Saturday, October 10, 2015

Here’s One Neat Trick to Beat Insomnia

There. I’ve always wanted to write a click-bait headline. ;)

But seriously, there is a payoff here. We’ll get there in a moment.

Insomnia, especially as you grow older, can be a serious problem. Once you have knee pain, it gets even worse.

Insomnia, or difficulty falling asleep, is an enemy to someone trying to heal their knees. Sleep is your friend. Sleep allows your body to rest and recover. Also, at sleep, your body is relaxed and your legs fairly straight, both of which should make you feel more comfortable.

Now, on to how to beat occasional sleeplessness. To be fair, I’m talking more about mild insomnia. Mine often comes after waking up around three a.m. to use the bathroom, then settling back into bed and lying there awake for 10, 15, 20 minutes, thinking, “Why can’t I drop back asleep?”

This trick has to do with breathing.

In the sleep state, you take longer, slower breaths. One night, as I was having difficulty falling asleep, I challenged myself to start breathing as if I were sleeping. That is, I tried to make my breathing slower and deeper.

Within minutes, I actually fell asleep.

I found this experiment quite interesting, so I repeated it another night. When I couldn’t sleep, I just focused on my breathing. Slowly in, slowly out, slowly in, slowly out.

Again, I fell asleep after a few minutes.

Now, the thing is, you actually have to focus on your breathing. You can’t just say, “I’m breathing more deeply now,” then let your mind wander. You have to concentrate on breathing in and out slowly, as if you’re sleeping.

And I’m finding that when you do that, sleep will usually follow.

Anyway, as everyone who reads this blog knows, I’m extremely curious and love to experiment. This is one case where it really paid off well for me. I sleep better now. I don’t need the sleep because of bad knees anymore, but because I have a 10-hour-a-day job and a one-and-a-half hour commute to work. That’s good enough reason for me!


  1. Such a coincidence to find this post today! I have been experimenting some insomnia recently and I also tried to mindfully breath slowly, and it worked! I am also using this technique as soon as I go to bed, because usually it takes me at least 45 min to fall asleep. I've found that breathing slowly helps. It is hard to do it mindfully though, your mind tends to wander around a lot... Also Valerian drops help :)

    Guys, this is not related with the post, but I wanted to let you know that I'm flying to US to visit my coach (finally!). After 10 months of working with her via Skype...
    We will have 3 sessions (I'll be there for a week) so hopefully this visit will help in bringing more insights of my knee situation and quad inhibition.

    I will let you know how it goes. (Going next month so still few weeks to go)


    1. Wow Athenea, that's thrilling! Please keep us posted on your trip to Austin! :) What was your squat load tolerance when you first started working with DK's coach? Mine was 20% and after 3 months I'm now at 55%, so I'm going to keep working with mine as well. Thanks to your story, I contacted one of them and have been so happy I did!!!!


    2. Also, are you still doing PRP injections?

      I've tried this sleeping technique many times and I can't seem to master it. I don't fall asleep within minutes and I feel like I'm breathing to slowly that I'm running out of air! Haha


    3. Hi Alex I had 3 PRP injections on each knee in Dec 2014 and I started my rebuilding training on Jan 2015. My load tolerance was also very low, between 20-30%. I will definitely keep you posted on how things go on my trip :)
      I'm glad to hear things are going well with you! That's an awesome progress!

    4. I'm not sure if this trick for beating insomnia will work for everyone, honestly. But Alex, that feeling that you're "running out of air" is the same sensation that I've had a few times while practicing mindful slow breathing at night, in bed, trying to fall asleep. So you're on the right track! :)

  2. Hello Richard,
    Firstly, I have to say you have done something awesome for yourself. Your attitude and approach to heal yourself, whilst modern medicine would have seen it with disdain, was inspiring.
    Secondly, its really relieving to know from your experience, from reading your book, and other readings it entailed, that cartilage can heal. Though specifically I am looking to know if cartilage can heal sufficiently in reasonable time in a mid 20s man, so he can resume hard sport.

