Friday, August 2, 2013

So What’s a Nice Financial Journalist Like You Doing in a Blog Like This?

Recently I was amused to discover my story being discussed here, among what appears to be a group of Australian triathletes. Many were dismissive.

The criticisms of the writing at this site (“so annoying”, “punishing to read”, “I could not make it through the first two paragraphs of that guys blog”), well, what can I say? I try not to be insufferably dull, or frightfully obvious, but look: I never promised you guys Faulkner. Remember, I write most of this at work, during my lunch break. :)

The other criticisms were familiar. One went along these lines:

Great, the guy rested his knees, gradually went back to a pain-free activity (walking), and got better. Whoop dee doo. Seems like common sense to me. Listen to your knees, time heals, be patient, yadda yadda. Not gonna blow 10 bucks on that book, mate.

Well, sometimes common sense can be surprisingly uncommon. But it’s not like you can sit around and rest for two weeks, then start a walking program, and a year later -- presto! -- you’re all better. Beating knee pain is much, much trickier than that. (I won’t rehash all the obstacles to getting better; here’s my latest summary on what I did.)

One quick example: “Listen to your knees” won’t work if you don’t account for the “delayed symptom” effect. When I felt miserable because my knees burned all the time, I would’ve happily paid someone $20 for an explanation of how that works, as it shows the damnable difficulty of listening to your knees the right way. (Most people, I think, “listen to their knees” the wrong way -- if the knee hurts during an activity, or right after, don’t do the activity. I never would have healed had I remained at that basic level of understanding.)

The other criticism (the one I really want to write about) goes like this:

The guy’s a financial journalist. Give me a break. You’re taking advice about how to heal your bad knees from some journalist who just surfed the Internet for a while. Good luck with that!

Ah. So the degree from Harvard merits no love. ;) (Okay, okay, it’s in government, not in orthopedics.)

Anyway, anyone about to write me off as someone blogging about things that he can’t possibly know about should consider the following:

(1) I quite regularly cite experts, and clinical studies, to support what I say. Much of what I believe comes straight from these sources.

It’s not like, in Joseph Smith-like fashion, I had a miraculous revelation of how to heal bad knees. Hell no. I did a lot of high-quality reading.

The same clinical studies your orthopedist has access to, I managed to dig out of the crevasses of the Internet. And while your orthopedist might have read the study once, I maybe read it five times. Because I had a lot at stake. I simply couldn’t imagine spending the rest of my life with chronic knee pain.

I found experts -- minority voices, true, but very intelligent people -- who suggested a better way than that espoused by traditional physical therapists. People like Doug Kelsey, and recently, doctor Scott Dye. The gist of their thinking was pretty much common sense. Instead of focusing on your quads, hips, butt (or whatever seems too weak or too tight or out of balance), you need to slowly improve the health of your knee joints, so they can comfortably tolerate greater and greater loads.

(2) If you’re the type that emphasizes degrees and qualifications above all, well, it’s not like you're listening to an illiterate street sweeper opine about the best way to do open-heart surgery.

For more than two decades, I’ve been a professional journalist. Every day, we journalists read and analyze and synthesize disparate bits of information from a multitude of sources. By occupation, and often by nature, journalists are reasonably bright generalists with some talent in using language well and precisely.

Now, admittedly, Saving My Knees isn’t only me writing as an objective journalist. The subjective me is present throughout, because it’s unabashedly my story. But I did try to choose my words carefully, and at the book’s conclusion, I undertook a weeks-long checking of facts, line by line, to ensure the material was accurate.

(3) The traditional view held by a majority of experts can be wrong. They’re only human, after all.

Image this conversation at Ye Olde Boar’s Head, say from the year 1820.

