1st Foot Pain, Now Knee Pain! Ideas??

[shadowcat]

Ideas for Help w/Knee Pain

All of a sudden I am now having pain in my knees. Did Marcy last weekend and they got a bit tired but nothing major. Then the next day while hiking down a small hill they really started to hurt; I mean so badly I was trying to walk without bending my knees. Didn't think much about it the following week, then this weekend I hiked Bros/Slide and on the way down they started up again. It's pretty darn hard to hike down hill without bending your knees! It's awful painful. (mostly on the outer knee area around the knee cap - maybe tendons?) I realize I'm getting older but this is ridiculous!!! If anyone else has knee pain what do you do? Any suggestions on maybe some type of support to wear while hiking: I've seen those bands you wear - they don't look like much but maybe they work? Or the knee supports that wrap around your leg? Suggestions on what to wear while hiking to help eleviate aggrevating the knee and also what to do afterwards to help it heal VERY much appreciated!

 

[adksteve]

Knee Problems

Your not going to like this answer but here goes.

Almost exactly 2 years ago I had a similar experience on a relatively short hike to Indian Head in Ausable Club. My right knee would swell up after each hike so I did a little research on the Web.

I decided to take it easy for a few months (6) and give it a try in the spring. That seemed to help but I did spend quite a bit of time with pain that subsided after some time off.

I took lots of Ibuprophen to control the swelling and the nagging pain. In the early spring I decided to start hiking again on short snowshoe trips up hill out of my back yard. I did continue to swell after hiking so I started putting ice on my knee right after a hike and this seemed to help along with the Ibuprophen.

Things didn't seem to get a lot better so I went to see a sports specialist MD who took some MRI's of my knee and seemed baffled by my problem. This guy is good he help me with my son's dislocated knee and I trust his opinion. He said I have a choice to do exploratory surgery or suffer the pain.

I decided to suffer the pain. So I got a hinged knee brace and started a regiment of regular hiking with gradual increases in distance and elevation changes. Icing the knee and more Ibuprophen. This seemed to work. My research on the Internet led me to believe that I most likely over exereted or extended the ligiments around my knee and possible caused a tear.

It took about a year to recover but now I'm out every weekend doing 15-20 mile days with 5000+ elevation climbs. I think the key to knee problems is take it easy for awhile and let nature take its course. If that doesn't work then talk to a proffessional.

I also changed my stride, started using poles, lightened my load, lost some weight and took into account that I am getting older.

Good Luck

 

[Rivet]

I am starting to have the same problem (knee pain after hiking). Walking on flats is fine, but I feel it when I take the stairs.

My limited knowledge on the subject leads me to the fact that the problem is due to forces imparted on the knees while descending. The solution is to lessen this force.

If you run down the mountain, this will lead to about twice the normal force. So, go slow. You can also try stepping sideways.

Some people use two hiking poles to shift weight from feet to arms (but you would really need to lean on them for this to have an effect).

Maybe inserts in the shoes could help (shock absorption).

 

[shadowcat]

knee problems

well, i use 2 poles - always, already wear inserts and run down the trail? in my dreams! i'm thinking adksteve may be right. even tho it didn't seem like i strained my knees doing marcy (it's a long hike but mostly flat) i must have stressed them just enough. i went mt. biking saturday and then sunday we did the bros/slide. i was w/ 2 faster hikers and trying to keep up w/them so i did push myself and also didn't realize the time my knees needed to recover. i'm not hiking this wkend - aaaahhhh but i know it's for the best and i'm going to try some type of knee support; either those bands or the knee wraps. if you guys have tried either and like one over the other let me know.
and, i am soooooooooooooo sick and tired of that "O" word! (older) that's just no excuse for all these aches and pains..... is it????

 

[LittleBear]

I had an issue with knee pain several years ago. It happened on Osseola while I was descending (only happened on the descents). It felt like someone was inserting a hot knife into the outer side of my knee the burning sensation was so bad. Only happened when I bent the knee. I could lead with that leg without pain but not the other way around. Needless to say, it took a long while to hike back to the car. I continued to experience the same problems while going down stairs, but no pain on level surfaces or while going up. I did try various knee supports and none of them worked for me.

What I had was iliotibial band friction syndrome. The iliotibial band is a thick swathe of tendon tissue stretching from the outer rim of the pelvis down the side of the leg, over the outside of the knee and attaching to the top of the outside of the large shinbone. Inflamation can occur where it rubs against the outer part of the knee joint. Often the underlying bursa is also affected.

Symptoms usually come on gradually and is felt as a tightness on the outer side of the knee which then turns to burning or stinging feeling. The pain is especially acute when going downhill or walking down stairs. If allowed to persist, this condition can be extremely difficult to overcome.

As much as I didn't want to stop hiking, I didn't do any hiking for three weeks. During that time, I iced my knee three times a day for 20 minutes at a time. I took ibuprofin to reduce the inflamation. Then, I began a program of stretching, targeting the iliotibial band (mostly sitting with my legs in front of me and bending the right leg and crossing it over the left and holding that stretch. (There are other stretches that will target that tendon, but that's a basic one). I was back on the trail and pain free in 3 weeks and I haven't had any problems since (it's been at least 5 years now.)

Recovery usually takes 3 to 5 days for mild cases; 2 to 3 weeks for more severe cases; and very severe cases (if you ignore it) may take longer than 6 months to improve.

This may or may not be your problem, but it sure sounds very similar. Good luck - knee injuries are tough.

