior cruciate ligament, located between the femur and the tibia, prevents the femur from sliding back onto the tibia.
  • The posterior cruciate ligament, located between the femur and the tibia, prevents the femur from sliding forward on the tibia.
  • The medial and lateral collateral ligaments prevent the femur from moving from side to side.

All of these different pieces come together to form your impressive knees. It is easy to overlook them, since they are with you every moment of the day. We expect our joints to work and take for granted the work that they do. However, not everyone is fortunate enough to have their knees in mint condition.

Obesity’s Impact on Knees

Carrying too much weight upon the knee can increase the risk of damage during daily activities or accidents. Additionally, it can cause further complications with preexisting conditions, such as osteoporosis and osteoarthritis.

Osteoporosis is a condition in which the bones become brittle and fragile due to loss of tissue. Symptoms of this condition can be:

  • Pain that is worsened after an activity
  • Stiffness in the morning or after a long period of stillness
  • Difficulty getting out of seats, walking up the stairs, or standing up in general
  • Creaking noises heard during the movement of the joint

Osteoarthritis is a degenerative disease in which the cartilage or tissue in the joints wears down. Symptoms associated with this condition can be similar to that of osteoporosis:

  • Stiffness in the joint and limited mobility
  • Mild to severe swelling around a particular joint
  • Pain that is worsened after an activity
  • Scraping feeling during the movement of the knee

Osteoporosis is the loss of bone mass, which can be painless if no injury occurs. Bones become fragile and prone to fractures. Osteoarthritis is a degeneration of the joint caused by damage to the ends of the bone. While these are similar and both more common with age, they are different conditions. If you are unsure which one you have, please reach out to your doctor for clarification.

There are plenty of people who are not obese that develop osteoporosis and osteoarthritis. Likewise, it is possible to be obese and not suffer from these conditions. However, your odds of developing them become greater over time and with increased weight gain.

Additionally, obesity can exacerbate the conditions once they develop. Even if they have the exact same amount of damage to their knee joint, a woman at 150 lb is going to experience much less pain than a woman at 180 lb due to the additional stress placed on that joint. The increased stress will wear the joint down faster and, if the bone is already brittle, increase the odds of a fracture by increasing the force of each move.

Eventually, if extreme pain in the joint of the knee develops, obese individuals can get trapped in a vicious cycle. The pain encourages immobility. Immobility can atrophy muscles, which decreases balance and increases the likelihood of a damaging fall. Additionally, it can cause more weight to be gained. That causes even more pain and discourages activity further. Sadly, this can escalate to a point where knee joint damage could be irreparable.

What is a Knee Replacement?

A total knee replacement surgery is a procedure where the damaged bone of a knee joint is replaced with artificial material. The end of the femur is removed and replaced with a metal shell or cap known as a prosthesis. Osteoarthritis is the most common cause for knee replacement.

Before the surgery, the knee joint will be carefully evaluated to assess the level of damage and projected benefits for undergoing a total replacement. The procedure takes anywhere between one and three hours.

It is important to note that, prior to surgery, your body weight should be at a healthy level. Excess weight can increase the risk of loosening and dislocating the weakened knee after the surgery. The first step for knee replacement patients is to lose weight in order to alleviate any unnecessary strain on the knee while it is healing. If the weight is not lost prior to receiving a knee replacement, patients significantly increase their risk of experiencing complications.


Physical therapy is imperative for a healthy and successful recovery after the knee replacement procedure. Without physical therapy, the knee will not heal properly. The knee joint needs to rebuild strength to work properly and return you to maximum mobility. Physical therapy provides safe, effective exercises to facilitate a positive rehabilitation. Pain, and stiffness are to be expected in the first days after the surgery; however, working through these pains under the guidance of a professional will yield the best long-term results.

Make sure to follow your doctor’s orders closely pertaining to the use of opioids. Opioids are used to relieve acute pains associated with the surgery or the after surgery. Pain medication is not a long-term solution and should not be used to treat chronic pains. Unlike opioids, which mask pain, physical therapy creates an actual, physical change. It takes longer and it is significantly more work. Nevertheless, in the end, the cause of the pain can often be improved or eliminated.

To get a consultation regarding your knee pain or schedule physical therapy, give the South Texas Spinal Clinic a call at (210) 614-6432.

Posted in Articles, Knee Pain, Pain Management
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