The most nutrient dense foods

I remember reading something about the diets of the Victorians. They ate a lot of odd foods, they ate a lot of food, and that their food was incredibly nutrient dense. And what the heck is purslane?

We hear about the lack of nutrients in our modern processed food but what should we be eating? What are the most nutrient dense foods? This question is relatively easily answered.

I downloaded a spreadsheet of the 2013 USDA dataset from the site of noted vegetarians James H. Thompson and William Harris... not that I'm vegetarian but I appreciate the data!

I reduced the dataset to a few a fields:

• Calcium, Ca (mg) per 100 Cal
• Iron, Fe (mg) per 100 Cal
• Magnesium, Mg (mg) per 100 Cal
• Phosphorus, P (mg) per 100 Cal
• Potassium, K (mg) per 100 Cal
• Zinc, Zn (mg) per 100 Cal
• Copper, Cu (mg) per 100 Cal
• Manganese, Mn (mg) per 100 Cal
• Selenium, Se (µg) per 100 Cal
• Vitamin C, total ascorbic acid (mg) per 100 Cal
• Thiamin (mg) per 100 Cal
• Riboflavin (mg) per 100 Cal
• Niacin (mg) per 100 Cal
• Pantothenic acid (mg) per 100 Cal
• Vitamin B-6 (mg) per 100 Cal
• Folate, total (µg) per 100 Cal
• Folic acid (µg) per 100 Cal
• Vitamin B-12 (µg) per 100 Cal
• Vitamin A, RAE (µg) per 100 Cal
• Retinol (µg) per 100 Cal
• Carotene, beta (µg) per 100 Cal
• 328 - Vitamin D (D2 + D3) (µg)
• 430 - Vitamin K (phylloquinone) (µg)
• 429 - Dihydrophylloquinone (µg)
• 428 - Menaquinone-4 (µg)

Most of these fields are normalized per 100 calories, giving me some sense of nutrient density. I then converted the value of each of these fields for each food to a score from 0 to 1. A value of 1 indicates that the food is the most dense for a particular nutrient. I then summed the individual scores to come up with a general nutrient density for each food.

So, what foods are nutrient dense? Or, more precisely, what foods have a nutrient score that are at least two standard deviations above the mean?

