A Sore Knee
Too much external load, too soon
A concept that can also be applied when we experience physical discomfort in our yoga movement practice
I recently watched a documentary called “Once is Enough”.
It’s a heart warming film about a comedian who picks up a trail running magazine while sitting in a hospital waiting room as his mother is dying of heart disease in her 50’s. What he reads inspires him to change his life and health outcome by training for and running an ultra marathon.
I got inspired from watching.
So I went out the next morning and more than doubled my typical mileage on hilly trails.
And it felt fine at the time, but….
My left knee was complaining by that evening. The kind of complaining that required a tylenol and my attention – stop running for a week but keep walking a lot, walk on less hilly surfaces, add in some corrective exercises specifically targeting the lateral hip muscles, check in with the function of my feet and ankles.
My left knee has a history of making noise during certain movements (going up stairs and standing up out of a squat) and I’d bet good money that imaging would show degenerative changes – probably some arthritis and cartilage changes under the patella.
This is very consistent with someone my age and definitely not a “sentence” to stop moving that knee, running on it, or catastrophizing it into something that will stop me from backpacking this summer.
The discomfort I felt after the run is likely a sign that I did too much too soon and my physiology wasn’t ready for that external load – meaning I added too much volume/mileage too quickly, especially in a hilly (think going downhill at a rapid pace) environment, for the left knee tissues to adapt.
Training volume is a metric I understand because, duh, I went to school to learn this kind of stuff.
A rule of thumb for increasing the volume (mileage) of running is to add 10% of the total miles run per week.
So, if I had been more thoughtful I might have added 1/3 of a mile or 2 -3 minutes to my normal runs that week, or added walk/run to build mileage, or run on a less hilly surface, or run more slowly.
These are all strategies to work on being prepared to do something new, different, or harder than usual – change the parameters slowly and consistently over time so that the tissues have time to adapt to the new loads in that particular movement task.
Let’s be clear… we DO want to ask our tissues to continue to adapt to new loads and novel movement, even as we age. Maybe more importantly as we age!
It’s part of staying strong, mobile, active, and having self efficacy – the confidence that we are capable of doing the things or most of the things that we really want to do.
And let’s also be clear…running is not a movement that is inherently dangerous.
In fact, almost no movement task is inherently dangerous, including most things we do on the mat in yoga.
Let’s repeat that… almost no movement task is inherently dangerous.
It’s more about how we approach these movement tasks, physically and emotionally.
Maybe we can begin to change the narrative about how moving in certain ways is bad or inherently dangerous.
Changing this narrative created a huge mind shift for me over the past few years – I’m letting go of my attachment to the story about being fearful of injuring myself.
It doesn’t mean that I’m sometimes not cautious, that I might not injure myself, or that I don’t have fear about moving in certain ways – crossing creeks on logs, jumping over things, falling off my bike.
It’s just that I practice being unattached to the story while making conscious choices about moving that serves me in the moment.
Sometimes that conscious choice is to push a little bit past my own comfort zone (physically, but more often than not emotionally) and sometimes the choice is to back off, do less, prepare more.
When we are sore, uncomfortable, or injured from a movement task like running, lifting weights, or any yoga pose, it’s usually a combination of
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performing an action we aren’t prepared to do
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doing it for a length of time we aren’t prepared for (endurance or number of reps/repeated actions of that task)
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and a load we aren’t ready to bear
It’s probably not the actual movement task itself that injures us or makes us feel discomfort.
And it isn’t that we can’t eventually build the necessary components for that skill, but we may need to approach that task differently (physically and emotionally) and allow time for adaptation (physically and emotionally).
My knee probably felt sore because I increased the external load for running too quickly and did it on hills (external load for running can be volume of miles, how hard the foot lands, where we run, speed, etc.)
If I want to run 4 – 5 miles on hilly trails I can slowly and consistently build the motor skills necessary, increase endurance, and the capacity for my tissues to adapt to what I’m asking them to do – even with my slightly wonky degenerative knee and my increasing age.
In addition to building small mileage increases over time, I probably need to increase strength and mobility to the ankle and hip and build in lateral activities to put the knee through different kinds of experiences than always moving me forward (think walking, hiking, running).
We can apply the same concepts to weight training. To build strength a person probably shouldn’t walk into the gym and try to deadlift 150 pounds if they’ve only ever prepared for lifting 40 pounds. But, hey, I truly believe in the concept of adaptation and most of us, through preparation, consistent practice, and slowly adding weight over time, could lift a much heavier bar than we think.
In terms of yoga asana practice, if we want to do longer asana sessions, hold poses longer, go “deeper” into the pose/shape, or “achieve” more advanced postures like arm balances, we need to prepare, work slowly and consistently through regular practice to build motor skill, strength, mobility, and proprioception to allow our tissues to adapt.
It’s not that running, the deadlift, or any yoga pose is inherently dangerous, it’s probably more about not being prepared to do the action, doing too much, and too soon (physically and emotionally)
Your tissues – bones, muscles, tendons, ligaments, fascia – are made to adapt to load. They will increase their tolerance to load. This is biology.
Importantly, it’s also how I “think” about what I’m doing and taking that into consideration.
So, the story we tell ourselves about it all really matters, but that’s a different blog post.
Although this blog post refers to running, it’s really about the fact that our bodies (and our minds) will adapt to the loads we impose on them, but sometimes we encounter what we might consider a “set back” because we’ve done something we aren’t quite prepared for and maybe too much of it too soon.
External loading is not a bad thing, in fact, it’s imperative for staying strong and functional as we age.
I think it’s crucial.
But we often fail to prepare, we do too much, and we do it too soon without a consistent build up over time and that helps cement the idea that what we’ve done is inherently dangerous in the first place.
We were built to move. Get out there and do what you love!