  3. I would really appreciate if from your experiences and knowledge, you could say if sport like soccer is possible again, and if you know such cases. For if cartilage heals slowly and under the right conditions, even 3/10 cases of major turnaround healing aren't bad, amidst wholly inadequate Medical advice for most.

    My details are as follows
    I am 25 years old and play soccer. Its a sport which is particularly unfair on knees - one has to not only run, but jump, pivot, change directions, practise juggling ball on feet and worst of all kick with all their might. I can say for the last 2-3 years I have been playing and following a standard soccer training programme without any problem, barring (Retrocalcaneal bursitis - which went away not with RICE or medicines but immediately with Stretching, so its not entirely ineffective) All this while reducing weight from 210 lbs to 194 lbs, not gradually but oscillating frequently due to bingeing, I stand at 182 cm.
    More pertinently though, 4 months ago I started experiencing knee pain, really in my dominant one but also mildly in the other. I can sort of see why this would happen. I made my training very stressful and intense, I had always had intense sessions, but they were spaced out comfortably(unwittingly), with ample rest and diet. For a couple of months before my pains though, I made a conscious decision to train HARD. For long I felt I had been stagnant at one level of fitness, I wanted to get leaner and faster quick, so I thought I would work as hard as was practically possible. I started almost X2 training, like running in the mornings and soccer in evening, or gym at either time. (Psychologically it felt awesome too, until it came to a grinding halt) Relative to this increase in intensity should have been a rise in sleep hours but they were stuck at 7 hours which for me has never been enough. That was my fault. Moreover I was doing some silly things in the gym which I didn’t realise at the time. In fits of Macho-hedonism I would squat with heavy weights, or standing on 1 leg - bend forward to stretch its hamstring, holding 60 pounds of dumbells. Then I would also sometimes crank up the resistance to 7/10 on the cardio bike and ride as fast as possible. It was all a bit extreme I now feel, especially when I already played a sport that overuses the knees. The morning I felt knee pain while running, preceded an evening of such exercises. When a huge problem was apparent - I stopped all running and soccer and haven't resumed till now - 4 months, but I continued some upper body heavy weights while Standing. I think it was a bad decision because MRI reports showed worsening of cartilage - semblance of chondromalacia patella AND Grade I in Posterior Horn of Medial & Lateral Meniscus when first felt pain; >>> to Grade I chondromalacia patella AND Grade II in Posterior-Medial Meniscus. Interestingly my other knee which has felt just fine almost pristine since ealier also has a Grade II in Posterior-Medial Meniscus in the latest MRI. This latter common Grade II Meniscus tear doesn’t have any symptoms of pain, but a Grade I Chondromalacia only in right knee does. I would think that Grade II is more worrisome that I. And really as yet pain is not such a huge deal. I can live with it and still play sport - but it keeps telling something is wrong and is likely to get worse.

    So currently I am only walking, swimming, very light biking, to keep "Moving the knee without loading it" - as I implied to be your core method. Along with upper body weights sitting/lying. I have reduced to 180 pounds now. Oh and I too changed many orthopaedists who claimed cartilage wont heal so I cannt play untill I found 1 who said they can heal but isn't now sure of resuming sport. I have been taking Collagen Peptide with rosehip extract on his prescription for 2 months along with Glucosamine-chrondoitin-Diacerin Combo for 1 month. I think maybe there is improvement, but I wouldn't be able to run/jump/kick or squat without major pain.

    1. Sorry to hear of your troubles, Prateek. I'm honestly not sure how much cartilage can heal, or how fast. I think it can heal based on studies I've seen that show full-depth cartilage defects filling in over time, in certain cases. I certainly had a good experience with my knees. Does my cartilage look beautiful and pristine now? I doubt it, partly because I'm back to riding hard on my bike and grinding up hills. But my knees no longer hurt. That's the only thing I think anyone needs to worry about.