• ACEROLA JUICE,RAW
• ACEROLA,(WEST INDIAN CHERRY),RAW
• AMARANTH LEAVES,CKD,BLD,DRND,W/SALT
• AMARANTH LEAVES,CKD,BLD,DRND,WO/SALT
• AMARANTH LEAVES,RAW
• ARUGULA,RAW
• ASPARAGUS,CKD,BLD,DRND
• ASPARAGUS,CKD,BLD,DRND,W/SALT
• ASPARAGUS,CND,DRND SOL
• ASPARAGUS,CND,NO SALT,SOL&LIQUIDS
• ASPARAGUS,FRZ,CKD,BLD,DRND,W/SALT
• ASPARAGUS,FRZ,CKD,BLD,DRND,WO/SALT
• ASPARAGUS,RAW
• BABYFOOD,CARROTS,TODDLER
• BABYFOOD,VEG,CARROTS,JR
• BABYFOOD,VEG,CARROTS,STR
• BABYFOOD,VEG,GARDEN VEG,STR
• BABYFOOD,VEG,SPINACH,CRMD,STR
• BALSAM-PEAR (BITTER GOURD),LEAFY TIPS,CKD,BLD,DRND,W/SALT
• BALSAM-PEAR (BITTER GOURD),LEAFY TIPS,CKD,BLD,DRND,WO/SALT
• BALSAM-PEAR (BITTER GOURD),LEAFY TIPS,RAW
• BAMBOO SHOOTS,CKD,BLD,DRND,W/SALT
• BASIL,FRESH
• BEEF, VAR MEATS&BY-PRODUCTS, LIVER, CKD, PAN-FRIED
• BEEF,VAR MEATS & BY-PRODUCTS,LIVER,CKD,BRSD
• BEEF,VAR MEATS&BY-PRODUCTS,KIDNEYS,RAW
• BEEF,VAR MEATS&BY-PRODUCTS,LIVER,RAW
• BEEF,VAR MEATS&BY-PRODUCTS,SPLEEN,CKD,BRSD
• BEEF,VAR MEATS&BY-PRODUCTS,SPLEEN,RAW
• BEET GREENS,RAW
• BEET GRNS,CKD,BLD,DRND,W/SALT
• BEET GRNS,CKD,BLD,DRND,WO/SALT
• BORAGE,CKD,BLD,DRND,W/SALT
• BORAGE,CKD,BLD,DRND,WO/SALT
• BORAGE,RAW
• BRAZILNUTS,DRIED,UNBLANCHED
• BROCCOLI RAAB,CKD
• BROCCOLI RAAB,RAW
• BROCCOLI,CHINESE,COOKED
• BROCCOLI,LEAVES,RAW
• BUTTERBUR,(FUKI),RAW
• BUTTERBUR,CANNED
• BUTTERBUR,CKD,BLD,DRND,W/SALT
• BUTTERBUR,CKD,BLD,DRND,WO/SALT
• CABBAGE,CHINESE (PAK-CHOI),CKD,BLD,DRND,W/SALT
• CABBAGE,CHINESE (PAK-CHOI),CKD,BLD,DRND,WO/SALT
• CABBAGE,CHINESE (PAK-CHOI),RAW
• CARDOON,RAW
• CARROT JUICE,CANNED
• CARROTS,BABY,RAW
• CARROTS,CKD,BLD,DRND,W/SALT
• CARROTS,CKD,BLD,DRND,WO/SALT
• CARROTS,CND,NO SALT ,DRND SOL
• CARROTS,CND,NO SALT,SOL&LIQUIDS
• CARROTS,CND,REG PK,DRND SOL
• CARROTS,CND,REG PK,SOL&LIQUIDS
• CARROTS,FROZEN,UNPREPARED
• CARROTS,FRZ,CKD,BLD,DRND,W/SALT
• CARROTS,FRZ,CKD,BLD,DRND,WO/SALT
• CARROTS,RAW
• CELTUCE,RAW
• CEREALS RTE,GENERAL MILLS,TOTAL RAISIN BRAN
• CEREALS RTE,GENERAL MILLS,TOTAL,CRANBERRY CRUNCH
• CEREALS RTE,GENERAL MILLS,WHL GRAIN TOTAL
• CEREALS RTE,KELLOGG,KELLOGG'S ALL-BRAN BRAN BUDS
• CEREALS RTE,KELLOGG,KELLOGG'S ALL-BRAN COMPLETE WHEAT FLAKES
• CEREALS RTE,KELLOGG,KELLOGG'S ALL-BRAN ORIGINAL
• CEREALS RTE,KELLOGG,KELLOGG'S PRODUCT 19
• CEREALS RTE,RALSTON ENR BRAN FLAKES
• CEREALS RTE,SUN COUNTRY,KRETSCHMER TSTD WHEAT BRAN
• CHARD,SWISS,CKD,BLD,DRND,W/SALT
• CHARD,SWISS,CKD,BLD,DRND,WO/SALT
