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

BroadArrow · Jul 13, 2015

Bare Lee said:
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.

am i correct in recalling that the last time you weren't having any problems was when you were running consistently? while we cannot be sure of the causality, we can still try to recreate that fixed-point/virtuous-cycle. so keep that pain-free thing rolling.

now, of course, i'm not a "doctor" (in that sense: i dropped out of medical school after only 5 days), but i've never had a problem with my feet that couldn't be solved by upping the mileage. so how about trying to run every day, starting out with like 30 feet or something and always going a little bit farther than before (31 feet!). forwards, backwards, sideways, on your hands: i don't care.

strength! courage! persistence! what other blessings should we call down upon you?

Bare Lee · Jul 13, 2015

BroadArrow said:
am i correct in recalling that the last time you weren't having any problems was when you were running consistently? while we cannot be sure of the causality, we can still try to recreate that fixed-point/virtuous-cycle. so keep that pain-free thing rolling.

now, of course, i'm not a "doctor" (in that sense: i dropped out of medical school after only 5 days), but i've never had a problem with my feet that couldn't be solved by upping the mileage. so how about trying to run every day, starting out with like 30 feet or something and always going a little bit farther than before (31 feet!). forwards, backwards, sideways, on your hands: i don't care.

strength! courage! persistence! what other blessings should we call down upon you?

Ah, I see we're on the same page after all. Apologies for the reactive response, but I'm a little tired of the 'you must be overdoing it" advice. You weren't saying that, but I get that from others a lot, including some of the people closest to me. Although, for example, I feel like squatting 275 was a real achievement for me, in the general strength training scheme of things, squatting a little over one's bodyweight, or even 1.5BW is nothing. Everyone should be able to do that given a year or two of training.

But you're absolutely right, I've felt (and documented) that the knee niggles are most likely to occur when I'm getting back into it, which, over the last year, has been an almost continuous process. In 2013 when my running was going well, I don't think I had any knee niggles except some lingering ITBS at the beginning of the year. By fall of 2013, I was routinely running 10-14 miles on my weekend long run, and 5-10 miles twice during the week. (I was also 30 pounds lighter, sigh.)

I think I also I wrote somewhere in this cycle or perhaps it was Cycle III that one rehab idea would be to walk the mile to my office everyday and run the last block or so, and then keep increasing the running portion a bit each day until I'm running the whole way, and then begin to add distance every other day, or something like that. So it's great that you also think this is a good idea. I think you have very good intuitions about this sort of thing, so your suggestion has me wondering about this possibility again.

The inherent risk with this approach is that, while it might get me up and running in the short term, it could lead to greater problems in the long run, like eventual arthritis and knee replacement surgery. No one really knows, but there's a fair amount of anecdotal evidence on the interwebs that running may help. But there's also a lot of doctors who are still convinced that running and squatting are bad for the knees. All I know is that I enjoy walking and moving around pain-free tremendously and so I'm a bit risk-adverse at this point. On the other hand, my meniscus tear is very small and deep, so the worst case scenerio in the short term is that it flares up again and hurts for a week or two. As long as it doesn't hurt, do you think I can assume that I'm not doing any long-term damage? I guess that's the question. Any thoughts or suggestions are more than welcome.

As for the causality, unless I'm suffering from repressed memory or PTSD, and have forgotten about some acute knee twist, everything I've read points to it simply being degenerative. I'm getting old, I'm starting to fall apart. Meniscus tears are exceedingly common for people in their fourth and fifth decades.

Anyway, thanks for the suggestions and support. I really appreciate it.

Funny about medical school. I dropped out at Organic Chemistry. I thought to myself, on one fine spring day my sophomore year of college, that I might be a little young to commit to that level of detail, and switched my major from biology/pre-med to anthropology.

Sid · Jul 14, 2015

Yes, I'm interested to see what your new doc says. I'm no expert, but I have a personal theory that if there's no or minimal pain, then it's okay to exercise. I wonder what his opinion will be.

Bare Lee · Jul 14, 2015

Sid said:
Yes, I'm interested to see what your new doc says. I'm no expert, but I have a personal theory that if there's no or minimal pain, then it's okay to exercise. I wonder what his opinion will be.

Yes, I think exercise is always recommended--a strong heart and overall health being more important than conserving the meniscus. The question is, in the absence of pain, what sorts of exercise are recommended. The first doc advised against heavy squats and running.

