Concurrent Strength Training & Running 2015: Eight-Week Workout Cycle IV

I'm no expert on meniscal tears, but there doesn't appear to be good evidence that supplements are effective.
http://www.orthop.washington.edu/?q=patient-care/articles/sports/arthroscopic-meniscus-repair.html

I like this website for reading about supplements.
http://www.nlm.nih.gov/medlineplus/druginfo/herb_All.html

Physical therapy?
https://drjengunter.wordpress.com/2...th-care-and-our-love-affair-with-the-scalpel/

These claims appear to be dubious.
http://www.thekneepainguru.com/meniscus-tear-treatment-a-holistic-approach/

I give Costco brand Glucosamine to my old dog, and it seems to perk her up. Then again, it could be that I put the pill in a treat pocket.
Since, I have it on hand, I've tried glucosamine myself on and off, and I can't say that I've noticed a difference. However, I may be younger in comparison, as far as dog years go!
Thanks for the links!

I guess I'll give the joint health supplements a try.

I'm not sure what physical therapy would entail other than what I'm already doing, or plan to do.

My first doc only recommended arthroscopic surgery to relieve pain. Since my pain has more or less disappeared, the trick will be to manage it. I'm seeing the second doc more to see what his opinion is on how to manage it, what sorts of activities he thinks are OK, and what the long-term prognosis is. I doubt very much he'll recommend surgery either in the absence of pain unless he has a more advanced technique than the first doc. My tear wasn't acute, but rather degenerative, and it's small and deep inside, where blood flow is poor, so it doesn't seem like there's much hope for repairing it. I still get a little pop when unbending my knee, but it's very faint now and doesn't happen very much anymore. This is what happened last fall too, when the locking and popping took care of itself over time. So it seems like the sort of thing that can be managed. Three years ago I had something similar in my left knee, and it too got better on its own, although once in a while I still feel a little something there. I've also felt like keeping the hammies and everything else good and stretched helps alleviate knee niggles.

I'm pretty sure running is still out, but I'm holding out for squats. I looked back at my logs and the mileage reporting, and it looks pretty clear that the pain is brought on by running rather than lifting, although it's difficult to be absolutely sure. There's a chance deadlifts are more aggravating than squats, but all the stuff I've read says that squats should be bad for tear, not deadlifts. I've sensed that the initial pull of the deadlift places a lot of compressive force on the knee. By doing SLDLs, I remove much of that force and yet still get a lot of the benefit of conventional deadlifts. Anyway, I'm hoping I can find a Goldilocks balance within the first doc's proscriptions, throw out running, modify the deadlifts, but keep the squats. But I've also read some people say they can run on their meniscus tears no problem (http://hss.edu/onthemove/should-marathon-runners-get-surgery-for-a-torn-meniscus/), so the question might be more of figuring out what the longterm consequences of doing so are. If I'm going to eventually need knee replacement surgery anyway, maybe I should keep running? The difference might be between getting the replacement when I'm 70 instead of 80, and in the meantime, I've enjoyed running and have maintained good cardiovascular health.
 
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My personal strategy is to keep as many of my original parts for as long as possible. Replacements just aren't as good.
I would not hesitate to quit running, and cycle or swim instead, should it be necessary at some point. I'm going to make my original parts last as long as possible, before considering any replacements.

http://orthoinfo.aaos.org/topic.cfm?topic=a00381
http://well.blogs.nytimes.com/2014/05/30/ask-well-exercise-after-knee-replacement/?_r=0
Yah, I'm still fighting it a bit, but running is probably out. It's a little hard to see other people out running now, or feel my plantar callus atrophy. And it's a little hard to admit that I'm old enough now to have to think about cutting out certain activities. Still, I'm not ruling anything out until I see Dr. Markman on Thursday, and I'm definitely holding out for squats if at all possible.

I guess I should seize the opportunity to finally get better at swimming.