      To stand your best chance of getting better, you may want to do something you may not be prepared to do: Forget about playing soccer for the next 5, maybe 10 years. Maybe substitute swimming. Or cycling -- as you become a stronger cyclist, and the activity doesn't bother your knees, you can even join a club, start racing, whatever. Then, about when you've really forgotten about soccer, take your brand-new bulked-up legs out there and try playing. I don't know for sure, but you may find a happier second life to your recreational soccer career in your thirties.

  4. Richard, please could I request you do a post on the diet you ate during your healing, I know you mention briefly about brown rice and garlic, but there must be more to it surely? I only ask because doug kelsey says how underestimated the role of good nutrition is in healing knee cartilage and particularly avoiding flour and sugar. Is it possible that your were onto a winning combo of movement and diet all in one? Please can you shed some light on this topic! Thank you for this me constant hope.

    1. Thanks for the kind words. I may post on my diet at some point, but honestly, I don't think it would be helpful. My diet was not that good. The brown rice and garlic was the best part of it (I did eat that particular dish a lot). I don't think the Chinese pastries I consumed regularly in Hong Kong on Saturdays (my end-of-the-week food reward) would help you, or anyone else, heal their bad knees. But while my diet was eh-eh, my knees definitely got much better. I attributed that largely to the movement regime.

      The better person to get diet tips from would definitely be Doug. You might want to check out one of his e-books. On diet, follow him please -- don't follow me!

    2. I'm not sure if you have already read them but DK has 2 blog posts about what to eat to help recovery:

      I hope this helps.

      My diet is mainly "paleo", but to be honest, I do have desserts and sweets from time to time.
      My breakfast consists of 2 eggs, half can of tuna, half can of beans, tomato, avocado and green tea. Sometimes I add spinach, or other veggies, or fruit, and also I make protein shakes.
      Lunch is fish or meat with veggies, and same for dinner.
      I basically do a mix of paleo, DK, and slow-carb diet (Tim Ferris). The main thing is to eat protein and stop eating sugars and gluten. You should feel energetic during the day and not hungry.
      If you exercise and follow a diet high in protein you should be fine :)

      By the way, I have found another blog where DK has a lot of articles (not related to diet but injury, exercise etc) if you guys want to have a look:


    3. Yes, Athenea makes a very good point about protein. One thing I did do was boost my protein intake (through supplements). I mention that in the book.

  5. Hello Richard,

    Just out of curiosity, have you ever had an MRI to see if your cartilage actually grew back?

    1. No, but people have asked me that question a bunch of times! :) Finally, I wrote a post on the topic. See here:

  6. Hi Richard!

    Yeah, sorry about that. I think I stumbled across that after I asked this question. I should have known better - of course you've been asked that question!!

    Thanks for the response. I'm finishing up your book and as someone who has been dealing with similar stuff for the last 4 months it gives me hope that i can feel better again.

    Do you still field questions about the book, your process, your condition at the time, etc? I was hoping to get some clarification on a few things.

    I'm trying to adopt a similar process - small, frequent doses of movement, journaling, etc because alot of it makes sense to me. I've also considered dealing with Christine Springer or Laurie Kertz to see if they have anything they could provide.

    Anyway, just hoping you'd be willing to take sone questions. I know we're all different so I'm not trying ti just copy you, but I think there are things you did, concepts from your book, that are universal.

    Thanks so much for your time!!


    1. Sure, but the best place to ask questions is here, in the comment section. That's because (as I've said a few times in the past): (1) If it's something I may know the answer to, everyone can read the reply (or sometimes I turn answers into blog posts. (2) If it's something I don't know the answer to, there are lots of smart people who visit here who may have insight I don't have. In fact, they often do!

  7. I'm going to break this into two posts due to length (I apologize!!!)...

    Well I had intended to ask my questions here, but some of them were fairly specific and I'm not certain anyone else but you might know.

