Knee Problems on the return trip

[dave.m]

I'm in no way discounting what Niel has said but I totally agree with Metsky on this. You really need to see a "good" ortho and a "good" PT person for this. In particular, I very, very strongly suggest trying to find both an Ortho and a PT who specialize in both sports injuries and the knee specifically.

Here's the real bottom line on this, imo. You really have to take full ownership yourself of your body's problems and the correct solutions. Niel has provided you with excellent clues and so has Dave Metsky and they are not in conflict. Niel's thoughts are one in a whole series of data points that you should be collecting. IME, I've made the most progress both in terms of avoiding re-injury, avoiding surgery and in pain reduction when I've partnered up with docs and PTs who specialize in the problem areas (mine are knees, flat feet, low back and now ankle).

How do you find them? Ask around. If I were new in an area, I would call coaches from universities and directors of PT programs at hospitals to get some idea of who is specializing in what locally.

 

[Rick]

....Without examining you or taking a proper case history the information you give leads me to suspect you have a lateral meniscus problem....
....Let me know if that sounds like you and I'll send you a bill

Ooooh Boy... Neil Stayed in a Holiday Inn Express AGAIN Last night!!!!!

 

[Neil]

Yep, trying to fix a knee over the net is pretty tough allright. The worse thing you can do is try and apply someone else's solution to your problem.

That caveat aside there is a really nice manipulation I use to put that critter back in its place. Trouble is, it will go back "out" again. My knee was producing excrutiating pain and by the time I got an MRI the pain was gone and the study was normal. My associate had been able to reproduce the exact pain with ortho testing and each day the test demo'd less and less pain until by day 3 or 4 the test was normal.
So, if I meet you on the trail and I see you circumducting your leg at the hip to avoid the pain I'll test it and if my internet diagnosis of a displaced meniscus proves correct I'll put it back into place for you. Watching the relief flood through you as walk normally down the hill will be payment enough.

Oh yeah, if you go to a Doc and say,"Hey, my knee hurts, I think its a displaced meniscus cuz that's what this guy on the net told me" don't be surprised if you get a negative reaction.

 

[Puck]

I'm in no way discounting what Niel has said but I totally agree with Metsky on this. You really need to see a "good" ortho and a "good" PT person for this. In particular, I very, very strongly suggest trying to find both an Ortho and a PT who specialize in both sports injuries and the knee specifically.

Here's the real bottom line on this, imo. You really have to take full ownership yourself of your body's problems and the correct solutions. Niel has provided you with excellent clues and so has Dave Metsky and they are not in conflict. Niel's thoughts are one in a whole series of data points that you should be collecting. IME, I've made the most progress both in terms of avoiding re-injury, avoiding surgery and in pain reduction when I've partnered up with docs and PTs who specialize in the problem areas (mine are knees, flat feet, low back and now ankle).

How do you find them? Ask around. If I were new in an area, I would call coaches from universities and directors of PT programs at hospitals to get some idea of who is specializing in what locally.

I have used an Ortho surgeon who is retained by local sports teams, both college and professional. THEY would know about knees.

 

[redcloud]

I am not looking for a cure over the internet, guys. I am looking for opinions and tips from you more experienced hikers out there. I don't think their is any harm in that. I was confident that others shared the problem that I have had and I am interested in their remedies.
These forums are all about sharing, and if I have anything to offer, I will. For now, I have been mainly asking for info.
Thanks for the discussion about my knees. I appreciate the time you guys have taken to answer me.
Take care, Eric

 

[Orsonab]

Sounds like the same thing that happened to me...

First, obviously, bite the bullet and seek medical advice (assuming you can afford it in this country...) BUT

I can say that this sounds very similar to my problem: pain only on the downhills, on the side of the knees, which went away quickly after the hike.

After consulting an orthopedist (sp?) and PT, the diagnosis was a combination of weak quads and hamstrings that needed stretching after years of little use. A series of simple quad strengthening exercises (squats, stepping up and down stairs, balancing on one foot while standing on a cushion AND trying to pick up a ball off the floor, etc) and stretches has improved my condition immensely.

I tried telling the Mrs that a hike every other day would soon cure the condition but she seemed strangely unimpressed by my pleas.

But that's just me.

 

[BorealChickadee]

Your comment about walking down the mountains backwards hit home. Been there, done that. I came down backwards on Giant a significant portion of the trail. It can be done. And if you've got bad knees, it feels oh so good.

Now Why did I have to hike backwards? Meniscus!!!! Torn up.(Neil is feeling mighty good right now) Both knees , throw in some ITBS, patellar tendonitis, and a couple of names I don't even remember. A recipe for a good orthopedist and physical therapist.

