Effective Exercise Recommendations for Seniors with Knee Pain and Obesity - Rehabilitation

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Hello Director Su,
My mother had lumbar spine surgery over a year ago, and now she is experiencing knee degeneration pain and has varicose veins.
What kind of exercises can she do?
P.S.
My mother is currently unable to stand or sit for long periods, and her walking is unstable.
She is also overweight and has fatty liver, so exercise is essential.
I kindly ask for your advice.
Thank you!

san, 30~39 year old female. Ask Date: 2010/01/18

Dr. Su Hongci reply Rehabilitation


Hello: If the knee joints have shown significant degeneration or if one is getting older, it is advisable to adjust the level of physical activity or consider alternative exercises, such as reducing the amount of jogging and substituting it with brisk walking.
Additionally, activities like swimming or using a stationary bike can reduce the load on the joints due to gravity, making them suitable exercises for individuals with lower extremity degenerative joint disease.

Both jogging and brisk walking offer similar health benefits, including improved cardiovascular function, increased muscle strength and endurance, enhanced circulation and metabolism, stretching of muscles, and stress relief.
However, there is a significant difference in the physical impact of the two.
When jogging, both feet leave the ground, and upon landing, the ground reaction forces are absorbed by the feet, ankles, knees, hips, pelvis, and spine.
This can place a heavier burden on the lower extremity joints in individuals with degeneration or significant spinal degeneration, as well as those with herniated discs.
In contrast, brisk walking maintains at least one foot on the ground at all times, resulting in lower ground impact forces and a significantly reduced risk of injury.
Lumbar degeneration can lead to conditions such as herniated discs, spondylolisthesis, bone spurs, and spinal stenosis.
When the degeneration is mild and does not affect daily life, the best approach is to engage in rehabilitation exercises to strengthen the lumbar extensor muscles and hip flexors, thereby increasing spinal mobility and support, such as through lumbar traction.
It is important to avoid lifting heavy objects with degenerative spinal conditions.
If lifting is necessary, one should squat down or sit low first, then slowly lift the object with the hands, rather than bending at the waist to pick things up or exercise.
Wishing you good health!

Reply Date: 2010/01/18

More Info


Dear User,
Thank you for your inquiry regarding effective exercise recommendations for seniors, particularly for your mother who is experiencing knee pain, obesity, and has a history of lumbar spine surgery. Given her condition, it is crucial to approach exercise with caution while ensuring that she can improve her overall health and manage her weight.


Understanding the Conditions
Your mother’s knee pain, especially in the context of osteoarthritis (common in seniors), can be exacerbated by excess weight. The added pressure on the joints can lead to increased pain and decreased mobility. Additionally, her history of lumbar surgery indicates that any exercise regimen must be gentle and supportive of her spine.


Recommended Exercises
1. Low-Impact Aerobic Activities:
- Walking: Encourage short, frequent walks. Start with 5-10 minutes and gradually increase as tolerated. Using supportive footwear and walking on flat, even surfaces can help minimize discomfort.

- Stationary Cycling: This is an excellent option as it provides cardiovascular benefits without putting undue stress on the knees. Ensure the seat is adjusted properly to avoid strain.

- Water Aerobics: If accessible, water exercises can be highly beneficial. The buoyancy of water reduces stress on the joints while allowing for a full range of motion. Activities like walking in water or gentle swimming can be effective.

2. Strength Training:
- Chair Exercises: Simple movements such as seated leg lifts, seated marches, or using resistance bands can help strengthen the muscles around the knees and improve stability.
- Wall Sits: If she can tolerate it, wall sits can strengthen the quadriceps without putting too much strain on the knees. Start with short durations and gradually increase.

3. Flexibility and Balance Exercises:
- Stretching: Gentle stretching of the legs, hips, and back can improve flexibility. Focus on hamstring stretches and calf stretches, which can be done while seated.

- Balance Training: Simple balance exercises, such as standing on one leg while holding onto a chair for support, can help improve stability and prevent falls.

4. Physical Therapy:
- Given her medical history, it may be beneficial for her to consult with a physical therapist. They can provide a tailored exercise program that considers her specific needs, limitations, and goals.

Additional Considerations
- Weight Management: Since your mother is overweight, a gradual weight loss through diet and exercise can significantly alleviate knee pain. A registered dietitian can help create a balanced meal plan that supports her weight loss goals while considering her fatty liver condition.

- Pain Management: If she experiences significant pain during or after exercise, it may be necessary to adjust the intensity or type of activity. Over-the-counter pain relievers, as advised by her physician, can also help manage discomfort.

- Regular Monitoring: Keep track of her progress and any changes in her pain levels or mobility. Regular follow-ups with her healthcare provider are essential to ensure her exercise program remains safe and effective.


Conclusion
In summary, a combination of low-impact aerobic exercises, strength training, and flexibility/balance exercises can be effective for your mother. The key is to start slowly, listen to her body, and make adjustments as needed. Encouraging her to stay active will not only help manage her knee pain but also improve her overall health and quality of life. Always consult with her healthcare provider before starting any new exercise program to ensure it is safe and appropriate for her specific health conditions.

Best wishes for your mother’s health and well-being!
Sincerely,
Doctor Q&A Teams

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