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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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March 03, 2008

My Knee is Killing Me… No, Really.

By Mark Sisson
45 Comments

One of the standard defenses uttered by those who desperately cling to the fast food and couch-potato lifestyle is, “why should I live like a hunter-gatherer? Their average lifespan was only 35 years.” Ipso fatso, if we clearly weren’t designed to live long, why make all those diet and exercise sacrifices?” This common faulty assumption that our hunter-gatherer ancestors lived “nasty, brutish and short” lives has always bugged me. Research suggests that Grok and his family were actually generally healthy (robust is the term), productive – and even so appreciative of their lives that they felt the need to express themselves through art. There are recent studies that suggest there may even have been a selective benefit within tribal units for grandparents – meaning that getting older may have actually had a selective benefit far past procreating. So, if they were so robust and if our genes truly evolved to allow us to live long lives, then why was the average lifespan relatively short? I had always assumed that it was things like deaths during childbirth, infections, accidental poisoning, even tribal warfare that brought the average lifespan down. But then I got a real-life experience of what might have affected the average more than anything else. And it’s really mundane, folks.

I made an unusually bad dive while playing my favorite game “Ultimate Frisbee” last September, slamming my knee hard into the ground and driving my knee-cap down my shin. The result was a torn quadriceps muscle, a ruptured prepatellar bursa and a smashed nerve. An x-ray revealed no other damage and my orthopedist said the soft-tissue injury would heal in 8-12 weeks. He advised me to use pain as my guide and come back slowly. Since I had no pain at all (smashed nerve, remember) I felt like I was recovering fairly quickly – to the point of even resuming my beach sprints in early December. As everything was on track, I decided to go snowboarding six days in Aspen over Christmas break. But despite wrapping the knee every day and taking it fairly easy, (wink, wink – and again no pain) I came home with a very swollen, black and blue knee. By the end of the week, I was unable to bend it more than a few degrees. An MRI revealed a large “organized hematoma” over the quad and kneecap which needed to be removed surgically – otherwise I would carry it with me forever. I went under the knife on January 9. It turns out that the original torn quad muscle had never repaired itself and was leaking blood into the space causing the hematoma. So my surgeon removed the hematoma and stitched the quad back to the patellar tendon. Total recovery time now: 12 weeks.

I tell you all this to illustrate a perfect example of why Paleolithic people may have had such a short lifespan. Here I am 54 years old, with the body of a 25-year-old (and the mind of a 17-year-old) looking forward to living well past 100…but I am effectively incapacitated for over two months now by an injury caused by a random fall. Of course, I have the luxury of modern surgical procedures to repair the damage and get me back on my feet (more on that in a later post) – but had this been 10,000 years ago, my inability to run towards dinner or away from a predator or to stand my ground against an invading tribe might well have been the beginning of the end of me. A small accident that today we take for granted – a fall from a tree branch, off a cliff, a broken arm or a rolled ankle – may have been enough to seriously jeopardize an otherwise healthy older person. The fact that I don’t have the same testosterone levels I had in my 20’s (when I could recover from an injury in two weeks) puts added pressure on my being able to safely afford two or three months of relative inactivity before I am able to hunt and gather effectively once again. The big revelation for me was that our ancestors had all the genetic potential to live to 80, 100 or longer – the lifestyle almost by definition precluded death by any degenerative diseases – but that daily living presented so many obstacles that eventually your number was up. Hence the “average” lifespan dropped and ruined it for everyone.

Alfer22 Flickr Photo (CC)

Further Reading:

Would Grok Chow the Cheese Plate?

What’s All This Talk About Inflammation?

Extreme Exercise: Ultimate Frisbee Included

Medieval Serfs Ate Better Than We Eat

Who Needs Shoes Anyway?

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45 Comments on "My Knee is Killing Me… No, Really."

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Tim
Tim
8 years 6 months ago

Actually, the short lifetime of Paleo humans isn’t the major problem with your diet theory (though your post above falls short on that too). The bigger issue that you fail to address is that humans have evolved considerably in the past 10,000 years. Just two examples: light skin and the ability to digest lactose are recent developments since the days of Grok. There is now considerable evidence that human evolution has been speeding up even in the past 5,000 years. So basing a diet on peoples that we don’t have much in common with really does not make sense.