    I'd like to get just a bit about me out of the way, as I'm fairly new to this blog:

    I'm a 37 year old male, 235lbs, but lost 40 since Jan 2015. My scale, FWIW, says I'm about 40% body fat. Not in the best of shape, but I'm not completely sedentary either, although my weight doesn't reflect that (my weight is more the result of crappy diet than lack of movement). I was taking various exercise classes with my wife as late as May.

    Short story about my knees: Prior to about mid June of 2015 I had no history of knee problems, nor did I have any symptoms. I first started noticing problems after working on refinishing my deck (a lot of up and down ladders, working on hands/knees, etc). It snowballed and by late June I was putting my knees in compression sleeves for a couple of days, icing, resting them, and then getting xrays. Like many people, xrays are negative other than the Ortho (who I didn't see until early October) says my kneecaps aren't lined up right, MRI shows chondromalacia, and according to him, that's that, good luck to ya.

    I've been doing physical therapy since the first week of July, so just about 4 months now. I've seen some improvement I think, but until recently haven't started truly

    keeping track of my progress.

    I stumbled upon Paul Ingraham's and also Doug Kelsey's blogs while fervently searching for answers, and I'm glad I did. I feel like I have something I can fall back on

    should PT not go as I'm hoping. I've considered and have actually made preliminary contact with, some of the associates on his blog, Christine Springer and Laurie Kertz. For now I'm going to continue with my PT, as I'm of the philosophy at the moment that although most thing we do probably won't solve the issue, we should at least try them. For example just recently she provided some show inserts, and while they don't fix anything, they do seem to help a little. So I'm trying to keep an open mind with the standard PT routine for now.

    I've purchased the Runner's Knee Bible, Paul Ingraham's PFPS book and have read both. I've also purchased and read your book, Mr. Bedard. My questions are

    for anyone who would like to answer them, but as I mentioned I think some may only be able to be answered by you.

    1. Tailgaters - in the Runner's Knee Bible it shows what they are, but he's using special equipment in the video. I've tried my own version which consists of me

    standing on one leg and slightly pulling with my hamstring, and subsequently relaxing my quad to letting my knee fall like a pendulum to create momentum, and then just

    subtle contracting of the hamstring to keep it going. I might do anywhere from 20-100 of those per leg. Is there a better way to do this that anyone knows of?

    2. Has anyone on here dealt with Ms. Springer or Ms. Kertz? If so, were they able to help you?

    3. Does anyone on here use a Total Trainer or Total Gym and has it helped you?

    4. Same question as number 3, but in regards to the Runner's Knee Bible.

    1. Hey Lumpster,
      In response to your questions.
      1- Tailgaters. Sit on the kitchen counter (your legs hanging) and move them, not too fast, not too slow.
      2. Yes I am working with one of them at the moment and thanks to her I have improved A LOT.
      3. I strongly advise you use a total trainer. It has helped. It is the base of everything. Without it I don't know what I would have done.
      4. Yes, but because I'm working with a coach, I don't need to follow the book, I follow the programme she has made for me.

      I don't want to sound rude but you need to get a PT that works on your problem, not around your problem. You have knee pain, you need to strengthen your knee. That's it. Your knee is weak and once you get it stronger, muscles will follow.

    2. Hi Athenea!

      I'm sorry i didn't even see this reply yesterday! It got lost in my long windedness.

      Quick question about total easy are they to tear down? I'd likely need to do a setup/tear down with each use due to space constraints.

      Thanks again for your help.

    3. They are pretty easy to set up and fold! Have a look at youtube, there are a good few videos where you can see how to do it :)

  8. Ultimately my goal is to put myself in a better position to age a little more gracefully. I'm trying to avoid the cycle of Knee feeling better-doing stuff-knee feeling

    crappy because my joint isn't healthy before it starts. This is the first time I've dealt with this and I want it to be my last. I want to be able to kneel, run, play

    with my future kids (none yet, but hopefully soon) and be able to travel without contstantly worrying about how my knees are going to react. I want to be able to get things done around the house (I'm kind of a DIY'er). I truly want to change my life, and feel I can do that, that it's not too late. I essentially want to feel the freedom of good knees again.

