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I'm new to running. I'm 48 years old and never ran before in my life. I did C25K this winter and started running 5K runs (by myself) on March of this year. From March 8th to April 5th, I did 5K runs (on my own) 8 times with no problems.
Then, on April 14th, while running, my knee stiffened around 2 miles in after a mistep and I had to run/limp all the way home. Since April 14th, I have tried running a 5K five times and always have the same result. About 2 miles in, the knee goes and then I have to limp the rest of the way. (Note, the 2 mile mark on my route does have a incline to it.)
Afterwards, the knee hurts like heck and going down stairs is extremely painful. However, within time, the knee gets better, and days afterwards, I have no problems at all. When free of the pain after running, I can exercise (like squat) and walk with no problems. When I walk a 5K, I have no problems.
I went to an orthopedist and he did x-rays. He said that my knees are in great shape. No arthritis. No calcium deposits. No tears. He just suggested rest. But, when I rested for two weeks and tried to run again, the pain came back.
I went to a running store and they did a test on me. They said that I overpronate on the left leg - and it's just the left knee that bothers me - and sold me custom FootBalance insoles and special running shoes. But, when I ran with them, my knee still killed me...same old story.
Note, I am not heavy. I am 5' 10" tall and weight 170 pounds.
Am I just doomed here? I quickly learned to love running and hate to think that I will never be able to run pain-free. It does seem strange that I never had a problem before that day on Aprl 14th.
Is it possible that I have a tibial bone bruise or a meniscus tear? I'm still trying to get an MRI to figure that out. (Long insurance story there that I will not bore you with.) Or, is it just runner's knee and RICE is the only way to try and keep the pain down?
Take a look at this short article Knee pain: Treatment base on individual evidence. What evidence did the did the shoe sales person provide you that you pronate excessively on the left? If you pronate more on the left the cause of the excessive pronation could be in the foot. However there are many other causes of excessive pronation such as weak hip muscles. There are other treatments for excessive pronation beside shoes and shoe inserts. Take a look at short article Pronation. An important clue is that you have knee pain only on one side. Take a look at short article Symmetry - Asymmetry: Problem Solving Repetitive Use Injuries.
Damien Howell PT, DPT, OCS - www.damienhowellpt.com
Damien - thanks for all this information!
The shoe store was Road Runner. They have that Shoe Dog system where they took video of me running barefoot on a treadmill and then slowed down the replay to show me where I was overpronating.
The strangest thing for me in all this is the fact that I was able to run (a personal) 5K eight times in a span of 4 weeks with no pain. And, then, when running on April 14th, I had pain and have had pain on every attempt since then - always around the 2 mile mark of the 3.1 miles. And, yet, the ortho said, after the x-ray, that my knees look great.
Why was I having no pain in the past and now have it all the time? Again, seems strange unless I had an injury and the doctor just missed it? FWIW, he is supposed to be one of the best in our area.
Apparently the Orthopedic Surgeon used radiographs to say the knee is normal. Radiographs visualize bones, they do not visualize "soft tissue". It is likely there is some soft tissue about the knee which is injured. However knowing the specific tissue that is injured is not as important as knowing the consistent pattern of movement which is associated with the pain. Take a look at this short article Diagnosis of Repetitive Use Injury. This article discusses use of diagnostic imaging, and identifying consistient patterns of movement which are associated with repetitive use injury. Apparently the shoe store sales person found that you pronate more on the injured side. Now the question is why do you pronate more on one side of the body. Excessive pronation can be related to alignment/weakness of the foot, but it can also be related to alignment/weakness at the hip joint. Excessive pronation can be related to alignment/weakness at both the foot and hip. Perhaps a smart Physical Therapist can help you clarify your diagnosis and treatment. Go to Find a Physical Therapist. It does seem the Orthopedic Surgeon has "missed it". Take a look at short article short article Who you going to call: Choosing a Healthcare Professional. This article discusses choosing a surgeon to manage a repetitive use injury may not be the best choice.
Damien Howell PT, DPT, OCS - www.damienhowellpt.com
Damien - thanks for the follow-up information!
Not really a response to the original question, but a similar question. I do have considerable osteoarthritis in both knees. I have variable pain - hurts more to walk down stairs than up, and also seems to be worse on wet days. My rheumatologist (who is following me for a different condition) told me I should not do exercises that put too much stress on the knees, such as squats and lunges. I didn't ask her about running, though. After a number of years without doing running, I'm interested in getting back into it. Any feelings about how running affects osteoarthritis in the knees?
munchko take a look at Osteoarthritis - Cartilage and Exercise. This article discusses the frustrating nature of cartilage and its relatively poor response to exercise. Also take a look at Knee Arthritis and Muscle Strength - The Truth is Gray. Hopefully these short articles will provide some direction on struggling with documented osteoarthritis in the knee and running.
Damien HOwell PT, DPT, OCS - www.damienhowellpt.com
It's true that x-rays don't show everything that is going on in your knee, but a doctor as good as yours is can infer a lot from an exam and x-ray image without actually having to see it. There is a small chance they could have missed something when they looked at your knee, but there is hardly any chance at all they would miss something major enough to cause that much pain, if it was actually coming from your knee joint. Knee pain is the most frequent complaint of runners, yet the majority of knee pain sufferers I have worked with have clean x-rays and MRIs. Clearly, there is another possible cause. Doomed? I'll bet there are a lot of seasoned runners out there who wish they had your knees!
One important thing that top athletes often learn, is the big difference between having knee pain and having a knee problem. As Damien suggested, many knee pains are caused by something outside the knee. In fact, many doctors believe that most knee pain is caused outside the knee, but with malpractice insurance rates as high as they are, doctors are compelled to spend your time and insurance money checking for the most serious possibilities, so you won't sue them for missing anything. It's also what we expect them to do. I am very lucky that my job only involves checking for probable causes after doctors have ruled out the others, so I'll try to be your virtual assistant today. Based on what I see time and time again, your intermittent knee pain is most likely caused by one or more muscles, whose involvement with knee pain is well documented.
It looks like you managed to make it into your late forties without this problem, until you were recently bit by the running bug. I started competing in 5ks when I was about your age, and encountered lots of pains within my first few years as my body adapted to the sport. Many years later, I experience a lot less pain from running, now that I am in my late fifties. I hope that encourages you to continue on, as long as your doctors say you are healthy enough to run.
One thing that probably helped me in the early days, is that I did not start out my running career by hitting the pavement cold-turkey. After patiently listening to well-meaning advice that running was going to ruin my knees, I purchased a small mini-trampoline and began to jog in place on it for several minutes a day, working up to about a half-hour per session. I held on to a counter top nearby for stability, so I suppose you could compare the strategy to what they now call a "rebounder," which is a mini-trampoline with bars to hold onto. The idea was to condition my knees for impact before hitting the road.
Since I was on my feet most of the time anyway, a month or so of this activity gave me the confidence to test running on the pavement. I started with miles, not 5ks. My first and second mile attempts took me over 12.5 minutes to complete, and were much harder than jogging in place. I called my folks back home to say my goodbyes, just in case this activity would kill me, because it sure felt like it would. Over the months I was able to get into the 8s, and set my goals for a 7, which I eventually did, after running slower at longer distances, including the 5k.
I too would encounter knee pains along the way, sometimes limping through entire races. While that was a dumb thing to do, I eventually mended and continued my quest for a six minute mile. By the time I broke that mark a few times I had experienced a few more aches and pains, but it is most likely that all of these were related to running too fast or too far. Still, I was becoming stronger. Goals make us try very hard, and our failure to reach them can still result in beneficial adaptations, along with a lot of pain. I think that after trying several times to go beyond 2 miles without pain, you will succeed, but there are a few things I have learned along the way that I would like to share with you, about how these pains are often caused and how to handle them easily, so you can continue to train safely. Running hurt can make you run sloppy, and running sloppy can result in the kinds of real injuries you fear.
If I understand your post correctly, you have been running a lot of 5ks, either in training or competition, within a very short period of time. If you push your running muscles hard enough, you can cause enough minor damage to result in a major change in how a muscle, or group of muscles, functions - without actually tearing it, or causing any other visible damage. You may even force a change in how a small portion of a muscle contracts, which is enough to create a big difference in how it acts on a joint. The most important point I want to make, is that your brain can do a super job of making you FEEL pain in an area that may eventually suffer damage you CAN see, if you ignore or suppress the pain. This miracle can occur long before there is any real risk to your knee joint, so it is good that you are asking questions now, rather than toughing it out until it is too late to avoid surgery.
You mentioned a misstep. Did you slip on something, or were your muscles tired? While there may be a link between that incident and your pain, there may be no direct connection. Sore muscles can stop working properly without a misstep, after becoming vunerable for some other reason. When RRS critiqued your slo-mo video, did they note what kind of over-pronation they were talking about? A physical therapist like Damien can tell you a lot more about your body mechanics after viewing a slo-mo video. The hip muscles he mentioned can rotate your leg into a position that is not favorable for preventing excess motion of the foot, more stress on your knee, and tiring of the muscles that stabilize it.
Chances are very good that the over-pronation has taken a toll on some of your muscles, but the pain in your knee may not be directly related to that either. In my case, the knee that bothered me most was on my stronger leg. One thing I found out about that leg, but was in denial about for years, is that it appears to be a bit longer than my other leg. There are many reasons why this could be, but it turns out that most people's legs appear to be unequal in length, which may be why they tend to hurt a little more on one side than the other.
