EF asks: I am a 43 year old male who was active in the past but in the recent years have gained a fair amount of weight. I have gained about 30 pounds and my knees are starting to ache when I go up and down the stairs. Also, I am having difficulty kneeling. I used to be able to play basketball with my son but my knees and my weight are really affecting me. Can you give me some advice on how to lose weight and also what exercises can I do to lose the weight.

Dr. Patel answers: Dear EF I am glad that you at least recognize your weight problem. The first goal in losing weight is to admit that you may be overweight. The bottom line in losing weight is controlling your input (calories) and increasing your output (metabolic rate / exercising). Losing weight is not an easy task but there are several things that can help. Caloric intake as well as the types of food you eat for the calories is important. Many of my patients have tried weight watchers and have been very happy with their results. Also, increase your salad and fruit intake. Our Western diet does not seem to emphasize that as much as it should. For every pound you lose, you can take up to five pounds of pressure off the knee cap.

The pain you are having when kneeling and going up and down the stairs is from arthritis on the knee cap as well as from weakness in your quadriceps muscle. To strengthen the muscle around you knee, try closed chain exercises. Closed chain exercises are when your foot is planted onto a surface while strengthening the quad muscle. Some examples are bicycling, leg press machines, and elliptical machines. I would advice against jogging as this may make your symptoms worse. Also, I don’t recommend leg extension exercises where the foot is air-borne as this may flare up the knee arthritis. Anti-inflammations may help you if not contraindicated by your doctor.

Dr. Manish Patel is director of Southampton Orthopaedic and Sports Medicine Center in Franklin and assistant professor of orthopaedic surgery at Eastern Virginia Medical School in Norfolk. Send questions for Patel to sports@tidewaternews.com.