Saturday, September 26, 2015

What I Hope Will Become a Full-Fledged Success Story

I found something buried below a recent post that I wanted to share.

TriAgain, as anyone who regularly dives into the comment section knows, has been participating for a long time in the dialogue here about how to heal painful knees. His interest, like that of so many others, arises from his own struggles.

Over the course of many months, he has shared his story with all of you in bits and pieces. Recently he set down the long version in a forum for triathletes. (U.S. English speakers, note that the Australian usage of “trannie” differs from ours ;). Also, TriAgain says there's a little "salty language" in his account FYI).

First, here’s a trimmed-down version of where he says he’s at right now:
3.5 years into the journey, pain down by 70-90% (varies a bit), function up by about 50% ... Day-to-day living/tasks much better. I do think prolonged sitting was a major factor in my demise.
This sounds pretty good. Not victory yet, but a lot closer. Note that he’s been working on healing his knees for 3.5 years. That will no doubt sober up first-time visitors to this blog. But sometimes the process takes a long time as you navigate setbacks and figure out what works and what doesn’t.

His full story is extremely detailed and quite interesting (I had to skim some parts, as I read it on a workday morning over breakfast and my train schedule is unforgiving). He credits Scott F. Dye with helping him arrive at a good framework for understanding what was going on. Dye’s common-sensical idea of “envelope of function” I wrote about here.

One thing I find interesting about TriAgain’s story is that he can wade about for hours, fly fishing, while on a rocky riverbed -- and his knees aren’t bothered.


I wonder if: (1) fly-fishing is something he enjoys, so he’s relaxed (2) the walking is slow, at a sort of aimless wandering pace, which when combined with some standing, makes for a winning combination of easy movement and rest (3) water helps a lot by cushioning the impact on his joints: walk over a rocky field and you’ll find the activity is very knee unfriendly, but walk over those same rocks under a few feet of water (which effectively unloads the force that your body lands with) and the experience is quite different.

Anyway, I encourage everyone to read this story. It’s broken up into pieces, and you can tell by the interspersed comments that TriAgain quickly manages to hook his audience. A good read (and encouraging for others worried about how long their knee program is taking).


  1. Yes Trannie/Tranny means the same thing here in Oz Richard, however that triathlon forum is called 'Transitions' (because between the swim & cycle, and cycle & run there is a Transition Area where you change into new gear for the next leg). In typical Aussie fashion (we abbreviate everything, and are into self-depreciating humour), members of that forum are collectively called Trannies/Trannys.

    One other thing I am noticing, is that the activities which set me back can be very specific. Cycling is a real problem for me. I worked my way up to 20mins on a spinbike with some hard efforts, but after a few months it sent me backwards. But some leg exercises with up to 40kg (deadlifts, kettle-bell swings) with 3-4 x 7-10 reps are fine - in fact they seem to help with leg function in everyday life.

    I seriously doubt I'll be able do triathlon again, or perhaps even ride a bike, but have made peace with the concept of another 5 years of recovery, moving on to new interests, and have found ways to stay fit while making small knee gains.

  2. Triagain, I do not have enough posts on "knee guru" to send you a PM. (20 is minimum).
    Well, to tell you the truth I'm not satisfied with my improvemen yet, but these are the things which, in ny opinion contribute-ed to my slow improvement:
    1.Time and patience with moderate walking-biking-swimming activities.
    2. Good night sleep ( at least 8 hours) stimulated with low dose of sleeping pills or nerve medications if nessesary (if pain is unbearable ).
    3. Orthokine (blood) knee injections.
    4. Less stress.

    1. Thanks gcoza - wish I could bike, but perhaps my attempts were just not moderate enough!

      Good show on Australian TV tonight about unnecessary surgeries & tests, of which knee arthroscopies are right up there -

      Just helps confirm what I wrote of Transitions - though my meniscus surgery was unavoidable as the torn piece was rubbing on the end of the femur and causing damage. But many people have 'clean outs/tidy ups' which do nothing or make them worse.

  3. Just commenting that today I told myself I am going to find out how to heal my knees. I came across your article and knew that this journey is well worth the effort. I have seen the professionals.... Cortisone shot helped but temporary... Some PT exercises help... Love 10-15 min on bike. I'm a nurse but find most doctors don't give you the full story. Anyway, looking forward to reading your book. Thanks for your efforts.

  4. Thank you so much for your book. I have a lot to say in relation to all this but I'll start with a very practical question as I'm about to start on my own repair programme.
    This is not specifically related to the post but to cut a long story short I'm in a similar boat - brought on like Tri Again by triathlon training - and I'm thinking about trying the bungee cord and climbing harness trick. I'm actually thinking of "sitting" in it or maybe sort of supported standing in it while I work. I work from home and it's all computer based. I can raise my computer up to work whilst standing. My hips are worse than my knees. I find that sitting is worse for my hips but after standing too long my knees hurt. I'm not a climber so I haven't had much experience with climbing harnesses. So very practical question given my intention would you suggest I need the complete climbing harness with the straps over the shoulders or just the thighs/waist version. The latter is a lot cheaper but I'm thinking I probably need the former for comfort. Or is the whole thing likely to be completely unworkable?!

    1. Hmm. An interesting idea you have there. Will it be unworkable? Hard to tell. My guess is you'll need supplemental padding in spots, because you'll have some minor pressure points, which will become annoying over the course of hours spent in this getup. Is the complete climbing harness going to be more comfortable? I would think so, but honestly, I've never tried to do what you're trying to do. So I am intrigued by it, but of not much help unfortunately. However, if you do try it, please report back and let us know if it helped. Cheers.

  5. Has any of you with chondromalacia patella had "water on the knee"?

  6. An update. Still improving. Now cycling 30mins pretty solidly at times and even started doing a tiny amount of running (10x 1min walk/1min easy run). It is a calf problem that is hindering my running more than my knees. Also doing regular leg weights (deadlifts/kettlebell swings/clams/wall squats using a fitball) which actually seems to make my knees feel better if they are feeling twitchy.

    Still need to be careful, and not doing anything like the 5-6hr ride/run sessions I'd do 4yrs ago, but I'm very happy to be where I am and with a huge reduction in the constant pain & stiffness, even though it still lurks and flares at times.

    Don't think I'll ever return to long-course triathlon. To be honest, it has a tendency to take over ones life and I was over all the training. Enjoying just doing 30-60mins of exercise a day for health and fitness rather than competition. The competitive streak has waned but I don't miss it. Goals now are to be able to ride solidly for an hour, do the local 5km Parkrun and perhaps the local mini-triathlon. If that takes another 5yrs, so be it.

    1. This is great! Congrats. I know it's taken a long time, but at least you've become acclimated to the timescale. Also, I have a hunch that the healing goes faster as you get better ... I guess you'll find out. Keep reporting back! :)