A theory that says heavy squats and running are still OK might go something like this:

1.) The small, interior tear to my medial meniscus was caused by normal (age-related) wear and tear--i.e., it's degenerative, not traumatic. The meniscus is like the brain and heart, the tissue doesn't have much regenerative power, unlike, say, skin.
2.) My meniscus will continue to degenerate no matter what I do, new tears may appear.
3.) Exercise may occasionally aggravate the tear, in which case I will have to back off and rest it.
4.) Exercise involving impact, repetitive stress, or compressive forces may aggravate the tear even more, but probably won't cause new ones.
5.) Exercise will help keep the rest of the knee healthy for longer. Exercise involving impact, repetitive stress, or compressive forces may help keep the knee even healthier, and so it's worth continuing.

I think the first doc's advice assumes that other types of exercise like biking and swimming will also keep the knee, heart, and everything else relatively healthy, so there's no point in doing exercises like heavy squats and running, which are harder on the meniscus. So the only point in doing heavy squats and running is if the benefits to the knee and/or overall health outweigh the degenerative effects on the meniscus.

Does this make sense?

I'm trying to reconcile the two points of view. Docs seem to argue from principle, and of course are liable for giving advise that may prejudice the particular body part or function they're responsible for, but a lot of anecdotal evidence says that heavy squats and running are still ok, as long as they're monitored and one is able to manage the occasional flare-up. But even if one is pain-free, is one hastening the demise of the meniscus, and thus bringing osteoarthritis and eventual knee-replacement closer?

But then, as medicine and technology continues to advance, does it even matter?

And then there's the simple fact that, as much as I like running and squatting (relatively) heavy, I like locomoting pain-free even more. Is it worth dealing with these occasional flare-ups?

Anyway, full report Thursday or Friday. Stayed tuned.

BTW, are you still meeting with the powerlifting trainer? Or was it a one-time deal?

BroadArrow · Jul 14, 2015

my brother has a little adage he likes to repeat: "it is hard to improve on the symptom-free state." yes, chemotherapy is a wonderful thing.... for the 16 types of cancer it is known to be good for (out of 320 million distinct variations...; totally made up numbers). so, if you have one of those 16, by all means, treat away. if you don't, well, the doctor with the crescent wrench isn't going to be able to help you pull that nail out very well. my mixed metaphors are to try to say: medicine does what it can do very well and does everything else very poorly. as i have gotten older and even more cynical, i have fallen into asking the epistemological question: how would they even know what to recommend for your knee? is somebody really out there taking 24 bad knees and splitting them up into three groups and.... no. they are not. so, it is sort of like weighing their 12%-valid intuition against your 8%-valid intuition. sure, they know half-again as much as you do about the area, but that doesn't mean they know much.

so, let me relate my shoulder story again. i used to play volleyball all the time and never had any trouble. then i moved away for three years and didn't play or exercise or anything other than chasing babies and walking up the escalators from the subway. when i came back, i started playing again, but somehow messed up my shoulder from either volleyball (it is my hitting shoulder) or fighting my incredibly strong daughter into a baby carrier. if i "warmed it up" by throwing a football or something, it would bother me less, but it kept being unhappy despite heat, cold, rest, movement, stretching, whatever. sure, those things would help a little "at the margin", but the core issue remained. i asked my doctor and PT friends about it and they said it sounded like a rotator cuff tear or something. great: i love surgery! then, for some unrelated reason, i got inspired and started doing overhead presses for breaks in my office. we're talking pretty low weight (say 40lbs) and only 1/2 or 3/4 range because i was fooling around and even more inept than i am now. magic! in a couple months, i noticed that my shoulder wasn't giving me trouble anymore. sure, i probably have a little less cartilage than there is supposed to be or something and i can make it click with a particular motion if i really want it to, but no pain, no nothing. and i presume that all the other muscles/etc around it are stronger and can help make up for whatever damage is still floating around in there.

in other words: obviously, there is a risk that the discomfort of trying to get back into basic running/lifting shape means that bad things will happen if you continue. there is also a risk that it is just the usual discomfort of changing to a new regime and that once you get past the reef it will be smooth sailing. based on no information and no expertise, my judgement is that it is worth it to assume that you can float carefully over/around/through the reef to open water. and if you keep your eyes open, you should be able to figure out if the reef is actually the shoreline....

more running + more strength - 30lbs = happy lee -> happier wife -> happier lee

Abide · Jul 14, 2015

Bare Lee said:
And then there's the simple fact that, as much as I like running and squatting (relatively) heavy, I like locomoting pain-free even more. Is it worth dealing with these occasional flare-ups?

