Joint pain after treadmill usage

December 1, 2009 11:46 AM

YANMD (or my personal trainer) but I need advice on a cardio workout that will help me lose weight and also not kill my joints. Difficulty: I am quite overweight...my BMI is just shy of 60

I have lost 50 lbs (yay me!) but still have a ways to go. To keep the momentum on my weight loss, my wife and I joined a gym this past weekend.

Living in a small town our gym options were limited and we settled for a Snap Fitness which has no 2 year contracts, is reasonably priced, and consists of a number of bikes, ellipticals, treadmills, and some nautilus-type weight equipment.

I am gunning for an hour workout a day, and as my goal is to build endurance and lose weight I'm focusing on cardio. My plan for these early days was 30 minutes on the bike and 30 minutes on the treadmill.

On Sunday, our first day working out, I did a bit over 30 minutes on the tradmill, my heart rate held around 140, and my average was just under 3MPH. I was happy with that result...it was a well paced walk, which is what I could handle at this point.

I quit after the treadmill, not moving on to the bike, because after stopping I realized I was in a lot of pain. It wasn't muscle pain, which is what I anticipated, but instead it was severe joint pain, focused in my ankle and my knee. My feet also ached.

I took some Advil and resolved to go back the next day, but the pain actually worsened the more time passed. It's now been over 48 hours and I'm still on a heavy Advil rotation and have not returned to work out as standard walking is quite painful at the moment.

(background: despite my weight I have no history of joint problems, and my feet do normally bother me if I walk a good distance of a couple miles, but never my ankles and knees like this).

I'm not sure if I should "push through the pain" and hop back on the treadmill, if I should just focus on the stationary bike for a while and do 60 minutes on the bike completely foregoing the treadmill, or if there is a better option.

Suggestions would be most appreciated.

posted by anonymous to Health & Fitness (24 answers total)

If you have a pool where you can do laps, this will burn the calories without the painfull impact to your joints and feet.

Lacking a pool, see if you feel better just using the bike. There is no striking the ground with each stroke.
posted by Midnight Skulker at 11:51 AM on December 1, 2009 [3 favorites]

Get good shoes. Never skimp on your running shoes.
Ever.

Also, in summer, Kayaking is awesome for cardio and will not give you joint pain. For 300$ or so you can get a decent beginners hull.
posted by damiano99 at 11:56 AM on December 1, 2009 [1 favorite]

Don't push through the pain. Let your knees and ankles recover for another day or so then go hit the bike. Find a recumbent bike, if you can (I found the angle easier on joints, but YMMV).

Kudos to you for dropping 50 pounds! I've lost 70 in the last year or so. When I started out, I walked it off, ignoring the pain in my knees and the swelling in my ankles. I ended up with bursitis on one knee and had to have it drained. I do not recommend this to anyone! Now that i've dropped the 70, walking is much easier but I still have pain in the knee that had to be drained.

Good luck with losing more!
posted by LOLAttorney2009 at 12:02 PM on December 1, 2009 [1 favorite]

Try an actual track or jogging course for the same amount of time.

When I started exercising, my doc specifically told me to do only low impact stuff due to my extreme weight. She was very worried about the strain on my knees, ankles and feet.

Use the elliptical. Your joints will thank you. I have bad knees and awful bunions, but I forget to tape up properly, so if I use the treadmill, I'm in agony. But I never have any pain after a good elliptical session (I don't know what your current weight is, but I started on the elliptical when I was about 310lbs. It was tough at first, and my heart rate hit about 160 going 4mph. After a few weeks, I could comfortably do 5mph and never break 140. It's also nice to switch up in the middle and go -backwards-!)
posted by Cat Pie Hurts at 12:03 PM on December 1, 2009 [2 favorites]

Athletes will ice painful joints after workout. 15m on, 15m off. NSAIDS are also a good idea if you sense there is inflammation. Good luck!
posted by gensubuser at 12:08 PM on December 1, 2009

Good shoes or not, jogging is going to be hell on joints at his weight.