• CHARD,SWISS,RAW
• CHERVIL,DRIED
• CHICKEN,BROILERS OR FRYERS,BACK,MEAT ONLY,CKD,ROTISSERIE,ORI
• CHICKEN,BROILERS OR FRYERS,DRUMSTK,MEAT & SKN,CKD,ROTISSERIE
• CHICKEN,BROILERS OR FRYERS,DRUMSTK,MEAT ONLY,CKD,ROTISSERIE,
• CHICKEN,BROILERS OR FRYERS,GIBLETS,RAW
• CHICKEN,BROILERS OR FRYERS,WING,MEAT & SKN,CKD,ROTISSERIE,OR
• CHICKEN,BROILERS OR FRYERS,WING,MEAT ONLY,CKD,ROTISSERIE,ORI
• CHICKEN,CAPONS,GIBLETS,CKD,SIMMRD
• CHICKEN,CAPONS,GIBLETS,RAW
• CHICKEN,LIVER,ALL CLASSES,CKD,PAN-FRIED
• CHICKEN,LIVER,ALL CLASSES,CKD,SIMMRD
• CHICKEN,LIVER,ALL CLASSES,RAW
• CHICKEN,ROASTING,GIBLETS,RAW
• CHICORY GREENS,RAW
• CHIVES,FREEZE-DRIED
• CHIVES,RAW
• CHRYSANTHEMUM LEAVES,RAW
• CHRYSANTHEMUM,GARLAND,CKD,BLD,DRND,W/SALT
• CHRYSANTHEMUM,GARLAND,CKD,BLD,DRND,WO/SALT
• CHRYSANTHEMUM,GARLAND,RAW
• CLAM,MXD SP,CND,LIQ
• COLLARDS,CKD,BLD,DRND,W/SALT
• COLLARDS,CKD,BLD,DRND,WO/SALT
• COLLARDS,FRZ,CHOPD,CKD,BLD,DRND,W/SALT
• COLLARDS,FRZ,CHOPD,CKD,BLD,DRND,WO/SALT
• COLLARDS,FRZ,CHOPD,UNPREP
• COLLARDS,RAW
• CORIANDER (CILANTRO) LEAVES,RAW
• CORIANDER LEAF,DRIED
• CORNSALAD,RAW
• COWPEAS,LEAFY TIPS,CKD,BLD,DRND,W/SALT
• COWPEAS,LEAFY TIPS,CKD,BLD,DRND,WO/SALT
• COWPEAS,LEAFY TIPS,RAW
• CRESS,GARDEN,CKD,BLD,DRND,W/SALT
• CRESS,GARDEN,CKD,BLD,DRND,WO/SALT
• CRESS,GARDEN,RAW
• DANDELION GREENS,RAW
• DANDELION GRNS,CKD,BLD,DRND,W/SALT
• DANDELION GRNS,CKD,BLD,DRND,WO/SALT
• DILL WEED,DRIED
• DILL WEED,FRSH
• DOCK,CKD,BLD,DRND,W/SALT
• DOCK,CKD,BLD,DRND,WO/SALT
• DOCK,RAW
• DRUMSTICK LEAVES,CKD,BLD,DRND,W/ SALT
• DRUMSTICK LEAVES,CKD,BLD,DRND,WO/ SALT
• DRUMSTICK LEAVES,RAW
• DUCK,DOMESTICATED,LIVER,RAW
• ENDIVE,RAW
• EPAZOTE,RAW
• FIDDLEHEAD FERNS,RAW
• FISH OIL,COD LIVER
• FISH,WHITEFISH,EGGS (ALASKA NATIVE)
• FRANKFURTER,TURKEY
• FRUIT-FLAVORED DRK,PDR,W/ HI VIT C W/ OTHER ADDED VIT,LO CAL
• GOOSE,LIVER,RAW
• GRAPE LEAVES,RAW
• JUTE,POTHERB,CKD,BLD,DRND,W/SALT
• JUTE,POTHERB,CKD,BLD,DRND,WO/SALT
• JUTE,POTHERB,RAW
• KALE,CKD,BLD,DRND,W/SALT
• KALE,CKD,BLD,DRND,WO/SALT
• KALE,FRZ,CKD,BLD,DRND,W/SALT
• KALE,FRZ,CKD,BLD,DRND,WO/SALT
• KALE,RAW
• KALE,SCOTCH,RAW
• LAMB,VAR MEATS&BY-PRODUCTS,KIDNEYS,CKD,BRSD
• LAMB,VAR MEATS&BY-PRODUCTS,KIDNEYS,RAW
• LAMB,VAR MEATS&BY-PRODUCTS,LIVER,CKD,BRSD
• LAMB,VAR MEATS&BY-PRODUCTS,LIVER,CKD,PAN-FRIED
• LAMB,VAR MEATS&BY-PRODUCTS,LIVER,RAW
• LAMB,VAR MEATS&BY-PRODUCTS,SPLEEN,CKD,BRSD
• LAMB,VAR MEATS&BY-PRODUCTS,SPLEEN,RAW
