Can you help me troubleshoot my issues with my cycle of injury, falling off the wagon, and gaining?

meggs9605

Sorry if this gets long. I will try to be concise and still include pertinent information.

Female
Age -35
Height - 5'6
CW - 212
HW - 290
LW - 145
GW - 155/160?

Background: I have always been heavy. As a child, I was active and even danced competitively, but still very overweight. I had open Gastric Bypass when I was 19 (in 2003). Lost 140+ lbs. Skin removal surgery (total lower body lift and breast reconstruction) in 2006. Weight stabilized around 160-170 throughout my 20s. If I gained a few, I could get back to good habits pretty easily and the weight would melt off again. I got pregnant in 2014, gained 70 lbs (but even my OB acknowledged that I was still proportionate and healthy despite the number on the scale). Wound up with an emergency C section that goes almost from hip to hip. Got back down to 180ish, but now up to 212.

I have flat feet (runs in the family; my dad has had triple arthrodesis on both feet to rebuild his foot bones). This has always made me prone to knee injuries along with being diagnosed with juvenile arthritis (around age 9) in my hips, knees and ankles due to my weight.

Now, the weight doesn't fall off like it used to and I am in constant pain. I feel stuck, because I know my joints wont hurt as much if I can drop the extra lbs, but it seems that every time I get back into good workout routines, I hurt myself, take time to let my body heal, gain more weight, rinse and repeat. It feels like a viscous cycle.

My core muscles are a hot mess from being cut so many times in so many directions. I also have 1 confirmed and 1 suspected hernia. So while I really love yoga, pilates, and barre excercises, I overcompensate for my weak and damaged abdominal muscles and wind up straining my back. This combined with the fact that the 360 degree incision from my lower body lift means that i have bundles of nerves wound up in my lower back. So often, where I actually feel pain in my torso does not accurately correspond to where I have have suffered an injury.

Currently I work out 5 days a week for a total of 30-90 min. Always 20-40 min of cardio (walking, elliptical, bike, etc), light free weights / resistance training and 3-4 days a week I take a yoga or barre class. But now that I have been back at it (again) for about a month, my left knee sounds like someone popping bubble wrap whenever I bend it (in addition to pain when going up stairs). I have constant nerve pain down the back of my leg, and I cannot get through a workout without accidentally staining the same 2 abdominal muscles. I have been wearing a knee brace and my hernia belt, but it's not helping. I am just so frustrated because I am (again) over the hump of constant general soreness that comes with starting a formal workout routine, and just today I did my very first pushup! But I also know that an injury is likely to happen at any time if I overdo it or fall out of proper positioning.

Any advice, feedback, and/or support would be greatly appreciated. I WANT to be healthy. I WANT to be fit. I WANT to feel comfortable in my own skin. But my f'd up body seems to have it's own agenda.

quiksylver296

You don't talk about your diet at all. What are you doing on that front?

meggs9605

quiksylver296 wrote: »

You don't talk about your diet at all. What are you doing on that front?

I admit, when I fall of the workout wagon, I fall hard and overindulge in crappy eating habits. But even on my worst days, i don't eat a lot, I just eat primarily processed/convenience foods. I would say, honestly, that 80% of the time I am easily under 1500 calories. Ocassionally, I have a huge binge. Especially when I'm PMSing. But, I dont ever eat sweets. And even on the days, I go off the deep end, I vomit most of it back up. (I'm not proud of that and its not intentional. My stomach only holds so much. So when I give into emotional eating, I pay the price). Also I am on a medication that affects my appetite. So most days my husband ends up telling me to eat.

quiksylver296

Weight loss is about your calorie intake. If you really want to lose, you'll need to dial that in.

Check out this thread.
http://community.myfitnesspal.com/en/discussion/1080242/a-guide-to-get-you-started-on-your-path-to-sexypants/p1

LyndaBSS

Did you speak to your doctor about that medication?

manderson27

You don't mention any physiopherapy for your various issues. Perhaps that would help you find out which excercises would be best and the correct form while doing them.

Otherwise I would be inclined to try swimming for excercise and just concentrate on my food intake to lose the weight. You may find that some of your issues resolve or at least improve once you have lost more weight.

I know my OA improved significantly after a 30lb loss.

concordancia

It sounds like you have a back and/or core issue. Talk to your doctor about physical therapy.

You may also simply be doing to much for your current physical state. Try cutting back to just 30 minutes a day until the issue resolves.

apullum

There are really two (at least) separate questions here: 1) Why are you getting injured? and 2) Why are you having trouble losing weight?

2) is easy to answer on most levels. You mention that you don't always weigh and log all your food, and you don't always stay within your calorie goal. That's at least part of the problem. Weight loss is 100% about consistently being in a calorie deficit. It doesn't have anything to do with what specific foods you eat, whether you eat sweets, or whether you consider those foods to be "processed." If you aren't weighing and logging your food, you don't know how many calories you're taking in, and therefore don't know whether you're in a deficit.

1) is harder to answer. It sounds like you may be doing too much too soon, and possibly doing exercises that aren't suitable for your medical history.