Don't "push through the pain", your body is hurting like it is for a reason. You taxed yourself, and it needs time to recover. If the pain keeps up I'd recommend talking to a qualified athletic trainer or a licensed personal trainer about the pain you're experiencing, they'll be able to help.

Once you're better, I'd say use the elliptical rather than the treadmill. There's not nearly as much impact which is what you need until you can get all of the supporting muscles strengthened and some of that fat burned away.

With that said, spending time on the bike and in the pool is a great idea as well. Just doing one exercise day in and day out isn't going to do much long-term, and doing those other exercises will work different muscle groups along with your cardio system.

Weight lifting is always a good idea as well. You don't need to (and shouldn't) jump right into maxing yourself out, instead concentrate on good form, lower weight, and higher reps. After you've been doing that for a couple months and once your technique has developed you can start adding weight, and that'll help strengthen you up for higher impact workouts as well.

Disclaimer: I am not a personal/athletic trainer, I just spend a lot of time around those that are.
posted by fore at 12:09 PM on December 1, 2009

Seconding your need for good shoes. When I switched from a pair of Nike's to a pair of New Balance, the joint pain in my knees after running completely disappeared. Like magic.

Hope that works for you, too.
posted by pick_the_flowers at 12:16 PM on December 1, 2009

High BMI here also. I like the elliptical although I know many who find the motion artificial. Different machines have different motions so if your gym has different models, try them all. I have lost 10's of lbs through using ellipticals (unfortunately regaining those lbs back :( so it is back to the gym for me!). I found stationary cycles uncomfortable and foot/butt numbing -- both the upright and recumbent. I suggest using whatever cardio you feel comfortable doing -- at this point, it really doesn't matter as long as you get your heart rate up.

Also, go for the weightlifting! Adding muscle mass will increase your metabolism and help you lose weight faster. Here's an article from the Mayo Clinic that says so :). Plus, it's fun :). Plus, fat people are often surprisingly strong -- after gasping on the cardio, it's a good ego boost to be able to lift a lot.
posted by elmay at 12:19 PM on December 1, 2009 [1 favorite]

I would completely forego the treadmill for now, at least until you have a better understanding of the pain. If your knees hurt, that's your body trying to tell you something. Muscle pain is something you can fight through (to an extent), but joint pain is something different and you really want to pay attention to what your body is telling you. If you're not used to walking around at speed, then your joints, your muscles, all of it is ill-equipped to handle the change right now. I would wait for the joints to feel better, and then get on a stationary bike. Once you feel strong there (give it a month, at least) you might want to try the elliptical. I would wait to see how your ankles feel there before returning to the treadmill.

Early on, these cardio workouts will be fine for losing weight. You'll be developing muscles that you haven't used for awhile and the muscle repair will last for 24-72 hours after your workout, causing you to use more calories while your body repairs and strengthens these muslces. As you become stronger, cardio workouts will up your heart rate, but will not be strenuous enough to cause the minor muscle damage that leads to increases in strength. Because of this, your workouts will no longer use as many calories. You will burn however many calories you burn when you're working out, but an hour or so after completion your body will have dropped back into its baseline metabolic state. Once you've reached this point, the only way to continue to burn those calories at your previous rate is to work on weight lifting. Someone above me mentioned starting at low weights, working on getting the form right. This is excellent advice. Keep doing what you're doing for now, but eventually you'll want to start adding in some other bodyweight exercises like squats, push-ups and pull-ups.

It sounds like you're really doing great work. Keep it up and I'm sure you'll get great results!
posted by scrutiny at 12:26 PM on December 1, 2009 [3 favorites]

I should also add that diet is far, far, far more important than exercise when it comes to losing weight. Not only the calories that you eat, but the kind of calories that you eat. You seem to be doing well (you lost 50 lbs after all!), but I don't want you to think that you can start substituting exercise for diet.
posted by scrutiny at 12:28 PM on December 1, 2009 [3 favorites]

Second swimming, but for at home, low impact (in truth, virtually *no impact*) cardio nothing beats an elliptical machine with variable resistance.
posted by gb77 at 12:56 PM on December 1, 2009