Nathaniel: Abigail! How are you?
Abigail: (coughing) Not so good. Still the pneumonia.
Susan: But surely you have been seen by a doctor.
Abigail: Yes, just this week, Doctor Perkins. He advised bloodletting.
Susan: And what were the results?
Abigail: (looking guiltily away) I don’t know. I didn’t have it done.
James: Monstrously stubborn woman you are, Abigail Smith! Perkins is the third physician to advise bloodletting for your pneumonia. And you refuse to listen. I have little sympathy for you, ignoring modern medical thinking. Everyone knows bloodletting is the best way to cure pneumonia. Why such obstinacy, woman?
Abigail: Well, I was talking to Horatio Adams, and he professed the belief that bloodletting was probably useless for pneumonia. He said a few doctors he’s spoken to are questioning the practice. He cured his pneumonia, he said, without bloodletting.
Susan: Horatio Adams! My goodness!
James: Horatio Adams, who writes for the Gazette, all those gasbag stories about how many tons of flax and tea moved through the port over the past month!
Abigail: Yes, he explained everything to me, the research he’s done --
James: Poppycock! Don’t listen to a financial journalist who tells you bloodletting is useless for pneumonia. Listen to your doctors, woman!
Susan: Bloodletting useless for pneumonia? What a crazy idea.

Okay, obviously I’m having some fun here.

The bottom line is this though:

At the end of the day, I could be completely wrong about everything I believe about healing bad knees. But so could the experts. It’s happened before.


  1. Ah well, I tried Richard, but the medico types were not willing to dig deeper & actually read your material.

    I do find it annoying that their criticisms are based on just a cursory glance of the material, but you can only lead a horse to water..... Perhaps it's a symptom of the current instant gratification electronic world? No one has the patience to do the hard yards. My job also involves research & data, and I find whenever I put up something on that site which requires reading more than 300 words, you lose 99% of the audience.

    In their defence, I don't think any of them have ever had the constant burning/aching we've suffered. Most of their knee injuries are the type that might hurt while exercising, then settle quickly when they stop the offending activity, and probably respond to the common short-term physio fixes, and even relatively short-term rest. I certainly had knee problems like that before I entered the current long-term labyrinth of Hell.

    It's only when you end up in the chronic discomfort place we did, and the conventional wisdom fails (or makes it worse) that you are willing to broaden your horizons & look elsewhere. And many people still never make that move, they stay stuck on the conventional medico round-a-about, or give up and live with the pain.

    cheers, TriAgain

  2. Am all about change in the cartilage paradigm- An analogy as example: Chondral shave is to knee, as auger is to schizophrenia.

    But this bet hedging, financial writer, woe is me cast away onto this shore of a blog of my own making BS needs to stop. Put up or shut up. Knees are complicated, yes, to those that know (and usually do not say) that is not a mystery. Buying a derivative against your own bet is pathetic and has been done before. Grow a set. R-X

    1. I was in the shower yesterday and think I already own a set. :) Seriously, you lost me on some of this R-X. Unless by “buying a derivative against your own bet” you are referring to my admission that it’s possible I could be wrong about everything I believe. A statement like that though isn’t some cynical attempt to cover my bets or play it safe. Rather, I happen to agree with John Maynard Keynes who reportedly said, “When the facts change, sir, I change my mind. What do you do?” I do strongly believe that what I think about healing bad knees is correct. But I don’t cling to my beliefs with a religious-like fervor based on faith; I want to always remain open-minded about new findings. Only by being willing to entertain the thought we may be wrong can we ever be confident of arriving at what is right.

      Still, I’m sorry if this post came off the wrong way. Sometimes my attempt at humor misses the mark, or sounds like sarcasm. And I certainly don't want to be known as the whiny, thin-skinned guy who writes about bad knees.

      The main reason behind this post was that these are two "drive by" criticisms that I hear a lot: (1) My message is simple and kind of obvious (2) Who am I to write about bad knees -- I'm not a doctor or physical therapist. I think both of these are off base, for multiple reasons. I also think it's good for people who maybe just landed here for the first time, to know why. But understood: the tone (and perhaps the content too) may be annoying to some.