• LAMBS QUARTERS,CKD,BLD,DRND,W/SALT
• LAMBSQUARTERS,CKD,BLD,DRND,WO/SALT
• LAMBSQUARTERS,RAW (NORTHERN PLAINS INDIANS)
• LAMBSQUARTERS,STMD (NORTHERN PLAINS INDIANS)
• LEAVENING AGENTS,BAKING PDR,DOUBLE-ACTING,NA AL SULFATE
• LEAVENING AGENTS,BAKING PDR,DOUBLE-ACTING,STRAIGHT PO4
• LEAVENING AGENTS,BAKING PDR,LOW-SODIUM
• LEAVENING AGENTS,YEAST,BAKER'S,COMPRESSED
• LETTUCE,BUTTERHEAD (INCL BOSTON&BIBB TYPES),RAW
• LETTUCE,COS OR ROMAINE,RAW
• LETTUCE,GRN LEAF,RAW
• LETTUCE,RED LEAF,RAW
• MALABAR SPINACH,COOKED
• MARJORAM,DRIED
• MUSHROOMS,BROWN,ITALIAN,OR CRIMINI,RAW
• MUSHROOMS,MOREL,RAW
• MUSHROOMS,PORTABELLA,EXPOSED TO UV LT,GRILLED
• MUSHROOMS,PORTABELLA,EXPOSED TO UV LT,RAW
• MUSHROOMS,PORTABELLA,GRILLED
• MUSHROOMS,PORTABELLA,RAW
• MUSHROOMS,WHITE,CKD,BLD,DRND,W/ SALT
• MUSHROOMS,WHITE,CKD,BLD,DRND,WO/ SALT
• MUSHROOMS,WHITE,RAW
• MUSTARD GREENS,RAW
• MUSTARD GRNS,CKD,BLD,DRND,W/SALT
• MUSTARD GRNS,CKD,BLD,DRND,WO/SALT
• MUSTARD GRNS,FRZ,CKD,BLD,DRND,W/SALT
• MUSTARD GRNS,FRZ,CKD,BLD,DRND,WO/SALT
• MUSTARD GRNS,FRZ,UNPREP
• MUSTARD SPINACH,(TENDERGREEN),CKD,BLD,DRND,W/SALT
• MUSTARD SPINACH,(TENDERGREEN),CKD,BLD,DRND,WO/SALT
• MUSTARD SPINACH,(TENDERGREEN),RAW
• NEW ZEALAND SPINACH,CKD,BLD,DRND,W/SALT
• NEW ZEALAND SPINACH,CKD,BLD,DRND,WO/SALT
• NEW ZEALAND SPINACH,RAW
• NOPALES,CKD,WO/SALT
• NOPALES,RAW
• ONIONS,YOUNG GRN,TOPS ONLY
• OOPAH (TUNICATE),WHL ANIMAL (ALASKA NATIVE)
• OYSTER,EASTERN,CANNED
• OYSTER,EASTERN,FARMED,CKD,DRY HEAT
• OYSTER,EASTERN,FARMED,RAW
• OYSTER,EASTERN,WILD,CKD,DRY HEAT
• OYSTER,EASTERN,WILD,CKD,MOIST HEAT
• OYSTER,EASTERN,WILD,RAW
• OYSTER,PACIFIC,CKD,MOIST HEAT
• OYSTER,PACIFIC,RAW
• PAPRIKA
• PARSLEY,DRIED
• PARSLEY,FREEZE-DRIED
• PARSLEY,FRSH
• PEPPERONI,PORK,BEEF
• PEPPERS,HOT CHILI,RED,CND,EXCLUDING SEEDS,SOL&LIQUIDS
• PEPPERS,SWT,RED,FREEZE-DRIED
• POKEBERRY SHOOTS,(POKE),CKD,BLD,DRND,W/SALT
• POKEBERRY SHOOTS,(POKE),CKD,BLD,DRND,WO/SALT
• POKEBERRY SHOOTS,(POKE),RAW
• PORK,FRSH,VAR MEATS&BY-PRODUCTS,KIDNEYS,RAW
• PORK,FRSH,VAR MEATS&BY-PRODUCTS,LIVER,CKD,BRSD
• PORK,FRSH,VAR MEATS&BY-PRODUCTS,LIVER,RAW
• PORK,FRSH,VAR MEATS&BY-PRODUCTS,SPLEEN,RAW
• POULTRY SEASONING
• PUMPKIN FLOWERS,CKD,BLD,DRND,WO/SALT
• PUMPKIN LEAVES,CKD,BLD,DRND,W/ SALT
• PUMPKIN LEAVES,CKD,BLD,DRND,WO/SALT
• PUMPKIN LEAVES,RAW
• PUMPKIN,CANNED,WITH SALT
• PUMPKIN,CKD,BLD,DRND,W/SALT
• PUMPKIN,CKD,BLD,DRND,WO/SALT