Sure it is, this is the argument that eventually everyone will get injured at some point. The good thing is they heal with time, usually quicker than what you are experiencing. Especially since you went from a hip issue to shingles, to nervous issues and then the knee.

rickwhitelaw · Jul 14, 2015

Hey friends, thought I would hijack your thread and say hi since the old timers hang out here.

Not much strength training going on. Lugging hay bales around, shoveling, mechanic work count?

Running (although shod and slow) has been going very well lately.

Abide congrats on your recent Ultra.

Bare Lee · Jul 14, 2015

BroadArrow said:
my brother has a little adage he likes to repeat: "it is hard to improve on the symptom-free state." yes, chemotherapy is a wonderful thing.... for the 16 types of cancer it is known to be good for (out of 320 million distinct variations...; totally made up numbers). so, if you have one of those 16, by all means, treat away. if you don't, well, the doctor with the crescent wrench isn't going to be able to help you pull that nail out very well. my mixed metaphors are to try to say: medicine does what it can do very well and does everything else very poorly. as i have gotten older and even more cynical, i have fallen into asking the epistemological question: how would they even know what to recommend for your knee? is somebody really out there taking 24 bad knees and splitting them up into three groups and.... no. they are not. so, it is sort of like weighing their 12%-valid intuition against your 8%-valid intuition. sure, they know half-again as much as you do about the area, but that doesn't mean they know much.

so, let me relate my shoulder story again. i used to play volleyball all the time and never had any trouble. then i moved away for three years and didn't play or exercise or anything other than chasing babies and walking up the escalators from the subway. when i came back, i started playing again, but somehow messed up my shoulder from either volleyball (it is my hitting shoulder) or fighting my incredibly strong daughter into a baby carrier. if i "warmed it up" by throwing a football or something, it would bother me less, but it kept being unhappy despite heat, cold, rest, movement, stretching, whatever. sure, those things would help a little "at the margin", but the core issue remained. i asked my doctor and PT friends about it and they said it sounded like a rotator cuff tear or something. great: i love surgery! then, for some unrelated reason, i got inspired and started doing overhead presses for breaks in my office. we're talking pretty low weight (say 40lbs) and only 1/2 or 3/4 range because i was fooling around and even more inept than i am now. magic! in a couple months, i noticed that my shoulder wasn't giving me trouble anymore. sure, i probably have a little less cartilage than there is supposed to be or something and i can make it click with a particular motion if i really want it to, but no pain, no nothing. and i presume that all the other muscles/etc around it are stronger and can help make up for whatever damage is still floating around in there.

in other words: obviously, there is a risk that the discomfort of trying to get back into basic running/lifting shape means that bad things will happen if you continue. there is also a risk that it is just the usual discomfort of changing to a new regime and that once you get past the reef it will be smooth sailing. based on no information and no expertise, my judgement is that it is worth it to assume that you can float carefully over/around/through the reef to open water. and if you keep your eyes open, you should be able to figure out if the reef is actually the shoreline....

more running + more strength - 30lbs = happy lee -> happier wife -> happier lee

Abide said:
Sure it is, this is the argument that eventually everyone will get injured at some point. The good thing is they heal with time, usually quicker than what you are experiencing. Especially since you went from a hip issue to shingles, to nervous issues and then the knee.

Thanks to both of you for taking the time to respond.

The guy I'm seeing Thursday actively publishes, so if there is anything to be gained from studies, he'll have a good knowledge of it. On the other hand, as BA, Rippetoe, and others have more or less pointed out, how much experience do they have with a middle-aged guy who still squats relatively heavy, or runs barefoot?

The internist I just saw today about blood pressure thought the idea of squatting with a meniscus tear was absolutely nuts.

Rippetoe and others think it's perfectly normal.

My internist and orthopedist have spent their entire lives thinking about how to preserve health, "do no harm," and all that.

Rippetoe has spent his whole life trying to break PRs, which occasionally involves some harm. It's an acceptable risk for him, because for him, life sucks if you aren't challenging yourself.

Neither one is objective, and neither one necessarily has optimal fitness in mind, which is my focus.

And then there's this: http://content.time.com/time/health/article/0,8599,1948208,00.html. The author concurs with BA and my intuition that it's when running is sporadic that the meniscus tear is most likely to flare up.