  3. My own experience with healing my knee has been very slow and frustrating.

    My analogy is that it is like trying to empty the ocean with an eyedropper EXCEPT that you are only allowed to remove one drop per day. If you remove two drops, then you have to put both drops back in the next day. But if you get very enthusiastic and remove 10 drops, then you have to pay the price by emptying an entire bucketful of water back into the sea.

    With most activities where you are striving to achieve for something, you push yourself to make and effort and try really. If you are trying to increase your abilities to do push-ups, you don't do one 1/2 push up once per day for a week and then the following week increase to 3/4 push-up once per day. Nope. Maybe the first day you start with 5 and then increase to 6 and then to 7 and you get to the stage where you push push push yourself until your arms are jelly.

    But, with this knee problem it is very frustrating because you want to "try very hard" and grab 20 drops in a day, but, this completely backfires. Not only is the penalty that a gallon gets poured back into the ocean, but your eyedropper might get taken away for a week while you elevate your leg and put ice ice ice on it.

    It sounds like there are people with more "normal" knees out there who can get better by doing quad exercises. Great! But, for those of us who are at the state where the regular quad exercises do more damage than good, it's a much slower (and more challenging, I think) process. I appreciated when that one MD (in an article Richard posted a link to) wrote that finding the right combo of activity and rest was like cracking a combination lock.

    1. Yes, I agree Knee Pain: the combination lock analogy is a great one. I hope you're making some (slow) progress anyway. Do you still get the stabbing pains? Are they as frequent?

    2. Knee Pain - I grabbed 20 drops over the weekend (2x30min easy little rides on a borrowed MTB) - big mistake.

      I have to put bikes out of my mind for a while - a long while & stick to what appears to be giving me slow, oh so slow gains.


  4. Hello Richard & TriAgain. Thank you for your replies. I went off on a vacation right after my post but now I'm back.

    Tri, I hope you have recovered by now from from your 20 eyedropper extravaganza.

    I'm so glad that I had no major flare ups on vacation. Thus, was able to walk through museums and airports and monuments fine. In order to protect myself from overdoing it, I took busses between locations as much as possible (instead of walking from location to location). I figured I was already doing SO much walking just to get through the museums and such that my knees could use a rest in between sites.

    Also, instead of "go go going" without stopping, took time to just sit in a cafe and relax.

    Avidly sought out elevators as much as possible.

    Sat at the bottom of tall spires while others climbed tall spires to the top for the views.

    Only one small stab while on vacation telling me I was starting to over do it, so I listened and ratcheted my walking back a bit to appease it. That seemed to work.

    On the long long long airplane flights, made sure to get an aisle seat and get up often and do some leg stretches and things that got my knees moving at least a bit.

    I know several people have said their knees felt better during vacation due to slow walking around all day with rests. I'm not sure if I can say my knees are "better," but it was certainly encouraging that I could walk around so much on vacation without a flare up.

    Now I'm back home and back at work in front of a computer 8 hours a day. I think I'll set an alarm to go off every 1 hour to remind me to get up and move.

  5. Knee Pain

    It is interesting that we both seem to be better on vacation. My recent vacation to Europe involved lots of stairs, dragging 15-20kg suitcases, and it did not seem to cause as much trouble as an easy 30min MTB ride or (like this week) and attempt to jog for just 30 secs and an attempt to walk a bit faster for 5mins.

    Were your knees entirely pain-free on vacation? Mine pretty much never are, there is always a background tingle.


  6. Hi TriAgain,

    My knees were nervous but held up really well. Was able to walk around European museums, palaces, airports with no significant Problems. I avoided stairs as much as possible even though it meant I had to miss some views from tall spires. I never rushed or moved quickly. Pretty much just walked around at a "museum pace" all day interspersed with sitting in cafe's and watching the world go by and eating delicious food.