On the triple whammy front, I read up a bit more on the blood pressure medicine I had been taking, and it's probably the cause of my persistent dry cough. The doc and pharmacist warned me about the cough as a side effect, but I didn't experience any side effects for the first two weeks and then the whole family got a dry, persistent cough a little before mine appeared, so I just assumed I had what had been going around. But then everyone else got better while my cough remained. Apparently, the medicine blocks something in the kidneys, which is then sent to the lungs, where it accumulates and irritates. Since its cumulative, it will probably take a few days or even weeks to flush out. The medicine may also be behind the fatigue I've felt lately, so hopefully my workouts will improve. I'm starting to feel like a real hypochondriac.
 
sorry for the slow reply. we're still moving between houses and doing the 5-year backlog of weeding, painting, blah blah blah. poor excuses.

i think for the cardio, i would try really slow running.

i am not going for walking here. i find that (for me) walking (especially barefoot or "minshod") has a much different and more complicated set of movements than running does. and possibly more stressful. for example, it seems like you have to throw your lower leg out in front of you, then stop it, then set it down. once it is down, there is a quirky two or three phase thing while your lower leg is in front, under, and then behind the main part of you. your ankle and hips have to do additional and more calibrated motion to keep your foot on the ground and your body from pogo-sticking. because you're moving more slowly (or maybe it is the lower cadence or something to do with the cadence/step-length regime) and have to support yourself throughout, you end up with those three pieces which don't always mesh together nicely and have the weird very beginnings and endings.

whereas, a running motion (even when running slower than a normal walk) doesn't have the throwing part (when the foot is in the air; you're really just dragging your knee forward instead of kicking the foot out in front) and has only the middle of the three phases. the knee stays bent and doesn't have the violent-ish stop right before the foot sets(/?crashes) down and you pick your feet up before the strange re-extension of the knee when your feet would be behind you in a walk. thus, your ankles just play shock absorber rather than having additional structural and propulsive roles. and, to beat on the ancient standard barefoot running advice, i've never heard of walking in place, only running in place. that's because it's really hard and clunky and feels weird to do. sometimes i wonder if the shoddy-runner knee injuries come not from the longitudinal heel crash shock with locked out knees, but from the rotational crack as the knee hits its internal bumper or whatever that constrains how far you can straighten your leg.

then, when you want to increase the intensity, you have two dials you can turn: speed and distance according to your whim and time availability.

so, i guess i'm saying to run really, really slowly and make your walking more like running. and maybe try running backward, too [you can't heel strike backward! :) ]. i remember reading in a plyometrics textbook about having people walk/run backward as part of treating knee injuries. it makes you use muscles differently and gives you a gentle plyo sort of thing or something. and, it would be good to have in the repertoire for ultras when something starts hurting from overuse in the forward direction. :) didn't OneBiteAtATime finish out the last 20 miles of a 50-miler last year using the "relentless backward progress" technique? (potawatomi trails, 2014, i think: http://thebarefootrunners.org/threads/potawatomi-50m-trail-run.16004/)

Ha I did actually try the backward walking thing downhill, but the steeps were a little sketchy to do it for long. Yeah your right it is a good idea to build some multi direction skill though, thanks for the reminder actually. I have been very focused on the forward motion plane. Funny how you forget about these things?
I will also give the slow running a try, I do already run slow but maybe a 13-14mm pace isn't a bad idea. Especially when it comes to the downhill. That is way faster than the 30mm pace I was going down some of the hills a couple of weekends ago.
 
Okay Lee, time for me to chime in about your injuries. About 18 years ago I got a diagnosis of my left knee identical as yours plus a few more injuries as well. Meniscus tear, cartilage damage, also a few tendons that were damaged. After all the tests were said and done my doctor said me down and had the "talk". He said that while he could go in and try to repair the damage, but he preferred to let it be as in a large number of cases, the cure half of the time made things worse. I took the leave it as is option. It took a while but about a year after I hurt my knee I was able to run half marathons again. The knee would always tell me when I pushed it too hard or went to fast, it is a good barometer as to where my fitness is. So with that being said and done, don't give up on your running. But it sounds like you might have to decide between weights and running, you have to find the balance point. I did very light weight workouts throughout my running life. I'm just wondering if your heavy lifting is affecting the recovery of your knee by agitating it. About a month ago both my knees were bad enough to be put on a waiting list for bilateral knee replacements, even with this it seems the only time my knees don't ache is when I'm running. Still fast enough to place second in my age group in a 10k in May. The damage to my knees was not caused by a lifetime of running but living life as a very active kid and adult and the mishaps that occurred during this life style.. The only time my knees give me heck is with prolonged standing and walking, no wonder I keep on running :D . Cheer up Lee, it will get better. :)
 
