Too heavy for Couch to 5k?
September 18, 2007 5:35 PM   Subscribe

I just had a doctor tell me I'm too heavy to run the Couch to 5k program. Is this really true?

I'm 25/F, 5'6, 240 lbs with a sedentary job and no exercise routine to speak of for the past 6 years. About 3 weeks ago, I decided I was fed up and I started the Couch to 5k program at home on a treadmill. I made it through week 3 feeling great, still motivated and really enjoying the challenge. I was also doing lighter walk/runs and weights on the in between days of the program.

In order to work out with a friend, I started running outside at the track. Within 2 workouts running outdoors, I started having crippling pain in my knees. Worried I'd injured myself, I went to an osteopathic doctor. She told me that I was "100 lbs too heavy to be running" and that it was an unacceptable form of exercise for me. She said that "all the extra weight had pounded my knees into a severe sprain." She told me to stop eating too much (without even asking about my diet habits, but oh well) and to stop exercising period until my knees healed, and then to only do low-impact exercise.

I agree that my knees are injured (obviously, the pain tells me that), but is it really that I'm just too heavy to run? Have others been successful doing the Couch to 5k program beginning at a similar weight? Is my being overweight truly the problem, or did I just overdo it by exercising with a bit too much zeal on the off days instead of resting as is recommended with the Couch to 5k program?
posted by aebaxter to Sports, Hobbies, & Recreation (61 answers total) 5 users marked this as a favorite
An alternative, until your knees are back in gear is to run in the pool, which is lower impact but similar in the level of work out.
posted by iamabot at 5:44 PM on September 18, 2007

I don't know, I guess I'd trust your doctor, but I had stats just like yours when I started a 5K program and I was fine. I was actually pretty fit before I started though and I didn't have shin splints or knee problems. YMMV, but I was OK. I do find it funny that your MD said NO exercise - not even arm strengthening? I mean, that's a little weird. But maybe it was one of those quickie appointments where they don't really share a whole lot. Good luck!
posted by BuddhaBelly at 5:44 PM on September 18, 2007

You probably can't run, but you might ask about other good aerobic activities - can you bike? Swim? Use an elliptical?

Congratulations on getting the motivation to improve your health; do NOT let your inability to currently do the program you mentioned dissuade you. Instead, find a way to get into shape such that you can begin it.

Incidentally, having to be 140lbs to run sounds quite inaccurate. I'm a 5'5" male, 155lbs, mostly muscle - am I "too heavy" to run, too? Of course not. I would seek a second opinion - while your doctor is probably right in that you can't take up the aggressive program you want to do quite yet, I expect that your gut instinct that this doctor was not giving you adequate attention is accurate.
posted by ellF at 5:53 PM on September 18, 2007

Do you have really good shoes? Although I am not overweight, I have had similar debilitating knee problems in the past. Going to a good running shoe store and getting specific shoes that are appropriate for my gait and arch height has made a HUGE difference.

I am pretty sure I can think of people your weight who are runners, but they are all at least six inches taller than you. It is quite possible that your weight is too much for your knees, given your overall bone structure.

Even if jogging causes damage to your knees, it seems that you should still be able to power walk, which in its most extreme form is still very similar to running, but is lower impact. Competitive power walkers can do better than 7 minute miles, and I recently participated in a relay walking event where people were going between 10 and 12 miles per hour, which is honestly the same speed that I run at most of the time. Power walking is different than just walking really fast and swinging your arms. It's worth a session or with a trainer to get the fundamentals of how it works. It is a very aerobic exercise, and still quite a lot like jogging while doing less damage to the knees.
posted by croutonsupafreak at 5:55 PM on September 18, 2007 [1 favorite]

Also, you might look up the book "Slow Fat Triathlete" if you're feeling down and looking for a little inspiration about what your body can accomplish.
posted by croutonsupafreak at 5:58 PM on September 18, 2007 [1 favorite]

Are you a member of a gym with a really a really good elliptical machine? If not, I would seriously consider it. My dad isn't overweight, but he absolutely destroyed his knees and since getting a really good elliptical he can exercise virtually pain free. It's essentially running, without that impact on your knees. Also, if your knees deteriorated in only three weeks of exercise, I would tend to agree with your dr, but obviously ianad. That seems very quick for your knees to get that bad.
posted by whoaali at 5:58 PM on September 18, 2007

Two words for you: Second opinion.

