In need of Knee advice

[summitseeker]

Hello All,

I would first like to start by saying that I will be seeking medical attention this week. That being said, I thought I would consult with some of the other hikers who have had experience with knee injuries so that I have an idea what I may be in for.

I am 35 y.o. and a potentially overactive person who is within their BMI. I have been doing a lot of hiking (2 to 4 major outings a month and smaller hikes during the week).

Here is my issue. My left knee is absolutely killing me and it bothers me when I walk and raise my leg. It does not make popping sounds like my other (now better) knee. The pain is on the front portion of the knee and despite glucosamine/chondroitin, icing, elevation, NSAIDS, and rest it is not getting any better.

My friend, Bernerbabe, just had surgery recently and I am hoping that I will not need to have a procedure, but my guess is that this is a cartilage related issue.

With all that being said, any words of advice, armchair diagnosis, or shared experience would be much appreciated. As a soon to be first-time father I am trying to prepare myself for what may be next. (besides a baby and less sleep )

Thank you,

Z

 

[Raven]

Hello All,

I would first like to start by saying that I will be seeking medical attention this week. That being said, I thought I would consult with some of the other hikers who have had experience with knee injuries so that I have an idea what I may be in for.

I am 35 y.o. and a potentially overactive person who is within their BMI. I have been doing a lot of hiking (2 to 4 major outings a month and smaller hikes during the week).

Here is my issue. My left knee is absolutely killing me and it bothers me when I walk and raise my leg. It does not make popping sounds like my other (now better) knee. The pain is on the front portion of the knee and despite glucosamine/chondroitin, icing, elevation, NSAIDS, and rest it is not getting any better.

My friend, Bernerbabe, just had surgery recently and I am hoping that I will not need to have a procedure, but my guess is that this is a cartilage related issue.

With all that being said, any words of advice, armchair diagnosis, or shared experience would be much appreciated. As a soon to be first-time father I am trying to prepare myself for what may be next. (besides a baby and less sleep )

Thank you,

Z

Hey Zac,

Sorry to hear of your knee troubles but happy to hear of the upcoming new role in life.

I'm not a doctor but....

Pain in the front of the knee can be many things. Patella tendonitis is one possibility if in the lower region; quadricep tendonitis would be above the knee cap. Deterioration of the meniscus is possible which leads to much less ability to absorb shocks and more impact of the bone and cartilege. I have had all three in one knee. I was very lucky and all my problems went away simply by putting my tennis rackets away and not playing competitively 4-5 days a week anymore. However, I found relief from:

Icing religiously. Ibuprofin even though I don't like taking Rx. Rest (yuk), and something that may not be as obvious: regular massaging of the knee cap and surrounding areas to increase blood flow to the capillaries in the area which will bring needed oxygen for repair. Electrotherapy can also do this - not sure how much those little handhelds are but a quick search will tell you. I used one and the combination of everything above helped. I also took some form of phytochemicals for a couple months but could not recall what they were (15 years ago).

Options are many but massage along with ice can do wonders if it's not irreparable damage. I have been one of the lucky ones and have seen not much more than achy knees after pounding them for a few miles on the descent.

That said, I'm constantly amazed by what people say knee surgery has done for them, even though I wouldn't want it either.

Good luck.

You should be able to get lots of knee advice here.

 

[summitseeker]

Hi Scott,

Thanks for your advice. I will try massaging the knee to increase blood flow.

Be well and thanks for the well wishing regarding the boy to be.

Z

 

[bikehikeskifish]

Hey Zac,

I wrote this thread just for people like you.

Tim

 

[summitseeker]

Hi Tim,

I had previously read most of this post when my right knee began acting up. This evening I read the entirety of it and I will definitely use this information to be proactive with my healthcare providers. I probably do have some muscular imbalance in my quadriceps due to an old injury (right side) but I will see if an MRI reveals more information (on my left knee, which is more painful as of late).

Thank you for your post and hopefully we can hit the trail again soon,

Z

 

[Tom Rankin]

Hopefully, your MD will send you to a PT. Listen to that person very carefully! Follow their advice for the rest of your life!

 

[--M.]

As our friends the Irish would say, I'm sorry for your trouble!

