
Ask HN: How can I deal with chronic ligament and tendon injuries? - dominotw
I love physical activities but I seem to get injured very easily.<p>I played tennis for a bit, now I have tennis elbow.<p>I did biking for a while, now I have IT band syndrome.<p>I tried swimming for while thinking it would be safe, now I have shoulder impingement.<p>I have had these injuries for decades and have gone to countless doctors, done countless hours of physical therapy. nothing helped. I just sit on my couch all day due to these injuries. I know people all over the world are suffering from much worse but this is making me depressed and resentful. What should I do? also,  Has anyone tried stem cell therapy?
======
stephenbez
I'm in a similar situation, and here are some thoughts:

How quickly do you increase your training volume? Do you have enough rest and
recovery time?

When you first start feeling injured, do you stop, and rest a week or two, or
do you continue through the initial pain?

For running, it's commonly known that you shouldn't increase your distance by
more than 10% per week. For me, if I find that increasing 10% per week causes
injury but if I increase only 6% per week, I'm ok.

Do you warm up and stretch? Do you do strength training or rehabilitation
exercises? What about core strength?

I found a great massage therapist who points out issues with my body and
recommends stretches to help fix some of them. (I can give you a
recommendation if you are in SF)

Are you sure you have the correct form for the exercises? Maybe work with a
personal trainer? I biked for years with a bike way too small for me. Only
when I went to get my bike fit, and got a different one did pain go away.

Have you read up and gotten a good understanding of your injuries? I was
better able to understand and manage some injuries when I read "Treat Your Own
Rotator Cuff" and "Treat Your Own Back".

How carefully do you track your exercise? I tracked my exercise for a year and
discovered that I was 3x more likely to be injured after any given workout if
I had done X minutes of lower body exercise in the past Y days so I cut back
and had less injuries.

If you find any good solutions, please respond to the thread and let us know!

------
jmichelz
Decide that you are going to fix your problems with weight training. Start
ridiculously light, so there's no chance you will make it worse. Train every
day at first, increase the weight by a tiny amount each workout. I would
suggest one arm overhead press for your upper body, leg press or split squat
for lower, preferably at home with your own weights. It's a pain to drive to a
gym to do a 5 minute workout.

Buy 6 0.625 lb washers, 2 2.5 lb plates, 2 5 lb plates, 4 10 lb plates, 2 25
pound plates to start. You should be able to combine those to get any weight
from 0.625 lbs up to 100 lbs in 0.625 lb increments. Keep a training log, I
use google docs on my phone. Each workout add to the top of the file. Copy and
paste the last workout and change the weights.

At first add weight to your working set in small increments. Gradually
increase the increments up to 5 lbs for legs, 2.5 for arms. When it gets too
heavy, reduce the jumps back down.

Do 3 sets of 15 for each exercise for your work sets. Divide the working
weight by 4 and warmup by adding weight in those increments. For example 12
lbs / 4 = 3 lbs. Do an unweighted set, then 3 lbs, then 6, 9, 12. When the
weight gets heavy, switch to 3 times per week.

You have to be in charge of fixing your problems. Not the doctor or physical
therapist. It takes discipline and commitment. Training will not always feel
good. You have to figure out when you're having acceptable rehab pain, and
when you're damaging yourself. Obviously work through the former, and stop
immediately with the latter. You will mess up and have to start over. Probably
several times. But you can fix these problems. I'm available to help if you
need it.

~~~
ta_donk_gt
I agree with this overall. It is a long road to significant improvement, with
the occasional setback (sometimes way back), but taking charge of this
yourself is the only viable path for the long term.

One disagreement, though...I probably wouldn't do any overhead lifting with a
shoulder impingement. But do research on exercises to strengthen the current
injuries you have, and work into more general weight training over time. My
two cents.

------
jwr
Do your injuries show up clearly on a CT/ultrasound/MRI? If the answer isn't a
decisive Yes (decisive, because if you look hard enough you will always see
something), you might be seeing psychosomatic symptoms: illnesses caused by
your mind. The pattern you described sounds familiar. Especially muscle and
tendon pain is suspect, but many back pain problems can be psychosomatic in
nature, too.

At the very least read one of John Sarno's books, and see if your symptoms
change. If they do, you are on the right track.