Another reason for one-sided injuries that runners frequently encounter, is the fact that most of the roads we run on are not perfectly level. If they were, rain water would pool up on them. Even if your legs were perfectly even, running on that slanted surface can produce the same results as a longer leg. The leg on the upward side (or the effectively longer leg) has to make some adaptations to avoid dragging the toe. This may involve some lateral movement and/or rotation of the leg that stresses the knee during this movement, and after impact when it has more work to do, before the knee is in its strongest position. The leg on the down side (or shorter leg) may have to lift a little further to keep you level, stressing the Achilles tendon more, which is what happened in my case.
What I decided to do, after years of experimentation with knee braces, ice packs, arch supports, and orthotics, was to settle on a minimalist fix to correct the leg length discrepancy. A thin, flat, tough gel sole in the shorter side equalized things to the point that I didn't have unequal injuries any more, since both of my legs now had exactly the same job to do, with no unequal work on either side. While all this helped to eliminate the cause, it was not the only thing I had to do to address the symptoms.
When a muscle, or a small portion of it - even a group of muscles - is compromised, they rarely forget this insult easily. Even if a runner takes a couple weeks off, as in your case, returning to the pavement often produces the same results, as if there had been no rest at all. This concept is what keeps therapists busy, that we have to train and condition our muscles to "learn" how to act. Once "they" learn something wrong (a lot of these adaptations are in the brain, not the muscle), that behavior has to be unlearned. The trick I have learned over the years is how to erase that muscle memory in order to allow it to function normally. In effect, you can "reset" the relationship between a muscle and the brain that controls its tension, and it's not hard to do.
Before you attack your muscles willy-nilly, it's a good idea to figure out which muscles may be causing the pain that feels like it is coming from your knee. First, you have to be specific about which part of your knee hurts, because at any given time, one or more of a dozen muscles may be directly controlling your knee pain. Fortunately for us, this happens in well researched, predictable patterns. Most of the visual therapeutic materials for mapping these pain patterns is copyrighted and can't be shown directly here, but I will do my best to discuss it in my own words so you can reap the benefits. Rest assured, I've paid big bucks for this knowledge!
Open this link as a visual aid, and you can press backspace or click the back/forward arrows in the upper left on your (PC compatible) keyboard and/or browser to flip back and forth between the images and this post... http://www.getbodysmart.com/ap/muscularsystem/legmuscles/menu/menu.html If you can bookmark it and open it up in a separate window, you can alt-tab to flip back and forth between this text and the visual aid link.
Some of the top muscular producers of back-of-knee pain are the upper fibers of the bulging upper calf muscle Gastrocnemius. It is special in that it controls both knee and ankle flexion, but performs most of these tasks most effectively when the knee is locked, because its reach spans both joints. When you are running, it helps initiate the upward movement of your heel as you leg moves rearward, after which it runs out of leverage. It performs a lot more work while standing or climbing, to lock the knee and keep you from falling forward (as when going down stairs). A tiny muscle that assists these actions (Plantaris) is located right in the back of the knee itself. Both muscles can produce knee pain where they are and farther down, the lower fibers of the Gastroc often producing pain all the way down in the the arch of the foot (one of the primary causes of arch pain). Another small muscle in the back of the knee, the Popliteus, goes from the rear of your Tibia to the outside bottom of your Femur. This strange arrangement is necessary to slightly rotate the knee joint and unlock it, after standing with knees straight. Sudden twisting movements can irritate it. You can see how this muscle's function allows the other two to flex the knee by unlocking the knee, and the "firing order" of these muscles changes, depending on what you are trying to do.
Another back-of-knee pain culprit is the powerful outer hamstring (Biceps Femoris), which would also be involved with rotating the leg outward, as many do during pronation. Unfortunately, many of us sit on it all day, which keeps it in a shortened state and starved for blood flow. All of the muscles I have mentioned so far can produce back-of-knee pain when you stand straight and lock the knee, because even though none of them perform this function, they are stretched to the max when you do. This is one of the true tests of whether or not they are sore. Gastroc and Plantaris are further stretched when you stand on your heels with toes up, knee locked.
Outer knee pain is often due to problems with the outer Quad (Vastus Lateralis), and running can really make this muscle painfully dysfunctional, without actually damaging it at all. Lots of people confuse pain in this muscle with ITB (Iliotibial Band) syndrome, since the ITB runs over top of it and attaches in a spot where this muscle often hurts most. When people think they are foam-rolling ITBS, the V. Lateralis is getting a treat underneath, and often is the reason the pain goes away. The ITB, which is blamed for many runners' knee pains, is actually best addressed by relaxing the Glutes and pelvic hip flexor/abductor Tensor Fasciae Latae, which is not the latest Starbucks sensation, but a narrow muscle on the front of the pelvis whose primary purpose is to keep the ITB tight, because a loose ITB is worthless. On the other hand, the inability of Gluteal and TFL muscles to relax can produce 24-hour pressure on the side of the knee, resulting in compromised tissue at that sight. The description of your symptoms, with knee pain after two miles, might point to TFL problems if you had been running for many years. I dont think that a few months of 5ks are enough insult to cause that much dysfunction in your ITB system, but it could hammer the sensitive outer Quad and the calf muscles (mentioned above) in very little time, because they are not used to this new kind of stress.
Front of knee pain that is not coming from the joint itself, is usually from your inner quad, the Vastis Medialis, which is known for creating the sensation that your knee is going to give out. Sometimes it actually does, though the apparent muscular weakness does not necessariy mean the muscle is actually weak, or has a neurological problem. It's usually because your brain will refuse to use it when it becomes sensitive from overtraining or other causes, and the lack of support can lead to a lot of falls. It doesn't take much to affect it in this way, but it is easy to fix.
Another quad muscle is the only one that spans both the hip and knee joints. Called the Rectus Femoris, it is on top of the others and runs straight up and down the top center of your thigh. The upper fibers can produce deep knee pain and discomfort that actually feels like debris under your kneecap. When people report these symptoms and scans come up empty, these upper fibers need to be checked and disarmed. The lower fibers can produce an aching pain above the knee. While this muscle does not have the disabling effect of the V. Medialis, there is nothing to exclude any number of these muscles from going down in a domino effect, multiplying your symptoms and probable solutions. Symptoms of "runner's knee" are often little more than bum Quads, but they can cause real knee damage if left to themselves.
Sometimes a slip or fall that spreads your legs can strain your Adductor muscles, which include Adductor Longus and Brevis. These are located up your inner thigh, but can send pain to the front of your knee, as well as to your groin. The Adductors also function as hip flexors, so your running can tire them until a simple misstep can finish them off. Once again, a muscle can become painful and dysfunctional without any actual damage being done. People may want to see actual physical damage or swelling when they feel pain, but most pain is invisible. Imagine how many cars would be on the road if the idiot lights came on after the damage was done. The early warning system in your body is even smarter than the one in your car.
Inner knee pain
This one can involve some of the muscles we have alreay covered. Two of the Quads, Vastus Medialis and Rectus Femoris, can be responsible for pain here, and though their health is important, there are other support muscles that can produce serious inner knee pain. Adductor Longus, which we covered above, can also be involved. Two long, skinny muscles that start on the inner knee, but run over and above the other muscles mentioned, like a couple of ropes, one to the outer hip (Sartorius), and one to the pubic bone (Gracilis), function as secondary hip flexors, but also abduct and adduct (respectively) your thigh at the hip. Both of them can shoot pain into the inner knee under stress, though they both tend to exhibit that pain along their length, which is the giveaway. Lots of people think they have medial meniscus problems, but wind up finding problems in some of these muscles. A clean scan is your cue.
Sartorius can be set off by a twisting slip or fall, or by hip flexor stretches. It can hurt while standing and feel better when sitting down, when it is relaxed.
Gracilis pain can be very persistent regardless of position, but can we walked out. Because it rides over the Adductors, it can become problematic when the other Adductors are in trouble, even if there was no trauma to the muscle itself. Muscles are often very sociable with each other, working in groups and backing up each others' problems in a pain-fest of sympathy strikes. Viewing these body parts as systems can save a lot of time over considering them separately.
Now that we have looked at a number of potential victims of whatever cause led to your pain, I will show you how I fix them so you can begin healing and continue training. Except in extreme cases, we are mostly made up of muscles, some of which are quiet and faithful servants like the heart, and some of which are quite sensitive, complaining at the slightest provocation. Most of the muscles you use to run are sturdy and pain free, but susceptible to overload and overuse. When the muscle, via its many nerves and specialized neurons, sends suspicious patterns of sensation back to the brain, it can result in a guarding reflex that tightens the muscle and makes it less useful. Even well-conditioned muscle can become exhausted to the point of failure to function, which is why our mightiest athletes often collapse in a heap. An elite marathoner may be forced to train easy for months after a win, but for most of us, the simple stresses of daily living, or moderate exercise, can cause similar dysfunction. As with our sports heroes, it is a mistake to assume that these muscles are not well trained just because they do not always work when we want them to. All muscles need recovery time, but just taking a break does not necessarily equal rest and recovery.