And this: http://www.drdavidgeier.com/is-running-bad-for-your-knees/, that running might be good for the articular cartilage.
http://www.livescience.com/36241-5-experts-answer-running-bad-knees.html

I think Abide makes a very good point about the futility of programming everything around injury prevention, but the meniscus issue is a little different, since it doesn't actually heal with time, especially if you're older and the tear is deep inside, like mine, away from a good blood supply. The reason the tear occurred in the first place is because the meniscus has a poor ability to regenerate itself. That's why it's a degenerative tear and not an acute or traumatic tear. When the chiro I saw about my sacro-iliac/pulled muscle told me I would have a permanent weakness in that area, I set out to rehab it, very cautiously, and prove her wrong. It hasn't bothered me since. But that was a stupidity-related injury, not an age-related one.

With my shoulder issue, I've learned it is very manageable with improved technique. I can bench more now than I ever have before. So that was technique-related.

What I'm confronting with the meniscus issue is "gettin' old," pure and simple. The tear is there and never going away, and I'm not sure it's worth trying to manage it so that I can continue to squat and run. It might be best to simply find other stuff what works nearly as well, like cycling, rowing, or 'striding.' The risk with the meniscus tear and/or general meniscus fragility is that I might make it worse, no matter how gradually I ease back into things.

Anyway, thanks to both of you for weighing in. You have both further swayed me to the idea of giving squatting and perhaps running a chance. I squatted 125 x 5 yesterday and it felt fine. Running seems more dubious, but we'll see what the doc says on Thursday.

One thing's for sure, I'm really tired of thinking about this. Thanks for hearing me out and making suggestions.

Abide · Jul 15, 2015

rickwhitelaw said:
Hey friends, thought I would hijack your thread and say hi since the old timers hang out here.

Not much strength training going on. Lugging hay bales around, shoveling, mechanic work count?

Running (although shod and slow) has been going very well lately.

Abide congrats on your recent Ultra.

Thanks Rick, I finally got around to doing a race report https://6movements.wordpress.com/2015/07/08/ultimate-trails-110k/ if anyone is interested.

I need to doctor it up before I send to TJ.

Glad to hear your doing well!

Abide · Jul 15, 2015

BroadArrow said:
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/)

Ok I gave the painfully slow run/walk idea a try and it was painfully slow. I think I averaged 9mkm or 14mm. Knee pain was still lingering, but the downhills at this pace were interesting as in mostly pain free. I'll keep it up, I was planning a longer run tomorrow so I'll keep that one at the same pace and see what happens. I also got a fitbit so its giving me some interesting data regarding my HR and pace. The difference between walking a 10mkm pace and running a 9mkm pace was 20 beats per minute, not sure if that increase in speed is worth it? Also keeping the knees bent when walking actually increased my pace. Strange how that works.

Went to the chiro and he mentioned maybe my quads are underdeveloped which made me look into this http://bretcontreras.com/abc-ask-bret-contreras-2/
This seems to hold true though.

Anyway maybe adding some front squats and heavy TBDL might be in order.

Abide · Jul 15, 2015

Bare Lee said:
What I'm confronting with the meniscus issue is "gettin' old," pure and simple. The tear is there and never going away, and I'm not sure it's worth trying to manage it so that I can continue to squat and run. It might be best to simply find other stuff what works nearly as well, like cycling, rowing, or 'striding.' The risk with the meniscus tear and/or general meniscus fragility is that I might make it worse, no matter how gradually I ease back into things.

Anyway, thanks to both of you for weighing in. You have both further swayed me to the idea of giving squatting and perhaps running a chance. I squatted 125 x 5 yesterday and it felt fine. Running seems more dubious, but we'll see what the doc says on Thursday.

One thing's for sure, I'm really tired of thinking about this. Thanks for hearing me out and making suggestions.

I was gonna comment but figured you probably are sick of thinking about it. You'll work it out in the end. It's funny before I was thinking that squatting may have cause my knee issues, but now I am thinking your Squat/DL balance theory and my lack of it is probably the root cause.

Bare Lee · Jul 15, 2015

Abide said:
I was gonna comment but figured you probably are sick of thinking about it. You'll work it out in the end. It's funny before I was thinking that squatting may have cause my knee issues, but now I am thinking your Squat/DL balance theory and my lack of it is probably the root cause.