That said, I started a successful couch to 5k at 225lbs, but I'm a 6'0" male.
posted by u2604ab at 5:59 PM on September 18, 2007

I will also remark that trying to flip instantly from one extreme to the other is a hallmark of failure. People set bad goals for themselves and then either can't meet them or injure themselves trying, as you clearly did. Then they decide it's just impossible and give up on the whole idea.

I'm 26, M, 175lbs and I started to injure myself running too much, too often earlier this year. It took me a couple weeks of quiescence for the ache in my hips and knees to go away. Running is extremely high impact and runners are extremely prone to injury.

Swimming. Brutally intense full-body workout with essentially zero risk of injury.
Elliptical machines. Very very slight impact, excellent cardio workouts.

Don't be discouraged! This is normal and ok. Let your body heal -- and remember rest days are a vital part of fitness. It is during rest days that you actually improve, as your body suddenly has the time and the resources to improve itself after finding that the demands you put upon it last week were too much. Weekends are my rest days.

Give it time. Devise a sane program and follow it. By this time next year the results will be amazing.
posted by kavasa at 6:01 PM on September 18, 2007

Without getting into an MD/osteopath debate, you might try talking to an MD. And you might go back to the treadmill, which was working for you, versus the track. The treadmill might allow you to focus on your form more effectively than a track can, which might reduce your risk of injury. There's no objective "these numbers mean you can't run" thing, just what's right for your body, which you'll figure out. My personal trainer was over 200 lbs when she completed her first triathlon.
posted by judith at 6:02 PM on September 18, 2007

If you're asking, "Can someone be too fat to safely run?", the answer is yes. If you're asking if YOU'RE too fat to run, the answer is we have no idea, that's something only you and your doctor can decide.

Seems like your doctor decided. Maybe try working out in a pool or on an elliptical machine so your knees don't blow out?
posted by Justinian at 6:03 PM on September 18, 2007

It might be worth seeing another doctor for a second opinion.
posted by occhiblu at 6:03 PM on September 18, 2007

Like someone else mentioned, you could always get a second opinion. What about a doctor who specializes in sports medicine?

Having said that, and IANAD, but IAAO (I am also overweight!), I've read many times that you want to do lower-impact stuff until you cut down on the weight a little. It's fantastic that your willpower kicked into gear, just re-direct it a little bit. "Crippling pain" is not good. The pool is a great option.
posted by Liosliath at 6:05 PM on September 18, 2007

I started a running program at ~240 several years ago. I would say consult another doctor if you feel you are physically able.
posted by imjosh at 6:08 PM on September 18, 2007

I would not strap on a 100 lb pack and go for a jog. The reason is that I don't want to ruin my knees.

When your knees feel better, I'd encourage you to look into cycling (not recumbent) and swimming.
posted by ikkyu2 at 6:10 PM on September 18, 2007

Walk or elliptical, swimming is just not going to burn enough calories unless you really push yourself on time. I would not run at your weight, it's not worth it. It's tough on your body even when you are skinny. Listen to your doctor.
posted by caddis at 6:10 PM on September 18, 2007

Gravity has a multiplyer effect on stressing your joints, so the higher your weight, the exponentially more stress your knees, back, etc. will feel. You need to eliminate gravity until you get your weight down.

People have already said it, but you should get down and dirty with swimming. It is an excellent work out and eliminates almost all of gravity's impact on the body. You might also try hot yoga to start, and then move to other types after you start to feel your body respond.
posted by dobie at 6:11 PM on September 18, 2007 [1 favorite]

nth those who say listen to your doctor. Even at my healthiest running gave me trouble, and I was at a low weight and doing triathlons. It's something you have to be really biomechanically built well for to avoid injury, and that's without having all that extra weight.

After you've healed, repeat the first one or two weeks over and over again, only very brisk walking instead of jogging. This will give you a semblance of interval training--much better for burning fat! Even better, follow other posters suggestions for using an elliptical, cycling, or swimming.