    My knee did feel a bit strained & grumpy sometimes. There's never a time I was not conscious of it. So, there's never an hour where i wasnt aware of it and monitoring it and trying to find ways to make things easier for it. That's in contrast to when I went to New York City around this same time last year when my knee was doing so well that I thought it was cured. I walked around NYC streets and did all those subway stairs without even thinking about it. So, this Europe vacation was significantly different in that I felt my knees and i was very conscientious about not "over doing it." for example, to get from the palace to a museum might be a mere 10 minute walk, but I took the bus instead in order to gives my knees a break and save their evengy for walking around the museum. Once at the museum, to move from floor to floor I would first seek out an elevator. If no elevator, I would still do the stairs, but I have this technique of using the railing heavily to take as much force off my knee as I can. Or, go one step at a time.

    Now that I'm back, I think in the first couple days my knee was actually HAPPY to have days off where it was not having to walk so much every day. So. Maybe on my next trip I should plan for "days off from walking" to let my knee recover.

    So, now I'm just starting up to get more methodical about healing my knee again.

  7. Hi Knee Pain. Very interesting all that. I'm mostly aware of my knees all the time too, though I have the odd few hours where they are so good I forget about them, usually at work meetings where something really interesting is being discussed, or I'm engrossed in something at my desk.

    I was going back through my triathlon training diary to see when the constant 'burning' started, and it was actually not till 5 mths after my meniscus surgery and during that 5 mths I was still doing a lot of cycling and some running. But during that period I'd also made lots of notes about grumbling knees.

    I'm going back to square one next week, back to my GP to tell him all that I've been thru over the past 15mths & see if he has any other ideas.....but I doubt it. I have been pondering if I've developed CRPS.

    I struggle to find rhyme or reason for my 'better' and 'worse' days, but there does seem to be a psychological element to it (eg. why do my knees feel good fly-fishing for 3hrs which involves going up and down river banks, but are worse with just 5 mins of faster flat walking ???).

    cheers, TriAgain

    1. Hi Tri,

      I don't know, but I do know that I do the same thing of trying to figure out WHY do that I can avoid the behaviors that cause problems. In seeking the WHY, I run though a bunch of "maybes" in my head.

      Maybe #1: maybe it's not just the fast walking, but what your knees did before & after the fast walking. For example, maybe your knees had not been active for a couple hours and thus the knee joint was "cold", then you did the fast walking which shocked the knee, and then right after the fast walking, there was no cool down time but you just sat down at your desk and worked immobile for 3 hours. So. Could be the knees objected to that.

      Maybe #2. If the fast walking involves a significant lengthening of your stride, maybe it's the increased force on the knee joint from that activity that your knee is objecting to.

      Maybe #3. Did your initiation of the fast walking include a "springing action" at all? Or even during the fast walking, are there times it's not just walking but you are also "pushing off" with your back foot to get more speed? The act of "springing" puts a lot of force on the knee. I think that's the main reason I'll have a flare up if I foolishly move quickly to catch the bus... It's the springing transition from walking to suddenly rushing that traumatized my knee too much. I think.

      Maybe #4. Maybe it wasn't the fast walking at all. Maybe it was something else completely like you twisted it while grabbing paper from
      the printer and pivoting with rubber doled shoes on carpet ... And the torque on the knees was just too much. However, you don't remember doing that and thus you are blaming the fast walking.

      Maybe #5: sometimes I wonder if there is a particular angle that is really bad for my knee. So, as long as my knee bends along certain lines, it's ok. But, if my foot position is off and then my knee bends in a way that's along the angle that's bad for it, then that will cause a flare up. Thus, when moving quickly I'm not paying attention to how my foot is landing and how my knee is bending. Hmmm.

      Maybe maybe maybe. It's enough to drive one crazy.

      So! I've just run you through what I do when I'm seeking an explanation for my own mysterious flare ups: Grasping at straws of possibilities. But then at that point I just throw up my hands and say "I don't know! I guess I'll just have to 'be more careful' -- whatever that means."

      Good luck.