Mark Sisson
8 years 6 months ago
Tim, I disagree that there is “considerable” evidence human evolution has been speeding up. Regarding your two examples: 1) Evolution of human skin pigmentation has been ongoing for at least 100,000 years of human migration out of Africa and, if anything, probably ceased or slowed down substantially in the past 5,000 years when clothing and shelter removed most remaining selective pressures. 2) Lactose tolerance is often submitted as one of the few – if not only – examples of relatively recent genetic adaptation. But there’s a big difference. It’s not as if we adapted a means of digesting a foreign… Read more »
Josiah
Josiah
1 year 2 months ago

I want to add clarification as Bovine Lactose digestion is a mutation over 70% of the population has inherited and which occurred approximately 8000 years ago. Approximately 7400 years ago we have record of consuming it where it seems to have started in what is now Turkey. I only add this clarification as someone may not pickup your two lactose distinctions in your second point. As humans we have always had the ability to digest human lactose, Just not lactose from other species.

Mike OD - IF Life
8 years 6 months ago

Mark,

Speedy recovery! I’m the same mentality. I messed up my wrist and shoulder playing ice hockey…so I just keep on playing! 😀 Thank god for supermarkets….makes it alot easier to hunt dinner!

Tim
Tim
8 years 6 months ago

Sorry Mark but you’re facts are out of date…as is the Paleo diet.

Gene studies show the skin color change is very recent:

And we are more genetically different from Grok than he was from Neanderthals:
http://www.reuters.com/article/healthNews/idUSN1043228620071210?feedType=RSS&feedName=healthNews&rpc=22&sp=true

But yes, heal fast!

P
P
6 years 5 months ago
I’m not a genielogist (sp,if that word even exists) but I can only take from Mark how his advice has affected me. Since going primal, and only two months ago at that, I feel lighter, fitter, and full of energy. I never feel bloated, or overly full anymore. Nor do I feel like I HAVE to eat every few hours. I have only continued to feel better and look better, aside from those few benefits I look at Mark as a Leader by example. While other leaders of diets “sell” their theories and advice Mark gives it for free and… Read more »
Jesse
Jesse
5 years 8 months ago
Tim, I noticed a couple things about the articles you posted. Number one, the researcher involved in the first one said there were probably other genes that cause paling in europeans. Not that this throws out the point, there may not be other genes, pale skin may truly be that recent. But it’s far from a certainty in either direction. The second thing was cool, because I had long believed it even though I hadn’t heard the explanation: human evolution is accelerating because of rapid population growth and massive changes in diet. This clearly means we are still adapting to… Read more »
Jesse
Jesse
5 years 8 months ago

Lol, sorry, didn’t notice the date. I thought this was new. I don’t really expect a response.

Chuck
Chuck
4 years 1 month ago
I know this is several years after the fact, but it is something that should be noted. Genetics are not the only thing that affects skin color. Diet affects it as well. Certain fruits such a papaya will over time cause your skin to darken a little. If you are outside a lot, your skin will be a darker tan. I mention this because I have seen it in action. As a child I ate a lot of tropical fruits, and my skin tone was darker. Due to my Northern European genetics, it had a red tint to it. When… Read more »
Migraineur
8 years 6 months ago

That sounds perfectly dreadful, Mark – wishing you a speedy recovery!

Scott Kustes
8 years 6 months ago

Hope you’re doing better now Mark. I wrote a post back in November that expands on your discussion of death during childbirth, modern surgical procedures, etc. Check out Paleolithic Longevity.