Also, swimming does burn quite a bit of calories, especially if you don't know what you're doing. Experienced swimmers may need to really up the intensity or length of time swimming because their stroke has become so efficient, but for most beginners the thrashing about is quite exhausting.
posted by Anonymous at 6:22 PM on September 18, 2007

Speaking as a runner, who undergoes frequent injury at 185 pounds, u2604ab got it right. See someone else, doctors get stuff wrong all the time. It is true that your osteopath has more credibility than the rest of us IANADoctors, but way LESS credibility than a sports medicine doctor or an orthopedic surgeon. Your knees are valuable - you only get one set, so see a specialist. This is not something to trust to someone who may spend 90% of their time on kids with the sniffles, and is speaking from a badly remembered textbook rather than experience.

Did you get an MRI? can your doctor actually confirm this is just a sprain, a tear, or even a fracture? Can he specifically name the ligament you have sprained? can he recommend muscle specific rehab for your knee? If you're doubting his diagnosis, sounds like you have some questions a specialist might help you with.

Lastly, I seriously doubt you are not capable period of running at 240. I know plenty of dudes and chicks who do it. What might be possible is that you dont yet have the muscular support yet. Once again, ask a sports medicine doctor. They will have real answers, more than your osteopath or the rest of us. Good luck with running, it was the best thing I ever took up.
posted by wuzandfuzz at 6:23 PM on September 18, 2007

Lots of women have knee problems (ie. luxating patellas) to begin with that can be seriously compounded by high impact sports, not to mention extra weight. My knees are so messed up that I have to wrap them in ace bandages or wear supportive braces on them when I play sports.

Maybe try some low-impact exercise like walking, biking or elliptical training with a combination of strength building exercises to build up your leg muscles.
posted by pluckysparrow at 6:25 PM on September 18, 2007

also consider that you might be too heavy for *your* knees.

if you've been sedentary for a long time, you may have lost more strength in your legs and core than you realize. women, especially, have stability issues in the knees because the width of our hips put more stress on the knees.

getting your muscles in shape will help stabilize your joints. try brisk walking and add a good strength-training routine into your workout.

i'm not a doctor, i just have crappy joints and have learned a lot from various trips through physical therapy. :)
posted by thinkingwoman at 6:28 PM on September 18, 2007 [2 favorites]

nobody seems to have considered that it might be the track that caused your issues.

the treadmill didn't give you problems. stick with that until you get some weight off and then you can talk to you doctor about wether or not you are ready for the track.
posted by Megafly at 6:35 PM on September 18, 2007

Now you've gone to the doctor, and the answer is: The actual doctor that you went to knows more about it than all the IANADoctors on AskMe.

This doctor that told her to stop eating too much without asking about her actual eating habits? That doctor made the rest of his/her advice, whether true or not, suspect. One can only wonder what other assumptions the doctor was making.

aebaxter, go see another doctor that is more interested in working with you formulate a sane plan for getting fit and losing weight.

Commonsensefilter: You already answered most of your own question. If it hurts when you do that, don't do that. Yes, you overdid it. Running is hard on a body. It's probably a combination of being heavy and not resting, and what percentage of the injury is attributed to which factor is irrelevant now, yes? You've injured your knees by overdoing it, so channel all that awesome motivation into a lower-impact version of a Couch to 5k-type schedule. And try to clear your mind of a comment from that doctor that likely came off more like a judgment than a helpful diagnosis.
posted by desuetude at 6:35 PM on September 18, 2007

Wait, wait. I realize that everyone in here is enjoying freaking out, and screaming, but:

You were fine on the treadmill, right?

Can't you just go back to the treadmill?
posted by thehmsbeagle at 6:36 PM on September 18, 2007 [1 favorite]

Man, I'd really say if you want to do something for fitness, don't do running. So hard on the body.

Alternatives such as swimming are great, cycling is okay too.

If you live somewhere near water, I'd really recommend Dragonboating or some other form of paddling sport. Low impact on the knees, good cardio if you find a recreational-competitive team, and lots of good friends and team motivation to keep you coming back.
posted by anthill at 6:42 PM on September 18, 2007

People fatter that you are running (and biking and swimming), so weight isn't the sole factor. But having a doctor who listens to you and doesn't diagnose you purely on the basis of your weight is important. I agree with those who suggest a second opinion, and maybe with a sports medicine focus. You may need to do some strength training in you legs, or there could be something else wrong all together. You might want to check out this fat friendly doctors list.
posted by kimdog at 6:42 PM on September 18, 2007

This doctor that told her to stop eating too much without asking about her actual eating habits?
This might be a faux pas, but is it really much of a medical error to assume that a 5'6" woman who weighs 240 pounds (and who is quite clearly not a bodybuilder) eats too much?

