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Apr 21, 2023Liked by Paul Ingraham

I’m sorry that that is happening.

Other people have said it more eloquently but… we want our lives to make sense. To have a certain narrative.

Looking back, I try to put things that happened to me in some sort of context, cause and effect but it doesn’t work. It doesn’t make sense.

What if it just doesn’t work that way? We don’t have control over our lives. Things just happen for no reason we can comprehend?

Sorry, that’s a bit meta. Again, sorry that your experiment did not have the result you were hoping for.

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Thank you, sir. I like "meta," and there's plenty of it to consider here. 🙂 Biology is destiny, and there are huge regions of that territory as unexplored as the ocean deeps. Humans have learned to control several nasty pathologies, but much of it is fragile and imperfect, and even that is only a fraction of what we need.

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Thank-you. One less worry...

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BTW Twitter is blocking (at least for me) liking and commenting on your post there about this article. They appear to be limiting posts linked to Substack. Which is a pity as it has given me a lot to think about as regards my own issues.

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Thanks for the heads up, I hadn't heard yet. Yes, it appears that Elon has made yet another ridiculous decision, and is blocking all engagement with tweets that refer to Substack. His pettiness is effectively unlimited!

https://www.nytimes.com/2023/04/07/technology/twitter-substack-elon-musk.html

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Apr 7, 2023Liked by Paul Ingraham

Thank you! I agree but sometimes I imagine I wrecked my muscles since the slightest thing, like moving a potted plant, makes them sore. I wonder if muscles can be permanently damaged? I think you already answered by saying exercise intolerance is a symptom and not a cause, but I don't know if the fatigue after doing anything is different than muscle pain. Probably it's all part of the big, ugly, life-ruining package.😡

I might add, at the risk of inducing you're ire, if the fact that I was completely disassociated from my body and totally in my head for many years made it possible for me to continue doing something I was too old for and didn't have the build for. I'm 5’7” and weigh about 12 lbs. If I had built up muscles, I never saw them!

So that's a roundabout way of saying mind/body stuff matters in this, I think. There again, you seemed to have had plenty of body awareness! Aaarrrrggghhhh!

If I have to ask myself once more, “Ok, I'm sad, where do I feel it in my body?” once more, I'll shoot myself in the face. Ok, that was violent, but it's a tough road back to a body I hate. Ya know?

Thanks for being your intelligent, undeterred, and amusing self.

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"If I have to ask myself once more, 'Ok, I'm sad, where do I feel it in my body?' once more…"

Well, for whatever it’s worth, I don’t think you need to ask that. 😜

"I don't know if the fatigue after doing anything is different than muscle pain…"

It’s certainly not normal to experience either significant fatigue OR pain after mild exertion. That sounds like classic exercise intolerance, and I know it all too well. But whether that abnormal reaction is JUST a symptom or it ALSO actually causes more trouble … I just don’t know.

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Muscles can be permanently damaged by rhabdomyolysis. Rhabdo is normally thought of as something that occurs only with extremes of physiological stress, causing severe and acute malaise. But it is likely that milder, non-obvious rhabdo is also possible, and it would just feel like a particularly nasty episode of post-exercise muscle soreness … and it’s possible that each such episode could do a little bit of damage, and it could accumulate over time. If that phenomenon has ever been confirmed, I am unaware of it, but unfortunately it is quite plausible. I discuss this idea in some detail here:

https://www.painscience.com/articles/delayed-onset-muscle-soreness.php

However, I still doubt that you need to worry about that. If you were doing that to yourself, you would have seen a slower progression of muscle weakness and pain over many months or even years… rather than the relatively sudden onset you have described.

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This was an interesting article. I've been wondering for years if I exercised myself into this state of Myofascial Pain Syndrome/Fibromyalgia/CFS/ME or WHATSTUPIDEVER this is. Maybe my story will add to your research. 2015 was also my own year of saying goodbye to everything fun I'd ever known. I was in my 50’s and a huge athlete. For 30 years I had been a triathlete so I happily ran, swam, cycled, hiked, mountain biked, etc., etc. before work. I did 100-mile bike rides regularly. For my 50th birthday, I did the 15-hour hike to the top of Half Dome in Yosemite. All of this, the harder the better. I loved it. I never got injured, I wasn't sore after stuff, and I never even felt tired. While still doing one sport before work each day, I settled into my eventual (and hardest) favorite, mountain biking. We were locally famous women. We were older ladies who could bike as long and as strong as the young men. We loved the work of it. I would come home all muddy after three hours of hammering the hills and before I'd go inside I would work in the garden for a few hours. No prob.

Then in 2015, one unfine day, I came home from a ride and felt tired. I didn't feel like gardening. I just wanted to sit around. I thought it was an off day but it kept happening. No pain, I just felt tired. Too tired. Eventually, the tiredness forced me to stop everything altogether. I was 57. You'd think I could then just take easy road bike rides around town, go for easy hikes, and swim a little. Nope, everything made me tired, and eventually, AFTER I STOPPED everything, it all began to hurt. My muscles felt worthless. I had to retire early. Here I am, eight years later and the same things hurt even though I haven't done ANYTHING to speak of. If I do the smallest thing I'm in pain for days.

