Persistent Knee Pain is a Capacity Problem

If you’ve ever been told “your knee is worn out”, “your scans explain everything”, or “you’ll just have to manage it”, I want to offer you a different way of understanding pain — one that actually makes sense of real life.

This idea comes from two very different people:

  • An orthopaedic surgeon who spent his career operating on joints

  • A neuroscientist who studied how the brain senses the state of the body

They worked in different worlds, but they arrived at the same conclusion.

The Joint Has a “Comfort Zone”

Orthopaedic surgeon Scott Dye described something called the Envelope of Function.

You don’t need the fancy name.
It simply means this:

Every joint has a range where it feels calm, safe, and comfortable.

Inside that range:

  • You can move

  • Load feels fine

  • Pain stays quiet

Outside that range:

  • The joint becomes sensitive

  • Pain shows up

  • Things feel “angry” or reactive

Here’s the important part:

Pain doesn’t mean damage.
Pain means you’ve exceeded your current capacity.

That capacity can change — up or down — depending on what’s going on in your body and life.

Pain Is the Body Asking for Help, Not Sounding an Alarm

Neuroscientist Bud Craig took this idea even further.

He showed that pain isn’t just about tissues.
Pain is part of the body’s internal monitoring system — the same system that tracks:

  • Fatigue

  • Inflammation

  • Energy levels

  • Stress

  • Recovery

In simple terms:

Pain is how your body lets you know that its balance is under strain.

Not broken.
Not damaged beyond repair.
Just out of balance.

Why Scans Often Don’t Explain Pain

This explains something many people experience:

  • Two people have the same scan

  • One has pain, the other doesn’t

Why?

Because scans show structure, not capacity.

They don’t show:

  • How well tissues are fueled

  • How rested the system is

  • How much load you’ve been carrying

  • How stressed or inflamed your body feels

Pain lives in the relationship between load and capacity — not in a single image.

The Big Shift: From “Fixing” to “Rebuilding”

Once you see pain this way, the goal changes.

Instead of:

  • “How do I fix this part?”

  • “What’s wrong with my knee?”

The better questions become:

  • “What is my system able to handle right now?”

  • “How do I gently expand that capacity again?”

This is why:

  • Pushing harder often backfires

  • Rest alone rarely solves the problem

  • Quick fixes don’t last

What works is gradual, intelligent rebuilding.

Why This Is Actually Good News

This perspective is hopeful — not dismissive.

It means:

  • Your pain is real

  • Your body isn’t broken

  • And improvement is possible

Capacity can grow.
Tolerance can return.
Confidence can come back.

Not by forcing.
Not by fearing.
But by working with the body instead of fighting it.

One Line to Remember

If you remember nothing else, remember this:

Pain appears when load exceeds current capacity — and fades as capacity is rebuilt.

That’s it.
That’s the whole model.

And it’s the lens I use every day when helping people move forward — calmly, steadily, and with far less fear.

What the Research on Load and Injury Actually Shows

This idea isn’t just theoretical.

Sports scientist Tim Gabbett has spent years studying why people break down — from elite athletes to everyday movers.

His key finding is surprisingly simple:

Injury and pain are most likely when load increases faster than the body’s capacity to adapt.

Not because the body is weak.
Not because joints “wear out.”
But because the dose of stress exceeded what the system could currently handle.

Growth Follows a Simple Formula

When you strip away the noise, recovery and resilience come down to this:

Appropriate stress + appropriate recovery = growth

That’s how:

  • Muscles strengthen

  • Tendons adapt

  • Joints become more tolerant

  • Confidence returns

Too much stress without recovery → symptoms
Too little stress → loss of capacity

Pain often sits right in the middle — when the balance has been lost.

This Is Why “Wear and Tear” Misses the Point

If pain were just about wear and tear:

  • Athletes would be in pain all the time

  • Older bodies couldn’t adapt

  • Rest would fix everything

But that’s not what we see.

What we see is that capacity is trainable at any age — when load is dosed well and recovery is respected.

That’s a very different story from protection, avoidance, and fear.

The Real Goal

The goal isn’t to protect your body from stress.

The goal is to rebuild your ability to handle it.