 

[coldfeet]

Had a torn miniscus(sp) fixed, rescoped 3 years later.. hiked Marcy in august, no problem, went salmon fishing 2 weeks later my good knee killed me, i was almost hopping on one leg.. was supposed 2 go to dr today but i got lazy and went to ems for info on winter trip.. my knee hasn't hurt since the fishing trip..weird..ps i go down side steps

 

[Stan]

This comes up so often that we could probably all write a macro to respond to these problems.

Here are my suggestions. I generally don't have knee problems but I sprained one a few years ago while building a stone wall and let me say that I've had a "knee awareness" since and tread carefully.

If I take ibuprofen I take it before I hike ... sometimes during ... after is too late, the inflammation has already begun.

Many hikers with knee problems swear by hiking poles to help alleviate the stress on knees.

Taping the joint helps. You may wish to experiment with taping it at the beginning of the hike or perhaps before the descent.

Check previous threads on this topic; there have been a lot of exercises described that help strengthen the knees.

See a good orthopedist.

Make sure the weight in your pack is evenly distributed.

RICE - rest, ice, compression (taping), elevation are standard prescriptions when all else fails ... personally, I subscribe to the oriental theory that the blood should flow, it heals, and not restrict it as icing does so I don't ice. Icing will alleviate the symptoms (pain) but not really help the healing.

I vary my activities between hiking and paddling to distribute the stresses on my joints without taking away from my enjoyment of the outdoors.

And my favorite post hike antidote, a shot of Sauza Hornitos. I am convinced that there is a medicinal quality contained in the agave plant that helps fight the general ailment called "arthritis".

 

[Orphic Seth]

LittleBear, thank you!

 

[snowshoe]

You could try 2 things one is to get inserts made specifically for your feet. or you can exercise your knee by using weights. Sometimes what happens is you get a muscle inbalance in your legs. Your upper legs may be sronger than the lower or vice versa. This tends to cause the stress on the knees. Try and do different leg exercises. Until things get better stay on flat trails or hit the bike. It is not a fun process but it is better to take care of it now and the proper way than ignore it and have to hang the hiking shoes up for good.

 

[shadowcat]

thanx

as usual you guys are always such a wealth of info and advice. i really have no choice but take it easy this weekend anyway. have a lot of bookwork to do anyway (yuck). but i just want to thank everyone - even tho we get into some tuffs and heated debates now and then you guys always pull thru when someone needs your help.
have fun and enjoy the colors

 

[trailbiscuit]

Another possibility that hasn't been mentioned here is an inflamed IT band. It's a common injury among runners who take time off due to another injury. (I've had it a couple times myself.) It's caused by doing too much too fast. With your time off with your prior foot injury, you may have jumped back into it too fast.

Your IT band runs from your hip to your ankle along the outside of your leg. The pain is caused by it rubbing against the knee joint.

Like I said, a common injury that is healed by rest...but active rest. Do what you can without overdoing it.

Along with rest and Vitamin-I, snowshoe's advice of light lifting to address the muscle imbalance is great. You'll be back at it no time!

 

[Periwinkle]

Lots of good advice here....

I have a similar problem and have used the same advice regarding poles and stretching exercises.

I have also been to a professional boot fitter, switching boots and going for a nice set of over-the-counter orthotics (expensive, but worth it!)

I hike with knee braces and find that they make a huge difference on the descent. They are also OTC (Tru-Fit).

Losing a little weight, both off my person and my pack makes a difference as well.

The greatest change has been gaining muscle mass and using it, but I am still limited to one long hike per week. That's about all I have in me. If I push it, as I did last week on Isolation (12 miles, 5000' gain/descent), I pay the price with stabbing pains in my knees. That was it for the week, even tho I tried to do a little more later. Not a good idea. Stiff legs on the way down isn't a safe way to go.

Lastly, as for slowing descent, I find that that doesn't help to a certain extent. Jogging downhill is out of the question, but an even pace with breaks is mandatory. I find that if I go too slow, I'm just pulling back too much on my knees. Try to find a good pace, commit to your footing, and go. Take more very short breaks in between so that you don't need to warm up again.

Good luck -- and I hope you have a good health insurance plan!

 

[nietzschescat]

knees

My knees hurt terribly everytime I went hiking last year(only on the descents) and I think my legs just weren't strong enough. I was also working very hard to keep up with my athletic friend and expecting my 44 year old body to act like it was 22 again. I ended up walking backwards down part of Katerskill High Peak because it was the only thing that didn't hurt. Then I decided to take ibuprophen (400mg)on the summits after lunch and that helped.
I did a lot of winter hiking with snowshoes and crampons and running down the mountains sometimes to keep up with my crazy friend and I think my legs are just stronger now. I had no pain all winter because I think the impact is less with all the snow and I think my legs are so much stronger because of all the hard work hiking in the snow.

Obviously there are serious injuries that can occur, but in my case I think my leg muscles weren't strong enough. I've been fine hiking since the winter.

 

[JonD]

As a runner, I've come into some knee problems. There's a lot of great advice on here already, but I'll throw my 2 cents in.

Shoes are important for your whole body. If you've racked up too many miles on your boots/sneakers, you probably worn out the cushioning.

During the week stretch daily and, like snowshoe suggested, do some cross training to strengthen the rest of your legs not affected by hiking. If you do some searching online you can find lots of excercies you can do without going to a gym.

 

[arghman]

Shoes are important for your whole body. If you've racked up too many miles on your boots/sneakers, you probably worn out the cushioning.

Amen to that, I missed most of this summer's hiking due to metatarsal pain, not knowing that my 3yr-old hiking boots were the cause.

I've had ankle/knee problems for the past 9 years, it's gotten a lot better with good footgear, orthotics, stretching/exercising (under controlled conditions -- hiking downhill is not), and passage of time. Have patience!!!!! physical therapists may be better at giving useful advice than doctors.