"Landscape" orientation of the plywood would look like this. However, the guy had to put a smaller piece in front, since his
bench extends a bit futher. My bench would fit, but my toes would hang off the edge, and that would be distracting.
http://www.modernjeremiah.com/home-gym-update-january-16th-2015/

I think I'll keep the plywood in "portrait" orientation after all. I'll keep a 1-2 foot lip in front of the rack, and that should keep it from tipping during reracking of squats.

I tried out the Ivanko collars. Very nice. There was some movement, when dumping the bar after squats, but much less then without them. I don't feel entirely comfortable about the safety aspects about dumping the weights, so I'll probably order the power rack this weekend. Hopefully, I'll get it by next weekend!

Did you end up getting that rack? I think that is one of the reasons I don't like the rogue racks I am not a big fan of bolting them down. But everyone's opinion is different. Plus I think they are way overpriced for what they do.

I like the comment about that guy buying the most expensive weight rack possible. Which is kind of true if you rack them like that.
 
Okay Lee, time for me to chime in about your injuries. About 18 years ago I got a diagnosis of my left knee identical as yours plus a few more injuries as well. Meniscus tear, cartilage damage, also a few tendons that were damaged. After all the tests were said and done my doctor said me down and had the "talk". He said that while he could go in and try to repair the damage, but he preferred to let it be as in a large number of cases, the cure half of the time made things worse. I took the leave it as is option. It took a while but about a year after I hurt my knee I was able to run half marathons again. The knee would always tell me when I pushed it too hard or went to fast, it is a good barometer as to where my fitness is. So with that being said and done, don't give up on your running. But it sounds like you might have to decide between weights and running, you have to find the balance point. I did very light weight workouts throughout my running life. I'm just wondering if your heavy lifting is affecting the recovery of your knee by agitating it. About a month ago both my knees were bad enough to be put on a waiting list for bilateral knee replacements, even with this it seems the only time my knees don't ache is when I'm running. Still fast enough to place second in my age group in a 10k in May. The damage to my knees was not caused by a lifetime of running but living life as a very active kid and adult and the mishaps that occurred during this life style.. The only time my knees give me heck is with prolonged standing and walking, no wonder I keep on running :D . Cheer up Lee, it will get better. :)
Thanks Dutchie, that means a lot to me. I was going to post a new thread, somewhere, asking for advice from you and other veterans, after I saw the second doc this Thursday and had a better idea of what I'm up against, but it's great to hear from you sooner.

My experience jibes with yours to the extent that my knee seems to bother me most when I haven't been running consistently and am trying to get back into it. Unlike your history of sports injuries though, it's impossible to know if anything specific caused my tear, or if it's just age-related wear and tear. I remember cycling 20 years ago I had some knee soreness for the first two months too until I learned to adjust my seat height and position properly. Who knows? Maybe that was the meniscus protesting back then too.

So yeah, it could be manageable, and it would be great if it was. On the other hand, I don't want to manage running on it for a year or two and then all-of-a-sudden provoke a much bigger tear. Right now, my knee feels 99% normal, so it's hard to believe there's anything going on there at all. It's a real blessing to be walking around and doing stuff painfree though, so I don't want to do anything to mess that up. Two weeks ago my son would ask me to walk down to the park after dinner while he rode his bike or battery-powered Fisher Price jeep. I had to say no, and that sucked.

As for lifting, I understand the reasons why heavy squatting might affect the recovery of the knee, but in my experience, especially last fall, squatting has always felt therapeutic for the knee, so I dunno. With something deep in the joint like my tear, it's really hard to get a good feel for what's going on until it's too late and it's been aggravated. Pretty much any other niggle or injury I can think of, it's been pretty apparent fairly soon if I was doing something to irritate it. But the meniscus issue seems to be almost random. I mean, why did it swell up for the first time a month ago? I had only run a mile and hadn't yet begun squatting very consistently. And then why didn't it hurt until the swelling had gone done? I was squatting with the knee stiff just fine, but when I tried to walk more than a mile or two on it, it really started hurting. But walking?

