Saturday, March 22, 2014

What Do Success Stories Have in Common?

For that subset of people who manage to beat knee pain, what are the common threads that run through their stories?

Of course I don’t know all the success stories out there, and I hate to generalize, but let me make some observations based on my experience (and that of a few others). I’m quite interested in success stories.

Here’s one (edited for length) that Larry Terbell recounted on Yahoo’s chondromalacia forum:
I had left knee cap pain that was getting worse. Resting my knee was not making it better, only weaker. Exercise aggravated my knee. I read articles by Doug Kelsey. His philosophy about joint motion interested me. I eventually went to Austin to have an appointment with Christine at Sports Center.

I started with 15 minutes of stationary bike, quad flex and one-legged leg presses on a Total Gym or Cybex Squat Machine (maybe about three sets of  15). After my appointment with Christine, I added the squat-hold exercise, hip exercise, and core exercises.

The first few months was the most difficult part. Too much load will set you back and too little load will not be helpful. I had to deal with the Goldilocks window also. I decided to try to stay in the pain-free zone. I began with a very light resistance and increased it very slowly. I only worked out about three days per week and often experienced delayed pain. I would simply lower the intensity or delay the next workout for a day or two. I avoided climbing up or down stairs. Doing a step-up on an 8-inch stair would cause pain. Jogging 10 feet was painful also, so I avoided activities such as these at first.

After about three months of low-resistance training, I was able to do a step-up with no pain. After about four months I could do the squat-hold exercise holding two 20-pound weights. After another month, I was doing step-ups while holding weights. The step-up turned out to be one of the best strength building exercises for me once my knee had enough strength. I found it  helpful to keep a workout log in which I monitored my exercises and how my knee felt.

Eventually I was able to resume full activities. Now I still do exercises to maintain my quad and hip strength.
So, based on Larry’s story and others, what are some recurring themes?

#1 It helps being methodical and detail-oriented.

One thing about Larry’s story that impresses me (and you have to kind of read between the lines) is that he sounds very much aware of the process he went through. He recalls precise details, and I sense he was quite deliberate in setting up his program -- everything from the amount of weight he used for squats to the height of the stair he stepped up on. Importantly, he had a plan. And it seems to me, he always had a good sense of where he was within that plan.

#2 It helps being very attuned to feedback your body is giving you.
I sense that Larry struggled the first few months (as did I), trying to figure out the right “baseline” of movement. As he says, too much load sets you back, and too little doesn’t keep you moving forward. Finding the right amount is very hard. God doesn’t toss you a manual that says, “For your particular bad knees, do x repetitions of y each day, then increase by z repetitions every two weeks.” You must figure this out (ideally with the aid of a physical therapist who is actually equipped to measure how much load your bad knees can tolerate).

If you don’t have that good physical therapist working with you, you’ll have to determine your baseline by yourself. Doing so will require being well attuned to the pain/discomfort signals your bad joint is throwing off.

#3 It helps being patient and accepting.

At first I just wrote “patient.”

But “accepting” is important too. Learning acceptance can be the result of a sort of “come to Jesus” moment. For example, your knees bother you after a seemingly innocuous activity and you have this epiphany: “Crap! My joints are really, really weak.”

Once you accept that, you can radically dial back on your program (if you recall from Saving My Knees, I spent weeks just walking slowly around a swimming pool every 10 minutes). “Accepting” means not fighting the fact that your knees are in bad shape; don’t pretend you feel okay after two weeks and go running a couple of miles.

And, if you’re patient enough, good changes should come!

One last thing: I was pleased to see Larry also kept a sort of “knee journal.” I thought mine was quite useful in helping me figure out where I should be going and keeping track of where I’d been.


  1. Be patient, but also accept that sometimes life throws unexpected events at you and you'll have to aknowledge some delays in your plan. Life is not a linear path, and nor is getting better. You may be walking 2 miles a day, all going well, and then you have to carry an injured child up the stairs, setting you back a few days in your plan. Or you need to walk faster to catch that train.
    How long does it take to recover? 6 months? A year? 2 years? Does it really matter if your plan is extended by a few months? After all, if you are in your forties, you have on average another 30-40 years left to live. Put into that perspective, 2 years are not that long

  2. I had terrible runner's knee, and first read your helpful book in November 2012. I agree that you have to take charge yourself, and be very methodical. But I think the primary thing that helped me was realizing that certain muscles weren't "firing" because I had run too much in 2011, and once they stopped firing then certain muscles took over and became increasingly stronger, while other muscles became weaker, which pulled my kneecaps out of alignment and resulted in the knee pain. The way back was long and hard, especially since almost no one in the medical field seemed to really understand my problem except this local chiropractor that I finally found. In short, I had to do key exercises to "activate" the muscles that weren't firing every day, and especially before running or bicycling, and be very patient. Now I'm running great, won a local 10K in 45:01 earlier this month, and looking to qualify for the Boston Marathon in June (need a time of 3:15). You can do it! Don't give up! I lost at least 18 months to runner's knee, and the mental and physical anguish was unbearable at times.