I too am old-skool about not getting cut if you can possibly avoid it, but my surgery (to clean up a pesky little tear) turned out A+ and that knee is now stronger than any other major joint in my body. I'm tempted to consider doing the other knee.

I would also mirror the physical therapy advice, including learning (and myth-busting) ice technique.

Mostly, though, the standard disclaimer about internet medical advice applies (!!!), but really, if you're having this much difficulty, it's probably time for a specialist. And knees are an area the surgeons have learned pretty well, so maybe.... Good luck!

 

[summitseeker]

Thanks all,

This is all very sound and useful advice. Hopefully my new Doc will put me on a course of treatment that gets to the bottom of the issue.

I hope this thread also provides some insight for others who are living with pain and wondering what an be done about it.


Your posts are truly appreciated,

Z

 

[DougPaul]

If the problem is chondromalacia patella, the underlying cause is weak quads resulting in the patella mistracking. Strait leg isometrics are the way to build the quads without putting wear-and-tear on the joint surfaces. (Traditional knee extensions can damage the joint faster than they build the muscle.)

Let the Dr diagnose the problem--once you know the problem, then you can seek the cure.

Doug

 

[Tim Seaver]

If you have mild Osteoarthritis but otherwise relatively healthy cartilage and no bone-on-bone contact, your condition may benefit from viscosupplementation. I started having some pretty limiting pain issues with running earlier this spring that is much improved after getting a series of these, so can personally vouch for the effectiveness of this treatment if your knees are relatively sound. It can last anywhere from 6 months to years, and isn't exactly cheap if you have to pay out of pocket for it.

More on viscos from Aetna

 

[Stan]

There are surgeons whose first impulse is to operate, others try different things, including physical therapy or some combination of treatments (without surgery) which you have already read in these threads. Depending on your diagnosis, you may be able to buy time with treatments other than surgery. Philosophically, that is my approach so if your surgeon seems to be rushing you to surgery, you might like a second opinion.

I tore a meniscus in my knee ... a simpler injury and repair than your's sounds like ... but after an initial treatment with NSAIDS and physical therapy, I was able to resume normal activity for a couple years before surgery became necessary. As someone else mentioned, I would endorse the practice of continuing your PT exercises long after corrective surgery since the strengthening of surrounding muscle etc. lends support to your joints.

 

[Becca M]

When you say, "potentially overactive" - does that mean you avoid resting it or cross-training???? Like anything, if you don't take a break, you are going to wear it out. Take it from me, I have had several knee injuries and reinjuries and seen various doctors/ortho/etc. The initial recommendation is always the same: "TAKE TIME OFF!!!!" It is excruciating, but, you really *have* to listen to your body!!!

 

[summitseeker]

Hello All,

Thank you so much for all of your information and wisdom.

Hi Becca, to respond to your question what I meant by "overly active" is really no different than what 90% of the people on Views would be considered by the general public. If I am not hiking I am usually doing something else outdoors (playing hockey with friends, tennis, kayaking, building something, chopping wood, etc. )

The last "real" hike I did was with Tim and some other Views members on 12-27-13. I feel like I have been sitting around forever waiting for this to heal, BUT of course you folks are right and that is why I came here first for some preliminary advice. More rest is most likely needed and I will have to sit out.

I will know more after February 3rd (the earliest appointment I could get with a specialist).

Thanks again everyone, I can't tell you how grateful I am for all of your advice.

Be well,

Z

 

[Breeze]

First you find out what's wrong.

Then you discuss what to do about it, and consider different viewpoints and scenarios such as costs, benefits, drawbacks, down time, recovery, future outlook.

12 years ago my DH had an arthroscopic Meniscus repair. All told he was back on his own 2 feet without crutches in 72 hours ( although he was on an NSAID and icing regimen for longer.)

Horse before cart. One foot in front of the other.

 

[summitseeker]

First you find out what's wrong.

Then you discuss what to do about it, and consider different viewpoints and scenarios such as costs, benefits, drawbacks, down time, recovery, future outlook.

12 years ago my DH had an arthroscopic Meniscus repair. All told he was back on his own 2 feet without crutches in 72 hours ( although he was on an NSAID and icing regimen for longer.)

Horse before cart. One foot in front of the other.

I am doing a lot of homework and trying to be proactive. Obviously a diagnosis would be key but at this point I will be doing a lot of armchair diagnostics until then.