A lot of meatheads seem to lift on this sort of thing just fine, and at least some runners too, so it's all a little confusing. Hopefully the doc will help clarify my options a bit better on Thursday, but it's great getting your feedback to add to the knowledge base. Thanks again!

P.S., coming the Twin Cities anytime soon? Don't you guys come down for an annual shopping trip?
 
As for lifting, I understand the reasons why heavy squatting might affect the recovery of the knee, but in my experience, especially last fall, squatting has always felt therapeutic for the knee, so I dunno. With something deep in the joint like my tear, it's really hard to get a good feel for what's going on until it's too late and it's been aggravated. Pretty much any other niggle or injury I can think of, it's been pretty apparent fairly soon if I was doing something to irritate it. But the meniscus issue seems to be almost random. I mean, why did it swell up for the first time a month ago? I had only run a mile and hadn't yet begun squatting very consistently. And then why didn't it hurt until the swelling had gone done? I was squatting with the knee stiff just fine, but when I tried to walk more than a mile or two on it, it really started hurting. But walking?

Same question here, why does walking/running bother yours and my knee but squatting and deadlifting doesn't? It's kind of odd. Or why can I bike just fine? Its virtually the same motion as running.
 
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Same question here, why does walking/running bother yours and my knee but squatting and deadlifting doesn't? It's kind of odd. Or why can I bike just fine? Its virtually the same motion as running.
I wonder if it's a combination of high reps and cumulative impact? I mean, with squatting and deadlifting, there's a lot of compressive force, but no impact, and the reps are minimal. Running also tightens up my whole lower body musculature/attachments, whereas with squats and deadlifts nothing ever feels tight after I lift, just sore the next day.
 
I wonder if it's a combination of high reps and cumulative impact? I mean, with squatting and deadlifting, there's a lot of compressive force, but no impact, and the reps are minimal. Running also tightens up my whole lower body musculature/attachments, whereas with squats and deadlifts nothing ever feels tight after I lift, just sore the next day.

Yep that's true and if you are sore it's in the muscle. Also your joints are in much more of a load bearing position when walking running, especially your knees, as they are stacked upon one another. Squatting probably relieves some of this pressure across the entire joint and muscular structure.

Well at least its three of us that have issues with standing and walking around. Although I think BA's advice about moving more in different planes is good advice too. Something we used to talk about a lot but I kind of forgot about it.
 
My knee used to act up almost instantly if I hyper extended the knee, I'm wondering if it could be the angle of the knee that irritates the joint. I am really conscious right now of maintaining my knee bend when I run. Lee, I think both my youngest girls are coming out your way for a collegiate soccer tournament end of August, So I just might tag along, and pay a visit to your city. Last May when I was there for one night I stayed downtown Minneapolis and was astonished how friendly the whole downtown area is for runners and bicycles.
 
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Yep that's true and if you are sore it's in the muscle. Also your joints are in much more of a load bearing position when walking running, especially your knees, as they are stacked upon one another. Squatting probably relieves some of this pressure across the entire joint and muscular structure.

Well at least its three of us that have issues with standing and walking around. Although I think BA's advice about moving more in different planes is good advice too. Something we used to talk about a lot but I kind of forgot about it.
Well, from my experience and from what I've read, it's the rotational movements that irritate the meniscus most. Sometimes during day-to-day activities I tweak it a bit while turning or twisting, but it doesn't last. The only other times I feel it outside of workouts is when unbending the knee, it clicks just a bit, but without any pain or discomfort.

But yah, my sense has always been that squatting helps the knee by strengthening all the surrounding muscles and attachments. Those two links I posted from Rippetoe's forum support this.
http://startingstrength.com/resources/forum/mark-rippetoe-q-and-a/15504-squat-meniscus-injury.html
http://startingstrength.com/resources/forum/mark-rippetoe-q-and-a/8459-meniscus-tear.html
Rippetoe thinks it's virtually impossible for squatting to cause a meniscus tear, and he doesn't think it aggravates the meniscus once it's torn. He's not a doctor, but he has a good knowledge of anatomy and biomechanics and tons of training experience with elite powerlifters as well as ordinary gym rats like us. My first doc actually told me to avoid squatting to parallel, but almost everything I've read says this is what puts the most pressure on your knees. I've also read online docs recommend avoiding bending the knee to 90 degrees or greater. But I'm also aware of the tremendous anti-squat prejudice out there, when, according to Rippetoe and others, the problem is poor squatting technique.