I'm not trying to be a jerk. I'm honestly asking here. Can a 5'6" woman get to 240 pounds without overeating or being a bodybuilder?
posted by Flunkie at 6:45 PM on September 18, 2007 [1 favorite]

It's not your doctor telling you you're too heavy to run, it's your knees. But they're really only telling you that you're too heavy to run on a track, since you were fine on the treadmill. Stick with the treadmill and try the track again in a few months instead of a few days.
posted by jacquilynne at 6:46 PM on September 18, 2007

Flunkie: that rather depends which direction she got there from, doesn't it? If she weighed 250 6 months ago, she might not need the 'stop eating so much' advice anymore.
posted by jacquilynne at 6:48 PM on September 18, 2007 [1 favorite]

Flunkie: that rather depends which direction she got there from, doesn't it? If she weighed 250 6 months ago
... then she wouldn't have said that she started exercising three weeks ago, after having had essentially none for six years.
posted by Flunkie at 6:51 PM on September 18, 2007

Here's my experience. I'm 5'4", 150lb, and I'm about 20lb too heavy to run. Sure, I have a knee injury. Sans knee injury? I *might* be able to run at this weight, but I wouldn't put money on it.

I am, quite simply, built wrong for running - and for most exercise that causes impact on back, hips, knees. At 200lb I could barely walk without crippling pain.

On the other hand, I have a couple of friends who at 200lb were running quite happily. I can't do that; I'm built all wrong.

Yes, there are people who can run with your stats; I'm not one of them, and perhaps, you aren't either.
posted by ysabet at 6:58 PM on September 18, 2007

... then she wouldn't have said that she started exercising three weeks ago, after having had essentially none for six years.

One can eat in a healthy manner without exercising.
posted by jacquilynne at 7:13 PM on September 18, 2007

I'm not sure everything you were told was exactly true, but what is true is that you entered into a high-impact exercise routine, and your knees hurt. Does weight factor into it? That's just plain physics. Does it very from person to person? Absolutely. Some people have strong support tissue (ie the ligaments and tendons around the knees) and at your height and weight, would have done better. In your case, at the very least, you have overexerted.

I have an MD, and I used to be a competitive collegiate runner, and if you ask me, you don't necessarily need a second, third or fourth opinion yet to figure this out. What you need to do is listen to your body. As a general rule, if a joint starts aching in the midst of an exercise program, it means that on a case by case basis, one has stepped up the routine too fast for your muscles, tendons, menisci, and ligaments, to adjust to the increased stress. You don't need an MRI or arthroscopic surgery to understand that. What you need is a simple course of rest, ice, and perhaps anti-inflammatories, until this clears. If it doesn't in a few weeks (which probably isn't the case 95% or more of the time), see another doctor. If it does, restart your exercise but for god's sake, take things slow. There's no rush to get to 5k.

Frankly, it's unclear to me from a health standpoint if there's anything to gain by high-impact aerobic exercise at all when there are so many alternatives. I have the battle scars still from spending a decade running circles as hard as I could around a 400m circle, and what I've learned from it is that running is just not for everyone. A large fraction of people, even with the best shoes and orthotics, just don't have the kinesthetics to support such high impact in the long term. Add a hundred pounds to someone with just a hint of pronation in their feet and you've got a setup for tendonitis, shin splints, stress fractures, osteoarthritis, degenerative disc disease and a host of other issues. In light of that, what I personally recommend to allcomers is a balanced routine of different low impact exercise that minimize the stress on any one joint. For example a mix of elliptical (stress on the legs, but better than running), swimming (shoulder stress), and yoga, in combination with resistance exercises. And always stretch and warm up. That's the key to limiting any potential injury to all that connective tissue.
posted by drpynchon at 7:15 PM on September 18, 2007 [9 favorites]

Sure, sure.
posted by Flunkie at 7:15 PM on September 18, 2007

I know nothing about such things, but right now, your knees are wounded, and it may be unsafe to do any kind of knee-related exercise until they heal. (Even treadmill or elliptical.)