Unlike our brains, there are a number of muscles that do not get to rest and recover every night. The heart is a perfect example of this, but there are other muscles in the body we use to position ourselves for work, or hold posture, even while we are sleeping or sitting watching TV. If that weren't enough, our muscles are the main source of our body temperature, which is almost always higher than the surrounding air. They have to work to produce this heat. It's not unusual to wake from a long sleep even more sore than you were before, and we can never assume that our muscles are relaxing along with the rest of us. They may not complain all the time, but they may when we try to use them for a demanding task, like the sudden urge to run 5ks. It takes energy to move a single meter, but 5,000 of them in a row is an incredible amount of work. Sure, we feel great afterwards, and want to do it again, but that does not mean our muscles are not in need of a major va-cay. There is a lot of damage at the cellular level you cannot always feel, and it takes more than time to fix. The most important thing to know is that simple rest is not always the rest you need.
If you were to look at your recovering muscle cells under a microscope after vigorous exercise, and contrast them with what you might find in a world champion marathoner, you would see a difference in how these two types of muscles react to training. Depending on how fit you are, you would see varying degrees of smearing of muscle cells, as they rupture and are broken down to be reabsorbed into the blood stream. The longer you have been sedentary, the more of this reconstruction will result from even a modest amount of training, as your weaker, more economy-minded muscle cells are destroyed and replaced by stronger, hungrier ones. However, anyone at any level of fitness can have this process going on at any time. The fitter you become, the more abuse it will take to push your muscle to the point it locks up (or fails to function) and forces you to let the reconstruction take place. Two important messages I want you to take away from this are (1) the muscle does not need to be locked up to heal (it may even slow the process), and (2) it may remain locked up indefinitely until you unlock it with the proper therapy. Just resting, stretching, or exercising are not enough.
If you are like most of us in this forum, you are somewhere between the two extremes of fitness. Only the ones at the top of their game are going to be able to go out and run some easy 100 mile weeks to loosen up. The rest of us would be destroyed by that, so one man's meat is another's poison when it comes to exercise. You've got to start at point "A" and work through the entire alphabet of fitness to get to point "Z" without causing serious damage to yourself. Yes, there are a few examples of people who have gotten off the couch and run sub-3 marathons, but they have to have already been exceptionally fit for some reason, genetic or otherwise. In our species, we all start with muscle tissue that is mostly the same. The man who most recently held the world record for the marathon used to run 10k to school and back when he was a kid, and he is still an awful overpronator. His muscles are so strong he can do all kinds of crazy stuff and survive it. Bill Rodgers had a really short left leg, but back-to-back Boston championships. I, on the other hand, needed a small thin gel pad in my shoe to balance me out enough to even qualify for Boston as an old man. It doesn't mean we aren't capable of great feats of endurance, but that we will have to take a little more care of ourselves than that guy over there stretching his leg onto the roof of his car.
Let's go to work... If you have reviewed and researched the muscles I have discussed, we can start trying to fix them so they will become less painful first, more mobile second, more relaxed around the clock third, and eventually, healed and strong, ready for more aggressive training. If you go back to the home menu on that muscle tutorial I linked, you can check out the section on how mucles actually contract, which I will not re-create here. Most of the information you need to know to take proper care of your body is spread all over the place, and rarely all in one place. As always, they charge money for the good stuff. I will do my best to sum it up for you. First, an overview of the complete picture.
Muscles are referred to by names that give us a roadmap for locating them individually, but they are sometimes interwoven in ways that combine function, as in the Quads. Within these muscle organs are sometimes multiple bellies, different motor nerves, and sections of fibers that have slightly different functions and can produce different types of pain. Some spots in these muscles may feel painful to the touch, others only when pressed, and others may display pain in another part of the body when we press them or they are tight. There are many cases when there is no pain, but dysfunction, and cases when there is pain, but no dysfunction in a given area. Troubleshooting muscles can be like a walk through a House of Mirrors, but there is a certain logic to it if you have the patience to learn. Most healthcare professionals do not have the time to commit all of this minutia to memory. The only reason I have the time to go on like this, is it's the only part of healthcare I really have to concern myself with. What keeps me sane is that the application is thankfully, very broad.
There is a tremendous variety of symptoms that muscle tissue can display when it is not working right. I believe you are encountering one or more of these symptoms, even if there is something wrong that is out of my scope of practice. Painless structural flaws and painful myofascial pain often run concurrently, which can be quite misleading. In most cases, muscle pain (myofascial pain) involves a very small part of a muscle or the fascia that surrounds it. A small area is all it takes to disrupt normal operation of the entire muscle and cause it to stiffen or to contract weakly. You can find these spots by scanning your muscles for tight fibers. I usually check mine with my fingers and a little soap and water in the shower. It helps to better define what is lurking under the skin. You'll get better at this with experience, but starting now will equip you to deal with other "injuries" you will encounter as you continue your running.
Myofascial pain usually involves one or more areas in a muscles fiber(s) that contract involuntarily into a mass that may feel like a rubbery lump of varying size, sometimes shifting location or changing its tension as you press on it. These spots are sometimes warm to the touch, and exhibit increased electrical activity when measured by equipment for the purpose. They are easy enough to find that nobody really needs to put a scope on you to find them, although there have been some advanced imaging systems developed for the purpose. Such equipment would be more widely available if an interview and fingers weren't so much cheaper. While areas of contorted tissue will usually stand out a bit and feel sensitive to the touch, they will often "refer" their pain to the end of the muscle or beyond, depending on how the nerves are wired and the brain interprets them. Most pain patterns are common, repeatable, and due to the same portions of muscle being in spasm. You can usually take a given set of symptoms to the bank, as being caused a certain way.
Working on these spots does not involve much more than that. You simply need to find them, apply varying degrees of pressure depending on sensitivity, and hold that pressure long enough for the tight fibers to "melt" under your fingers. Sometimes a little circular movement helps, and sometimes static pressure is less irritating. Sometimes the order in which you address each area matters. You get better with practice, and often have to repeat these actions enough times to get plenty of that. Whether you need to repeat this, and the frequency of treatment, is often dependent on the length of time the syndrome has been present, its severity, how much subsequent rest from activity you are getting, and whether or not you can gently move the tissue to re-educate your brain about its potential for movement. Your brain has a lot to keep track of, and often allows such tissue to remain in a dysfunctional state until you bring it to your brain's attention, front and center. This means you must often confront a wee bit of pain, and sometimes a lot of it. I've had conditions that felt for all the world like a broken bone, and it is usually worst the first time you go in. A little patience soon tells the difference between a real injury and myofascial pain.
So, why is there such pain, and why might you feel it in your joints? There is a lot of settled science on the subject, but more to be learned about the exact chemistry and neurological component. Much of the problem has to do with the breakdown of tissue that we discussed earlier, and the need to stimuate increased circulation and evacuation of waste product. Any time there is microtrauma to tissues that are served by blood or lymphatic flow, the cells of your immune system are attracted to the area to begin the process of reconstruction. Unfortunately, the original pain and dysfunction is not enough to bring this action about. Part of the problem may be physical, in that there was possibly a small blockage that lead to the dysfunction in the first place, and we essentially "break" this up. There may also be the neuromuscular component, in which the brain's perception of sensation results in altering motor nerve activity. Part of the solution is without question psychological, since an intervention is being made. It is a well established fact that people are capable of psyching themselves into muscular dysfunction, and the further pain and damage it may cause. In this case, making something feel better accomplishes more than it would seem.
One thing is for sure: when muscle loses abnormal tension in any or all of its fibers, it rests better. The time off that you take, then accomplishes something. You sleep better, with the satisfaction that something has been changed. Your hands were in that tissue just as surely as if a scalpel had been used, without the great potential for damage more invasive procedures entail. While the fix is not always instantaneous, it often is. I have seen huge improvements in tone, function, and perceived pain within a few seconds. Most of the time, it is an ongoing process, as is the stress that leads to dysfunction in the first place. In my view, it is an ongoing reality, and required skill, of the athletic lifestyle.
Doctors take a Hippocratic oath to "do no harm." That means, if push comes to shove, they will usually advise you in such a way that you will not be encouraged to harm yourself. If a physician looks at a set of symptoms and follows a differential diagnosis, myofascial pain may be down the list of potential severity. It almost always is. The reason is obviously what can happen if they make the wrong call, and you go out and break your leg. Give them credit for scaring you away from that possibility sometimes. There could still be a problem caused by impingement of spinal nerves, and that can be teased out by working with a physical therapist. Based on the progression you report, the symptoms would have been likely to occur during other activities, if that were the case. Nerve-related pains can be brought on by activity, but activity is not necessary needed to bring on false nerve generated pains. Movement-only related activity is usually muscular in origin, but can still involve pressure on nerves. If you still have fears of structural flaws, an ultrasound image may be cheaper than an MRI, and there are dye-injected tests that reveal more detail if required.
The reason why your doc is so good, is that he has acheived enough comfort with his material that he does not need to do this as much, and has the integrity to avoid pumping your insurance money. If he tells you there is no medical problem, and that it will eventually go away on its own, he is probably right. What I have covered here, is the gap between an acute medical condition that requires aggressive treatment, and one that can be taken care of at home. Though thousands of pages of medical literature have been written on the subject, it usually does not meet the test of urgency required for acute care, and you often cannot get insurance to cover treatment without a special addendum to your policy. This bothers me enough that I spend a lot of time trying to teach people how to handle it themselves. I was once where you are now, but thanks to patience and a lot of research, not any more. It didn't take me all day to write this, and I still have time to enjoy the 15-miler I had planned for today. I'm sure you'll be able to do the same someday. I know this is a lot to cover on a Sunday afternoon. but I'm sure you'll do fine.
