I had the opportunity to examine a very nice women today. She was having knee pain on her right knee only. The fact that it was ONLY her RIGHT medial knee is crucial. After examining her knee and looking at her walking shoes I asked her if she had seen any other doctors. She said yes and that they had taken x-rays. She explained that her x-rays were ‘clean” and the doctor said there was no arthritis. I knew from my exam that there was no arthritis but rather a medial meniscus strain. I asked her what the doctor told her to do. She replied “lose weight”. I asked her if the doctor was implying that her RIGHT knee hurt because she was overweight? She said yes. “Does your left knee need to lose weight too I joked”. She and her daughter laughed hysterically at my humor. They proceeded to speak in Spanish to one another and started laughing all over again. The joke was not lost on her. How on earth could her right knee hurt but not her left from being overweight? It could not! Common sense tells us that. The problem with common sense is “it ain’t that common”. People spend alot of money to attend school and earn a degree only to lose their common sense in the process (I am referring to you doctor).
We fitted her for some decent walking shoes at the San Diego Running Institute and added a supportive insole. We also fit her for a temporary knee compression sleeve. She was instructed to follow up with me via email in 2-3 weeks to make sure her knee was improving and no further treatment would be necessary.
The idea of losing weight for general health is typically a good idea for those overweight but to blame a patients knee pain on their weight is negligent and requires for you to throw common sense out the window. A thorough orthopedic examination will typically reveal the true source of the patients pain and then allow common sense solutions.