    In addition to PT, I'm trying frequent but small doses of movement. I figured it couldn't possibly set me back on my PT, and the therapist herself told me it's good to get up and move around. I walk a lap around my floor at work (about 150 steps) every 30 min, at home I move around about the same amount of time. I'm starting to get outside for the occasional walk to the end of the block and back (about 750 steps). I'm averaging around 4500 steps/day.

    I fortunately have been able to rid myself of the VAST majority of creaking/cracking/rubbing/grinding sensations. I still get a very subtle click in my left knee, but that tends to go away as I move, and seems to even get better when I where my shoes with aforementioned inserts. My right knee tends to get a rubbing sensation in it, but typically after standing still or leaning against something for a while. It tends to go away fairly quickly. Both of these seem to be on the decline as well. It makes me hopeful that I am truly healing but who knows. I still get pain (most of it medially and in the lower quad/top of knee cap area) and stiffness(in particular in the mornings, it feels like I worked out the day before), and it's somewhat difficult to gauge if it's getting better or not. I've only recently started keeping a notebook of scores, similar (i.e. almost identical) to what Mr. Bedard did, so I at least have something documented to tell if I'm improving or not.

    Here's some more specific questions:

    1. When you first started getting up and moving around, how poorly were you walking?
    2. How much did you push yourself in terms of pain? If for example you got a sharp pain in your knee somewhere, would you typically stop or see if it would go away with a few steps?
    3. Did you ever take days where you just rested, and moved VERY little?
    4. How much weight could/would you lift?
    5. How much were you moving when you first began? I'm ranking my knee scores (1-20 similar to yours) in the 7-10 range right now typically, and I'm moving around about 4500 steps/day, although I might be able to do more.
    6. How much swing in your scores were you getting during this whole process?
    5. Ultimately the above questions could fall into one: How did you nudge yourself along to keep improving? Was it just a trial and error thing from day to day?

    I understand I can't just cookie cutter what worked for you and expect the same results. I'm just trying to find a clearer frame of reference, I guess. Apologies to everyone for the length of this, and thanks in advance for any insights you can provide.

    1. I understand your worry, I've been there myself. Don't give up. As simply as that. Have faith in your body. It can heal. You just need to give it what it needs to do so :)
      Before I started my recovery programme my load tolerance for each knee was 20% of my body weight. I was really bad. I lost range of motion also due to patellar tendonosis. My life was crap. I had depression.
      I couldn't really walk pain free, I started to walk 10 min, then rest 5, then walk another 5 and so on.
      I take breaks every 30 min and walk around the house for 4-5 min. That helps.
      It is tricky to tell you if you should move more or not, because each situation is different, but my advice would be try to move, even if you just walk for 5 min, and then rest for 30. But move. Unless you are in a very acute pain or something, move.

      In my case I decided to work with a coach and that has helped a lot. I started my therapy on January 2015. At the moment the load tolerance for my right knee is 80% of my body weight and my left knee is 70%.
      I've had setbacks, I've had periods when my left knee was giving way for no reason, I had pain after doing the exercises (it is normal to have symptoms), etc.
      It is a roller coaster. And it is hard to manage your fears and doubts and trying to understand what's going on, all at the same time...

      If you feel lost, and need help, try to work with one of DK's coaches.
      You can work with them via Skype and if you can fly at least once to visit them so they can put some hands on your knees and do an assessment, do it.

      That's what I can advice from my experience.

      There are a lot of smart people in this community who have also had success without a coach so I'm not saying you HAVE TO get one :)


    2. Thanks Athenea!

      My situation doesn't sound nearly as bad as yours. I still have full range of motion. I'm sure my leg strength is poor though, as I haven't done much strengthening exercises in the last 10 years other than what I'd probably get from some workout videos. I took three 10-15 minute walks this past sunday without any major issues, and increased my steps that day to about 5500-6000. Many of my symptoms seem to slowly be subsiding, but even still I feel like I have a ways to go.

