Knee problems

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RussL

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My knees ache on the decent after 10-12 miles. Any advice:confused:
 
See a doctor and/or sports therapist. Knees are tricky beasts, and there are all sorts of things that can go wrong inside them. It's probably best to have an MD rule out some of the major medical problems because continued exercise and stretching can do damage to certain conditions.

-dave-
 
sorry to hear about your knees. i've had problems over the last few years, mostly due to the wearing down of cartiledge from skiing, soccer and running.

i'd suggest seeing an orthopedist if you are having chronic pain...asap. i did so and his advice was to minimize running and other jarring activities. due to my condition, the more damage i do the worse i get and the more irretrieveable my knees become. hopefully, your condition is not as serious.

in the meantime, you can try a few of the following, including the suggestions from trailbiscuit - especially the trekking poles:

1. weight training for quads and calves - this may strenthen the area around the knee(s) enough to alleviate the symptoms

2. yoga/stretching - this helps to get blood flowing to the area and increases flexibility and strength - i'd suggest something like power yoga - i.e. ashtanga

3. during painful periods of downhiking, if the trail conditions allow, actually turn around and walk backwards - this may slow you down, but i find that it takes the pressure off my knees and can be a short term fix

4. ice your knees after any physical activity - i cannot stress this enough. do this religiously after hiking - it will reduce swelling quickly and increase recovery time

good luck!
 
I have had both my knees "worked on" over the years and they would ache badly any time I would stop for a few minutes. They would not hurt if I kept moving and it seemed much more acute in the winter months.
I would have to agree that overall weight reduction... including my own physical weight... and leg strengthening routines has brought me the greatest relief.
I have tried different knee warmers...much like a wool sock for the knees ...and though undecided on the benefits, I do believe it is related to keeping a healthy blood flow to the area, summer or winter.
Though much is said in favor of hiking poles, I think they may be an aide, there is nothing equal to having your legs as strong as possible to let the muscles do their job and relieve the stress on the knees.
 
knees

I found that as I hike more, my legs have gotten stronger and my knees hurt less. For awhile I was taking 2 motrin on the summit with my lunch to survive the descent. One of my first Catskill hikes was Katerskill High Peak from Palenville and it's atleast 10 miles and I had so much pain in my knees that I ended up walking backwards as much as I could to take some of the stress off.
My knees didn't bother me at all this winter. I'm a very small person, so it isn't extra weight that was bothering my knees, just a little out of shape and I didn't realize it for awhile.
 
Summary: slow down, take shorter steps, lighten up, use poles, take glucosamine regularly and finally, aspirine an hour before the descent. Consider orthotics and stay fully hydrated.

As a 48 year old chiropractor with the same knee problem let me point out that downhill hiking produces tremendous friction between the knee cap and the femur. IMHO the forces brought to bear upon the femoral surface of the patella are not influenced by the strength or flexibility of the thigh muscles. Rather, the hiker's weight, speed and stride length are key factors and these may be controlled. Decreased speed and stride length are better. Hiking poles are very important. I lean way out over mine on the descents to the point of having stiff shoulder and abdominal muscles the next day.

Orthotics devices in your boots can have a very favourable impact on how the patella tracks, thereby decreasing friction. Glusosamine sulphate has been shown to be effective in reducing wear and tear on the cartilagenous surface of joints. I take it regularly. On big hikes with lots of vertical I pop 2 extra strength aspirines about an hour prior to the descent and a couple more back at the car. I definitely feel the difference during the hike and the next day.
 
Thanks for the advice. I'll give glucosamine a try. Any brands you recomend?
NeilL said:
Summary: slow down, take shorter steps, lighten up, use poles, take glucosamine regularly and finally, aspirine an hour before the descent. Consider orthotics and stay fully hydrated.

As a 48 year old chiropractor with the same knee problem let me point out that downhill hiking produces tremendous friction between the knee cap and the femur. IMHO the forces brought to bear upon the femoral surface of the patella are not influenced by the strength or flexibility of the thigh muscles. Rather, the hiker's weight, speed and stride length are key factors and these may be controlled. Decreased speed and stride length are better. Hiking poles are very important. I lean way out over mine on the descents to the point of having stiff shoulder and abdominal muscles the next day.