The best approach would be to consult your doctor and/or physical therapist about that medication you're taking, your binging and vomiting, safe exercises for your body, and a timeline for increasing your activity.

wiigelec

See if one of these folks can help you out:

https://startingstrength.org/site/coaches

kshama2001

I would be miserable on just base calories so always try to get in about 500 exercise calories per day. I too struggle with knee issues, am dealing with golfer's elbow now, and have had hip and lower back issues in the past. I am constantly modifying so I don't hurt myself.

It really sounds to me like you are trying to do too much for your current capability. I suggest you get a referral from your doctor to a physical therapist and let them put together a routine for you that won't hurt you.

Meanwhile, as others have said, you can lose weight by simply focusing on calories. Do always weigh and log. See what foods fill you up for the least calories and focus on them. For me it is protein and fiber.

aokoye

I'll essentially second (third, fourth...) what's already been said. There are at least two issues here. 1. you're not losing weight 2. you keep getting injured.

The first issue is the easiest to deal with. Start eating in a deficit consistently. The second issue is a bit more complex. I agree that you probably need physical therapy and also need to slow way down with regards to the amount of exercise you're getting. I would also suggest seeing if a reputable doctor try to diagnose some of what's going on with regards to your knee and nerve issues. Additionally there's the hernia that may need to be repaired.

tcunbeliever

Weight loss happens in the kitchen, totally agree with everyone one that.

Regarding the injuries - it's all about proper form. If you are doing pilates or yoga with proper form then there's no way to overcompensate with your back. If you are unsure of proper form, then find a good local studio and inform the instructor that you are prone to overcompensating with your back. He/she should then be able to watch for that and adjust your form as needed.

Building your core will help support and protect your back from future injury, so to me, it would be worthwhile to invest in that given a history of injury.

It sounds like you are having sciatica pain, this is primarily caused by poor posture, in your case I'm guessing it's likely to be related to your weak core and unbalanced core/back muscle strength. You should probably see a doctor to confirm, but balancing those muscles out should be feasible.

Maybe cut out anything that hurts in terms of activity and stick to walking or bellydance or anything that is low/no impact. Focus on form, even when walking. Everything in everyday life, form matters.

kshama2001

tcunbeliever wrote: »

Weight loss happens in the kitchen, totally agree with everyone one that.

Regarding the injuries - it's all about proper form. If you are doing pilates or yoga with proper form then there's no way to overcompensate with your back. If you are unsure of proper form, then find a good local studio and inform the instructor that you are prone to overcompensating with your back. He/she should then be able to watch for that and adjust your form as needed.

Building your core will help support and protect your back from future injury, so to me, it would be worthwhile to invest in that given a history of injury.

It sounds like you are having sciatica pain, this is primarily caused by poor posture, in your case I'm guessing it's likely to be related to your weak core and unbalanced core/back muscle strength. You should probably see a doctor to confirm, but balancing those muscles out should be feasible.

Maybe cut out anything that hurts in terms of activity and stick to walking or bellydance or anything that is low/no impact. Focus on form, even when walking. Everything in everyday life, form matters.

I'm not arguing with your points about yoga, merely expanding upon them

Yoga can be healing, but it can also hurt.

I'm a certified yoga teacher and have become a lot more conservative about my yoga practice since reading “The Science of Yoga”. For example, I never do shoulder stand anymore. Sure, I could do modifications / use props, Iyengar style, but after reading about spinal injuries I decided it wasn't worth it.

I'm prone to injury, and often warmed up before taking another teacher's yoga class as most of them simply don't do enough warm ups as far as I'm concerned. Now, the only types of classes I would even consider taking from teachers I don't know would be along the lines of Restorative / Gentle / Beginner.

Also, there can be a big difference in "yoga studio yoga" and "gym yoga". Which is not to say one can't find a good teacher at a gym - I've taught at gyms and know many other good teachers who teach at gyms. But the barrier to entry for getting a job teaching yoga at gyms is very low.

Here's an excerpt from “The Science of Yoga” afterward: https://6thfloor.blogs.nytimes.com/2013/01/10/the-healing-power-of-yoga-controversy/?searchResultPosition=3

meggs9605

OP here...Thank you all for your feedback!

So, I have a bit more info that is both helpful, but also very discouraging. I has some testing done just this morning. According to my body scan, which takes into account my height, weight, body mass composition, and a ton of measurements, my BMR SHOULD be around 1701. However, I did an RMR test as well, and I am actually only burning 1008 calories per day in a resting state. The physiologist who did my tests said it was the lowest metabolism data she has ever seen.

So now that I have this information I am trying to figure out my next steps. I actually can gain weight eating as little as 1200 calories a day if I am not very active. But I also don't have much (if any) wiggle room to eat at a deficit. Obviously I want to continue working out. But I feel dejected knowing that any additional calories burned still only allow me to eat very little, and likely not lose any significant weight. I am thinking (please correct me if I'm wrong) that I really need to focus on incorporating strength training to hopefully increase my lean muscle mass?

As for the injury pieces... my sister is a PT, so I will ask her to assess my knee at least. She has helped me with my SI disfunction before. I would love to fo to an orthopedist. But even though we have insurance, we have a pretty high deductible. It is very hard for me to justify seeing a specialist who will likely order a MRI when I know that it will be very expensive for our family.

meggs9605

OP again...I also forgot to add that I do track my food daily. I just use another app that I like better. So I am pretty confident that my general calorie ranges are fair.