Saturday, May 25, 2013

What I Like About ‘Taking Smaller Steps’

Have you ever seen a sand mandala?

They’re beautiful. Tibetan monks painstakingly arrange grains of brightly colored sand in striking patterns to create them. (And then, finally, they are swept away -- so there’s always a larger, humbling message about our impermanence in a permanent universe.)

When you stand before one, the feeling must be one of awe.

Last week I wrote about “Runners Knee Cured,” an interesting and entertaining success story. The punchline was that, after taking pain pills and stretching and icing and getting bad (and conflicting) advice from doctors and trying half a dozen other things, the author fixed the problem himself.

The two-word solution, embarrassing in its simplicity:

Smaller steps (while running).

This week I decided to write about what I like so much about “smaller steps.” The first part of the appeal is really on a figurative level. Saving bad knees, like creating a mandala from nothing more than bowls full of dyed sand, requires enormous patience and great attention to detail. And, like putting together a mandala, it requires “going small.”

Metaphorically, for one, you must take smaller steps.

I found it very comforting when I concluded that fixing my knees would take many months, or even years. Why? Because I could get off the crazy up-and-down merry-go-round of hope and despair, where one week I felt a bit better and thought I was making progress, then the next I felt worse and a lost, hopeless feeling returned.

Adjusting to a long timeframe for healing is what I call “getting on cartilage time.” Getting better will demand extraordinary patience, as you slowly push your knees harder. If you walked two miles a day this month, next month maybe you increase that to three. Or maybe only to two and a half.

So the advice “take smaller steps” has a figurative appeal to me.

But I also rather like it as a literal prescription. Take smaller, easier steps. Reduce the impact on your joints. Nothing wrong with that!

I recall the many months I spent working toward my recovery. I did take smaller, slower steps. I knew I was injured and had to heal, but the process couldn’t be rushed. I knew that I needed to move my joints, but at the same time I tried to reduce the forces being transmitted through them.

You should have seen me walk downhill. It was like there was an egg between the bones in my knee joint that I was in fear of breaking. That’s not because of any sensations of pain; rather I knew that walking downhill posed special risks because it’s easy to let your legs slam forward, step by step, propelled by gravity. I actively resisted that tendency.

And I’m sure I was taking smaller steps while doing so.

So this part of his story really resonated for me. I like the simplicity of the message, and the advice works on multiple levels.

Note: Commenters have noted that the author of "Runners Knee Cured" actually had his knee pain return. If so, I think there's a good message of caution in the coda to his tale: Healing painful knees is very, very slow and be careful of declaring victory prematurely.


  1. I am happy to know that taking "small steps" has worked for many people.
    So over the last two and a half to three years I've had two patellar dislocations and a meniscal tear (which I've had surgically repaired) all in the same knee. I am 238.4 lb (this morning)at 5'9", and I just turned seventeen earlier this month. I saw your other post about losing weight to help knee pain, and I totally agree. When I think about it, in theory, it's an amazing cure, and a near-permanent one, too. In reality, though, when I have tried it, I screw up and quit and start back up again, so that "crazy-up-and-down-merry-go-round-of-hope-and-despair" has been my life for the past three years (or so). When I was a lot younger, I used to do tae kwon do, play soccer, basketball, almost everything. Now I feel like I can't do anything because one day my knee is excellent and then next it's trying to commit suicide. I started Insanity (the workout program), and was following its nutrition guide, which is pretty basic but makes sure you have all the nutrition you need without having too much extra. The first days I felt amazing. This past Thursday (getting closer to the end of my second week), both of my knees hurt so bad that I was afraid to get off my chair an hour after my workout because I felt like my knees were both about to dislocate or collapse. I definitely saw and felt amazing results using Insanity (my legs felt much stronger, especially), and I figured the jumping around would get easier as I got lighter. The issue is that my weight wasn't dropping as quickly as I anticipated. I gained five pounds in the first five days of the program, and I was eating SO much less than I used to on a normal daily basis. For now I've stopped the program because of my knees (and my mom acts like she'd chop my head of if I put my knees at risk).
    Now. Get to the point.
    You say to take small steps. Look...I just turned seventeen, I'm way overweight, I hate the way I look, I'm constantly uncomfortable, I'm extremely insecure, and I'm just sick and tired of this lifestyle, but no matter what I try to do about it, I can't finish what I started. I really do not know what to do. My doctors didn't sugarcoat anything. They told me to lose weight. But I need help. Whether it's the exercise or the clean eating, I just fall out. And quite honestly, I hate having to face that "taking small steps" is the solution. I've got one year of high school left, then I'm going off to a university to be a physical therapist (hopefully), and I want to be able to do so much more in as little time as possible. I don't have time to take small steps. I want results as soon as possible, and I want my knee to be as close to normal as possible. I just DON'T know how to keep myself on track. Can you suggest something or post a solution using me as an example, please?

  2. Hi Sissy, my heart hurts just hearing your journey. I, too, have bad knees... So bad that I could not depend on exercise on my path towards weight loss. Thus, I had to focus on food as my main method of losing weight. I tried to do it on my own, but I would just give up. However, then I tried an official "diet program" and that made a huge difference and I was able to lose weight with nearly zero exercise.