No, I guess what I meant is that I'm sick of thinking about it, but thinking about it is necessary, as I would like to be able to formulate a plan of attack after seeing the doc tomorrow. And you guys' comments/suggestions are an invaluable contribution to this process. So any further thoughts are more than welcome. At this point, I'm leaning heavily towards doing squats of some kind, maybe just light to medium weight, 5-8 reps, and build up from there. I did 5 x 125 on Monday, and I enjoyed feeling sore in areas that the SLDLs simply don't effect much if at all. I'm convinced squats are fundamental and should be done if at all possible. The SLDLs are proving to be a good substitute for conventional DLs. I've always felt a lot of compressive force on the knees at the initial pull. I still get that movement in with squats, so it was kinda redundant anyway, and I think the rest of the movement of the SLDL is actually superior to the conventional deadlift for working the posterior chain. I still haven't decided whether or not to reset after each rep, but it's probably the best way to do it for the lower back.

Running is still questionable, but in one of those article links I posted the author claims that the pumping motion of running actually brings in more nutrient-rich fluid to the interior of the joint, which helps keep the cartilage healthy. So one idea would be to just run a mile or so everyday, and then maybe run/walk 3-6 miles on the weekend. I could make up the balance of aerobic work with the rowing, striding, biking, or even a Nordic Track Ski Machine (there's one for free on craigslist right now). If I could run at least minimally, that would be great. I think running confers unique benefits that other forms of aerobic exercise lack, and it would be nice to keep some semblance of plantar callus as well.

I would think your ITBS is still mostly caused by running such long distances on a sporadic basis, but I'm also fairly convinced that there's something to the idea of structural balance. Doing more rows for example, really helped my left shoulder issue when benching. So yeah, you've always been deadlift dominant, and probably need to get more serious about your squats. Whether or not it helps relieve the ITBS is hard to say, but it's a worthy goal in its own right.

I still can't wrap my head around the idea of doing hip thrusts/bridges. Just feels so awkward and unnatural to load it heavier than . . .

Nice write-up by the way. Unusually loquacious for you. And great photos! Have you ever thought about long-distance cycling? I'm sure you'd enjoy it and Europe has some great tertiary roads.

P.S., I'm picking up some Rehband knee sleeves. I like the Harbinger knee wraps, but for knee health, some have said sleeves are superior. I could also use them for running or other activities.

Abide · Jul 15, 2015

Bare Lee said:
No, I guess what I meant is that I'm sick of thinking about it, but thinking about it is necessary, as I would like to be able to formulate a plan of attack after seeing the doc tomorrow. And you guys' comments/suggestions are an invaluable contribution to this process. So any further thoughts are more than welcome. At this point, I'm leaning heavily towards doing squats of some kind, maybe just light to medium weight, 5-8 reps, and build up from there. I did 5 x 125 on Monday, and I enjoyed feeling sore in areas that the SLDLs simply don't effect much if at all. I'm convinced squats are fundamental and should be done if at all possible. The SLDLs are proving to be a good substitute for conventional DLs. I've always felt a lot of compressive force on the knees at the initial pull. I still get that movement in with squats, so it was kinda redundant anyway, and I think the rest of the movement of the SLDL is actually superior to the conventional deadlift for working the posterior chain. I still haven't decided whether or not to reset after each rep, but it's probably the best way to do it for the lower back.

Running is still questionable, but in one of those article links I posted the author claims that the pumping motion of running actually brings in more nutrient-rich fluid to the interior of the joint, which helps keep the cartilage healthy. So one idea would be to just run a mile or so everyday, and then maybe run/walk 3-6 miles on the weekend. I could make up the balance of aerobic work with the rowing, striding, biking, or even a Nordic Track Ski Machine (there's one for free on craigslist right now). If I could run at least minimally, that would be great. I think running confers unique benefits that other forms of aerobic exercise lack, and it would be nice to keep some semblance of plantar callus as well.

I would think your ITBS is still mostly caused by running such long distances on a sporadic basis, but I'm also fairly convinced that there's something to the idea of structural balance. Doing more rows for example, really helped my left shoulder issue when benching. So yeah, you've always been deadlift dominant, and probably need to get more serious about your squats. Whether or not it helps relieve the ITBS is hard to say, but it's a worthy goal in its own right.

I still can't wrap my head around the idea of doing hip thrusts/bridges. Just feels so awkward and unnatural to load it heavier than . . .