Thanks for the informative articles. It's pretty clear that there are no clear answers. My understanding is that the propensity to develop osteoarthritis also has a substantial genetic component. For now, the pain I experience is pretty sporadic, although my knee joints are pretty noisy when doing movements like extensions. Although I haven't been running on a regular basis for a number of years, I do tap dance on average 4 days/week, which also gives the knees a bit of a pounding. I haven't been able to see a clear correlation between activity level and knee pain.
JamesJohnsonLMT - thanks for all your input on this matter! You've put a lot of time into your response and it is greatly appreciated! I'm going to read it all over and will let you know if I have any questions.
For what it's worth, yesterday I tried a new running route. Instead of taking local sidewalks and streets, I went to a park with a blacktop, flat, track. And, before going, in addition to stretching my quads, hamstrings and achillies, I did some "IT" stretching and used a rolling pin (since I don't have a foam roller).
Starting out, I felt great. I was starting to think I found a miracle cure.
And, then, about 2 miles into the run, that usual bad news mark for me, the pain in my knee returned. However, this time, it was not as painful in the last. Therefore, I kept going, for a bit, stopping every quarter-mile or so to rub the "IT" a tad.
I could tell that it wasn't going to leave me. So, I decided to stop running about six-tenths of a mile short of doing a 5K. All told, I ran for about 23 minutes. It was a decent workout. I did get a nice sweat going. That was enough. I didn't want to push it. After all, I did just run three days earlier. I'm rather not have the pain again that I had on that Thursday, after running, and be able to try it again in a few days.
Maybe I just need to stick with this new track and "IT" focus for a while until I can get past that 2-mile knee pain mark?
My friend's wife is a PT and she said that I probably don't have an injury to my knee because I don't feel the pain when I start and the pain does go away the day (or so) after I run. She thinks it's something in my running that's making the knee hurt. Maybe it is ITBS?
I think your friend's wife (the PT) is right, and you will recover from this problem as soon as we find the trigger for your knee pain. Word in the PT community is that flat track running is much easier on ITB symptoms, if that's what you have.
If this pain is on the outside of the knee, don't fear. You are not likely to have classic ITBFS this early in your running, but it's not unusual to have similar symptoms in the area.
I used to have problems with my quads locking up in marathons, usually somewhere between 16 and 23 miles. I would have to stop, rub it out, and walk-run the rest of the way in. I don't have the problem anymore, even under those extreme conditions (I've run over 30 miles a few times), which is why I am confident you can overcome it too.
Rather than use a rolling pin (!), try this while sitting in the car: Reach down with the fingers of your left hand to your outer quad, all the way up to the back of the knee joint. You should feel the thick outer hamstring tendon on the very bottom. move up until that tendon is just below your fingertips, as you sink your fingers into this crevice between the quads and hams. Gripping the outer quad muscle firmly, lift it upward slightly while curling your fingers under the muscle. If you feel sensitivity in there, there's your problem.
Try that and get back to me. Meanwhile, there are many potential snags along the ITB route from the glutes and pelvis to the knee, many of which are felt at the knee, because that's where this power-train ends. Though you feel the pain there, where the tension begins is more important. Get yourself a tennis ball or something round and soft (no rolling pins, they're too hard and potentially damaging). Find a soft place to lay down like a couch, firm mattress, or a yoga pad on carpet.
Place the tennis ball under your glutes and roll your body gently over it until it reaches the upper pelvis in the rear. Take note of any sensitive spots you find, and spend a little more time loosening them up. A stretch before releasing a muscle can make it worse, but a stretch after releasing a muscle can make it better. Just keep the pressure from the ball moderate, and the stretches gentle. A series of slow 2-second stretches in a set are more therapeutic than one long stretch. This ain't yoga, it's rehab. Next, run that ball up from the outer knee to the front of the pelvis, just below that bony knob you feel when your hands are on your hips.
IMPORTANT When you work your legs with any kind of roller, ball, or massage device, make sure you glide from bottom to top ONLY. The veins and lymphatic vessels of your legs have one-way (semilunar) valves in them that do not like pressure going the wrong way. It can collapse them and cause CVI and varicose veins. Those valves are there to keep fluids from rushing toward your feet when you run, which is also something nobody wants.
In the image on the right, we see first the correct return of fluids, how they are prevented from returning, and what happens when they are damaged (many thanks to vasocare.net for the above images).
Many thanks to reachphysio.com for this brilliant image of the ITB in all its glory, and the important muscles that tension it (from left to right, Glute Max, Glute Medius, Tensor Fascia Latae). You can see the outer quad and outer hamstring underneath... Roll all those babies!
We will probably find that the overpronation could be a factor in your case. I found that the first metatarsal of my foot was a bit shorter than the second (see #8 in picture below, for exaggerated example), which turns out to be very common, but not optimum for distance running. I glued a small quarter-sized pad of thin gel material under the part of my insole where the ball of my foot goes. It seems to help with foot stability in a lot of people, and can minimize pronation and knee problems if your foot is like this. You have to line up the bones in cross-lighting to check if yours is like this, and it doesn't matter how long the toes are. It's where the ball of the foot is in relation to the bones next door that counts.
(thanks to drnelsonclinic.com for bone image)...
JamesJohnsonLMT - more great information! Thank you again. I am amazed by your kindness on this matter and the amount of detail that you are providing me. This is all very, very, appreciated. Yes, overpronation may be a factor in my case. I did the Road Runner Sports Shoe Dog thing and the video showed me overpronating a bit on the left side only. (Same side as the knee problem.) I'm hoping to have a MRI later this week - just to make sure the knee is sound. And, if that comes back clean, I then know it's ITBS or something else that I'm doing to myself. And, at that point, I'll look into some stability shoes and some custom insoles to try and help with the overpronation. I'm going to print out all your info and read it over tomorrow during breakfast. Thanks again for all this!
JamesJohnsonLMT - Thanks again for all your time and information! I read through it all this morning and it's super.
FYI, I did your sitting in the car test. But, I could not find a pain point. That's the thing - right now I have no pain.
My knee feels fine - maybe a tad sensitive - but, strong. And, it feels fine when I run - until I hit that "2 mile" mark. And, then, it hurts (if I push it) for the remainder of the day (where I walk with a limp and see stars if I walk down stairs) and maybe a little for the next day. But, then, I'm fine again - no pain, etc.
For what it's worth, here's my timeline since I first had the knee pain in April 14th:
April 14th – I hurt my knee while running. It happened about 2 miles into my 3.1 mile run. Knee goes stiff and I had to limp the last third of the 5K home. Knee hurts for a week or so.
April 30th – After resting my sore knee for about two weeks, I try and run again. And, it happens again. About two miles in, it starts killing me. The next day, I can barely walk without a limp. Going down stairs is a nightmare full of pain.
May 7th – I go to see an acupuncturist and she thinks I have a torn meniscus.
May 11th – After resting my knee for about 10 days, I try and run again. This time, I only get one mile into it and the knee starts to stiffen. So, I shut it down.
May 16th – I get a major thigh strain. Not sure how it happened. The side of my thigh, down by my knee, spasms like crazy. I cannot lift my left leg without terrible pain. Standing is very difficult unless I take the weight off my left leg. Pain is so bad I feel like Dr, Gregory House walking around with a limp because of the thigh paim.
May 17th – I go to see an orthopedist. He thinks it's a bone bruise and says not to run again until June 1st and to take celebrex for nine days.
May 21st – After days of intense leg pain – enough to keep me up at night – I go back to the acupuncturist. A few days after that, the thigh pain starts to get better. I had been using a heating pad with a massager on the leg and that seemed to help the quad.
May 24th – I'm not feeling anything bad with my knee or my quad, at all. Maybe the celebrex did the trick?
June 1st – I go for the test run. It's not good. Two miles into it, my knee gets stiff. I still end up running 3.1 miles. Later that night, it starts to get worse. It's very painful going down stairs.
June 2nd – My knee is killing me. I cannot walk without a limp. I don't even think about walking down stairs. I call the orthopedist and they want me to come in for an MRI to see if I have a tibial bone bruise or a meniscus tear.
June 3rd – I wake up and my knee feels fine. No pain at all. However, later that morning, when running up stairs, I twist my knee and the pain comes back again. Yet, later in the day, it goes away.
June 4th – I wake up and again my knee feels fine. I have a busy morning with no issues. It wasn't until later in the afternoon, when I am walking down a hill, that my knee starts to bother me again and causes me to limp. But, once I get down the hill, it passes and I'm OK for the rest of the day.
June 15th - I try and go for a 5K run again. Two miles into the run my knee started to hurt. And, then, I started to limp. It was so bad this time that I had to switch back and forth between running and walking for the last mile. I'd walk for 20 seconds, or so, to get the pain to lighten-up, then I would run again as long as I could before the pain came back, then I would walk again, etc.
June 22nd - Go to RRS and do the Foot Dog thing. Get custom inserts and stability shoes. June 23rd - Went for a 5K run with the new shoes and insoles. The pain in my left knee came back. It was enough for me to feel, and enough for me to wince every time I had to step up or down a curb. But, it was not enough to make me stop running. When I got home, my knee felt terrible. I could barely walk on it.