Not by forcing.
Not by pushing through pain.
But by applying the right amount of challenge — and giving the system time to respond.

That’s how resilience is built.
That’s how pain settles.
That’s how people return to living fully again.

10 Simple Tips to Maximize the Benefits of Dry Needling

10 Simple Tips to Maximize the Benefits of Dry Needling

Dry needling can be an effective tool in managing pain and promoting muscle recovery, but like anything, small tweaks can make a big difference.

Here are 10 straightforward tips to help you get the most out of your sessions, without feeling overwhelmed:

1. Hydrate Before and After
Proper hydration helps your muscles recover more effectively and flush out metabolic waste. Drink water before and after your session to keep things moving smoothly.

2. Breathe Deeply
When the needle goes in, it can trigger a muscle twitch or discomfort. Focus on deep, slow breathing to calm your nervous system and help the muscle release more easily.

3. Move Gently Post-Treatment
After your session, engage in gentle movement like walking or light stretching to encourage blood flow and prevent stiffness. It helps integrate the benefits of the treatment into your body.

4. Apply Heat Afterward
Depending on how your body reacts, applying heat to relax tight muscles can amplify the positive effects of the treatment. You can have a warm shower or use a wheat bag. Listen to your body and apply whichever feels more soothing.

5. Get a Good Night’s Sleep
Your body does its best healing while you sleep. Prioritize rest the night after your session to allow the treatment to fully take effect.

6. Stay Active, But Don’t Overdo It
While movement is key to recovery, avoid intense exercise immediately after your session. Gentle activity helps, but pushing too hard can negate some of the benefits.

7. Eat Nutrient-Dense Foods
Your muscles need fuel to heal. Eating foods rich in vitamins, minerals, and anti-inflammatory properties (like leafy greens, lean proteins, and berries) can aid recovery.

8. Communicate with Your Practitioner
Don’t hesitate to let your practitioner know how you’re feeling during and after treatment. Everyone’s body responds differently, and small adjustments in technique can lead to better results for you.

9. Stay Consistent
Like most treatments, consistency matters. Dry needling is most effective when integrated into a broader care plan, so stick with your sessions and give your body time to adapt.

10. Be Patient with the Process
Change doesn’t happen overnight. Focus on the small improvements and trust that they build over time. Sometimes the biggest differences come from these small, consistent steps.

Bonus Tip: Keep Stress in Check
High stress can keep muscles tense and make it harder for the body to heal.

Incorporate stress-reduction practices, like mindfulness or simple relaxation exercises, to enhance the benefits of your dry needling treatment.

Remember, sometimes the smallest adjustments can have the biggest impact on your recovery.

These simple steps can help you maximize the benefits of dry needling without adding complexity to your routine!

Understanding Your Body Through the Pliability–Strength Matrix

When someone first walks into my clinic, I usually see two types of people:

(1) those who do too little because they’re afraid of pain and

(2) those who do too much because they’re afraid to stop.

Both end up stuck — not because of weakness or willpower, but because their system has lost rhythm.

That’s why I use something called the Pliability–Strength Matrix:

A simple way to help you see where your body sits in the balance between strength (load) and pliability (recovery).

It explains why pain, fatigue, and stiffness aren’t random — they’re just feedback that your stress–recovery equation needs a tune-up.

Before we get to the quadrants, let’s define these two terms pliability and strength.

🌿 What Is Muscle Pliability?

Pliability means your muscles can contract fully and then relax completely.

It’s the ability of your tissue to stretch, adapt, and return to shape — without staying tight, sore, or weak.

When a muscle is pliable, it’s strong and responsive: it can handle stress, move smoothly, and recover quickly.

When it’s not pliable, it feels stiff, heavy, or “switched on” all the time — a sign the body is protecting itself rather than adapting.

In simple terms:
Pliability is your muscle’s ability to tighten when needed and let go when finished — strength with softness.

💪 What Is Muscle Strength?

Muscle strength is your body’s ability to create force and handle load — to lift, move, and stabilize without strain.

Strong muscles support your joints, absorb impact, and protect you from injury. They help you stand taller, move with confidence, and do more with less effort.

When strength drops, your body feels unstable or easily fatigued.

When strength improves, you feel solid, capable, and powerful.