So I had to wonder all these years, “Did I do this to myself?” Once I began to feel too tired to even think about biking, it only took a few months to be unable to do anything.

Other than you're continuing on in terrific pain for your sport, what is the difference in our experiences? If we caused our own weird illnesses, why we're the way we ended our sports so different? I stopped almost right away and you kept going yet we both landed here.

I'm no scientist and you are the brilliant one! What do you suppose?

Jody Eastman

California

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Apr 7, 2023·edited Apr 7, 2023Author

"We were locally famous women. We were older ladies who could bike as long and as strong as the young men."

Love it. 🙂

I think the difference in our experiences is that you had a sudden onset, with no warnings signs that you were overdoing it prior to the start of your troubles. My problems evolved slowly, and there were many signs for years that I, perhaps, was overdoing it.

I don’t think it’s inconceivable that intense exercise could insidiously undermine health… but it seems quite unlikely to me. Even WITH the warning signs that I had, blaming the exercise is quite speculative.

You sound a lot more like many cases I’ve heard of over the years, where some unknown pathology relatively suddenly strikes… and hard exercise becomes impossible, and easy exercise becomes hard. It seems most likely to me that your exercise intolerance is entirely a symptom, not a cause.

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Apr 7, 2023Liked by Paul Ingraham

Some of the causality may have run the other way... i.e. giving up ultimate became thinkable *because* your baseline & recovery capacity were dropping...? I often find myself mysteriously giving up on activities, and blaming my mood, or my character, only to find the next day that a virus has got ahold of me: my body knew I was sick, and took measures to accommodate it, before I did. (Whatever "I" means. Cognition is a weird gig.)

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Perhaps! That is exactly the kind of possibility I like to consider. But at that point in the year I had only just begun the downward trend that was much more obvious by autumn, and I hardly needed any additional incentive in any case: I had been teetering on the edge of quitting for at least three years, routinely questioning the sanity of continuing. And I had started planning and psyching myself up for retirement a full year earlier. I started telling people in the summer of 2021 that the next summer would likely be my last.

But despite all that, it is still possible that I sensed the impossibility of continuing, and that helped me finally make the difficult choice.

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Apr 7, 2023Liked by Paul Ingraham

I've had an identical experience with hiking. Greatly exasperated symptoms after hiking, but when I took a break from hiking - exasperated symptoms! I'm trying to split the difference by taking it slower and mixing up my exercise (gym, bike, hike.) I tell myself it's down to age (I'm in my 60s) but I'm not convinced, and I miss the joy of a beautiful and strenuous 10 mile hike.

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Apr 7, 2023Liked by Paul Ingraham

I'm sorry you're dealing with this. It's not your age! You were doing reasonable exercise and taking care of yourself by doing so, in my opinion. I'm glad for you that you can still do some things. Keep it up! You're out there, able to do something! Good luck to you.

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deletedApr 8, 2023Liked by Paul Ingraham
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Yeah, it could be a factor, and I considered covering that in the post. And I knew someone would probably ask. 🙂 But I just don’t believe that deleting one pleasure from my life can possibly account for SO MUCH worsening in the fall and winter… especially when, if anything, giving my body a rest is a much more plausible source of relief. I really miss ultimate, for sure. But I have endured far greater psychological hardships in the last eight years WITHOUT any apparent effect on the course of my illness. I covered the psychological angle quite thoroughly in a past post:

https://tryeverything.substack.com/p/did-stress-cause-my-pain-and-illnes

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deletedApr 8, 2023Liked by Paul Ingraham
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It sure is. It happened in slow-motion, so it never felt like a huge blow, and I found reasons to keep hoping for months. But at the end of the winter here, looking back, I think this probably ranks as the most painful defeat and disappointment of the whole pitiful saga. There's plenty more for me to try still … but nothing as promising as knocking off the extreme exertion. Bah!

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Good morning. First, if someone wants to know what KB is asking about, it’s a story I tell about apparently curing someone from a very nasty shoulder pain in just a couple minutes back when I was a massage therapist:

https://www.painscience.com/trigger_point_doubts

So what really happened? Obviously "I don’t know" is actually the only truly correct answer, but I get that you're asking for my best guess. 😜

My best guess is that it was exactly what it looked like: I suspect that trigger point therapy really did work … despite my doubts, despite the uncertainties. I do not have high confidence in this interpretation, but it is my best guess. Some "trigger points" (whatever they are, however they work) do sometimes respond well to some stimulation.

But the point of sharing the story is that I cannot possibly KNOW that, and it’s really quite important to acknowledge that and to explore alternatives to "I just had amazing massage skillz." So what's the next most likely explanation? What could explain his experience that doesn't have anything to do with a putative "trigger point"? My best guess at THAT …

An expectation effect (placebo) boosted by just the right social cues and some "persuasive" sensory guidance. My style and framing of the experience and the way that I touched his shoulder and all contributed to his FAITH that he was getting a lucky dose of just the right medicine... producing a mind-powered "healing" effect. This is basically how faith healing works... but by appealing to different biases and hopes and values.

But I also think that this is all a bit of a reach. I think THAT interpretation is actually a bit sketchier than the trigger point therapy interpretation! But they both have big problems.

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deletedApr 10, 2023Liked by Paul Ingraham
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