    I think the main factors were 1) I had very clear guidelines and what to eat and what not to eat. 2) I had knowledgeable people who staffed the program who I could ask questions to 3) there was an online support community who I could write posts and get emotional support and encouragement when things got tough.

    I think there are multiple reputable diets out there which have these three elements, so they key is to find one that sounds like it will work for you and your lifestyle.

    As you know, to maintain weight you need to burn the same amount of calories as you eat. To lose weight, you need to burn MORE calories than you eat.

    One interesting thing I learned was about how many calories are in everything .... And how that relates to how much exercise would be required to burn that off. For example, it takes about 1 miles of walking to burn 100 calories. So, if I ate a 300 calorie muffin that would require me to walk 3 miles to burn that off. And at that point I could not even walk 1 mile. So, it's easier for my weight loss journey to eat a 70 calorie apple rather than try to burn off a 300 calorie muffin.

    Or, even with more vigorous exercise, it burns more calories than walking, but, it is very easy to put those calories right back in by accidentally eating a high calorie thing. For example, let's say a person burns 260 calories by doing aerobics for 30 minutes in the afternoon. Woo hoo!!! But then for dinner that person chooses a beverage like a chocolate milkshake which is 560 calories. Then, despite having done that great workout, they've actually gained 300 calories. Oops! Whereas, if that person had had 200 calorie beverage with dinner instead, then they'd be ahead by 60 calories.

    What I'm trying to say is exercise can certainly help burn calories, but what one eats is even more important.

    So, hopefully any diet plan you look at can help you look at "calories in" vs. "calories out."

    Good luck!!

    1. Sissy, Anonymous above has some very good ideas about losing weight. Keep the faith. It is important to shed those pounds, but it's not easy. I have some thoughts, which I hope to include in a future blog post (though to be honest my focus during my recovery was on knees, and I don't pretend to have any expertise in how to lose a lot of weight). Cheers!

  3. I like this post about facing it will take years to solve in all increments.

    As a person who works behind a computer all day from approx 9-6 Monday through Friday, here is my little system I'm implementing to help remind myself to take a short stroll at least every hour to get my knees moving.

    On Monday morning I grab a rectangular shaped yellow sticky note.

    I draw a quick table with 12 columns and 6 rows.

    In the first column as the heading for rows 2-6 I scribble in the day of the week: Monday - Friday

    In the first row as the heading for columns 2-12 I input the hours as: "before work," 9 am, 10 am, 11 am, through 5 pm and then "after work"

    So each time I get up and do a healthy knee stroll, I make a mark in the box related to the hour. My goal is to do a quick stroll at least once per hour. For example, if I get water, I go use the water tank which is way over on the other side of the office which is 200 steps away. So, that's 400 steps there and back. Or, before work if I have time I'll get off the bus early and then walk .5 miles to the office .... Then I get to put 0.5 in my "before work" box on the grid. The main thing is during the day, though. I depend in re-filling my water or trekking to a bathroom on the far side of the office as my "excuse" for taking the walk.

    It's Amazing how easy it is for me to sit and sit for hours and hours without moving! So, this is a visual reminder for me to get up and MOVE and I can quickly see how doing each day with a glance at my yellow sticky note which is stuck to my monitor's stand. Afternoons seem to be my
    Most challenging time frames.

    This is one of those examples of something that is relatively easy & simple to do (especially when it's new), yet it's hard to do it consistently, day-in and day-out, day after day after day after week after week.

  4. Hey all--
    Try rope work for good cardio that you can do seated. Heres an example
    All they are using is rope and a weight. Sissy, it can be a great workout that won't kill your knees. Hang in other and keep posting!

  5. Hi again:

    I looked at my crummy typing from last night (I was on a tablet)and thought I'd try to add to my comment above in a more graceful way.

    Like many others I've struggled with how to lose weight/get cardio when you can't do much with your legs other than walk. I can't be on a treadmill for more than about 30 mins at a slow pace, otherwise I pay for it later. Forget about an elliptical trainer. I've tried aqua jogging and that can be a good option, all you need is a flotation belt and a pool.

    So at the gym they have this rope machine--basically a heavy rope on a continuous loop where you can adjust the tension. It has a bench, and you can stand or sit. I do most of it sitting, and you can use it for cardio and strength training. If you can't find something like that at a gym, there are lots of places that sell 2" rope that can be threaded through something to make some resistance--a kettle ball, for example. What I haven't figured out is how to couple the two ends of a rope, though if you knotted each end, maybe a couple of feet before the end itself, you could just pull it through, then grab the other end and start over. The video I linked above shows something like this, and while they are on the floor, I do all this on a bench.

    I find it burns a lot of calories, and you can vary what you do just by moving the rope around or by shifting your position on the bench.

    To get an idea of this, look at the kinds of exercises below. A lot of them are standing, but you see the range of activities that could be replicated without the machine itself (which costs a fortune if you thought about buying one!).

    I hope that might be helpful to anyone else who is looking to get some exercise. Working on one's upper body can help lose weight, feel improvement, and help fight that feeling like you're (getting) out of shape.

    Best of luck to everyone and if you have any questions let me know and I'll try to answer them here.

  6. Thank you all very much for the advice. It has definitely helped the desperate part of me - the part that always thought it was impossible. Tracking and managing my food intake has helped me feel better overall, even though I haven't seen a change in weight just quite yet. I'm going to keep at it, hopefully. Thank you all again. :)