~~~
jey
This can be true even if there's something "obvious" on the MRI, since the
importance really depends on the base rates of that abnormality in healthy
individuals without symptoms[1]. For example, it's easy to find bulging discs
when looking for the cause of back pain, but bulging discs are also very
common in asymptomatic individuals[2].

1\.
[https://arbital.com/p/bayes_rule/?l=1zq](https://arbital.com/p/bayes_rule/?l=1zq)

2\.
[http://www.ajnr.org/content/early/2014/11/27/ajnr.A4173.full...](http://www.ajnr.org/content/early/2014/11/27/ajnr.A4173.full.pdf)

------
mancerayder
Diet is important. The system needs food and the right nutrients to recover.
Read up on this, as there's an extensive amount of information to read. If
TLDR, then go high on the protein, go low on the carbs and cut out simple
carbs and sugar. Make sure you get the micronutrients as well (electrolytes
like magnesium, potassium, etc. etc.)

Rest properly. I sleep poorly, but I also only work out very heavily three
times a week. The system need rest to recover.

It sounds like you're not differentiating different types of activities. So we
don't know how often you do them, or anything else. Whether you took lessons
or professional guidance or just jumped in the water and starting splashing
hard around you, or what. Calisthenics / bodyweight training is very powerful,
well-rounded as it will strengthen your ligaments and tendons as well as your
muscles. In contrast to weight training (stay the hell away from machines
unless you are in physical therapy), calisthenics strives for functional
movements, which use several muscle groups in conjunction. You can find a lot
of material on this online.

Tennis elbow I can't help with, but running pains are very normal. I have
over-pronating feet so always suffered from knee issues and shin splint. But
most runners I know have issues like this. Muscle imbalances mixed with
individual mechanical quirks like flat feet (me). The muscle imbalance part is
even more common, and fixed by educating yourself and doing complementary
exercises. For example, exercises like squats and lunges help balance things
out against the evils of running alone.

Doctors are a pain. As someone said, find a sports one. Otherwise you'll risk
hearing 'Okay, stop exercising for 2 months and take aspirin every day.' I
hate it when doctors do stuff like that (ignore the individual person's goals
rather than work with them).

------
adamqureshi
Do yoga. Get an MRI see WTF is going on with your tendons or CT scan. Older
people typically get these types of injuries 60+. Its possible your straining
yourself too fast. Your body has to get "used" to working out then up your
workout. Your muscles need to support your activity level. You can't make your
tendons "stronger" they have to be stretched out / warmed out. Im not a
doctor. I don't know what i'm talking about BUT i been working out all my
life. My 2 cents. Gud Lucky. ;-)

~~~
rosser
Yoga is a great idea for many — probably even most — people, and has certainly
been good for me. Another comment suggested the possibility of Ehlers-Danlos
Syndrome (among other things, a connective tissue disorder), however, for
which yoga can be somewhat contraindicated. I'd want to that rule out before
beginning a yoga practice beyond Yin or restorative.

A friend with EDS practiced and taught Ashtanga for years before her
diagnosis. The ways the syndrome affects the joints meant that she was able to
perform asanas from the later series within a couple years of beginning her
practice.

Since she was doing stuff she was only capable of doing because of her
condition, however, and not stuff she'd trained up to, she ended up doing
significant damage to her joints; she's at the point now where her shoulders
often dislocate just from carrying too many full grocery bags up the stairs.

------
JakeAl
You need to find a doctor that practices professional sports medicine. You
know, the kind that treats professional athletes. Not the run of the mill
storefront doctor or GP.

------
Sanddancer
Have you ever been tested for Ehlers-Danlos Syndrome or similar connective
tissue diseases? A lot of the time with rare diseases, you can go quite a
while between doctors that have even heard of the disease, and come up with a
course of treatment that actually would be useful. Chronic sprains and other
tendon injuries are a pretty classic sign of the disease, and there are
definite exercises you can do to help mitigate effects, but because a lot of
the exercises are counterintuitive, developing a course of action that
actually works is difficult.

------
chadcmulligan
Have you tried Pilates? I was getting aches and pains, had a bad shoulder from
tennis for years, getting hip pain when I hiked and so on, just assumed I was
getting old.

I've taken up reformer pilates and I'm the best I've been in years, maybe
stronger than I've ever been (done about 30 sessions so far), shoulders
better, pains are gone. It relies on strengthening your core muscles - and all
the little muscles that don't get any work when you're sitting around. It may
be a lack of strength in these that is causing your pains. My recovery time
has increased to, yesterday I went for a 3 hour hike, thought I'd be sore
today, but no! I've wound the clock back 20 years.

If you do decide to do some though, look around for someone who knows what
they're doing - preferably a diploma and some years experience.

I go 2x1 hour sessions a week, and thats all you need, just whatever other
exercise you want each day apart from that, eventually you'll be doing pilates
3 or 4 times a week on your own should you choose.

It has been magic for me, I recommend it to everyone.

Edit: oh and sitting on the couch is probably the worse thing you can do, all
those little muscles will lose strength and aches and pains will not go away.

------
LeonB
As disturbed as I am that you'd ask about this on hacker news... it sounds
like a classic connective tissue disorder, i.e. joint hypermobility or Ehlers
Danlos Syndrome. Your history of medical mismanagement is also typical of
people with this problem: people will try to chase the problem around rather
without identifying the underlying cause.

------
DanBC
You deserve treatment for any psychological stuff caused by your physical
illness.

Some people with long term pain benefit from cognitive behaviour therapy. You
might want to see a pain clinic to get best quality advice about pain, and
about rehabilitation.

If you want to know what treatment you could expect from the English NHS you
could enter the condition in the search here:
[https://www.nice.org.uk/](https://www.nice.org.uk/)

They tell you the evidence they've used to come to their decision. They
sometimes give "Do NOT" advice, telling people to avoid some treatments.

Or you can try NHS Choices to get some general information.
[http://www.nhs.uk/pages/home.aspx](http://www.nhs.uk/pages/home.aspx)

In general, getting medical advice from the Internet is probably a bad idea.