In simple terms:

Strength is your muscle’s ability to produce force and stay steady — power with control.

🧭 The Four Quadrants

Your body constantly adapts to stress.

Too much or too little load, without enough recovery, leads to one of four predictable patterns.

Each has its own story, physiology, and path back to balance.

1. The Stone — Weak + Stiff

State: Low energy, low movement confidence.
Nervous system: “Freeze” mode (dorsal vagal).
Tissue story: Poor blood flow, cold or heavy muscles, dehydrated fascia.
Load–recovery equation: Too little load + too little recovery.
The system has shut down to protect itself.

Feels like: heaviness, chronic tension, fatigue after minimal activity.
Likely background: long periods of sitting, fear of flare-ups, burnout, under-recovery.

What helps:

  • Start with FEEL — breathing, gentle movement, warmth, circulation.

  • Dry needling can act as a “reboot,” waking up frozen tissues.

  • Think micro-steps, not marathons.

  • Practice self-compassion: your body isn’t lazy, it’s conserving energy.

Pathway: 🪨 → 🌾 → 🌿
Move from stillness to mobility, then build strength.

2. The Willow — Weak + Pliable

State: Flexible but under-supported.
Nervous system: calm but low-energy ventral state.
Tissue story: under-toned muscles, weak collagen scaffolding, low metabolic drive.
Load–recovery equation: Low load, adequate recovery — but not enough stress to stimulate growth.

Feels like: floppy, unstable, easily tired.
Likely background: lots of stretching or yoga, low protein, minimal resistance work.

What helps:

  • Shift into MOVE — isometrics, glute/core activation, controlled tension.

  • Dry needling can improve muscle activation, not just release.

  • Learn to create healthy stress.

  • Self-compassion: your openness is a strength — it just needs grounding.

Pathway: 🌾 → 🌿
Build tone and power without losing flow.

3. The Oak — Strong + Stiff

State: High output, low recovery.
Nervous system: sympathetic “fight/flight” mode.
Tissue story: tight, dehydrated fascia; acidic, over-worked muscles; low sleep recovery.
Load–recovery equation: Too much stress, not enough recovery.

Feels like: tight, wired, sore, restless.
Likely background: heavy training, HIIT, perfectionism, caffeine-fueled days.

What helps:

  • Shift into FLOW — breathing, walking, massage, gentle mobility, sleep prioritization.

  • Dry needling can restore circulation and decompression.

  • Learn that recovery is not the opposite of progress — it is progress.

  • Self-compassion: your drive is valuable; it just needs rhythm.

Pathway: 🪵 → 🌿
Learn to bend without losing strength.

4. The Bamboo — Strong + Pliable

State: Adaptive, balanced, responsive.
Nervous system: integrated — sympathetic and parasympathetic in harmony.
Tissue story: hydrated, elastic, well-perfused, mitochondria humming.
Load–recovery equation: Balanced stress and recovery cycles.

Feels like: light, powerful, confident.
What helps: maintain rhythm.
Your job isn’t to do more — it’s to keep the oscillation between effort and ease alive.
That’s what the daily KIN Foundation routine is for — a 7-minute recalibration of breathing, movement, and flow.

The sweet spot isn’t zero stress — it’s oscillation.
Bamboo physiology means your system knows when to tense, when to release, and how to bounce back.

💓 HRV and the Nervous System

  • Stone: HRV very low — system frozen, unresponsive.

  • Willow: HRV moderate but flat — relaxed, not reactive.

  • Oak: HRV low — over-aroused, poor recovery.

  • Bamboo: HRV dynamic — flexible, rhythmic.

High variability isn’t the goal — appropriate variability is.
You want HRV that dances with your day: low during effort, high during rest.

🧘 The KIN Foundation Pathway

FEEL → MOVE → FLOW → MAINTAIN

Each phase restores a layer of regulation:

  • FEEL: restores interoception and safety.

  • MOVE: rebuilds strength through control.

  • FLOW: restores pliability and recovery.

  • MAINTAIN: keeps the rhythm as life changes.

KIN isn’t about doing more — it’s about recovering smarter.
It’s the missing link between therapy and performance.