• PUMPKIN,CND,WO/SALT
• PUMPKIN,FLOWERS,CKD,BLD,DRND,W/SALT
• PUMPKIN,RAW
• PURSLANE,CKD,BLD,DRND,W/SALT
• PURSLANE,CKD,BLD,DRND,WO/SALT
• PURSLANE,RAW
• RICE BRAN,CRUDE
• SAGE,GROUND
• SALAMI,CKD,BF&PORK
• SAUCE,FISH,READY-TO-SERVE
• SAUCE,RTS,PEPPER,TABASCO
• SEA LION,STELLER,KIDNEY (ALASKA NATIVE)
• SEA LION,STELLER,LIVER (ALASKA NATIVE)
• SEAWEED,AGAR,RAW
• SEAWEED,CANADIAN CULTIVATED EMI-TSUNOMATA,DRY
• SEAWEED,CANADIAN CULTIVATED EMI-TSUNOMATA,REHYDRATED
• SEAWEED,IRISHMOSS,RAW
• SEAWEED,KELP,RAW
• SEAWEED,LAVER,RAW
• SHORTENING,VEG,HOUSEHOLD,COMP
• SPEARMINT,DRIED
• SPEARMINT,FRESH
• SPICES,BASIL,DRIED
• SPICES,OREGANO,DRIED
• SPICES,THYME,DRIED
• SPINACH,CKD,BLD,DRND,W/SALT
• SPINACH,CKD,BLD,DRND,WO/ SALT
• SPINACH,CND,NO SALT,SOL&LIQUIDS
• SPINACH,CND,REG PK,DRND SOL
• SPINACH,CND,REG PK,SOL&LIQUIDS
• SPINACH,FRZ,CHOPD OR LEAF,CKD,BLD,DRND,W/SALT
• SPINACH,FRZ,CHOPD OR LEAF,CKD,BLD,DRND,WO/SALT
• SPINACH,FRZ,CHOPD OR LEAF,UNPREP
• SPINACH,RAW
• SQUASH,SMMR,ZUCCHINI,INCL SKN,CKD,BLD,DRND,W/SALT
• SQUASH,SMMR,ZUCCHINI,INCL SKN,CKD,BLD,DRND,WO/SALT
• SQUASH,WNTR,BUTTERNUT,CKD,BKD,W/SALT
• SQUASH,WNTR,BUTTERNUT,CKD,BKD,WO/SALT
• SQUASH,WNTR,BUTTERNUT,RAW
• SQUASH,ZUCCHINI,BABY,RAW
• STINGING NETTLES,BLANCHED (NORTHERN PLAINS INDIANS)
• SWAMP CABBAGE,(SKUNK CABBAGE),RAW
• SWAMP CABBAGE,CKD,BLD,DRND,W/SALT
• SWAMP CABBAGE,CKD,BLD,DRND,WO/SALT
• SWEET POTATO LEAVES,RAW
• TARO LEAVES,CKD,STMD,WO/SALT
• TARO LEAVES,RAW
• TARO SHOOTS,RAW
• TARO,LEAVES,CKD,STMD,W/SALT
• THYME,FRSH
• TURKEY,LIVER,ALL CLASSES,CKD,SIMMRD
• TURKEY,LIVER,ALL CLASSES,RAW
• TURKEY,WHL,GIBLETS,CKD,SIMMRD
• TURKEY,WHL,GIBLETS,RAW
• TURNIP GREENS,RAW
• TURNIP GRNS&TURNIPS,FRZ,CKD,BLD,DRND,W/SALT
• TURNIP GRNS&TURNIPS,FRZ,CKD,BLD,DRND,WO/SALT
• TURNIP GRNS,CKD,BLD,DRND,W/SALT
• TURNIP GRNS,CKD,BLD,DRND,WO/SALT
• TURNIP GRNS,CND,NO SALT
• TURNIP GRNS,CND,SOL&LIQUIDS
• TURNIP GRNS,FRZ,CKD,BLD,DRND,W/SALT
• TURNIP GRNS,FRZ,CKD,BLD,DRND,WO/SALT
• TURNIP GRNS,FRZ,UNPREP
• VEAL,VAR MEATS&BY-PRODUCTS,LIVER,CKD,BRSD
• VEAL,VAR MEATS&BY-PRODUCTS,LIVER,CKD,PAN-FRIED
• VEAL,VAR MEATS&BY-PRODUCTS,LIVER,RAW
• VEGETABLES,MXD (CORN,LIMA BNS,PEAS,GRN BNS,CRRT) CND,NO SALT
• VEGETABLES,MXD,CND,DRND SOL
• VINESPINACH,(BASELLA),RAW
• WATERCRESS,RAW
• Whale, beluga, meat, raw (Alaska Native)
• WHEAT BRAN,CRUDE
• WORTHINGTON FOODS,MORNINGSTAR FARMS,SPICY BLACK BEAN BURGER
• YEAST EXTRACT SPREAD