~~~
cpncrunch
>You deserve treatment for any psychological stuff caused by your physical
illness.

Quite often the pain itself is caused by psychological factors. It's certainly
worth addressing psychological issues either way.

------
weaksauce
Coming from a climbing background I can say that tendons, ligaments and
pulleys are very common injuries because they take the longest(years!) to
strengthen up to the demands that climbing puts on them. Take it slow, listen
to your body, and rest enough.

------
giardini
What about walking, hiking and running?

About the tendons et al: are you able to voluntarily move your shoulder out of
joint? Can you bend your fingers and thumbs backwards? Would you characterize
yourself as "double-jointed"?

[http://www.livescience.com/33186-double-jointed-people-
hyper...](http://www.livescience.com/33186-double-jointed-people-
hypermobility.html)

[http://www.wisegeekhealth.com/what-does-it-mean-to-be-
double...](http://www.wisegeekhealth.com/what-does-it-mean-to-be-double-
jointed.htm)

------
duncanawoods
I have to live with a bunch of crap too (biceps, shoulder, back, knees). You
might be at the point where injuries don't go away, you just manage them. My
tips:

i) don't give up on exercise, I have had chronic injuries stay static or
worsen with deliberate rest and only improve with focussed work. Very high rep
pump exercises (30+ reps) getting a lot of blood into the muscle/tendon area
really helps. Cable machines are great. You can usually find an
exercise/angle/attachment combo that works the area without aggrevation.
Something like walking for a few miles helps my back.

ii) avoid actions that aggravate the specific impingement e.g. using a mouse
would cause acute pain in my shoulder but it was difficult to correlate
activities because the pain can show up a few days after the activity.

iii) Work on flexibility and mobility. Causes of injuries are often non-local
i.e. things are pulling other things out of place. Just work on complete
flexibility especially where you are inflexible - like hip-flexors, shoulders
and stuff. I have to do yoga exercises, stretching (90 second holds) and foam
rolling everyday if I want to sit down for hours without significant pain.

------
moc7
I sympathize with your situation. It sounds very similar to chronic pain
issues I've suffered for most of my life. I know how despondent it can make
you feel, I've been there. Being able to enjoy physical activity is very
important to one's mental and physical well being.

However, in recent years my condition improved dramatically. I believe I've an
autoimmune disorder. Here's some suggestions that helped me figure it out and
reverse it's progression:

Try high dose magnesium (Mg) for short while. 600-900mg of magnesium citrate
daily is best I think. It's not to correct a deficiency. It's for the effect
it has on the bowels. At a high does the bowels loosen and the microbiome
quickly changes. This alters how new immune cells develop, hopefully
positively as it did for me.