Final Thought

Your pain, stiffness, or fatigue isn’t random.
It’s your system asking for rhythm — not punishment.
The KIN Foundation exists to help you rebuild that rhythm: seven minutes a day to Feel, Move, and Flow your way back toward Bamboo.

Bamboo bends but doesn’t break.
That’s not luck — that’s physiology in rhythm.

Daniel O’Grady, Physiotherapist
KIN Foundation™ — Feel. Move. Flow.

10 Things Running and Marathon Training Taught Me Over the Last 10 Years

Ten years ago, I stood on the Verrazzano Bridge in New York City, about to run my first marathon.

I had NO idea how much that experience would change how I think about the human body.

A decade later, running has become more than training or therapy.

It’s been my teacher.

It’s taught me about physiology, resilience, patience, and trust — lessons I could never fully grasped in textbooks or clinic rooms.

Here are ten things I’ve learnt from marathon training that go far beyond pace, finish times, or medals.

🏃 1. Endurance Is the Foundation for Strength

I used to think strength was the key to everything.

If I could just get stronger, everything else would fall into place.

But running taught me the opposite — endurance builds strength.

When your aerobic base is weak, even small loads feel heavy. When it’s strong, recovery speeds up, tissues stay oxygenated, and your whole system adapts better.

Endurance is the foundation of every adaptive system.

⚖️ 2. The Power of Adaptation

For years, I viewed pain through a “wear and tear” lens — that something was breaking down.

Tim Gabbett’s research changed that for me.

It’s not load itself that causes injury — it’s spikes in load beyond what the body’s ready for.
Pain is often feedback from a system not yet adapted, not a sign of fragility.

Through marathon training, I learned to see pain as part of the process.

The body’s constantly negotiating with stress — and it always adapts when the dose is right sand recovery is good.

💊 3. NSAIDs and the Body’s Hidden Intelligence

I haven’t taken an anti-inflammatory in over 10 years.

I learned that inflammation isn’t the enemy; it’s the signal that healing and adaptation are happening.

NSAIDs can mask that process, dulling both pain and progress.

By learning to listen instead of silence my body, I discovered how much healing power it already holds.

Running taught me to work with pain, not mute it.

🧠 4. The Power of Interoception

Running isn’t just physical — it’s deeply physiological.

It’s one of the best forms of interoception training there is.

Pain isn’t just tissue damage….it’s chemistry (pH, inflammation, fatigue metabolites) mixed with context (beliefs, emotions, environment).

Neuroscientist Bud Craig’s research helped me see pain as a homeostatic signal — the body’s way of saying, “Something’s out of balance.”

When I stopped fearing pain and started feeling, everything changed.

Running tuned me into the subtleties — how fatigue feels different from threat, how effort transforms with breath, how awareness itself is therapeutic.

🦵 5. The Paradox of Knee Pain

Almost every new runner feels some form of knee pain…I did too.

It’s frustrating — especially when everyone warns that running “wrecks your knees.”

But as I adapted, something flipped.

The stronger and more consistent I became, the less my knees hurt.

Over time, running didn’t cause pain — it protected me from it.

Research now supports this: experienced runners actually have a lower risk of knee osteoarthritis than non-runners.
It’s one of the great paradoxes — movement that seems to hurt at first often becomes the very thing that heals.

🦶 6. The Calf: The Real Shock Absorber, Not the Cartilage

The knee cartilage is often thought to be the shock absorber of force — but now I know it’s the calf that is the real unsung hero.

The calf muscle and Achilles tendon act as dynamic springs, absorbing and reusing force with every step.

When they’re weak or fatigued, that energy shifts upward — straight into the knee.

Once I learned to build calf endurance (especially hilly easy paced long runs), everything changed.

It’s elegant biology — not engineering.

⏱ 7. Pacing: Staying Relaxed Under Stress

Pacing is the ultimate lesson in self-awareness.

When I force effort, my body fights back — heart rate spikes, form collapses, fatigue sets in early.

But when I relax, breathe, and find rhythm, everything flows.

Good pacing isn’t about running slow or fast — it’s about learning to stay calm inside effort.

That’s not just physical endurance; that’s movement mastery.

🧍‍♂️ 8. Don’t Get Stuck in Perfect Movement

For years, I chased perfect posture and activation.