Cheers
Scott Kustes
Modern Forager

Sasquatch
8 years 6 months ago
Hi Tim, Very interesting links. I’m with Mark on this one though. Just because our genes have changed doesn’t mean we’re all of a sudden adapted to eating grains. I do agree that we’ve begun adapting to an agricultural lifestyle. You can look at the duplication of the salivary amylase gene, lactose tolerance, resistance to zoonotic diseases etc. You can also point to the fact that the first generation to go from hunter-gatherer to agriculture is usually very unhealthy. But I think we are far from fully adapted. Just look at the obesity/diabetes/heart disease epidemic. And modern humans still have… Read more »
Mark Sisson
8 years 6 months ago
Tim, When you suggest my facts are out of date, you are assuming that there are actually “facts” that all scientists agree on in these fields of paleobiology, evolution, genomics, nutrigenomics and epigenetics. Most would agree that “facts” are very hard to come by in these fields. We all work off of theories, hypotheses and selective data, but that doesn’t mean that there is any real answer to these questions. If there were, everyone would be doing the right thing and agreeing on it. The PNAS paper you cite is interesting, but I disagree with the interpretation of the findings.… Read more »
Sasquatch
8 years 6 months ago
Hi Mark, This is turning into a nice little discussion. I like your idea of accumulating mutations due to a lack of selective pressure. I’ve often thought about that myself. I call it “devolution”. I’m not sure that was happening when we first adopted agriculture and it was making us really sick, but I bet it’s happening today to some extent. We live in a climate-controlled world where we can drive and take elevators almost everywhere. If we can’t see, we get glasses and cataract surgery. 20,000 years ago, if you couldn’t get around and couldn’t see, you were dead.… Read more »
Migraineur
8 years 6 months ago
An interesting discussion indeed, and not everything I’m about to say here is completely thought out. Still, I’ll throw it out and see what others can do with it. Surely we are also seeing diseases that would be maladaptive in younger people, but are not selected against because they occur either after our reproductive years or so late in reproductive years that we have already passed the genes on to at least one offspring. I’m thinking of things like diabetes and most cancers, of course. I don’t think that particularly supports either Mark or Tim’s point, but it’s fascinating to… Read more »
Mark Sisson
8 years 6 months ago
Sasquatch, Tim, Migraineur, Scott, Mike OD, I think I may have to do a piece on this. Part of what we are dealing with here is a semantic issue: how is the term “evolved” to be used in the context of the Primal Blueprint? On the one hand, evolution does mean “the changes seen in the inherited traits from one generation to the next”…on the other hand, I have always put evolution in the context of “favorable heritable traits that become more common in successive generations of a population while unfavorable traits are selected out”. And I think here we… Read more »
Scott Kustes
8 years 6 months ago
Mark, Epigenetics is a very interesting topic that I’ve touched on a couple times over on my site. Epigenetics is, as you said, why some people can be “susceptible” to a disease genetically, yet not get that disease. Epigenetics is the upper layer of that onion that determines which genes are expressed and which aren’t, the genotype vs the phenotype. I recall reading that in one of Jared Diamond’s books as well, that as a whole, we’re allowing maladaptive features to exist because of civilization and our ability to take care of all. I also recall him saying that amongst… Read more »
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[…] cell insulin sensitivity and normalize blood glucose, burn fat and preserve muscle. And all the recent discussion here on MDA about “all the many genetic differences we are seeing in the human […]

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[…] many of you know, I am coming off a three month rehab from knee surgery. I’m about 95% healed now and can even do my “Indigenous Peoples Stretch” (a full unloaded […]

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[…] Primal, but not to a fault (no coming-of-age blood initiation rites, no dying out because of a sprained ankle). Likewise, we’re modern (modern evolutionary science has given us the tools to conclude that the […]

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7 years 9 months ago

[…] Primal, but not to a fault (no coming-of-age blood initiation rites, no dying out because of a sprained ankle). Likewise, we’re modern (modern evolutionary science has given us the tools to conclude that the […]

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[…] My Knee is Killing Me… No Really. […]

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7 years 8 months ago

[…] My Knee is Killing Me… No Really. […]

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7 years 8 months ago

[…] My Knee is Killing Me… No Really. – Mar. 3 […]

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[…] fats and protein (with copious amounts of vegetables) while watching the carbs will keep us trim. Grok didn’t have it so easy. If Grok broke a leg or dislocated a shoulder, he wasn’t bouncing back after a quick visit to the […]