I wouldn't recommend taking Mg like this long term though. The best way to
positively improve the balance of components of the microbiome is to consume a
lot more fiber of various sorts and sources than is common in the western
diet. The usual advice on diet is to be recommended. Cut down on highly
processed simple carbohydrates. Some meat is ok but not a lot. Same for
alcohol. If you want to eliminate meat that's ok as long as your diet is still
varied and includes probiotic and fermented foods. And generally eat a lot
more plants.

To sum up I believe the immune system is groomed in the gut and the microbiome
is an essential part of that process. A malfunctioning and misdirected immune
system is responsible for many illnesses from those well known like arthritis
to ones we probably don't even have a name for yet.

Whether this helps you or not don't give up and keep looking with an open
mind.

------
jrockway
I agree with the others that suggest overuse injuries. Try resting more
between workouts (yup, that means sitting on the couch even though you're not
tired).

As for biking, a proper bike fit is crucial. Did you pay someone $200 to set
up your position on the bike? If not, it's probably wrong. (Even if you did do
a fitting, it could still be wrong. The fit changes as your develop or lose
strength, flexibility, etc.)

Biking is a great exercise because you can collect so much data while you
ride. Power is especially useful, so you can objectively judge how hard you
worked out and how much recovery time you need.

Cycling generally makes your IT band tight. Foam roll it after your workout. I
also spend a lot of time stretching out my hamstrings, because they are very
tight from sitting at a desk all day and directly affect one's posture on the
bike. (Standing desk is helpful for keeping your hamstrings long, if you can
actually be productive while standing.)

------
crawdog
With every sport if you have bad form it will lead to injury.

Let me address 2 of the non-impact sports you listed:

1\. Swimming - if you have a bad stroke and immediately go on to do long
yardage workouts you will hurt your shoulders. Working with a stroke coach and
slowing down to focus on your form will do a lot to avoid shoulder issues.
Alternate breathing mixed with some dry land work will help muscle imbalance
issues too

2\. Cycling is about fit and form. For i/t band issues if your position is
incorrect and you do a lot of mileage you will have knee problems. Also doing
some weight training can help. Get a proper fit from a bike shop that
specializes in shoe/saddle fit as well. Adding some resistance training will
also help

You must work up to being competitive. Going out and doing 60m or 3000 yards
on the first day will definitely lead to injury. Investing in a good coach
here can help.

------
Protostome
I have been experiencing similar injuries myself. After talking to several
trainers and physiotherapists, I found out that the problem is my sedentary
life style.

If you spend your entire day sitting in front of a desk, the muscles in your
body becomes less flexible and weaker. This effect is hard to reverse by
exercising alone. (9 hours of sitting on a chair vs. 1 hour of exercise)

For a person who lives this kind of lifestyle , you need to have much longer
warmups, do a lot of stretching (even on resting days and in the office), and
most of all, try to change the sedentary lifestyle by working standing up /
walking (walking desk) and stretch every few hours.

And a final comment, sitting on the couch all the is the worst thing you can
do. Don't give up on exercise, even if it's just walking. (you'll be surprised
how difficult a fast paced 10 mile walk can be!)

------
Thriptic
How much time have you invested into developing the proper form for these
activities? Does your training regimen make sense? I'm a powerlifter so I
can't speak to specific injuries in these sports, but most of the chronic
injuries I see in my sport are form-related or volume-related (over training)

------
Mz
Let me suggest No on the stem cell therapy:

[http://www.nytimes.com/2016/06/23/health/a-cautionary-
tale-o...](http://www.nytimes.com/2016/06/23/health/a-cautionary-tale-of-stem-
cell-tourism.html?_r=1)

I improved my tendons by consuming gelatin as a supplement daily for like a
year or two when they were so bad they were seriously interfering with, for
example, my ability to get out of bed unassisted.

/anecdata

------
r2d2too
I've been struggling with chronic issues like this for the past few years. The
only consistent relief comes from yoga (I like vinyasa) and physical therapy.

I find there are some things that make it worse but overall feels pretty
uncorrelated with anything obvious. Try keeping a detailed log of symptoms
along with possible triggers as well as things that make you feel better.

Good luck

------
kelukelugames
Fixing tennis elbow is trivial. They invented a foam bar and began clinical
trials. The stupid thing was so effective they had to end the trials early.