NOTE: Energy drinks also do surprisingly well because many are fortified and low-calorie but I've omitted them from the list since I wanted to focus on real foods.

Sure enough, purslane makes the list.

Injuries: BJJ and the Meniscus

BJJ hasn't been kind to my knees. Fortunately, I'm in good company. Jiu-Jitsu Vortex provided a great list of athletes who have specifically suffered knee injuries: "Kron Gracie, Xande Ribeiro, David Avellan, Dustin Hazelett, Bas Rutten, Roger Gracie, Tito Ortiz, Romulo Barral, Marco Ruas, Georges Ste-Pierre, to name a few."

The question is really "what do we do about knee injuries in BJJ?" I'm not a medical professional but I now have some hard-won perspective on the topic:

1. Recognize that you probably will get injured. BJJ is a contact sport and injuries are common. Fortunately, we know a little bit about the types of injuries you are likely to face based on your activities. We know the MMA frequently results in facial lacerations, hand injuries, and nose injuries. We know a bit more about judo where the average risk of injury is 11-12%, consisting mostly of sprains and strains to the knee, shoulder, and finger. Throwing is the most common vector of injury. Army combatives frequently results in injuries to the knee and shoulder areas. Surgery is required 24% of the time with labral repairs being most frequent. Finally, we can also look at a 10-year study of general knee injuries. Here's the abstract in all of its glory:
1. We have documented 17,397 patients with 19,530 sport injuries over a 10-year period of time. 6434 patients (37%) had 7769 injuries (39.8%) related to the knee joint. 68.1% of those patients were men and 31.6% were women. Almost 50% of the patients were between the ages of 20-29 (43.1%) at the time of injury. The injuries documented were ACL lesion (20.3%), medial meniscus lesion (10.8%), lateral meniscus lesion (3.7%), MCL lesion (7.9%), LCL lesion (1.1%), and PCL lesion (0.65%). The activities leading to most injuries were soccer (35%) and skiing (26%). LCL injury was associated with tennis and gymnastics, MCL with judo and skiing, ACL with handball and volleyball, PCL with handball, lateral meniscus with gymnastics and dancing, and medial meniscus with tennis and jogging.
2. Triage if you get hurt. Do what you need to do in the short term: RICE, pain killers, etc. And stay off the mats if you have to! 
3. Assess criticality. Get a professional assessment. If you've ruptured or severely strained something, you need to know. Your family doctor/GP can probably do a basic assessment and get you a referral to either a specialist or a physio. If something is severely wrong, see a specialist.
4. Eliminate diagnostic noise. There likely isn't anything "severely wrong." Instead, you've got a case of crappy knee with any number of symptoms (e.g., pain, loss of terminal extension, pain when ascending and/or descending stairs, minor swelling, loss of stability around the patella, a feeling of giving way, etc.). It seems like these symptoms can be caused by a number of things such as ilotibial band syndrome, patellar femoral pain, meniscus wear, etc. You might have any and or all of these things! In my case, I hurt my knee doing cleans in the gym but the injury occurred after I had ramped up my time on the mats. My GP noted that I hadn't done anything severe and referred me to a physio. The physio confirmed that I hadn't done anything severe but noted that I had a spectrum of dysfunction so we started working on the most pressing issues that seemed to be related to ITB syndrome (e.g., some strengthening and mobility work).
5. Refine the diagnosis. My symptoms cleared up and I continued to train but my knee was giving me grief by the end of ski season (6 months after the initial injury). Then one day we trained o-soto gari and closed guard. My knee was very sore by the next morning. And then I stepped in a hole while cutting the grass and reinjured my knee. I went back to my physio, he confirmed that there was nothing severely wrong, and that the injury was now quite clearly some damage to my lateral meniscus caused by some laxity in the LCL. Nuts. For me, the best indicator of this problem was difficulty with internally rotating my foot against resistance (e.g., kicking a ball or trying to pull off a rubber boot).
6. Establish a baseline. It can be difficult to monitor progress with a knee injury, particularly if you're trying to deal with it via physio. I think it's important to monitor your progress. One approach is to use a formal instrument such as the Western Ontario Meniscal Evaluation Tool (WOMET). It has been validated. Another approach is use some basic tests of function. For example, take note of things that you can't do and then record when you can do them. For example, I found it difficult to get on a bike due to the required hip mobility. Other basic tests that I have used include "how long can I sit in seiza before it becomes uncomfortable?" and "how long can I sit cross-legged?". Doing these tests every couple of weeks can at least give you some indication of whether or not you are actually getting better.