There should be low-impact exercise forms besides swimming, like yoga, or upper-body weight training which should be safe, although talk to your instructor before the course so that you can avoid the dangerous stuff. Your osteopath should have pointed this out, rather than just telling you to avoid exercise.

Think about getting a second opinion from a real doctor; osteopaths tend very often to be from the dolphin therapy and ear-candling camp.
There's also a possibility that the osteopath mis-diagnosed, and you have something torn that needs treatment, not just rest.
posted by sebastienbailard at 7:16 PM on September 18, 2007

I'd suggest you get into biking-or into a Spinning class or elliptical or something.

I too wish I could run but I am still overweight and I like my knees. All my runner friends have all kinds of injuries, while even when my foot and ankle kick up I can still go to Spin class. You don't want to risk screwing up your knees to the point you can't do ANYTHING. Meanwhile, I myself can kick major butt in spin class now.

Also, frankly, for weight loss purposes, walking for long periods of time cannot be beat, particularly at the beginning of your journey.
posted by konolia at 7:16 PM on September 18, 2007

Well, at least two people with medical degrees have weighed in on this to say that you don't really need to be a brain surgeon to figure this one out. Try swimming or cycling for a while and then try running again.

Muscle soreness is expected, but exercise shouldn't hurt your joints.
posted by Mr. Gunn at 7:42 PM on September 18, 2007

This doctor that told her to stop eating too much without asking about her actual eating habits?

If Calories in > Calories out, you gain weight. if you're 100 pounds overweight, it's clear that your caloric intake is too high. So, the doctor gave very sensible advice to stop eating so much. Nothing wrong with that.

Some more low-impact exercise:
Cross-country skiing
Swimming (and Water Polo)
posted by chrisamiller at 7:43 PM on September 18, 2007

What thinkingwoman said. Everyone's anatomy varies, and some of us, especially women, may have alignment or other weaknesses that make high impact activity like running much more difficult to practice safely.

A 240 pound person, male or female, with naturally good alignment and strong muscles may be able to run with little chance of injury. A 240 pound person, male or female, with a prolonged sedentary history and anatomical or muscular weaknesses may be an accident waiting to happen. Hell, 15 years ago when I was 120 pounds, I started running 5 km 3 times a week in the dead of a Toronto winter -- and LOVED it -- but after 4 months, I developed patellofemoral pain that I had a terrible time shaking off. I'm at 140 pounds now, and I'm not even considering going back to running until I lose another 20 pounds and have gone through several months of stretching, strengthening, stability and alignment exercises, and I'm getting my form and fitness signed off by my sports doctor and physiotherapist first.

(I wouldn't assume that you're OK to run on the treadmill just because your injury showed up only after you ran on the track. It just may have taken that long for the injury to manifest itself, no matter what surface you ran on.)

I'd suggest that for now, you try lower impact aerobic activities that don't hurt. See a sports medicine specialist and get a diagnosis and a referral to a physiotherapist. Let them tell you whether rehab alone would let you run with little or no change in weight, or whether both weight loss and rehab would be necessary. It's your very specific anatomy we're talking about here, and a bunch of anecdotes from those of us of varying weights and anatomy won't tell you much about what your unique body needs.
posted by maudlin at 7:46 PM on September 18, 2007 [1 favorite]

Get a second opinion from a medical doctor who is board certified in sports medicine or orthopedics. Let your body heal from your current injury. Then, once you're feeling better, develop an exercise routine under the advice of said doctor and a trainer who has experience working with people who have previously been sedentary and are carrying some extra weight. You can definitely find a form of exercise that will work with your body; you just need to work with qualified experts to figure out what exercise that should be. That exercise may or may not be running right now, but a good medical doctor, not an osteopath you don't seem to trust or like, should help you figure that out.
posted by decathecting at 7:57 PM on September 18, 2007

if you're 100 pounds overweight, it's clear that your caloric intake is too high.

No, it's not. At best, it's clear that at some point in the past, your caloric intake has been too high. But if you're 100 pounds overweight now, and were 140 pounds overweight six months ago, then your caloric intake over the past six months is, overall, about right.
posted by DevilsAdvocate at 8:21 PM on September 18, 2007 [1 favorite]

I did couch to 5k, ran a 5k, now doing 5 mi.