Water aerobics! I'm about a hundred pounds overweight, and I found that water aerobics was exactly as difficult for me as it was for skinny people. Which is to say, hard as HELL, and I felt that hardcore exhaustion the next day, but without the punishment to my ankles and knees.
posted by KathrynT at 1:07 PM on December 1, 2009

I think you need to ramp up much more slowly - like, ridiculously slowly, with lots of breaks - in order to avoid injury. Too much too soon is the #1 cause of exercise-induced injury, and your joints are especially vulnerable because of the weight. Now that you've joined a gym you feel understandably impatient to start long workouts, but you have to be patient! Remember the parable of the tortoise and the hare...

So, whether or not you chose the bike, elliptical, or treadmill, I would recommend planning out a two or three-month long ramp-up period to your hour-long workouts. So for instance, start out aiming for just 10 minutes total on the treadmill, and do that in 2-minute intervals with a minute of rest in between. From there, add on say 2 minutes a week, and in 10 weeks you'll be up to 30 minutes. Then you can start adding in the bike.

The rest breaks are very important in this plan - don't skip them!
posted by yarly at 1:29 PM on December 1, 2009

From a guy who ran for well over 25 years, two things:
1. it won't bother your knees, usually, later on in life.
2. the comment is right about the greater importance upon DIET.
posted by Postroad at 1:37 PM on December 1, 2009

Many people when losing weight try to go pure cardio which is a bit limiting.

Don't be afraid of hitting the weight bench. Do light weights with 30 second rests in between sets. Something like bench press 5x10 reps with 30 seconds between sets. I like to break up the weights into days of chest/tris and back/bis to give them some rest. These won't work your knees at all.

(also swimming, elliptical and bike should all be relatively low impact)
posted by bitdamaged at 1:50 PM on December 1, 2009

The key to protecting your joints is mixing it up. Don't do a single exercise for a long time, but rather do many different exercises for shorter periods. Even if you were to stick with pure cardio you could do 10 to 15 minutes per machine and use multiple machines. I agree with bitdamaged that adding in some resistance training has many benefits. Again, keep it on the lighter side so you can do 12 to 15 reps and make sure you exercise all the complementary muscles to keep things balanced and not put undue stress on joints and ligaments. If your BMI is this high you may very well have issues with blood sugar and resistance training may be superior to cardio for helping to control that and decrease insulin resistance. I would do both though for maximum weight loss and also to keep your interest level high.
posted by caddis at 3:08 PM on December 1, 2009

Also, the classic exercise to strengthen the muscles supporting the knees is the lunge. It comes in many variations which you can find with Google. While it is a strength exercise it will get your heart rate up.
posted by caddis at 3:10 PM on December 1, 2009

As I got older, running became much harder. Then I lost 15% of my weight, and suddenly running was easy as in pain-free, spring in every stride, floating easy.

Stick with the diet and switch to low-impact exercise. Swimming, cycling, etc. Come back to running every 10lb or 15lb reduction (on a track or trail - lower impact than a treadmill or road) and keep at it when it doesn't hurt anymore. Take it slowly and build up.
posted by zippy at 3:14 PM on December 1, 2009

I've trained a lot of people who have started where you are right now. And. I have joint damage from many years of high-impact sports. Let me tell you what I've learned.

You eventually need some impact. It will build bone density and connective tissue strength. But you have build up to it very slowly and set about maintaining your joint health with consistent range-of-motion resistance/strength training exercise

Consistency, rest, intensity, and cross training will be your mantra.

An excellent work out for beginners is to use a stationary bike and elliptical on opposite days. You never require more than 20-30 minutes total to improve cardio heath dramatically. The only reason to do more is for weight loss or to train for an endurance event. As your body adapts to the load you will plateau. The mistake people make is to ad more and more time. Increasing reps/time to a repetive task is what will wear down joints unless your very, very, careful.