Once I know what is wrong I can move on from there but it will be quite a while before I can get any real answers from medical personnel.

 

[Raven]

One other thing you may wish to consider is that a misaligned spine can cause knee, ankle and hip issues. It sounds like you have something that needs to be fixed but for maintenance, there are more than a few ways to keep a straight and mobile spine. Chiropractic works but is relatively high impact. A physical therapist can do the same thing over 30 minutes that is much less aggressive and gets the same or better results. Yoga and good spine stretches will also keep the vertebrae flexible. I have had good luck with all three but focus on yoga and stretching at this point, mainly for financial reasons.

Again, this may not address your issue at this point, but considering the thread, it may be a possible maintenance plan for some.

For the record, I have seen a chiropractor to specifically address knee and foot issues.

 

[summitseeker]

One other thing you may wish to consider is that a misaligned spine can cause knee, ankle and hip issues. It sounds like you have something that needs to be fixed but for maintenance, there are more than a few ways to keep a straight and mobile spine. Chiropractic works but is relatively high impact. A physical therapist can do the same thing over 30 minutes that is much less aggressive and gets the same or better results. Yoga and good spine stretches will also keep the vertebrae flexible. I have had good luck with all three but focus on yoga and stretching at this point, mainly for financial reasons.

Again, this may not address your issue at this point, but considering the thread, it may be a possible maintenance plan for some.

For the record, I have seen a chiropractor to specifically address knee and foot issues.

Hi Scott,

I had never considered the idea that chiropractic treatment could benefit the lower extremities to the extent that you are suggesting. Thank you for the lesson, Teach.

I hope to hit the trail with you again soon.

Thank you,

Z

 

[Raven]

Hi Scott,

I had never considered the idea that chiropractic treatment could benefit the lower extremities to the extent that you are suggesting. Thank you for the lesson, Teach.

I hope to hit the trail with you again soon.

Thank you,

Z

Yes, let's do that!

If your hips get out of whack, one leg is effectively longer than the other and...you can fill in the blanks.

 

[summitseeker]

Z, (Tried to post this before; if it appears twice I apologize.)
Sounds like you have the same thing as me. Go see the people at Alpine Clinic in NoCo (536-2270; they also have an office in Plymouth). They take care of the US Ski Team and also a lot of us hikers here on Views.
My knee that I had arthroscopic on 3-1/2 months ago is about 80% healed, but I still feel it when the weather changes.
There are some tears that will heal on their own (Tim was lucky), depending on where they are located. I waited a year before having surgery, but since it didn't heal, I finally decided to have it checked out.
"Dr. Dan" F. O'Neill's book, Total Knee Recovery, is really cheap (like $10). I read an excerpt from it online last night, and plan on getting it.
Unfortunately my other knee is not able to bear full weight right now and is scheduled for an MRI this week, and I'm probably headed back to NoCo on Friday. I don't think it's due to favoring that knee, it's just unstable due to abuse, a "hit" and a small fall. I'm hoping to avoid surgery, but since I've been doing the exercises they gave me on both knees since August 1st, and it's not helping, I'll see what's going on.
I did just recently get an exercise bike; they highly recommended that, to strengthen the muscles around the knee. Some days I can do it, and some days I can't. Vitamin I does not do much right now.
Surgery is never a cure-all, and you have to weight the pros/cons, and take into consideration your situation/lifestyle.
I still walk 2-3 miles a day. Some days I don't ice at all; some days I do it twice a day. 3 cups water + 1 cup alcohol fit nicely into a quart-sized freezer bag and works great as it doesn't ever freeze completely.
I was hoping to finish the W48 this season... I'll try like hell, but if I don't, I'll do it next year.
And, you can always use your new baby as weight to do leg lifts!

Thank Roberta,

I have been using some homemade cornbags to ensure a fairly consistent 20 on, 20 off routine, but that sounds like a good easy fix for cold compresses.

I remember you speaking highly of the folks in N. Conway and if my docs recommend surgery I will make the trip based on your positive experience. This morning it felt good to start but the pain began after about 5 steps at work.

At this rate you and I will be finishing our winter 48 in the same relative proximity of our 48s

Be well,

Z

 

[bikehikeskifish]

I too have nothing but high regard for Dr. Dan O'Neill. http://www.thealpineclinic.com/

Tim