Nice write-up by the way. Unusually loquacious for you. And great photos! Have you ever thought about long-distance cycling? I'm sure you'd enjoy it and Europe has some great tertiary roads.

P.S., I'm picking up some Rehband knee sleeves. I like the Harbinger knee wraps, but for knee health, some have said sleeves are superior. I could also use them for running or other activities.

Yeah I read that article too, its very strange how medically trained folks can have such a variety of opinions about it. Well you could always join the slow runners club that's in vogue right now? I do think and agree with BA that speed, body weight and distance determines if running can be healthy or not. Just finding the right balance is key. I know the crap I am doing is terribly unhealthy.

Hip thrusts are a PITA, but I think I am going to do them for a while and see what happens. I don't really have anything lose. I use a rolled up yoga mat that I do my ab roll outs on and I push the weight down my femur a bit and that is much more comfortable than around the sensitive parts. I think though that ratio holds true for me right now so who knows how much value doing them will have. I am also going to do front squats once a week for a bit.

Thanks yeah it was a wordy one for me, and yeah I have considered it. I wish I had more time to do it too but with family and work responsibilities I'll probably have to wait another 20 years, was actually thinking about cruising down to Brugges this weekend but I think I need to spend al little more time on the mountain bike.

Bare Lee · Jul 15, 2015

Abide said:
Yeah I read that article too, its very strange how medically trained folks can have such a variety of opinions about it. Well you could always join the slow runners club that's in vogue right now? I do think and agree with BA that speed, body weight and distance determines if running can be healthy or not. Just finding the right balance is key. I know the crap I am doing is terribly unhealthy.

Hip thrusts are a PITA, but I think I am going to do them for a while and see what happens. I don't really have anything lose. I use a rolled up yoga mat that I do my ab roll outs on and I push the weight down my femur a bit and that is much more comfortable than around the sensitive parts. I think though that ratio holds true for me right now so who knows how much value doing them will have. I am also going to do front squats once a week for a bit.

Thanks yeah it was a wordy one for me, and yeah I have considered it. I wish I had more time to do it too but with family and work responsibilities I'll probably have to wait another 20 years, was actually thinking about cruising down to Brugges this weekend but I think I need to spend al little more time on the mountain bike.

Yeah, the variety of opinion is frustrating, but when one considers the longstanding myths that squatting and running are bad for healthy knees, it seems reasonable to question that sort of assertion for unhealthy knees too. Although, intuitively, anything involving repetitive stress or compressive loading on a degenerative meniscus would seem to make it worse. Then again, science is all about replacing our intuitions with evidence-based conclusions, and some studies at least, for healthy knees at least, have shown that squats and running make knees healthier. Do they do the same benefit for unhealthy knees? All I've encountered so far has been anecdotal. Like BA says, that's probably all we can hope for at this point. If I could somehow conclude that the detrimental effects are at worst minimal, that would tip the scales.

Yah, even "Just Run" Barefoot Gentile is joining the slow run club. At this point, I'll take any kind of running, or any kind of squatting for that matter. It's still easy for me to know when I'm doing something at an aerobic pace/level, so I won't be donning a heart rate monitor anytime soon. I already feel ridiculous with knee wraps.

It'll be interesting to see what you think of hip thrusts/bridges. I have an irrational bias against them, mainly because Bret, man of a million exercise variations, likes them so much, and has branded himself as 'the glute guy.' But more than bias, my dislike is mostly due to the fact that I just don't enjoy doing them. There's always about a 10-12 lifts that I always find myself coming back to. And those are the ones I've included in this week's lifting template. There's the six main lifts, and then two sets of four assistance exercises. Wait a minute, that's 14, but pushdowns, curls, and shrugs are pretty marginal.

I sent a message to Greg Nuckols asking him what he thought of squatting with a meniscus tear. Hopefully he'll reply. I would actually like to ask Bret too, since he's read so much research, but I don't see any way to contact him on his website.

Looking forward to the 8-Rep sets later today. It feels good to be back in the swing of things, lifting-wise. All the percentages have been reset, so the routine has become fairly workaday again. It's so much better when it's mindless and relatively easy. I should be in decent shape again by the end of this cycle, knock on wood.