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[…] in shape he just might not be able to obtain food, fight off predators and invaders, and survive the daily grind. Grok also had his community to think […]

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[…] fitness department, he was also spot on (again, by basic evolutionary adaptation). However, in the “I just broke my leg” department, we moderns win it hands down. In the “It’s freezing rain, and some shelter and soup sure would […]

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[…] dampening the impact and increasing the resistance) or perhaps some hill sprints (when I had my knee problem, hill sprinting worked best because I wasn’t “falling” as far on each step, if that makes […]

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[…] Primal. Then, when you’re ready, regroup and give it your all. Otherwise, malaise or even injury can easily set in. Get real about what you’re up for, then do it! Oh, and if you’re […]

Ramsey Clark
Ramsey Clark
6 years 2 months ago

I just had my third surgery (meniscus tear) and it looks like my high impact days are over. I tore my ACL at age 18, later needed arthroscopic surgery to remove scar tissue and now this. Not to mention the three on my nose from fighting MMA… I recently switched to a primal lifestyle and I am never EVER going back!

-Cheers from Panama Mark, keep up the good work!

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[…] standards – a broken arm, a rolled ankle, or a minor infection – could have prematurely ended Grok’s life. And that these cases say nothing about Grok’s potential to live 70+ years. The “short and […]

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[…] was strong evidence in favor of stretching as a protective measure, I would be all over it, because I hate down time. But the latest research indicates that stretching is harmless at best and a performance-detractor […]

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[…] was strong evidence in favor of stretching as a protective measure, I would be all over it, because I hate down time. But the latest research indicates that stretching is harmless at best and a performance-detractor […]

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[…] my knee injury was an acute one, a freak accident caused by impact with the ground. It wasn’t exactly a […]

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[…] and his clan on a idyllic pedestal, it’s important to note they had little choice. They otherwise weren’t likely to see the next chapter of the Paleolithic story. Even in the best of personal circumstances and choices, many succumbed to all manner of […]

Animanarchy
Animanarchy
3 years 6 months ago

Back in what I think was grade 8.. maybe 7.. I tried out for the school volleyball team. Made an awesome dive where I literally did a barrel-roll.. like a screw.. hit the ball and scored a point. Didn’t get selected for the team!!

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[…] of a dumb instrument. It evolved in an environment when little mistakes could be very costly. A sprained ankle could mean death, destitution, or a limp that never leaves; these days, a sprained ankle means some ice, some […]

Erock
Erock
2 years 6 months ago
If you watch “The Perfect Human Diet” You will see the explanation of some of the best scientists in the world telling how we have not changed at all (blueprint) just the expression of different genes are what has been happening and that this is due to environmental factors including diet, exercise, level of activity…etc. The most interesting part to me was the they explain why so many people have glasses and crooked teeth (as I have both). Not that crooked teeth or poor vision are being passed on from one generation to the next as a form of Devolution,… Read more »
Alexz Ross
1 year 8 months ago

Are you okay now? Try to do some exercises and eat some healthy foods.

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1 year 7 months ago

[…] My Knee is Killing Me… No, Really. | Mark’s Daily Apple – Dear Mark: Pregnant Exercise, Low-Carb and Alcohol Tolerance, Ancestral Sun Dosages, and Knee Mobility Dear Mark: Bee Products, Unable to Squat After Knee Injury The …… […]

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[…] and Grok in all likelihood saw many of his clan succumb to everything from animal attacks to accidental injury to childbirth to interclan skirmishes. Animals died around them every day – the work of other […]

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[…] to its credit, has developed ways to save and even restore quality of life in situations that would’ve been our inevitable demise even a few decades ago. But it’s a different focus than efforts that simply prolong life in a […]

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[…] My Knee is Killing Me… No Really. […]

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[…] of a dumb instrument. It evolved in an environment when little mistakes could be very costly. A sprained ankle could mean death, destitution, or a limp that never leaves; these days, a sprained ankle means some ice, some […]

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