Started @ 265lb (6'1") and now 215lb. 6 months.

I had knee problems/shin splints/ankle problems that strength training took care of (losing weight helped, but I was 240lb when I ran a 5k in 30 minutes).
posted by sirliberal at 8:36 PM on September 18, 2007 [1 favorite]

My goodness. Please fire your doctor if that's what they said - you do need someone supportive on your road to becoming healthier.

I would not doubt that your knees (and supporting muscles) are not quite ready for the exertion. It sounds like you might want to consult a good personal trainer to not only help you recouperate, but give you the specific program to reach your goals.

Everyone deserves to be healthy and feel good about their athletic achievement. You might not be able to run, for whatever reason, but you should be able to get some advice that gets you as close to there, as efficiently as possible.
posted by beezy at 8:37 PM on September 18, 2007

A few years ago, Mrs. Advicepig decided to start training on a treadmill and surprise me by going running with me and running me into the ground. She discovered rather quickly that treadmill running simply isn't as hard as running outside.

I'd say take some time off to heal and then restart the couch to 5k plan, but run/walk and run for real, not on a treadmill.
posted by advicepig at 8:42 PM on September 18, 2007

I was planning on doing the same thing - 5'3", 215 lbs here - and noticed early on that my knees and joints were a mess.

I chose instead to train to walk the Avon Breast Cancer Marathon.

Yes - I chose to walk 26.2 miles instead of run 5K. Then, in my last 6 weeks of training, I got stuck on a job that prevented me from training, and got tonsillitis which knocked me on my ass for two weeks.


This past weekend I'm happy to report that I completed the marathon - yes, a few blisters and a really sore foot, but unrelated to my weight according to the docs they had on site.

Running is hard on ANYONE'S knees, regardless of their weight.

Walking, swimming, elliptical - all much better for your joints. And training for any type of activity like this requires that you not only walk, but that you do some cross-training - like swimming or weight lifting - so you're not constantly pounding your knees and other joints into submission.

Look - see another doctor, do the research. Go to a running store and have them evaluate you for the best pair of shoes (overpronators, for example, need a different type of sneaker).

Then commit as best you can and constantly remind yourself that however much you're doing now is WAY more than you were doing before...and feel really proud of yourself.

posted by OhPuhLeez at 9:28 PM on September 18, 2007

Oh - and what advicepig said - treadmills SUCK for training. Get outside, no matter what the weather, and set your own pace.
posted by OhPuhLeez at 9:29 PM on September 18, 2007

it's awfully difficult to say whether you should run or not -- all we have is a few stats. yes, you are on the heavy side and that is a concern but you could get special shoes. are you an overproner? the first thing you should do is go to a real runners shop and get the right kind of shoes fitted. don't just go for some sneakers for your closet and whatever they give you, discard after five months - assuming you work out daily.

not only your knees are at risk of being overused and thus damaged, your achilles tenderloin is another area where you can very easily experience a tough time if you don't watch out. it is very easy to make some pretty major mistakes here and I would recommend that you get a licensed personal trainer who knows a thing or two about running. that person should show you how to stretch, which you should do religiously every single time you work out, and should be able to adjust your workout regime to your abilities. this probably means starting with incline walks for the first four or five months. don't worry, they get pretty darn challenging and you will be able to burn almost as many calories with them. also make sure that you learn about proper warmups and cooldowns.

you sound like you are fairly new to this so I'd be kind of surprised if you really sprained anything already (inflamed perhaps) but all this is mute if a second MD tells you to not do it. a real doc looking at your body in real time beats all of us on the internet every single time. my main point though is that you should really get someone with more experience to assist you. you can hurt yourself and you can waste a lot of time by just trying it.

take a look at the runners world discussions and consider posting to either the Beginners or Injuries forums. there are some really experienced people in there and you might just meet a workout partner there.
posted by krautland at 10:06 PM on September 18, 2007

that should have been from your closet...
posted by krautland at 10:07 PM on September 18, 2007

I have had the almost identical experience to you. I was working through the couch to 5k loving it but my knees started hurting a lot.