Sid · Jul 15, 2015

http://www.bodybuilding.com/fun/personal-trainer-of-the-month-bret-contreras.html

Abide · Jul 16, 2015

Bare Lee said:
Yah, even "Just Run" Barefoot Gentile is joining the slow run club. At this point, I'll take any kind of running, or any kind of squatting for that matter. It's still easy for me to know when I'm doing something at an aerobic pace/level, so I won't be donning a heart rate monitor anytime soon. I already feel ridiculous with knee wraps.

Well I just bought one of the new fitbits and it has a HR monitor, GPS etc.. all in a simple watch. It's actually a very easy way to accumulate an amazing amount of data all in one place with very little extra work besides pushing a button or two. The sleep time has been very interesting.

Anyway here is some info from my run this morning. I went between walking 1k at a fast pace and running 1k at a slow pace and the info is very interesting. My heart rate sits around 160 when I am running a ~13mm pace which is about the slowest I can run. I was also only breathing through my nose so it felt very easy? Here is the pacing and then the related HR. Apparently at a maff pace I am in peak cardio. Shit I may be in worse shape than I like to admit?

Bare Lee · Jul 16, 2015

Sid said:
http://www.bodybuilding.com/fun/personal-trainer-of-the-month-bret-contreras.html

Thanks Sid for the contact info on Bret. Nice sleuthing! I'll contact him presently. Greg Nuckols has already replied. He didn't say much, except confirm that a lot of people continue to squat heavy with worse injuries, but that in my case (I gave him age and told him the tear was degenerative) I may have to take it easy for the rest of my life. Meaning, I think, that I can still squat, but don't push things too much. Which is basically what I do already. When he says push things, he's probably thinking about competitive powerflifters squatting over 600 lbs.

Abide said:
Well I just bought one of the new fitbits and it has a HR monitor, GPS etc.. all in a simple watch. It's actually a very easy way to accumulate an amazing amount of data all in one place with very little extra work besides pushing a button or two. The sleep time has been very interesting.

Anyway here is some info from my run this morning. I went between walking 1k at a fast pace and running 1k at a slow pace and the info is very interesting. My heart rate sits around 160 when I am running a ~13mm pace which is about the slowest I can run. I was also only breathing through my nose so it felt very easy? Here is the pacing and then the related HR. Apparently at a maff pace I am in peak cardio. Shit I may be in worse shape than I like to admit?

Funny you should mention the fitbit. Yesterday my wife asked for one for her birthday. Will arrive tomorrow. She didn't think the one with the heart rate and GPS was necessary, so we got the next best one.

I don't have any comments on your data, but if you're running ultras and racing your bike, I would say you're in pretty good aerobic shape. The Maff rate is always about 20 beats lower than the standard calculators, like the Mayo Clinic's, so I wouldn't sweat any discrepencies. My heart rate monitor is simple: when I don't feel an urge to stop or slow down, I know I'm running aerobic. Muscle fatigue, and not oxygen supply, becomes the limiting factor.

Abide · Jul 16, 2015

Bare Lee said:
Thanks Sid for the contact info on Bret. Nice sleuthing! I'll contact him presently. Greg Nuckols has already replied. He didn't say much, except confirm that a lot of people continue to squat heavy with worse injuries, but that in my case (I gave him age and told him the tear was degenerative) I may have to take it easy for the rest of my life. Meaning, I think, that I can still squat, but don't push things too much. Which is basically what I do already. When he says push things, he's probably thinking about competitive powerflifters squatting over 600 lbs.

Well that's clear as mud... but yeah why would we ever really push maxes anymore anyway? I am going to focus a little more on eccentrics as your doc and mine recommended. And squats are an easy choice with a good range of motion.

Bare Lee said:
Funny you should mention the fitbit. Yesterday my wife asked for one for her birthday. Will arrive tomorrow. She didn't think the one with the heart rate and GPS was necessary, so we got the next best one.

I don't have any comments on your data, but if you're running ultras and racing your bike, I would say you're in pretty good aerobic shape. The Maff rate is always about 20 beats lower than the standard calculators, like the Mayo Clinic's, so I wouldn't sweat any discrepencies. My heart rate monitor is simple: when I don't feel an urge to stop or slow down, I know I'm running aerobic. Muscle fatigue, and not oxygen supply, becomes the limiting factor.

Well my maff pace is what 144, yeah that makes sense if its a bit excessive. I don't think I could run at that rate though. Today was a very easy pace too so definitely in the aerobic range.