I lived by the rule: “Move well, THEN move often.”

But somewhere along the way, that became a trap.

I spent so much time correcting that I forgot to adapt.

Marathon training reminded me that progress beats perfection.

You don’t need perfect movement — you need a body that can tolerate imperfection and still function.

That’s what resilience really means.

⚡️ 9. The Power of Dry Needling

Dry needling changed how I understood pain.

When a deep, stubborn ache suddenly released, I realised — this wasn’t structural damage.
It was physiology.

Circulation, pH, muscle tone, and local chemistry can all shift pain in seconds.

Seeing pain change that fast taught me something vital:

If pain can change quickly, it’s not fixed — and neither are we.

✅ 10. Acceptance and Control

I used to believe that if I just worked harder, I could fix everything — old injuries, genetics, structural degeneration.

Now I know that some things we simply can’t change.

But that’s not defeat…it’s direction.

What matters is where we place our effort on the things we CAN control — into functional capacity, load management, recovery, mindset, nutrition, and the stress–recovery rhythm.

Acceptance isn’t giving up…it’s turning your energy toward what can adapt.

💬 Closing Thoughts

Running taught me more about physiology, psychology, and healing than any textbook ever could.

It’s taught me patience, rhythm, and respect for the body’s complexity — and its capacity for change.

Pain isn’t failure; it’s feedback.

The body isn’t fragile; it’s antifragile — waiting for rhythm, recovery, and respect.

Ten years on, I still run to remind myself of that truth.

When More Data Hurts: How Chasing Perfect Numbers Can Keep You in Pain

When More Data Hurts: How Chasing Perfect Numbers Can Keep You in Pain

“More data—such as paying attention to the eye colors of people when crossing the street—can make you miss the big truck.”
— Nassim Nicholas Taleb

“When a measure becomes a target, it ceases to be a good measure.”
— Goodhart’s Law

We live in a world that celebrates data.

We track our steps, sleep, heart rate variability, calories, strength, and range of motion.
And in many ways, this is progress — awareness can help us make better choices.

But there’s a tipping point where helpful data becomes noise.

Where tracking starts to replace trust.

Where chasing perfect numbers makes us feel worse, not better.

The Trap of Perfect Metrics

In rehab, we can measure almost anything:

  • how strong your muscles are

  • how far your joints move

  • how many hours you slept

  • how fast your heart rate recovers

  • your level of structural degeneration on scan

And yet, many people still suffer with persistent pain — even when their numbers look better.
Why?

Because pain doesn’t live in numbers.

It lives in the body’s sense of balance — what neuroscientist Bud Craig calls homeostasis.

The Homeostatic View: Feeling Over Fixing

Bud Craig’s research showed that pain is not just a “damage signal” from tissue.

It’s a message from deep within the brain’s insula, the region that constantly tracks your body’s internal state — things like energy, temperature, oxygen, hydration, and even emotional tone.

Pain is one of the ways your body says,

“Hey, something’s out of tune. Can you listen?”

When we over-focus on data and targets — how many steps, how high our HRV, how long we slept — we can actually increase internal stress.

We lose touch with feeling and get stuck in fixing.

The Inverted U of Data

Like Taleb’s quote, there’s an inverted-U curve with data.

At first, tracking helps.

It brings awareness and motivation.

But too much, for too long, creates pressure and anxiety.

Instead of helping us self-regulate, it can make us second-guess our body’s natural rhythms.

When the measure becomes the target — when “perfect numbers” become the goal — we stop listening to what the body is really trying to tell us.

What Actually Matters

Sometimes, the biggest healing shifts come from the unmeasurable:

  • feeling refreshed after a better night’s sleep

  • A slow walk after dinner

  • A conversation that lifts your mood

  • A few deep breaths before reacting

  • Letting yourself rest without guilt

These don’t always show up on a graph — but they move the system toward balance.

Simple Is Not the Absence of Science

It’s the refinement of it.

When you understand your body as a dynamic, self-regulating system — not just a collection of metrics — you begin to trust again.

You stop micromanaging the data and start tuning in to the rhythm.

Because healing isn’t about perfect numbers.

It’s about restoring flow.