The point is, knees are complicated. If you've gotten to the point where walking backwards downhill is better, then you have to go to soemone trained in joints. It's not worth wasting months of pain when it can get worse. Compensating will throw you out of alignment and just give you problems on the other side. I know.

 

[Bob Kittredge]

Itbs

On either knee, I'll start to feel this pain on the outer side of my knee joint, and when it starts, I know that I have injured it and it will be getting worse. don't know.

That sounds rather like Iliotibial Band Syndrome. I developed it once at the end of an agressive snowshoe, and the pain was really sharp. Checkout http://www.itbs.info/ or try googling ITBS. It's possible you simply need a good pair of orthotics. See and orthopedist and/or a podiatrist.

Good luck.

 

[JohnL]

Yep, trying to fix a knee over the net is pretty tough allright. The worse thing you can do is try and apply someone else's solution to your problem. QUOTE]

That is so true. I had nearly the exact same symptoms as redcloud and yet my problem had nothing to do with my knee, even though the end result of my problem was pain in my knee. I went to a chiropractor who is an excellent diagnostician who listened carefully, asked questions and examined me, showing me the differences between my right and left legs. I had no structural problems and he put me on a regimen of specific stretching exercises. They worked like a charm. No knee problems while hiking since then.

JohnL

 

[RGF1]

Redcloud. knee problems are common with many athletic activities . it really is hard to say much. I would get a OTC Brace and take a Non Steriodal aniti inflamatory ie Advil aleve ect . Although as i found out the hard way with injuries the best bet is to see your GP and go from there . Because I did not do this i now have to have some surgerey and taking a pain killer for a very long time . I cannot stress how easy it is to make a minor injury inot a big mess in a short time . Try taking shorter less demanding hikes and if you still have problesmn go to your GP ASAP Best of luck

 

[Pete_Hickey]

What is the difference

What is the difference between a sports doc (and PT) and a regular one?

The sports one says, "We'll do what we can to get you back hiking (cycling, skiing, etc) as quickly as possible.

The other ones say, "Take it easy for 3 months so it can heal."

My first experience was a sholder injury, a week or so before an XC ski race. "I'll show you how to tape it up, so that you can still race. It won'T be your best time, but at least you can race."

Sports med people UNDERSTAND.

 

[Rob S]

That sounds rather like Iliotibial Band Syndrome.

I agree. I had it, too. My doc called it Iliotibial Friction Syndrome, but I believe they are the same thing, or very similar. Hurts like hell, but only on the downhills.

Lots of good advice already given, especially the recommendation to see a doctor who is familiar with sports injuries.

(I've found that using hiking poles and taking ibuprofen the night before and/or the morning of a hike allows me to hike mostly pain-free. But PLEASE take this as information only and not advice to follow without speaking to your doc first)

 

[DougPaul]

Sports med people UNDERSTAND.

Not always...

I had equally poor luck with 2 orthorpedic surgeons and the sports med orthopedic surgeon with my chondromalacia patella. They were able to diagonse the problem but I had to figure out how to fix it on my own.

Doug

 

[Rivet]

Not always...

I think Pete meant the need to get out and hike and not sit around and wait for three months.

 

[DougPaul]

I think Pete meant the need to get out and hike and not sit around and wait for three months.

I think I knew what Pete meant...

For active people, the goal is to return to activity, not just making the pain go away by resting.

My point was that not all sports med types understand that.

Another issue may be that some sports med types don't place the same value on non-competitive sports such as mountaineering as they do on organized competitive sports.

My experice was 20 years ago--hopefully a higher percentage of the orthopedic types would be helpful now. In my case I was given advice that made the problem worse--I had to figure out how to make it better.

Doug

 

[dom15931]

Could be tendonidis. You may want to check around to see if the symptoms match what you are saying. I used to get it all the time from being inactive all week then going for a crazy hike on the weekend. It took me about 2 months of painful trips, running 2-3 times a week and alot of stretching before it went away. But the good news is that with time it can go away. The key I found was to exercise till you start to feel the pain then to stop and rest till it goes away which in some cases was a few days.

I get this exact condition frequently for the same reasons also. One must be careful not to keep going when it starts to swell. I had tendonidus so bad two years ago I couldn't hardly bend my knee for a week and needed to be careful for two months. This was from several days of intense hiking after it was starting to hurt. Bad idea on my part.

One thing I have noticed is that it is best to avoid having a dominant leg for climbing over boulders. Often I overuse my left leg for this and my left knee lets me know...