Understanding your Target Heart Rate
It is recommended that you exercise within 55 to 85 percent of your maximum heart rate for at least 20 to 30 minutes to get the best results from aerobic exercise. The MHR (roughly calculated as 220 minus your age) is the upper limit of what your cardiovascular system can handle during physical activity.

So 220-36 = 184 * .85 = 156

My 160 average when I was running still seems a bit high. Hopefully I am not suffering an early heart attack event!

Bare Lee · Jul 16, 2015

Abide said:
Well that's clear as mud... but yeah why would we ever really push maxes anymore anyway? I am going to focus a little more on eccentrics as your doc and mine recommended. And squats are an easy choice with a good range of motion.

Well my maff pace is what 144, yeah that makes sense if its a bit excessive. I don't think I could run at that rate though. Today was a very easy pace too so definitely in the aerobic range.

Understanding your Target Heart Rate
It is recommended that you exercise within 55 to 85 percent of your maximum heart rate for at least 20 to 30 minutes to get the best results from aerobic exercise. The MHR (roughly calculated as 220 minus your age) is the upper limit of what your cardiovascular system can handle during physical activity.

So 220-36 = 184 * .85 = 156

My 160 average when I was running still seems a bit high. Hopefully I am not suffering an early heart attack event!

Well, the visit with the second doc went well. In fact, he referred me to a third doc even higher up the ladder of professional knowledge and skill! Actually the doc I saw today is on medical leave, so can't do surgery. Their orthopedic center is quite impressive, with escalators in the lobby and a nice open feel. The walls are adorned with photos and jerseys of local sports stars, signed with thank you notes.

Basically, the second doc said yes, running is best avoided. Second, he said squats are OK. In fact, he said the reason the meniscus and arthritis issues didn't show up and give me trouble earlier is because the rest of the joint and supporting musculature are so strong. So keep doing squats! He also liked the idea of replacing conventional deadlifts with SLDLs.

He referred me to the third doc in order to look into three possible "joint restoration" procedures: (1) clean up the joint via arthroscopic surgery, (2) "pick' the femur where my articular cartilage has worn away, in order to induce scar tissue, which can serve the same function as the missing articular cartilage, and (3) look into injecting cells that might help maintain cartilage health. This third option is pretty cutting edge, and the third doc he referred me to is a top researcher at the U of M.

So, the visit went about as well as I had hoped. I knew running was probably out, but I'm glad I can keep the squats and deadlifts. The first doc was reluctant to do surgery in the absence of pain, but the second doc thought I could get considerably more mileage out of my otherwise healthy knee if I had these procedures performed. The second doc was also considerably more attentive.

After the appointment, I picked up the free Nordic Track Ski Machine that was on craigslist. So now I have four aerobic options: rowing, "skiing," biking, "street striding." Oh, I guess I can also swim, but I'll put off that possibility for the time being. So it's now a matter of programming a nice mix of aerobic activity to go along with my lifting, which doesn't need to be modified much at all. I will probably avoid doubles and singles from now on, and stick with the SLDL, but otherwise, I'll keep the 5-8-3 weekly wave and six main lifts framework. Spraining my left thumb a little last week on a failed bench single is further reason to give up on the 1RMs. It's just not worth the injury risk, and there's probably not that much training benefit. Plus it keeps all three weekly workouts fairly uniform, efficient, and simple.

I'm sorry I can't comment more on the heart rate stuff. My eyes just glaze over. Back when I was a runner, I always felt I had good intuitions about what an aerobic pace was, what a tempo pace was, and what a good 100-yard interval pace was. Just doesn't seem that complicated. Same with cycling, it's always been obvious to me what gear is best for a sustainable pace. Plus none of the physiology stuff I've looked at, to the extent I understood it and can now remember it clearly, ever gave any credence to Maffetone's fat-burning theories or the importance of avoiding anaerobic exercise while you're building your base. A lot of stuff supports the basic idea of always training different intensities, as there is a lot of carryover. I've certainly found that to be true with my weekly rep-count wave. Really seems to speed up improvements. Unfortunately, I never ran consistently enough to put my weekly intervals-tempo-aerobic program into place long enough to judge results, but it seemed like a good idea.

My plan with cardio stuff now is probably to always maintain an aerobic level, mainly to avoid extra pressure on the knees. But I will seek out hills once in a while I think.

Sid · Jul 16, 2015

Abide said:
The MHR (roughly calculated

Check out the graph.
https://www.ntnu.edu/cerg/hrmax-info

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

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