So, I quit running and just started doing a lot of walking. Low impact, less traumatic on the body and it's helped me lose a lot of weight!
posted by tomble at 1:31 AM on September 19, 2007

M 5'9 240lbs, and I did the couch to 5K plan. If your knees hurt that much you should definitely stop, you don't need a doctor to tell you that. Like everyone else suggested, try less impact exercises (elipticals, biking, walking).

Also any doctor who doesn't listen to you and simply brushes off your complaints as "you're too heavy to run", just rubs me the wrong way. Get a second opinion, maybe this time an orthopedist, and maybe even a nutritionist.

Good luck!
posted by ruwan at 3:55 AM on September 19, 2007

I weigh less than you do, and am taller. And running makes my knees hurt. Running with a 50 pound backpack would probably do devastating things to my knees. I figure that some of us just aren't meant to be runners, and almost certainly not before both loosing some weight and building up your muscles. I'll second the walking, swimming, and cycling suggestions -- all are really good exercise, and none of them make your joints hurt. Moreover, all are easy to start gently, and then ramp up as you get fitter.

I also think, though, that you should consider finding a new doctor. What your doctor told you may have been true, but it doesn't appear to have been couched in a very helpful way. A doctor with a better bedside manner might have worked with you on alternatives to running, particularly while your knees heal, and certainly would have discussed your diet in a more helpful way. If both diet and exercise are things you are thinking about changing, then perhaps talking with both a nutritionist and a personal trainer would be helpful, all with the knowledge of and input from your (new) doctor.
posted by Forktine at 6:56 AM on September 19, 2007

The "I couldn't run if I had a Xlb backpack strapped on" comments don't make any sense, guys, unless you're planning on putting on the backpack now, making sure it's some very ergonomic backpack that distributes weight all over your body, getting used to it as part of your own body with all the various muscle growth and alignment compensation that will create, and then going running.

And yes, overweight people are very likely eating less than thin people, which is actually likely to cause them to gain more weight in the long term.

Any doctor who sees an overweight person and immediately gives advice to "eat less," without actually talking to the patient, is operating out of bias and drug company propaganda, not out of knowledge. As everyone else says, trust your body, but I wouldn't trust this doctor.
posted by occhiblu at 7:22 AM on September 19, 2007 [3 favorites]

IANAD, but how thorough was that exam? Were you given a referral for PT? Depending on the location of the knee pain, it could be an IT band issue. IT band soreness can pop up when you increase your workout - so the transition to a track from a treadmill could have created it. I only mention it because an IT band issue is resolved through stretching and rest. PT would be a huge help. Also, depending on the injury some non-impact activities might not be appropriate. Biking and spinning can be a killer too, but it really depends on the specific Dx.

That said, I do marathons with Team in Training. Right now I'm walking events, because I find that more enjoyable than running. (Don't scoff! I finish marathons faster than many runners.) Team in Training participants start at all fitness levels and weights, but with a few months of training they complete a marathon, half marathon, century ride or a triathlon. Having witnessed tons of people work through the TNT program, I don't think anyone is too heavy or unfit. Some people are just going to need longer to prepare than others. However, a key to the program is that participants have coaches who monitor their progress and help prevent injuries. In my time with TNT I've seen very, very few injuries which is surprising considering the number of newbies who join us each season.

You might want to look into similar structured programs in your area. A good program should cover topics such as running form, shoe fitting, bra fitting, event day nutrition, training nutrition, stretching programs, recovery days and cross training. Also, the program should have a coach who is unafraid to chat with you about your weight and the limitations that it may create. Coaching is not a substitute for your doctor, but a coach can be there during your workout to make corrections in form and monitor your progress.

It sounds as though you doctor is a bit of a plonker. Get a second opinion, and a referral for PT if it's appropriate.
posted by 26.2 at 7:51 AM on September 19, 2007

I think your doctor is taking the wrong approach (and should be replaced) but made the right recommendation vis-a-vis running, because, weight aside, you've shown that you can and will ignore an injury until it becomes a serious problem. If you do any form of exercise as a heavier person, you have to be extremely aware of what your body is telling you to avoid injury -- a little twinge may be all the warning you get. Being very motivated actually works against you, since that motivation causes you to "power through" those warning signs.