      I actually did 8 minutes on a stationary bike with my therapist just an hour ago, and when I tried it on my own about a month or two ago I ached almost immediately (although it could have been some the single leg raises I did shortly after, might have been too much at the time). At any rate, I still feel pretty good, despite feeling kinda crappy this morning. Like you said, it's a rollercoaster. I'm hell bent on beating it though before it becomes a vicious cycle.

      Thanks again for your insight and support.

    3. Good to know you're improving! keep moving, slowly but surely! :)

    4. Brandon/Lumpster, thanks for coming by. My first impression is that you should think about losing weight/improving your diet. I'd be surprised if that alone didn't solve a lot of your problems (it may take some time, but ...)

      On your questions about my pain scores and such: I'm not sure that you need pain scores per se (some people on this blog have commented that after a while they gave up the intense journaling/pain scoring, as the level of obsessiveness wasn't helping their knees -- fair enough, I understand that). Yes the scores will swing around some. There are peaks and valleys; the road to getting better is not linear unfortunately.

      As for your level of pain, I can't give you great guidance there. I'd just be concerned about continuing if pain is sharp, and it persists. I always tried to minimize pain myself. But I was luckier than many -- I had burning and discomfort but not sharp pains (maybe only a few times). On the walking, my walking was pretty good right from the beginning, so that helped. Yes, I did take "easy" days, often when I had suffered a setback and needed a bit of time to recover.

      Judging by the nature of your questions though, you might benefit from a coach. Athenea has had a great experience with one of Doug Kelsey's coaches. Knowing when to nudge yourself a little more can be a hard thing to know exactly. A coach could help on that.

  9. Richard,

    Thanks for the reply!

    I agree with you; I need to lose weight - alot of it. I haven't been 200 pounds since about 10+ years ago. In the last year I've made significant changes in my diet, and the bulk of my aforementioned weight loss has been since about May/June. I obviously have a ways to go, but I am indeed working on that. I have made significant dietary changes in the past few months.

    Your other comments help as well. I actually like journaling because even though it is still really subjective, it's at least SOMETHING to help you get a frame of reference for judging whether or not I'm improving.

    I've actually contacted both of DK's coaches (the one was no longer listed on his "About" section anymore shortly after I contacted her with questions, not sure what's up with that). Anyway I'm definitely considering hiring one of them, but I'm going to be patient. Affording it is a bit tricky, and their services aren't covered by insurance. First I'm going to work on getting a Total Trainer. After that I'm going to try to work through the Runner's Knee Bible. I've prepared more detailed versions of the training logs and test sheets. I've printed/bound the book, flagged important sections, and gone through it with a fine-toothed comb. If I get stuck or it's not helping I think I may have to talk to one of the coaches again at that point.

    Thanks for your time!

    1. It's a shame the insurers will pay for total knee replacements but not for good preventative measures. The absurdities of our modern health care system!

  10. @Athenea...

    If you see this, and forgive me if I'm asking too much here, but is there a way I can private message either on these forums somehow or contact you in some way or another (I'm flexible with how we do that) with more questions about coaching and your healing path? There's stuff I'd prefer to not necessarily discuss in a public forum (nothing too crazy, I'm just too uptight to say any more about it than I already have in a public posting). Plus some of my questions are based around specifics of how they operate, bill, etc so I don't know if I should be asking that publicly either.

    I asked them a few questions about their services, of which they gladly answered, but after a couple of emails back and forth they told me they cannot answer any more of my questions (I SWEAR it was only a few questions lol).

    If the answer is no I can totally respect that and I'll just post here.

    If the answer is yes, we'll figure out a way to correspond, and I promise I will NOT inundate you with questions. :)

    Thanks, and again, sorry if this is a bit out of line for this forum.