Here is a link to the product.
[http://amzn.to/29Ni3Ex](http://amzn.to/29Ni3Ex)

~~~
meandinger
I've tried this product. It exacerbated my tennis elbow.

I don't understand the "the our product was so successful we were forced to
end trials" argument. How long is the trial? 4 weeks? How big is the control
group? 8 people? Is it really unethical to have the control group wait a few
weeks to start using the effective treatment? This sounds like the exact
argument that a snake oil salesman would use.

------
dredmorbius
Continue with the medical route. If you're not satisfied with your docs, find
better ones. Demand they address your specific concerns, and any failure of
treatment or diagnosis to address root causes.

------
55555
This is almost certainly not truly a physical problem. It is not normal to
hurt yourself seriously and repeatedly doing normal physical activity. Do all
of your tennis, biking, and swimming buddies end up with serious chronic pain?

You likely have a deeper physiological problem that the physical activity is
bringing to the surface.

I can't help though, because I don't have mobility/physical issues and so I
don't research it much. My friend who is very smart and has mobility/back
issues says that this is the best book on the topic in the world, though:
[https://www.amazon.com/Becoming-Supple-Leopard-2nd-
Performan...](https://www.amazon.com/Becoming-Supple-Leopard-2nd-
Performance/dp/1628600837)

------
NegativeLatency
Try crawl stroke or breast stroke of your shoulders hurt from swimming. I swam
competitively for a long time and training backstroke always made my shoulder
hurt

------
toodlebunions
Are you overweight? Do you have a history of taking quinolone antibiotics? Is
your diet terrible?

Just a few thoughts, could be related. Good luck, chronic health issues suck.

~~~
Boothroid
Second this, I had a terrifying reaction to Ciprofloxacin to the point where I
could barely walk at one stage and have a range of progressive health issues
that may be related. My advice - do not take these antibiotics unless you
absolutely have no other option.

------
jmnicolas
To my knowledge inflammation comes from lack of water, bad food (red meat) and
bad posture.

If you drink sufficiently, have a clean diet and had some chiropractic
consultations then you need to explore radical options.

Look at the Wim Hoff method, it's a crazy Dutch man that swims near icebergs
and run naked in the snow. The method consist of breathing exercises, yoga
postures and cold showers. Apparently it cures inflammation in the body (among
other things).

I plan to give it a go this winter. If you can't afford it ($200) the backup
torrent is not that hard to find ;-)

~~~
dominotw
>To my knowledge inflammation comes from lack of water, bad food (red meat)
and bad posture.

I've been researching this for a bit and seems like chronic tendon injuries
show no sign of inflammation.

[http://www.aafp.org/afp/2013/0401/p486.html](http://www.aafp.org/afp/2013/0401/p486.html)