June 26th - I tried my new running route and "IT" stretching idea. Starting out, I felt great. I was starting to think I found a miracle cure. And, then, about 2 miles into the run, that usual bad news mark, the pain in my knee returned. However, this time, it was not as painful in the last. Therefore, I kept going, for a bit, stopping every quarter-mile or so to rub the "IT" a tad. I could tell that it wasn't going to leave me. So, I decided to stop running about six-tenths of a mile short of doing a 5K.
I'm hoping to get that MRI this week. It was scheduled for June 6th. But, the doctor's machine broke and I've been waiting on them to get the new one installed.
Update: On July 1st, I decided to try a 5K run. But, to maybe offset my potential ITBS, I decided to run my usual route backwards. No luck. I was fine for the first 13 minutes into it. And, then, my knee started to stiffen – just a tad. So, I kept running. However, 6 minutes after that, the pain got worse. Not wanting to push it, I ended the run with six rounds of "run a bit, walk a bit." Total time for the 3.1 miles was 30 minutes and 29 seconds. Later that night, after dinner, I was seeing stars walking downhill – my left knee was screaming. Further, it still hurt when I went to bed. (Also had major foot cramps – no idea what that was about?) But, the next day, I was fine. This has to be ITBS, right?
Got a pair of stability plus running shoes, some custom insoles, and a foam roller and it's now fine. Last two 5Ks runs had no knee pain. Must of been ITBS and I just needed the right shoes, etc.
ACTIVE is the leader in online event registrations from 5k running races and marathons to softball leagues and local events. ACTIVE also makes it easy to learn and prepare for all the things you love to do with expert resources, training plans and fitness calculators.


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STOCKTON - An armed man stole a dartboard from a business in the 7500 block of Pacific Avenue about 6:15 p.m. Friday, police said.
Witnesses said the man entered the business and asked for a specific item. As an employee walked to the back of the store to retrieve the item, the thief grabbed a dartboard and headed for the exit.
The employee yelled for two coworkers to stop the man, but he escaped after brandishing what appeared to be a gun, authorities said.
The thief was described as a Latino male in his 20s, 5 feet 6 inches tall and 170 pounds, police said. He was wearing black jeans, a white shirt and a black Echo jacket, authorities said.
Location, ST | website.com

subset: commoncrawl


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Teachers' Voices with Briana Gryzynger and Greg Stafford
Who is teaching the teachers? Meet a pair of classroom educators who also contribute to their peers' ongoing learning at the Biosphere 2
Who is teaching the teachers? Meet a pair of classroom educators who also contribute to their peers' ongoing learning at the Biosphere 2
Two educators talk about a new program where teachers - instead of students - are asked to become immersed in the indigenous culture of their school.
Learn how an elementary school science fair transformed into an annual three-day math and science extravaganza at the Tucson Convention Center.
Meet the originators of SANITY, a collaboration dedicated to getting students out of the classroom and into nature.
A science teacher at Flowing Wells and a U of A grad student discuss the innovative classroom projects they were able to create because of their BioME partnership.
A teacher and a U of A grad student discuss their partnership through the BioME Project.
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OAKLAND -- It's a tough sell after the most successful road trip in franchise history, but Warriors coach Mark Jackson is still offering up familiar rhetoric that his team hasn't done anything yet.
Moreover, in the face of forward David Lee winning NBA Western Conference player of the week and improving his standing as a potential All-Star, Jackson also maintained the Warriors don't and won't chase individual accolades.
One can see his mindset in both instances. The Warriors are barely more than a quarter of the way through the season, and although 16-8 following n historic 6-1 trip, it won't mean a lot if the club doesn't successfully navigate its next stretch of games in which it plays eight of 11 at Oracle Arena. That string starts Tuesday night when Golden State hosts the New Orleans Hornets.
"You notice the confidence level rising, you notice a sense of accomplishment, but you also see a group that understands that we've done absolutely nothing," Jackson said. "The thing that's important for us to realize is we have to do the things we preach every day to put us in position to win. If we don't, we can be beat. We don't have the luxury to just show up and win ballgames."
It's one thing for Jackson to spout it. What's notable is that his team appears to believe it to the letter. To wit, Lee took the honor of winning the player of the week award Monday as an advertisement of what the team has done, not so much what he has accomplished individually.
"You can't be player of the week unless your team is doing well," he said. "If you're averaging 30 points and you're 0-3 for the week, they don't give it to you. So I'm happy that the Warriors are starting to get recognition for the hard work they're putting in. But it doesn't change my approach whatsoever."
Said Jackson, "I told the guys in the huddle, we will not chase down individual awards. When they do come, we're certainly going to acknowledge and embrace them, and then we're going to continue to chase down awards collectively. But it's a heck of a statement for this franchise and for David Lee. We're proud of him."
No question, Lee had a great trip and a particularly magnificent week. He averaged 22.8 points, 12.5 rebounds and shot 60.6 percent from the floor (40 for 66). But perhaps his defining moment was a foul -- the hard hack he put on Miami's LeBron James as he was driving the lane during the Warriors' most high-profile victory on the trip.
Lee's playing improved defense, too, and protecting the paint as a power forward must. James fell awkwardly after being hammered and appeared a bit stunned Lee had delivered such a rough foul.
"A number of times I've seen on 'SportsCenter' where guys just hack him on an arm, it's a and-one and the whole crowd goes crazy, or he dunks on someone and the crowd goes even crazier," he said. "I was just trying to make sure. I don't feel like we have to be tough guys. What I feel is we're a group that isn't scared of any team and we're not going to back down."
What they hope not to do more than anything is relax. The Warriors can really make some significant hay on this next run of games and really establish themselves as a bona fide playoff contender by duplicating the same kind of intensity, focus and execution they demonstrated on the road. At the same time, they don't want to start giving those hard-earned road victories back at home.
"We believe we can play with anybody, we believe we can beat anybody," Lee said. "At the same time, against some of these teams we have coming up with lesser records, we know we can lose to anybody. We have that fear of letdown games."
Jackson said the voting doesn't matter to him.
"I don't expect them to be voted in," he said. "That's a popularity vote and some guys with bigger names will certainly get the vote."
That said, he did give a forceful stump speech on behalf of his top two players.
"When you start talking about All-Stars in this league, if it was voted on today, you've got to have Steph Curry and David Lee in the discussion," he said. "I'm not talking about the fan voting. What I'm talking about is the coaches who watch what these guys do every single game, and watch the run these guys have been on. Hopefully we continue to do it, which I fully expect. If that's the case, I expect educated guys to make educated choices."
tuesday's game
New Orleans (5-18) at Warriors (16-8). 7:30 p.m. CSNBA


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Many in the past have argued this day would never come. That we were crazy theorists. This day we should add up what has come to pass in the last 80 years. Starting with a central banking system, a falling away from a republic and regulation. So much more than words can explain. This day we can use a cowardly approach to killing Americans. This day the definition of a terrorist includes any one who would lay down their lives for the Republic. This day I can be labeled a racist for disagreeing with a president. Drones Mr. President?....I disagree. This day we have traded our liberty for security. This day we all died.
Primary tabs
What do you think of the memo that justifies using drone strikes to target Americans?
10 Comments
My main issues is not with drones. The method of killing makes no difference.
The issue lies in who is determining who is a terrorist?
Without the ability to defend oneself from the charges of being a terrorist, the rights provided by the Constitution are abridged.
Does it matter if the citizen is in the States or not?
That is what the Constitution is for, so a citizen cannot be accused, convicted and terminated without a chance for a defense.
What is going on in the US?
If the person is aiding our enemy in attempting to destroy our nation then they are enemy combatants and have no claim to legal niceties such as a day in court. They are enemies and should be killed wherever found, engaged in combat or just sitting around eating a meal with other enemy combatants.
That said I believe the whole drone attack business is another case of short-sighted expediency that deliberately discounted any and all possibility of others applying the same sort of technology against targets in this country because it was convenient to kill enemy combatants without the mess of having to deal with US casualties domestically. Those that made and continue to make the drone kill decisions seem to believe, at least their short-sighted actions seem to indicate, that they have nothing to fear because by the time any of our enemies get drones capable of attacking the US they will have long retired from office and blame.
It is long past time for politicians to make real considerations about the unrestricted employment of weapons prior to the implementation of policy approving the use of these weapons. The idea is supposed to be the protection of this nation's citizens and the use of remote weaponry at the command of any leader, just because of its expediency, without regard to future ramifications is just plain stupid in addition to counter-productive.
Robert Ireland (PUFL)
Most poll questions are ambiguous at best. The very word "Americans" is misleading. Even substituting the word "terrorist" is deceptive. When "5th column" and "treason" were understood by Americans, justifiable action could be condoned. It must be recognized that in today's America, countless millions of individuals are living here (some with visit/work permits, some with citizenship papers, some illegally)who neither care about this country nor swear allegiance to our flag. To a large degree they either usurp our hospitality or hate us or both. They are not Americans. The use of drones in the context discussed is justified if it is well defined as related to enemy combatants who swear allegiance to a country or entity that is bent on destroying our constitutional republic. But that defination does not exist. The word "Americans" is a deliberate deception coupled with rhetoric to mask the implied wording. And the implication is this. In the event that civil unrest over government policies erupts into armed confrontation, is it then justifiable to use drones on the "true" American, patriot, taxpaying, constitution/bill of rights public for the purpose of killing to sustain the corupt powers that control our lives unconstitutionally. Would we then be considered domestic terrorists for resisting tyranny? If we justify the use of drones as put before the public by the politicians (elected or otherwise) while using the term "Americans" we will, in essence, sign our own death warrant.