So start with 3x per week doing 10-15 minutes on the elliptical on one day and switch to bike the next. The secret is to vary intensity. It won't take much at first. Do little thirty second sprints every four or five minutes. After a couple weeks get your sprint frequency up to every one or two minutes.

The most optimal approach is at regular intervals get off the machine and quickly do 5-10 free squats (or burpees when squats get easy) and/or 5-10 push ups, and get back on to complete your time. This will spike your heart rate, is low impact, and is perfect strength training for your joints and tendons. You can play with these intensity intervals as you get in better shape. More reps. Or more sets. Sometimes it depends on how busy the gym is and if someone wil get annoyed your getting off the machine and back on.

After three weeks increase the duration to 20-25 minutes. After another three weeks ad another day. From there it's up to you if you want to go to five days a week. Listen to your body.

Obviously you can add a little basic weight lifting in there as well. But start with real simple body weight exercises to build up your joints for the first few weeks.
posted by tkchrist at 5:03 PM on December 1, 2009 [5 favorites]

Response by poster: Give up on the running. Running is one of the most injury-prone sports even among people of normal weight. You're asking for the joint pain, honestly.

Swimming is excellent. Elliptical is fine. Biking can be hard on the knee joints if you're unaccustomed to working out. Also, if your gym as a rowing machine, USE IT. The rower (like a Concept 2 or something similar) is one of the most underrated and underused cardio machines on the planet (probably because you can't read Cosmo while using it). It is a legitimately excellent full-body workout and actually works with your weight rather than against it.

Also, please start a weight training program (like Starting Strength) if you haven't already. Don't underestimate the importance of it.
posted by Anonymous at 5:06 PM on December 1, 2009

Biking works great for my husband, even with his arthritic knees. He actually has less pain when he is biking regularly.

Treadmill is not the same as walking. Walking, especially over natural ground, provides variety to your pace and gait. The treadmill locks you into an extremely repetitive movement that regular walking does not.
posted by SLC Mom at 5:14 PM on December 1, 2009

I started off about 100 lbs. overweight, and have lost around 65 - 70 so far. So I'm familiar with the situation.

The first suggestion is to get great shoes -- that is, great shoes for you. If you have a running store in your town, go there and get fitted by a pro. They should watch you walk around barefoot first, to get a visual on your stride, so they can pick shoes that will help you compensate if you pronate or supinate. The shoes might be expensive, so you might buy your first pair at that store, then buy subsequent pairs (once you have a brand and model that fit you very well) via the internets.

If you have adequate insurance, you may also want to go to a podiatrist and get evaluated for orthotics. I wear orthotics only in my workout shoes, and it's done wonders for my hips, knees and ankles.

And I highly recommend the elliptical. I did find the movement very, very awkward at first. My first few elliptical workouts I could only go ten minutes or so, but my body adapted and I easily worked up to 60 minutes -- all totally without joint pain . If your gym has the model with the arms that swing back and forth, feel free to skip that part entirely. (I'm very short and I have never found a model that allows me to use the swinging arms and maintain adequate posture.) You can still get a nice workout without it.

Lastly -- enjoy the process! You're at the perfect point where if you stick with it you're going to see great results, especially via your heart rate monitor. I remember being amazed as I watched myself working hard, and seeing my heart rate no longer going insane. It showed me, day by day, that I was getting stronger!
posted by BlahLaLa at 5:55 PM on December 1, 2009 [2 favorites]

I'm going to agree with all the comments encouraging you to consider the elliptical.

I try to run 4-5 days a week but haven't been able to recently due to a twisted ankle. After two and a half weeks on the couch I decided that it was time to hit the treadmill again. I made it all of 3 minutes before the pain in my ankle was overwhelming. A friend suggested the elliptical and after a full hour my ankle was fine. It was as if I wasn't injured.

Give the elliptical a shot, it's forgiving.
posted by ASM at 7:23 PM on December 1, 2009 [1 favorite]

Enter my personal hero (and probably yours), the exercise bike.

Have you tried a recumbent exercise bike? (Link to YouTube video.)
posted by iviken at 2:50 PM on December 3, 2009