by T.J. Murphy
As an older runner/triathlete/guy, long ago I quietly considered the limited function of my right knee as a given. This goes back to when I was 16, playing fullback on our sophomore football team at an away game. I was carrying the ball in an off-tackle play when I got smashed into by two defensive players, one twisting my upper body one way and the other wrapped around my legs and twisting the other. That’s the extent of the memory, along with a sharp pain and knowing something had given. Later on it had been identified as newly-shredded meniscus. An arthroscope didn’t do the job. They had to open it up and cut it out. This was 1978 I think.
I recovered and rehabbed well enough to play more high school football. What was pleasantly surprising was how in later years, my 20s, I was able to get into racing in triathlons, marathons and road races. Later on even track. And in my thirties I raced five Ironmans. I was getting in as much as I can I guess. It was my understanding that the knee would ultimately get the best of me in the form of arthritic pain and I’d have to leave it behind.
So in my 40s, when limited range of motion in the right knee was coupled with a loss of power in the push-off of my right leg when running, I tried to counter it with weight training stuff and flexibility work, to no real improvement.
What it felt like was this: Each time my foot struck the ground, there was a slight wincing recoil. An reflexive, protective action. I could run less and less and was injured more and more. Shoes couldn’t solve the problem. This led to a CrossFit Endurance-style intervention, where I came to appreciate the visionary thinking of Brian MacKenzie. It truly blew my mind in terms of how much athletic capacity was restored so quickly. (I wrote about this in the book, Inside the Box.)
But the right leg has continued to lag behind my left leg. Even though I rebuilt a lot of strength and power throughout my physiology via high-intensity functional fitness training and mobility work, under high loads and when running fast or long my right knee would fatigue and behave like a dead spring.
My left leg compensated. Or tried to. Last fall, I ran in a half-marathon. It wasn’t good. I finished but felt like I was just doing damage. In a post-mortem of the race, I acknowledged that whether it was arthritis or atrophy or both, my right leg was operating at what I subjectively perceived to be about 60% of what my left leg was doing.
I’m in my early 50s now. It’s a time when at least some of the hobbled who have been at it for decades start thinking, well, maybe I’ve competed in my last endurance event that involves running. In my stubborn youth, I would have just wrapped it up and tried to run through it all. But it’s become abundantly clear that such a temporary and risky solution has costs.
But some things started to open my mind to new possibilities. Revisiting the core principles taught by Ready To Run physical therapist Dr. Kelly Starrett were the start. One of Starrett’s messages is that if what you’re doing to solve a problem isn’t working, the answer is not shrugging your shoulders and giving up on it. The answer is to dig deeper. My preference is to dig in places that are nowhere near an orthopedic surgeon. Perhaps that’s a resort, but I’ll practice the Dr. Tim Noakes, MD, principle of Avoid the Knife if at all possible.
This led to a visit to Acumobility clinic not far from where I now live in the Boston area. Coincidentally, Acumobility is now an official partner of the Spartan obstacle course racing series. (I’ll explain the coincidence shortly).
Acumobility’s Brad Cox told me that I can absolutely solve this problem using a unique combination of mobility exercises and deep trigger point work. He gave me several routines to help exorcise the demon responsible.
Discussions with Brad about how to attack this kind of old-injury/mobility/power-loss problem led me to reading what I could find on neuroplasticity and injury. I came across the work of Dustin Grooms, a PHD who had focused his studies and research on a new idea that synced with what Starrett and Cox practiced: Rather than thinking of just joint and the tissues of the joint, think of the problem as both a tissue problem and a brain problem. (“We are a system of systems,” Starrett has said.) The reason my knee is shaky and weak is that muscles aren’t being fired to stabilize and power the joint. The brain isn’t sending the signals needed. Conversations with Grooms led to a story on how he’s finding success in approaching rehab by testing ways to restore recruitment of these muscles to full or close to full capacity. (He started on his path by witnessing the limitations of traditional PT work being used with famed quarterback Carson Palmer).
In the past month, I’ve been using these ideas, along with advice from a leading CrossFit Endurance/Obstacle Course coach and thinker, Rich Borgatti, to focus almost exclusively on work to restore function of the knee. Talking with Rich after finishing an on-ramp series at his gym, Mountain Strength CrossFit, in the metro Boston area, he was fully confident that I could not only restore my knee and leg into a more powerful state of capacity, but that I could train for a Spartan Sprint race in November. For me, completing an obstacle course race fully-powered and pain free would be a great place to start a return to triathlon racing in 2018 (I’m thinking Escape from Alcatraz).
I moved the needle in June in a way that I haven’t been able to. Ever. The change is evident even when I’m walking up and down steps. I’m using my right leg in a more complete and balanced way. I’ve also noticed that my right knee is stabilizing in situations where it felt wobbly and like it could collapse.
I see hope.
I have developed a new approach using as much tech as I can get my hands on. The payoff being a return to competitive athletics. (And more importantly being able to run around with our kids).
Here’s the toolbox I’m putting to use and why:
Mobility equipment. I have lots of stuff, but to do the exercises Brad Cox prescribed for me (they don’t take long but they are mighty uncomfortable. He has told me that they’ll get easier) I’m using the Eclipse Roller and mobility balls.
Halo Neuro. Ultimately, what Dustin Grooms told me was that the key issue when it comes to these lingering joint/power-loss issues is that it’s a neuroplasticity problem. I brought this up to in a recent LAVA podcast with Tim O’Donnell and Halo Neuro CEO Daniel Chao. I asked Chao if he thought Halo Neuro tech could support the objective of re-igniting dormant motor patterns. He thought it was a solid fit. So before mobility and strength sessions I’m using Halo Neuro to warm up the learning center in the brain.
Marc Pro Plus. The Marc Pro Plus has two primary functions: The low-intensity electrical muscle stimulation that is ideal for post-workout tissue recovery (blood and lymph circulation) and the high-intensity setting that is good for joint soreness. Each night I spend some time doing both: recovery the muscles in the hips, thighs, lower back and the high-intensity on the knee to reduce soreness from the heavy work load.
As far as the rehab/training work itself, I’ll detail that in a later post. I have certain constrictions that force a bit of creativity. Namely we have a 3-year-old boy and a 4-month old girl. Right now parenting tends to officially start at 5am with our son, who is ready to roll. And our baby girl—well, she’s a total sweetie, but has a schedule all of her own that she likes to spring on us in the moment.
When I can, I go to Mountain Strength CrossFit for a mobility/strength/metabolic conditioning workout. If I can’t get to class, I do a bodyweight version in a local park on my way to make daycare pickups.
At night, when the kids are in bed, is when the focused work begins. I’m calling it the Hour of Power. Halo Neuro, Acumobility work, MobilityWOD work and following it with a Marc Pro session
The question I’m curious to answer: How much capacity can I recover in my right knee?
Only with a 90% or better functioning right knee is a return to competitive running/triathlon a wise choice. So that’s the motivating force.