You have to think about governments hidden agenda. Quite frankly, I don't trust any of them. The majority of U.S. citizens have already turned into what I call "Sheeple"...just hanging around being led by their noses. To concerned about their everyday life, not seeing the big picture. Our Constitutional rights are eroding little by little with each decree made by government.Though the thought of drones against the bad guys sounds intriguing,how quickly that can be used against the general population. These new gun control laws are a perfect example. If they can prohibit assault rifles, that just opens the door to prohibit other types of weapons. I have not touched a weapon since my discharge in 1971. I presently own no weapons and I am not a member of the NRA. But, I'll be damned if I'll let my government take away my rights...rights that I as well as my predecessors fought and died for. We need to keep our government in check.
One man can't have that much power without a judicial review and a record of such. What happens when "another country" wants to take out a person within our boundaries of the USA? This drone technology is not just ours, it is very easy to manufacture and launch. Theirs may be not so pin-point accurate either.
It is my belief that if an American citizen leaves the US, and joins a group of terrorist we are at war with, such as Al Qaida and the Taliban, then they have effectively given up their right to be an American citizen. Period. Therefore, our military has every right to treat them as a combatant enemy and should have full authority to do so. We do not need Congressional approval for every enemy we take out. How many of you remember the constraints put on us Vietnam Vets! Never again.
As long as the "American" is an enemy combatant, he is fair game. I don't remember details of WWII but I'm sure there were turncoat Americans who were killed by US agents. Was there any concern over that back then?
Allowing the use of drones to attack U. S. Citizens, within the continental U. S. borders, is commensurate with declaring war upon the American citizenry.
Collateral deaths, of innocent American citizens is fully acceptable and so stated, in the Department of Justice memorandum.
I'm very disappointed with the language used by the editors, or those with the assigned responsibilities of compiling and structuring the wording of this poll question. LOOK at the question CLOSELY! Does the question imply, or infer ANY information linking or affiliating Americans to acts of terrorism, treason, or acts of betrayal to the government of the United States of America? The answer LITERALLY is NO! The question was poorly constructed, and NEEDS TO BE RESTRUCTURED.
For example, if the question was rewritten as "What do you think of the memo that justifies using drone strikes to target Americans implicated, or participating in acts of terrorism, treason, or betraying the United States government in its time of war by cooperating with the enemy?" OR:
"What do you think of the memo that justifies using drone strikes to target Americans linked with, aiding, or cooperating with the enemy, Al Qaida and the Taliban while the United States is in a state of war?"
The language (i.e. wording) of the former and latter questions definitely imply, or implicate, applicable Americans in crimes against the United States of America; and such Americans are not only subject to prosecution, but to JUSTIFIED, deadly force implemented against them; by the U.S. military, federal law enforcement and intelligence agencies (e.g. FBI, CIA); and any OTHER APPLICABLE department of the United States government while our nation is in a STATE of WAR!
The original question posed in this poll participation is ambiguous, and too abstract to define, assert, and imply criminal intentions and presumptive acts that would justify deadly force (or even prosecution) against "Americans." Newly admitted American citizens into the U.S. whose native language is not English, and are not too familiar with federal laws, and the reading of the U.S. Constitution; would struggle in understanding to respond to any inferred, but not implied language to this (original, poorly worded) poll question. Legion editors and/or writers need to restructure the language of the ORIGINAL poll question.


text:
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A Taste of Justice: Mandela Family Launches Wine Label
Meet Nelson Mandela: global citizen, revolutionary, Nobel laureate and…winemaker.
Yes, the father of modern-day South Africa has added the latter to his long list of skills and accomplishments – in a sense. With his blessing, his daughter and eldest surviving child Makaziwe (or Maki, for short) and granddaughter Tukwini recently launched the House of Mandela label – an attempt to introduce South Africa wine to a broader international audience, including the all-important market of the United States.
Maki admits she was initially skeptical when the family proposed the idea back in 2005. "Why wine?" she recalls asking at the time. But then she quickly learned the answer: Wine is not only a vital part of South Africa's economy – South Africa is the eighth largest wine producer in the world and its wine industry employs more than 400,000 people – it's also a product that speaks to the Mandela family's history and rural/agricultural roots and its sense of passion and pride.
"Wine is about tradition, culture and customs," says Maki, "and we at the House of Mandela are steeped in those things."
The family doesn't own any actual vineyards. Instead, the winery takes something of a cooperative approach, meaning it buys product from a variety of top South African family-owned wineries, so long as those wineries adhere to practices – such as embracing sustainability and affirmative action – that are key to the Mandelas. But the final product is very much a "Mandela" wine, explains Maki.
"We are what you call wine negociants," she says. "We source and then we have our own winemaker who blends the grapes in terms of the styles we like."
In many ways, the focus is on varietals that are hugely popular on the international market – chardonnay, cabernet sauvignon and shiraz, among others. But the idea is to show how South Africa brings a different approach to winemaking from other locales. In many ways, South Africa represents the Old World school of wine – indeed, wine has been produced in the country since the 17th Century. But because it's now just fully emerging on the global marketplaces, its wines are steeped in New World techniques and taste preferences.
And don't forget the unique terroir, with the country's mountainous terrain and warm climate. "We have very rich soils," boasts Maki.
As much as the family hopes that the House of Mandela will boost South Africa's reputation in the wine world, they very much consider the label a business venture. "Obviously, we want to be profitable," says Tukwini, who is Maki's daughter. But Maki concedes that "right now, it's a labor of love." (She adds that about $600,000 has been invested in the label to date.)
Still, some in the wine industry see huge potential for the House of Mandela, whose wines are at various prices — $13-$16 for an entry-level series and $30-$50 for a reserve one. And it's not insignificant that Southern Wine and Spirits, one of the world's largest wine distributors, is helping launch the brand in the United States – in fact, Maki and Tukwini were in attendance at the recent Food Network South Beach Wine & Food Festival, which Southern coordinates. Southern Senior Vice President Mel Dick says the significance of the family is hard to ignore when discussing the wine – "This is such a great name," he says – but he also believes the label's releases can and will stand on their own. "The wines are excellent," he adds.
But what does Mandela himself think of them? Maki admits he's not much of a drinker – at least when it comes to traditional dry wines. "He's always loved his sweet wine," she says.


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Pop\\\' Hostel is the perfect option for your stay in Avignon. Centrally located, our wine bar offers a friendly... More Info »
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Wine tours, Events & Incentive travel
VIAVINUM is a fully registered and certified Travel Agency & DMC in Spain (C.I.C.MA 1668) providing full comprehensive services, and specialized in the organization of exclusive wine & culinary tours.
Our agency was founded to satisfy a traveller eager to gain new experiences surrounding wine, gastronomy & culture. In other words, with the idea of offering an attractive combination of cultural and culinary tourism, where wine is the great protagonist.
We not olny provide wine country travelling and other travel services for couples and larger groups, but also integral services to the MICE sector, assisting companies and meeting planners in all the designing and organization of their events, meetings/conventions and incentive travel.
All of our programs are elaborated to reach and surpass objectives, needs and interests of each individual visitor to the Spanish Wine Country and to any of our portfolio selected destinations (i.e. France, Italy, Portugal and Croatia).
For your convenience, we have created the application below "NUEVA CONSULTA" where you can manage on your own your reservations directly with the hotel you finally choose, knowing in real-time its availability and conditions. And best of all, with an advantageous price in most cases, and making payment directly at the hotel. (Please pay attention to the booking and cancellation conditions of each)


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Serving the cities and communities of: Avondale, Buckeye, Circle City, El Mirage, Glendale, Goodyear, Litchfield Park, Morristown, Peoria, Sun City, Sun City Grand, Sun City West, Surprise, Wickenburg, Wittmann, and Youngtown.
View the District 4 Interactive Map
Avondale - In the late 19th century, Avondale was a pit stop on the main thoroughfare for folks racing to the 'Golden Coast'. Today, this vibrant city is a premier destination for International NASCAR racing, festivals, shopping, dining, recreation, education, family living, employment and business location.
Buckeye - Founded in 1888 and incorporated eight decades ago as a 440-acre town, Buckeye has surged into the 21st century with a planning area of almost 600 square miles. While Buckeye's population of about 30,000 residents is expected to increase at a rapid rate over the next few decades, the family-friendly festivals sprinkled throughout the year help maintain the small-town feel that makes Buckeye a nice place to visit – and to live.
El Mirage - Settled by migrant farm workers in 1937 on the west bank of the Agua Fria River, this residential community of approximately 11 square miles was incorporated in 1951.
Glendale - Founded in 1892, as a religious and temperance colony, for the first decade, irrigation farming was the main occupation. Then diversity – economic, ethnic and religious – brought new life to Glendale.
Goodyear - A city with a rich, rewarding quality of life and great community spirit. Nestled near the base of the Estrella Mountains, Goodyear is one of the fastest growing cities in the State. Yet it offers all the advantages of a small community – less traffic, safe neighborhoods day and night, and a friendly atmosphere that lets you feel at home right away.
