Fellow T-people, I have an aunt (age 31, wt. 250, bf 43%) who has been doing your typical yo-yo diet on and off for 10 years. She recently came to me as kind of a last ditch effort. I’d love to help her out, since her family doesn’t think its possible.
I recently met with her and set her up with JMB’s meal combos and calorie requirements. She is willing to follow my recommendations in exercise and diet for 3 months, then evaluate progress and decide if its worth it.
Now my main question, she has bad knees that hurt if she does squats to parallel, rides bike or jogs for more than 20 min.
What are the best exercises to strengthen the knees with out hurting her joints?
Also anyone that has trained someone this obese or has any other advice, fire away!
Thanks-LW
How tall is she?
Instead of having her do weight bearing cardio work, put her in the water for that part of her program. If she is determined to work hard, jogging in water can be very effective and is completely unstressful to the knees. She can also begin working her quads and hamstrings in the gym without doing squats. For quads, have her sit on the floor and extend her legs forward. Doing one leg at a time, she just lifts the leg off the floor (not very high) and brings the leg back down almost to the floor, but doesn’t let it rest. The weight of the leg alone is usually enough for a beginner. If it isn’t (ie. she doesn’t feel it in her quad after numerous reps), she can put a dumbell on her thigh, above her knee. This exercise sounds really easy, but it isn’t and it is completely safe for the knees because they aren’t being asked to do anything. For hamstrings, if you have one of those exercise bands, have her tie it around her ankles, lie facedown on a mat, bend one knee till there is tension in the band, and pull that ankle in towards her butt and back down to the point of tension. The knee of the working leg should not leave the floor. Again, because the body and the knees are supported and resting on the floor, the exercise is completely safe for knees.With this exercise, she can begin with single pulls, then two up, two down, in for three, down for one–vary it up as her stamina increases. Same thing for the quad exercise.Oh, and if you don’t have a band, another way to do hams is to lie on the back and bring one heel in towards the seat, lifting the toes and the seat. Other leg is extended out (the lower it is the harder the exercise will be). Then she simply lifts her hips higher by a few inches and lowers them again, but not to the floor. If the bent leg is close enough in to her seat she should feel that in the hams very quickly. Again, it is her own bodyweight working here and the knees aren’t doing anything. Strengthening both hams and quads should help her knees, but knees are the type of thing that once they go, they never really come back, so she will always have to watch what she does. That’s why water exercise programs are so popular with many people. They don’t jar the joints at all. But–you really have to push yourself hard in those programs to get the same kind of result that you would in a gym.
Good suggestions, GM! 
LW you are most definitely a T-Person for even taking the time to care about such a person. I hope one day soon she will realize how rare people like you are. I am training a 47 year old with heart disease who is 33% bf and I know what you are going through. Send her here for uplifting motivation. First thing I would say is absolutely no jogging. She is just to heavy for her joints to tolerate. Lots of antinflamatory stuff like glucosamine and salmon oil. Her joints are going to take a beating. It is the hardest thing to get people to do but…if you can get her to do kooky stuff like set her watch to go off every fifteen minutes and walk around the building twice, you will have a much better chance of success. Any training that requires strain when you are that fat is going to be rather discouraging. I just try to get them to realize that the heart is made to beat and beat hard. Also 3 months is not very much time. If her health will allow I would have her stacking and cycling MD6 and T2, just to make absolutely sure she will get results and not fall out of line. way to go LW yours is a Noble Struggle. After all we all know she could have turned to the NAAFA board.
I commend you for your caring and effort. I agree w/ D_End, you are a true T-person. I can only agree with other comments made as far as suggestions go. I like the idea of shorter bouts during the day. nothing serious, just something to get her moving. And the water jogging is a fantastic suggestion. I would hazard a guess that it taxes the metabolism even more than normal jogging because of the resistance in both directions. Keep us up to date on how things go. Good luck!
Thanks for the props and encouragement people! Yes I know it will take a lot of dedication to make a lasting difference in her physique. I really care for this lady she is the closest my age of my aunts and she used to spend alot of time baby sitting me. Now I’m trying to supply the info and training to help her.
A few more details: she is 5’7" and a large bone structure. She weighs 250 @ 43% bf ( app. 141 lbs lbm & 108 lbs fat). The first month I’ll get her aquainted with intense Meltdown style training (as much as she is able). 4 days a wk. wt. training with cardio on the off days. The second month I plan to start a Methoxy, T2, MD6 stack.
The main thing I want to avoid is slowing her metabolism more. Which is basicly what she’s done for the last 10 yrs.
I will see if she is willing to post on the forum. I’ll keep you posted on her progress.
Thanks for any critiquing or advise !!!
Later-LW
Thanks 
LW,
You're a great nephew! :)
I'm wondering if her knee problems are due to the fact that she's overweight and it puts too much strain on the joints or there's something wrong w/ knees themselves. My friend who's overweight says her joints hurt when she does a lot of intense workout, but when she's not doing anything intense, she's fine.
If you suspect that there's something wrong w/ the joints themselves, she may be better off seeing a doc. I have knee problems myself, and my orthopedic surgeon can't figure out why cuz I'm not overweight and MRI showed that my knees are fine except for the fluids around the joints, which he can't drain. I had to stay away from doing any serious workout for a while because of them cuz they are painful, and they bruise black and blue after squats and sprinting. (I don't bang them against anything.)
Anyways, good luck to your aunt! She may be able to achieve great results in three months if she sticks to it, and that may motivate her to continue to eat well and exercise. And tell her she should be so proud of you! :)
Tell your aunt that she is mot alone in all of this. I think the Laurie Dunsill lady started at the same point your aunt is. She is doing th4e FAT FAST, which maybe too intense for your aunt.
I am doing my own version of the FAT FAST, and meltdown training. I started even higher at 278lbs 48%BF. I am now at 257lbs 45%BF. I did that in only 8 weeks. I must say that I don’t have knee(joint problems, so I sprint and run/jog every day.
Tell you aunt to post here, as she has a partner in me with stats almost like her.
I may not have some suggestions as to training, but I can encourage her.
I forgot to include some glute suggestions last time and concentrated only on hams and quads. For glutes, again, she should be lying down on her back with her knees bent and feet on the floor. She should then raise her hips slightly off the floor. This is her starting point. From there she just squeezes her cheeks and releases for 8-12 reps, then squeezes in a holds for a count of 8-16, then repeat as many times as needed. As she squeezes the cheeks she will note that her hips will rise slightly, but it shouldn’t be the focus–lifting her hips. This isn’t a thrusting exercise. This exercise will work the gluteus maximus. For the medius, the exercise band around the ankle comes into play again. She should tuck her hands under her hips to help ensure that her legs are straight up to the ceiling (if they are angled to the floor this will cause lower back discomfort). Once the legs are elevated up, simply pulling out and in, always maintaining tension on the band. Again, this can begin with singles, then two in, two out, pulses, etc. as she becomes stronger. Again, in both of these exercises, the knees are not involved. Both target the glutes.