7. Do your physio. Seriously. If you've got a program, do it... every day. If you can't comply with your program then you need to see your physiotherapist more often. I like to see my physiotherapist every two weeks. This interval keeps me engaged in the program and gives us enough time to introduce exercise variations.
8. Give your physio enough time. It's going to take some time. Give yourself 12 weeks. Establish a baseline, monitor your progress, and -- most importantly -- do your physio.
9. Get a good physio program. My physiotherapist gives me programs and they work... I don' t know why but I can share what he tells me. Basically, my program is always:
1. Heat (5-10 minutes)
2. Friction massage of the lateral knee
3. Some sort of resisted dorsiflexion with a band around my quad or the back of my achilles
4. Some sort of squat that gaps the joint (i.e., a towel behind the knee or a voodoo band wrap)
5. Some sort of one-legged hip rotation with resistance
6. Glute work (clam shells, monster walks, etc.)
7. General strength (e.g., Romanian DL, dumbell press, etc.)
8. Ice
10. Ask: "Do I really need surgery?" Meniscus injuries are surprisingly common, particularly after the age of 35. A common clinical intervention is surgery. It is, perhaps, too common. After I injured my knee I was told that if I was an elite athlete, or under the age of 35, I would be a candidate for surgery. But since my future most likely has more arthritis than gold medals, I should probably adopt a conservative approach. I was thankful for the advice. BJJ Europe recently reported on a recent Finnish that study noted sham surgery (i.e., a placebo) was as effective as  arthroscopic partial meniscectomy. Furthermore, there are a number of studies that report that physio is as effective as surgery at six month and twelve month follow-up. That said, if you've got something "severely wrong" or if your knee locks up -- something my wife described to me as "like a stick in your spokes" -- you need surgery. If not, give 12 weeks of physio a try.
11. Adjust your game. My GP is also a friend and I asked him if I should stop training. He said: "The last thing a guy your age needs is an excuse to be less active. Keep training!" So I keep on training. That said, I've had to radically change my game to minimize the chance of injury. For me, the goal of BJJ is no longer "submit the other guy". It's now "keep training without screwing up my knee." Certain techniques are -- for now -- out of my repertoire. Unfortunately, some of them were pretty fundamental! I now avoid closed guard and most takedowns. My goal is to keep my game as closed chain as possible (e.g., foot on the floor) to avoid sheer stresses through the knee. This approach greatly limits my game. For example, I can't really pull guard so much as pull someone down on top of me (i.e., pull side control). It's not a great position but at least I can still roll. I have also taken some inspiration from Gordo Correa and really started to work on my deep half guard game. Again, it's a really terrible position for me but at least I can keep training (n.b., if you spend a lot of time on the bottom of deep half you might want to invest in some head gear to protect your ears!). My top game is largely unchanged but I try to play a pressure game using the Tozi pass. In short, embrace the opportunity to train from a position of weakness!
12. Adjust your training. It's not enough to change BJJ; adjust the rest of your training. Use the basic rule that if it hurts a lot, don't do it. But if it hurts a little, it's might be okay. That said, ask yourself: "Do I really have to do ass-to-grass squats?" Maybe a few months of Romanian dead lifts aren't such a bad thing. 

UPDATE! A few more things...

• Get knee sleeves. They really help. I've started using my classic Tommy Kono's (available at Rogue) and they're great. They just seem to keep my patellas in the right place and provide a sense of stability, particularly for no-gi. That said, they're not perfect in that they slip and bunch up behind the knees. I've talked to a few people who swear by the Cliff Keen air brace. 
• Try supplements. I don't completely believe in their effectiveness but they seem to help. I've been taking Webber Osteo Joint Ease and my knee is getting better. That said, the supplements might actually remind me to do physio... 

I hope this helps!