Litchfield Park - Started in 1916 when Goodyear Tire and Rubber bought farm land to grow Egyptian long-staple cotton to use in tire cords. This project was developed by Paul Litchfield, then a junior executive with Goodyear. The company town was given his name in 1926.
Peoria - Established in the 1880's when William J. Murphy's vision of fertile farm lands fed by water from the Salt River became reality with the completion of the Arizona Canal in 1885.
Sun City - A place of cleanliness and friendliness, a wide variety of interests and activities, an ideal adult community where all residents can be as active as they wish.
Sun City West - Del Webb Corporation, the nation's leading developer of adult communities, completed construction of Sun City West in 1997. Its four recreational complexes, nine golf courses, convenient local businesses, churches and nationally ranked hospital are all in place -- not promises of things to come.
Surprise - Vibrant Southwest living; a place of educational excellence where community, family, and traditions are built. Surprise is a collection of distinctive neighborhoods with a small town feel and big city amenities.
Wickenburg - Ranchers and farmers discovered the fertile flood plain of the Hassayampa River and settled in the area. Together with miner Henry Wickenburg they helped found the young community of Wickenburg in 1863. The Town of Wickenburg was incorporated in 1909.
Youngtown - Considered "America's First Retirement Community" was founded in 1954 when real estate broker Ben Schleifer and banker Clarence Suggs purchased land from a dairy ranch. Youngtown was incorporated in 1960 and became the first city occupied solely by senior citizens.


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LHL1: Emeraude classic cruise | 2 days 1 night packaged
11:30 – 12:00 Registration, safety briefing at Emeraude Cafe
12:00 – 12:15 Embarkation
12:15 – 12:30 Check-in
12:30 – 12:45 Captain raises anchor
12:45 – 14:30 Cruising Halong Bay
12:45 – 14:00 Vietnamese & International Buffet Lunch
14:00 – 14:30 Free & easy
14:30 – 15:30 Guided shore excursion to Song Sot Grotto
15:30 – 16:30 Cruising Halong Bay
15:30 – 16:00 Crepe Station on Sundeck
16:00 – 17:00 Guided tour of Pearl Farm, swims or kayaks*
17:00 – 17:45 Cruising Halong Bay
18:00 – 18:30 Vietnamese Fresh Spring Roll Cooking Class
18:30 – 19:00 Cocktails on the Sundeck (Chargeable)
19:00 – 21:00 Vietnamese & European dinner buffet served
21:00-22:00 Bills settlement (Optional)
20:30-23:00 Squid Fishing (Seasonal)
20:30 – 23:00 Screening of highly acclaimed classic "Indochine"
06:00 – 07:00 Complimentary cafe gourmand served on the Sundeck
06:30 – 07:00 Learn ancient art of Tai Chi on Sundeck
07:00 – 08:00 Leave luggage/bags outside cabins
07:00 – 09:30 Cruising Halong Bay
07:00 – 08:30 Energizing breakfast served
08:30 – 09:00 Check-out
09:30 – 10:00
10:00 – 10:15 Drop off point: Emeraude Café
NB: (1) Massages available all day, (2) Cruises with 14 persons and below set menus will be served, (3) Day cruise fee at US$59/person apply in the event overnight cruise is not authorised by port authority due to weather conditions.
The Route
Your cruise through Halong Bay wends among otherworldly karst formations and opens up views of one stupendous seascape after another. Be sure to key on the following attractions, as well. Changeable conditions and tides can affect the route, visibility and anchorage, but the following spots should be visible from the sun deck.
Sung Sot Grotto
Early French tourists who wandered among the 10,000 square meters of this cavern dubbed this space "Grotte des Surprises", or Surprise Cave. Sung Sot more
From the wharf, 50 steep stone steps lead up to the entrance, but the view is worth the effort. The grotto features thousands of stalactites and stalagmites. Paths, lights and signposts guide you through two caves which continue to offer yet more twists, turns and, yes, surprises throughout.
Cua Van and Vung Vieng Floating Villages
Seven hundred people live at Cua Van in a calm bay surrounded by limestone karsts. Most, not surprisingly, earn their living by fishing and spend almost their entire existence living on the water.
The following day you will also pass Vung Vieng Floating Village. Sixteen hundred people live on Halong Bay itself in similar communities.
Hang Trong Anchorage
The Emeraude anchors at Hang Trong. Hang Trong , or Drum Cave, refers to a nearby cave that earned
The waters here are quiet for swimming and there is lots to explore by kayak.
Depending on conditions there are as many as five potential anchorage spots. Though Hang Trong is the most used, conditions may mean the vessel's captain opts for another site.
Titov Island
Titov Island was named after an illustrious visitor, Gherman Stepanovich Titov, who visited the spot on November 22, 1962 alongside President Ho Chi Minh. The Soviet astronaut was the second person to orbit the earth. Titov himself returned some 35 years later on June 27, 1997.
The island is noted for a beautiful crescent-shaped beach that's popular with swimmers and water sports enthusiasts. You may also hike 420 steps up to a pavilion at the summit for a panoramic view of Halong Bay.
Soi Sim Island
On its return to Bai Chay, the Emeraude cruises past Soi Sim. Unlike the limestone karsts, this soil-based island supports ancient trees and a stunning white sand beach.
Emeraude Shuttle
Most travelers journey to Emeraude Pier with their tour group. But independent travelers can elect to take the Emeraude Shuttle.
Two 16-seat Mercedes Sprinter mini buses make daily departures from Hanoi and Halong City. The eastbound bus to Halong leaves from the Emeraude's sales office at 46 Le Thai To every morning at 8.30am. The westbound bus leaves Emeraude Pier for the return trip to Hanoi at 9.30am. The three-hour each-way trip costs $40 return.
Emeraude Cafe
From shuttle to cruiser, we anticipate virtually direct boarding but, for those arriving independently, the Emeraude Cafe offers a comfortable place to spend time until embarkation.
Shop for souvenirs or enjoy a drink or snack. The Café serves a wide selection of international food including freshly made sandwiches, panini and pizzas. In addition, there are teas, coffees, fresh juices and a wide ranging wine list.
The Emeraude Cafe also provides complimentary WIFI access.
Emeraude Pier & Embarkation
After boarding via Emeraude Pier, park your luggage in your cabin and head to the sundeck for a refreshing welcome cocktail.
A buffet lunch is served as the vessel casts off and heads out onto the magical waters and into the unrivalled scenery of Halong Bay.
While aboard the Emeraude, be as active or as indolent as you please.
Go caving at Sung Sot Grotto. Take in the bay from its entrance before heading into the darkness and its natural wonders.
Experience the jade-green waters. At the overnight anchorage, take a swim from the dock, dive from our decks or launch a kayak for a nearby islet.
Drink a cold beverage. Prepare for sunset with a drink in one hand and a camera in the other.
Whet your appetite. Learn a few tricks of the trade from our Vietnamese chefs at a cooking demonstration.
Behold the silver screen. After dark, gather topside for a viewing of "Indochine," projected on deck with surround sound and surround scenery. An unparalleled movie experience.
Squid anyone? Try your hand at squid fishing with the Emeraude crew.
Tai Chi, Halong style. To enjoy the ultimate serenity in the ultimate location, meet our tai chi instructor on the sun deck at dawn with complimentary tea and coffee.
All Hands on Deck. Foot and shoulder massages in the sunshine or go below deck for body wraps and scrubs – without losing that Halong Bay View.


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KFOX Radio
What is KFOX Radio?
KFOX is a Christ-based, student-led campus radio station dedicated to bringing quality music and programming to George Fox University students and surrounding communities. Our desire is to honor God through providing entertainment that glorifies Him and meets our listeners' needs.
How Do I Listen?
Just play to start/stop the stream!
Old Style Audio Player
Weekly ScheduleMelting Pot
Sundays 3:30-4:30pm
Joe Djanga and Sierra Brambila
Bringing a weekly dose of culture to the GFU community through music from across the world.
Audio Garbage
Mondays 8:00-9:00pm
Lauren Bass and Melanie Schroeder
Are you down in the dumps because of a heap of homework? So are we. Welcome to the magical landfill of all things fun and ridiculous. Join your hosts as they explore the humor found in the inane.
Love Songs for Lonely Hamsters: An hour of improvised hilarity with Alex and Nate
Mondays 10:00-11:00pm
Alex Davis and Nate Downer
The piano/guitar duo of Alex Davis and Nate Downer perform entirely improvised songs that try to answer life's big questions: "What is love?" "When can I get my own dinosaur?" "If there is a good God, then why did I sleep through doughnut day at the Bon?" "When I get my own dinosaur, can it have big red spikes on it?" and many more. All music is performed live at the KFOX studio, right here at George Fox, so tune in Every Monday at 10pm and see what happens.
The Three Amigos Radio Show
Tuesdays 9:00-10:00pm
John Weinert and Matt Johnson
Get ready to feast on a hand-made content-burrito packed full of hot-poppin; topics, delivered to your ear-mouth every Tuesday night at 9.
Metal Hour With Paul Gallagher
Wednesdays 9:00-10:00pm
Paul Gallagher
A show for the metalhead in all of us. Playing the best of new and old Christian Metal, featuring bands such as Fit For A King, August Burns Red, The Devil Wears Prada, and Underoath.