Orthotics devices in your boots can have a very favourable impact on how the patella tracks, thereby decreasing friction. Glusosamine sulphate has been shown to be effective in reducing wear and tear on the cartilagenous surface of joints. I take it regularly. On big hikes with lots of vertical I pop 2 extra strength aspirines about an hour prior to the descent and a couple more back at the car. I definitely feel the difference during the hike and the next day.
 
Check the archives

There was a lengthy thread about conditioning and joint pain a few months back. A lot of good advice was posted. I suggest you check back in the archived posts.

KZ
 
Lots of good advice here. I've been diagnosed with ilio-tibial band friction syndrome. Not fun. But hiking poles have helped a lot. Also, going slowly during descents seems to make a difference. I take "Puritan's Pride" brand glucosamine. It has 500mg glucosamine and 400mg chondroitin. They have a website here. Like others have said, if there is a lot of vertical or I'm carrying heavy, I'll pop two pain relievers (Aleve, Advil, or E.S. Excedren) about an hour before the descent just as an extra precaution.

Dave Metsky said
It's probably best to have an MD rule out some of the major medical problems because continued exercise and stretching can do damage to certain conditions.

I agree 100%. Everybody's different and your doctor can advise you as to the best treatment.
 
I also suffer from chronic knee pain. I used to do a lot of long distance cycling, several centuries a summer, as well as many multi day winter back packing trips (50-60 pound packs). The last year I really did a lot of cycling was 2000; I found during the summer of that year that the only way I could finish a ride of any length (greater than 40 miles) was to take 2-3 ibuprophen and a couple of asprin about 30 miles into the ride. It got so bad that year that by the end of the summer I could not even push the clutch down on my Mustang and had to garage it early. Hiking with a big pack (I used to love winter trips) was right out of the question, as was sking on any trail that had anything that looked like bumps. About 2 years ago I started taking Glucosamine Chondroitin with MSM (I use the Flex-a-min brand). It took over a year before I really began to notice a difference. I started cycling and skiing again in 2003. This year I have been cycling on a regular basis (1 day on, 2 days off) and have done several rides in the 30 - 40 mile range without taking any pain meds. The pain is still there, but it is manageable, down to a very dull ache from a very sharp pain whenever I bent my knees. I am planning on a 65 mile ride in a few weeks and if that goes well, a century and perhaps a self contained bike tour in the fall. Needless to say, I am pretty happy with the results I have seen so far.
 
>>My knees ache on the decent after 10-12 miles. Any advice<<

where do you find 10-12 mile decents???????

i got a pain the first few times on long hikes (about 15 miles) - i then started using hiking poles on the descent and it stopped - i then didn't need the poles after about 1/2 year - - i then went on a very long (20+ miles) hike and felt it again. the advice i got from one of the guys with me was "advil, advil, advil" - advil relaxes your muscles - i was also told to start taking it the night before since it needs to build up, i wouldn't exceed the recommended dose though (although many hikers do). after that time i havent had any trouble, i usually don't use the advil but if i expect to do something like 20 miles i do take it as a precaution - - - - you have to be careful you are not masking something with the advil - if you need it a lot you should probably see an orthopedic surgeon and have him order a cat scan to see what is inside just in case something is wrong in there (besides irritation or swelling muscles).
 
David Metsky said:
See a doctor and/or sports therapist.

Yeah. Look for a doctor that specializes in sports medecine. A regular doctor will, most likely, tell you to rest, relax, keep off your feet, etc. The sports guy will ask, "How soon are you going out again?"

A different mindset.

I'll be seenig my guy in a few days. Pretty sure he's going to tell me to do lots of bicycle riding. :) sure beats sitting on the couch watching TV.

Usually sports medecine clinics are associated with colleges/niversities. Check out your local one.
 
I've never considered getting professional help because my knees get tired, instead I just hike more frequently at that distance until they get stronger. When they don't hurt at that distance, I'll add distance, weight or elevation until I find my new limit.
 
... never considered getting professional help because my knees get tired ...

Tired knees, no. But that is not the problem. Searing pain that feels like a hot knife inserted under the knee cap ...... that is the problem.