I'm not being judgemental -- I have the same problem, and have a long history of injury, particularly knee injuries, due to ignoring early signs that my (then 350+-pound) body was giving me. In the last year, I think (hope?) I've broken out of that mode by doing three things:

1) Losing some weight before even starting exercise to reduce joint stress. Unexpectedly, this has been extremely valuable psychologically because I know that, even if I can't exercise due to injury, I can still lose weight (although nowhere near as fast).

2) Doing nothing higher-impact than walking and taking extremely good care of my knees. I ice them both after every walk, no matter how good they feel. At this point, I'm pretty sure I could start running if I wanted to, but I don't think the small short-term cardiovascular benefits (I can get my heart rate where I want it with fast walking) would outweigh the long-term knee wear and tear.

(Plus, there's part of me that loves being the fat walker who passes joggers on the trail.)

3) Not doing any exercise if I'm even slightly injured. I'm trying to turn my perfectionist streak from always staying on a program to always restarting the program after stopping for a week or so.

I'm not saying this is the best approach, but it's the approach that's worked well for me.
posted by backupjesus at 8:00 AM on September 19, 2007

Lots of good comments here -- two things I would add are:

1) you are *totally* rocking the casbah by getting off the couch and out. I did the same thing four years ago after quitting smoking, and now run 5k and 10k races, bench 250 and squat 350;

2) IANADoctor as well, but it sounds like you just went too fast. It's great to be motivated, but most injuries occur when people push themselves too far. Your body is your best RSS feed -- pay attention. Get a second opinion, and talk to a sports medicine specialist. AND DON'T QUIT!
posted by liquado at 8:10 AM on September 19, 2007

With all the cycling advice (which is great :P).. Beginner cyclists often peddle too slowly, which can also cause knee strain. Remember to use an easy gear and peddle fast (at least 90rpm, cruising around 100-107rpm works well for me).
posted by Chuckles at 8:14 AM on September 19, 2007

Response by poster: Thanks to everyone who took the time to answer my question. I appreciate all the advice on lower-impact exercise, and have made an appointment with a personal trainer to discuss some options.
posted by aebaxter at 1:03 PM on September 19, 2007

I'm 37/m 6'4"/250lbs and I started Couch to 5K on Monday. I'll let you know if I screw my knees up. ;-)
posted by schwa at 8:23 PM on September 19, 2007

i'm not a doctor and i don't know much about mass-related joint problems, but i do have bum knees, and a few years ago i started to exercise after a long, injury-induced sedentary period. the following advice worked for me.

if you decide to run again, make sure you have good shoes, and run on grass whenever you can. concrete is a no-no- really avoid sidewalks. if you must run on pavement, try to find asphalt. knees need springy surfaces. try to run in a way that feels minimally poundy. don't bounce- run low and smooth.

whenever your knees hurt, stop running immediately.

you probably just need to work up to it. stairclimber or elliptical machine might be a good start, and they're low impact. you'd do well to strengthen the muscles & ligaments in your legs, so try stuff like lunges holding dumbbells, using weight machines (leg extensions & hamstring curls & calf raises & squats) and that thing where you put a ball at your back and roll up & down a wall like you're sitting in an invisible chair. hatha yoga helped me, too.

good luck! congrats on getting active!
posted by twistofrhyme at 10:37 PM on September 19, 2007

I'm 25/M, 101kgs (which is _shocking_, seeing as it is that was 75kg only two years back) and this couch-to-5k thing sounds exciting!
posted by the cydonian at 7:42 PM on September 21, 2007

First, let me say that your zeal is commendable. But honey, you are too heavy to be running right now. As a trainer, my advice - the best thing for you to do is to keep up on that treadmill for a while until you get lighter. Going from Couch to 5k is some type of bullshit - don't take it literally! It takes time to be able to do that. Be patient with yourself, and realize weight loss takes time (you should shoot for no more than 1-2 lbs. a week). If you keep up running right now, trust me, you'll never be able to run a 5k. Keep the end in mind, and get after the walking. I'll let you in on a little secret: walking is the best way to shed fat and preserve muscle-inspired metabolism. When you bust your ass, you burn muscle along with fat, but the harder you go, the more metabolic-producing muscle you lose. Good Luck!
posted by gmodelo at 10:19 AM on November 26, 2007

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