The Talk Show with Avery and Juan
Thursdays 10:00-11:00am
Avery Nielsen and Juan De Howitt
A humorous talk show with two young, dashing co-hosts. Listen in to get music and movie reviews, genuine interviews, other laughable content and everything GFA. It's "The Talk Show with Avery and Juan!
Out of Left Field
Thursdays 7:00-8:00pm
Ryan Lackey and Jack Shannon
Two cool dudes talk about sports and politics and why the other dude is obviously and horribly wrong. But in a totally friendly way. Usually. Also sports and politics!
The Contemporary Collective
Thursdays 9:00-10:00pm
Kiri Guthridge and Carolina Fudala
A conversation about contemporary movements, cultural norms, and the communication of our generation today.


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Forget lining up for Thanksgiving leftovers. Thursday evening, eager shoppers were lining up for deals, getting a head start on the biggest shopping day of the year. Some, like sisters Lindsey Vickers and Chelsea Worstell, had been anticipating the frenzied overnighter for longer than others.
"Chelsea and I have been plotting since June. That's when we set up our babysitting," said Vickers as she waited for another round of door busters at Marietta Wal-Mart Thursday evening.
Vickers planned to shop through the night and into Friday morning, when she would ring in her 30th birthday.
Article Photos
The Associated Press
"It's the best birthday shopping ever," she said.
Having spent the past four Black Fridays in a similar fashion, Vickers, a Marietta resident, and 22-year-old Worstell, of Columbus, are no newcomers when it comes to hunting for deals.
"It's not as good as years past," added Worstell, who did not like the new door buster format that had Wal-Mart shoppers waiting for DVD deals in the milk aisle and vacuum cleaners in the sporting goods section.
Fact Box
Upcoming events
Annual Marietta Christmas Parade, featuring Santa and Mrs. Claus
- Saturday 1 p.m., Front and Second streets
Raising Cane Grand Illumination Ceremony, lighting ceremony for new downtown Marietta decorations
- Saturday 5:45 p.m., 132 Putnam St.
Small business Saturday, goal is to support small, independently owned businesses
- All day Saturday, downtown Marietta and Harmar Village
Annual Beverly-Waterford Christmas Parade and Dodge Park lighting ceremony, free refreshments, canned food donations welcome
- Sunday, parade starts at 5:30 at Waterford High School and ends at Dodge Park for the lighting ceremony
Cyber Monday, the online equivalent to Black Friday
- All day Monday, various websites
To combat the confusion, Wal-Mart shoppers walked around with maps of the store, showing them where and when different products would be on sale.
At Marietta Kmart, which closed at 4 p.m. Thursday, customers lined up around the building in anticipation of the stores 8 p.m. reopening. Two big television deals drew shoppers in, but not everyone was happy with the results.
"They said they passed out tickets," said Marietta resident Randy Oliver, who had waited in line since 6 p.m. Thursday evening to take advantage of one of the television bargains.
Oliver and his family managed to snag a 24" LED television, but without one of the seven tickets handed out in line outside the store, they did not get the sale price on it.
"We're disappointed. We weren't that far back in line," he said.
But maps and tickets did not leave everyone in the lurch.
"Best Black Friday ever," said Dan Postlethwait, 28, of Caldwell, as he wheeled his 50" LCD television to the car.
Postlethwait said he actually appreciated the ticketing method at Kmart because it saved shoppers from stampeding for the electronics section once inside.
"It saved all that commotion," he said.
Though certain deals tended to draw large crowds Thursday and Friday, not everyone was shopping for specific items.
"I'm here to buy stuff. I just don't know what yet," said 21-year-old Kelly Moats as she browsed at Wal-Mart near midnight Friday.
Mother and daughter shoppers Laura Nottingham, 43, and Marisa Devlay, 12, had a similarly laid-back attitude at Kmart.
"It's easier when you're not after something specific. We sort of just take it easy," said Nottingham.
Added Devlay, "I like shopping, but people are crazy."
Marietta resident Craig Nichols and his nephew Christopher Becker, 31, of Devola, found a cozy way to avoid the craziness while shopping at Wal-Mart.
Comfortably seated on an end cap stuffed with furry comforters, Nichols said the he would have gladly stayed home if not on a mission for a particular deal.
"But it's nice seeing people you know. There's a lot of people out," said Nichols.
Typically Black Friday is the biggest shopping day of the year, the day when retailers begin to turn a profit or go "into the black". However, the retail holiday's slow creep into Thursday became ever more apparent this year.
Last year, only a handful of stores opened at midnight at the Grand Central Mall in Vienna. This year that number was well over half, said the mall's specialty leasing manager, Janet Spoerer.
"Almost the entire mall," she said.
The burst of early shopping slowed down in the pre-dawn hours and was just picking back up around noon Friday, Spoerer added.
Kmart manager Lori Posey also noted Friday morning that it had calmed down significantly since the Thursday evening rush.
"It was nuts, but it was a good nuts," said Posey.
The store closed at 3 a.m. Friday and reopened with a final set of sales at 5 a.m., but the last round of door busters drew less of a crowd than Thursday's 8 p.m. round, noted Posey.
This year's Thursday sales bump and Friday morning drop off could have an impact on retailers' actual Friday profits.
"Thursday went extremely well. However, it impacted our sales today in a negative way," said Peebles manager Summer Mason Friday morning.
Still, said Mason, more customers than ever were waiting for Thursday night's 8 p.m. opening.
"We had a total of 78 people waiting for us at the front door which is the most people we've had come through," she said.
The National Retail Federation, which tracks spending over the Black Friday weekend, will release this year's shopping results Sunday. However, the according to a preliminary survey, NRF found that 147 million people planned to shop over the weekend, five million fewer than those who planned to do so last year.


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- Show Your Support for Germany!
- Currently Unavailable
Thomas Muller is a sensational attacking midfielder who made waves at the 2010 world championships, even earning the award for best young player and the Golden Boot. The German playmaker is just as highly praised for his assists as he is for his goals and he's only getting better as he matures.
Show your support for Die Mannschaft with this away jersey from adidas. This ClimaCool jersey has the adidas logo and German national team badge applied to the front.
The green color harkens back to the old school Germany away jerseys, including the one the team wore when they won the 1972 European Championship 40 years ago!
100% polyester. Imported.
Apoya a la Selección de Alemania y al espectacular mediocampista Thomas Muller con esta camiseta de visitante hecha por adidas. Esta camiseta ClimaCool viene con el logotipo de adidas y escudo nacional aplicados al frente. Su color verde recuerda los viejo


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Starting Tuesday, April 2, the Huckleberry Park Ramp Park will have normal Spring operating hours: 3:30 p.m. to dark weekdays; and noon to dark Saturdays and Sundays.
The Ramp Park is for roller skates, roller blades, skateboards, bicycles and scooters. The cost is $2 on weekdays and $3 on weekends. An annual pass costs $35.
Users are required to wear helmets. Users are required to have a signed waiver and release of liability on file. Anyone under the age of 18 must have a parent or legal guardian sign the waiver.
Location, ST | website.com


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Discover a selection of top forums bruder kong on the internet. Come to share your passion on forums bruder kong and meet other fans of bruder kong. Then, why don't you create your own forum of bruder kong ?
Omejo technology (Hong Kong) Co. , Ltd. is a leading manufacturer in producing Wholesale spy detective equipment, Home Security Camera Systems, spy hidden camera, spy camera series, Surveillance Camera, our factory is base in mainland china, set up
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The mixing starts right away during an ok Jim opener, they aren't warmed up yet. Feedback continues during Foam which was nice and dynamic. Sparkle was good, Melt was rocking, and Mound was pretty solid. Punch is getting there; it's just not automatic yet. Sample was slow tonight, but still good. Reba was good overall, but kind of had a weak ending. IDK had more feedback adjusting for Madonna maybe? Bowie was ok, it seemed to go on and on, and it sounded like Mike wanted out about two minutes earlier than Trey did at the end.
It was a strange way to open second set with Fish leading the Lengthwise chant into an average Maze. Bouncing was pretty standard. Pen had more squeaks going on, but was good until the end. Hood was not good at first, but rocked by the end. Then the Balls come out and it almost sounds like Fish does a little Hot for Teacher drumming in there. Ice's first verse was off and was a little weak throughout the whole song. YEM also seemed a little lackluster, but had a good jam with kind of a Smoke on the Water flavor to it. A funny vocal jam leads us to...holy crap...we have a Harpua!!! I always love to hear these and this one is no exception. Great story as always from Trey and great sound effects from the rest of the boys too. And if that wasn't enough they get a Chalk Dust closer? It was rocking, but kind of had a weird tag ending on it to say thanks. Crazy set, but not the best playing.
Bag is slowly making its way back into set list rotation and tonight it gets the encore spot. This one is pretty good for the most part and then everyone gets shushed for and average Adeline.
I'm not sure if the sound issues had anything to do with it, but I'm sticking with three stars on this one even though I really want to bump it up for the YEM, Harpua, Chalk closing.


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ST. THOMAS — A 2012 Dodge Ram driven by James S. Over, 51, of St. Thomas was traveling east when the vehicle failed to negotiate a curve and hit a "sharp left turn sign," ran off the road and rolled onto its roof at 11:05 p.m. Sept. 28, on Brandts Church Road.
Over was not hurt, according to Pennsylvania State Police.
Location, ST | website.com