My knee used to act up almost instantly if I hyper extended the knee, I'm wondering if it could be the angle of the knee that irritates the joint. I am really conscious right now of maintaining my knee bend when I run. Lee, I think both my youngest girls are coming out your way for a collegiate soccer tournament end of August, So I just might tag along, and pay a visit to your city. Last May when I was there for one night I stayed downtown Minneapolis and was astonished how friendly the whole downtown area is for runners and bicycles.
That makes sense to me. Even though I run barefoot and am under the impression that my form is decent, maybe, if I resume running again, I'll try to focus more on keeping the knees bent too. Thanks for the tip.

Well, just let me know if you're in town. I owe you the beers. And yeah, Minneapolis (& St. Paul) has become the number one city for cycling in the USA. I'm still nervous about mixing it up with cars though, so if and when I begin cycling more, I'll try to stick to dedicated bike paths as much as possible. We're also getting a Street Strider (http://www.streetstrider.com/summit-8r-p-161.html), which should be a lot of fun:
iu

Maybe I could switch between elliptical, rowing, biking, and running (once a week?).
 
Was feeling deprived due to not being able to make further progress with squat and bench, so placed order for rack last night.

After reviewing many options, decided on Rogue, due to being able to get the exact rack configuration that I want. Will have 3x3 steel on all sides of the cube, except the bottom front and back. Need the sturdy frame to support the freespotter setup. Expensive, yes, but injury is more costly.

Will be bolted down to 3/4"x4'x8' of birch hardwood plywood. Easily the heaviest sheet at Lowes, ~100lbs? Will keep entire sheet intact, with rack on one end and will deadlift on the other.
 
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Saw someone in town riding riding one of those. It piqued my interest until I saw how much they were on this side of the border. I would be all over one of those if the price point was right.
My brother found one, the 8-speed Summit model, on Alibaba (the Chinese Amazon) for $619, free shipping. I wired them the money last Thursday. Once it clears, they promised 3-5 business days delivery. It's a bit of a risk not using Paypal or a credit card, but I think it's a factory outlet or something that mostly deals with retailers. If the deal goes through smoothly, I'll post the particulars. I'm not one for fads, but it looks like it could be a great workout and it gets you outside like running.

Fun reads:
http://www.nytimes.com/2014/05/25/opinion/sunday/fitness-crazed.html?_r=0
http://www.howardluksmd.com/sports-medicine/is-running-bad-for-your-knees-maybe-not/
Fun listen:
 
i'm liking the bent knees and continued weights theory for your knees. perhaps you can just adapt all the advice you would give someone for barefoot running to your knees (too much too soon, listen to your body, etc, etc) and then we can start calling you "bare knee/bare lee".
Thanks for the encouragement. However, as someone who has been participating in these Concurrent ST & Running threads for about a year now, you'll recall that my rehabs (hammie strain and/or meniscus aggravation --> sacro-iliac strain and/or pulled piri formis muscle --> stubbed toe --> knee swelling and/or meniscus aggravation) have all been very gradual and my running short and sporadic at best. I mean, I still haven't come close to attempting my DL 1RM PR of a year ago, and I don't think I've run more than three and a half miles continuously for at least a year. But at least now I know the cause of the recurring knee niggles, which might help me better monitor things, should I choose to continue. The thing that weighs most on my mind is this last week of pain-free walking/movement. A few weeks ago I could barely make it down the stairs. I don't want that to happen again.

Anyway, I'm thinking about trying some 125-pound squat reps today to test things out. Might be good to hear a state 0f the knee address ahead of deliberations with the second doc on Thursday.

Dutchie: it's interesting what you said about extending the knee. Maybe that's why walking isn't always any better for me, because I extend the knee more when walking than when running.