~~~
lj3
All chronic tendon injuries? Or yours? I guess what I'm asking is, have you
had blood tests done to check your omega-3, omega-6, and c-reactive protein
levels?

~~~
dominotw
>have you had blood tests done to check your omega-3, omega-6, and c-reactive
protein levels?

I've had blood tests done but i am not sure if these were tested. I am
reasearching these now and will get this done if not already. Thanks for the
pointer.

------
kspaans
Have you looked into Trigger Point Therapy? It's worked for a friend of mine
with RSI.

------
rabboRubble
If you are female, have you had your progesterone levels checked post
ovulation?

------
diyseguy
It sounds simple, but are you drinking enough water?

------
arisAlexis
There are some studies about collagen

------
NullNull7524
Hello,

I'm so sorry to hear about your frequent injuries! I'm chiming in here to
agree with Sanddancer. Seven years ago, I suffered what I thought was my first
tendon injury. One year ago I was diagnosed with Ehler's Danlos Syndrome, a
disorder in producing one of the types of collagen the human body uses as a
building block and sort of 'glue'.

Ligament and tendon injuries are the most common and most disabling part of
this disorder due to their longer/hypermobile length, lack of tensile strength
and poor healing abilities. We are prone to frequent dislocations and partial
dislocations causing extreme pain. If this happens frequently enough, the
tendons and ligaments in the joint can't pop all the way back into shape.

In normal people, these generally heal on their own and beyond anti-
inflammatory meds, pain killers and steroid injections, orthopedic doctors
don't have any ability to help. Every kind of surgery they've developed to
physically shorten ligaments and tendons has failed- generally within 18
months of surgery.

I have severe right shoulder instability, instability in both hips and both SI
joints, and patellar pain on both sides due to my knee caps not gliding
properly. I've recently discovered something called Prolotherapy. These
injections consist of a numbing agent, then an irritant followed by a pain
killing dose of high concentration oxygen injected directly into the stretched
and torn ligaments and tendons. The irritant causes new cellular
proliferation, inflammation and healing and thusly, shortening of the damaged
ligaments and tendons. If you are currently taking any anti-inflammatory
medications- I'd stop now. They are blocking a natural healing response of the
body. That pain is the feeling of healing. I made the mistake of taking them
myself not knowing I was compounding the problem.

These treatments are rather controversial in the EDS community due to the
rarer forms of EDS causing healing abilities so poor that they prevent the
irritant from working. I have the most common form of EDS and the two
treatments I've recently had in my hips and SI joint systems have taken me
from thinking about a wheelchair to imagining hiking and dancing again. I too
have always been a very active person and I look very forward to returning to
my activities.

I'd look into visiting a geneticist to determine whether or not you have EDS.
If so, and if it's Hypermobility Type III, I'd skip being told there is
nothing available by an Ortho doc and go to the best Osteopathic Doctor you
can find in your area.

After recieving my diagnosis, I realized I'd been suffering minor dislocations
since childhood. Ten or so 'sprains' before 15 was probably not normal.
Wishing you all the best and I hope Sanddancer and I are wrong. Without EDS or
some other genetic connective tissue disorder though, the treatments I
mentioned should be even more effective.

------
Boothroid
Perhaps you are just not made well enough for strenuous activities, sorry to
say - this is the conclusion I have come to as I can't really run or cycle for
more than a few miles before my knees get so sore I have to stop. I can walk
around 15 miles tops and can lift weights if I'm very careful to not go too
heavy. I have had a similar experience where I really want to exercise but
keep getting injured. So these days I walk and lift weights gently. I've found
that doctors are dangerous, prescribing poisonous combinations of drugs that
is NSAIDs and quinolone antibiotics. Stay away from those and Aspirin unless
you have absolutely no other choice. I seem to recall reading about stem cell
treatments for people that had had bad reactions to quinolones but think its
in its infancy. I am unusually flexible for a bloke so think this
hypermobility probably goes hand in hand with injuries. Don't know if you find
the same?

------
GFK_of_xmaspast
Why would the hacker news commentariat know more than actual doctors?

~~~
jmnicolas
If you still trust doctors, you must be healthy ... once you start to have
problems, especially the chronic kind, you will see that doctors don't know
much and are just big pharma salesmen.

~~~
dominotw
This has been totally true for me. 99% specialists I've seen are totally
clueless. Some of them flat out said they have no clue and can't help me other
than offering advice to rest.

~~~
x0x0
Find a sports physician. Ask around at a good powerlifting, strongman,
olympic, or maybe even crossfit gym. (What is a good gym? They should have a
lot of people squatting/dl over 500, and a handful 800+. There will be names
on a leaderboard.) They'll know doctors that help you work through injuries.

And foam roller your it band. Every evening, and maybe every morning as well.

edit: with the it band, make sure it is your it band. Check with a good pt
person that you don't have weak butt muscles (I forget which.) There's a
simple test for this that involves lying on your side and raising a leg, but I
don't think I can adequately explain it in text.

source: 10 months on crutches and a very tight it band.

~~~
to3m
"500"? Permit me to channel my secondary school chemistry teacher: 500
elephants? 500 biscuits? Units, lad! UNITS.

(Of course - I know you mean kg! But the point stands.)

~~~
x0x0
pounds

500kg = 1102lbs; the list of people who can dl that is: Eddie Hall. AFAIK only
4-5 men have dl'd over 1k lbs ever (regulation height, no suit, not tire
deadlifts or some bs) -- Benny, Eddie, Andy Bolton, Jerry Pritchett, Brian
Shaw.

The list of 1000 pound squatters (no suit) is short too. Ed Coan, Malanichev,
and a few others.

Anyone who can squat 500 lbs is strong. To depth, obviously -- lots of people
can do 500 lbs knee bends.

~~~
to3m
Hash tag british humour.

Ordinarily I'd deploy hash tag that was the joke... but your reply in this
instance was far too informative, and I'd run the risk (?) of looking (?) like
(?) a twat.

~~~
x0x0
whoosh

the sound of that joke going over my head =P