Pete has it right about seeing a doctor who specializes in sports medicine. I found that out the hard way. When I first started having problems, my primary care physician always said to hike less mileage, or stop altogether if the pain is that bad. That, of course, was unacceptable. Finally, after a year of the BS, I found an awesome sports therapist. Now, without surgery, I am backpacking again with little or no pain thanks to stretching techniques, a few modifications to my supplement intake, and using hiking poles.
 
Shortening my stride length helps me tremendously. I discovered that on my own--nice to see it supported by a doc. :)

Also, don't be afraid to use OTC anti inflammatories (aspirin, acetaminofen, naproxen sodium--Bayer, Tylenol, Aleve). Be sure to take with food though.

So many people don't like to take drugs, but these can help save you from overuse injuries.
 
Yes, if the pain is not just from tired knees, see a doctor. However, the original post looked like tired knees, given the limited description.
 
how my knee problem resolved

I used to run, perhaps 8 to 10 years ago, and began to develop knee pain after a mile and a half. I had an MRI and saw a reputable orthopedic sturgeon. He cupped my kneecaps with his palms and rubbed them; it was painful. He said my running days were over as I had chondromalasia. And so, every time I ran about that distance I had pain. I took up road cycling with no pain. I did Marcy from ADK Loj and back via Lake Tear and suffered on the downhills. Next year I had pain descending Street & Nye then Dial and Nippletop. I used poles and took it easy. Next Spring I ended up running just about a mile and a half 2 times in a few days and suffered not at all. On a trip to New Orleans I didn't want to lose aerobic fitness so I took running shoes. I ran 23 minutes and pain ensued. 2 days later I ran 21 minutes and no more; no pain. I ran 21 minutes for a month perhaps 3 times a week. I then increased my mileage 10% per month. The next Spring I ran a half marathon and qualified for the NYC Marathon, which I ran with no knee pain. After the first 23 minute run with knee pain I never had it again. I now run competetively (veteran's division) and hope to complete my 46 next month, having had no further pain on the downhills. A knowledgeable person surmised that my chondromalasia was probably secondary to a tibia fibia alignment problem which resolved with correct running and cycling ( 2000 to 8000 miles a year). I am a lucky lad. Some illnesses only resolve successfully with an incorrect diagnosis...
 
Dig out the advice from this story . . .

The following may or may not help anyone’s bum knee cause. But it is a story I like to tell, and the entree has been provided . . ..

A few years back (maybe 3-4-5) while descending along Mt. Mansfield’s (VT) summit ridgeline in early August I gave my right knee a considerable wrench that resulted in immediate pain. Stopping was not an option, so I continued on and before long the pain dissipated. No further trouble for several weeks, despite a number of ascents (and descents).

But then, on Labor Day Monday, no less, I awoke at 4 in the morning, in my home bed, with burning pain in that knee. The pain did not go away with Vitamin I. Ice packs did not help. Neither did liniment applications. Tylenol 3 on hand as a hiking emergency scrip by my regular doc did not even “touch” the hurt.

By midafternoon I was ready for a trip to the local hospital emergecy room.

The ER doc surmised that at my age I probably had arthritis or a calcium deposit chip floating around in the joint. (Smug kid!) Preliminary X-rays nixed those theories (smug old guy, me, now!), and after a while I was fixed up and sent home with a leg brace, a scrip of something like Vicadin and a referral to an orthopaedic surgeon who has an inerest in sports medicine. The leg brace (immobilization) worked. The dope did not.

The appointment with the orthopaedic guy -- on a Thursday -- was pretty interesting.

After X-rays, Orthodoc pronounced my knees to be in remarkably good shape for a tubby guy my age. No arthritis or significant degeneration of working parts. Whopeee! But the pain still was there, and very real. Orthodoc surmised it might be a case of inflamed tendon, probably not related to my episode on Mt. Mansfield, and said there were two ways to test that premise through treatment with common steriods.

First option was to dose me with tablets. If Orthodoc was right, pain would go away in “a few” days.

Second choice was for Orthodoc to inject steriods directly into the inflamed area, which might provide nearly immediate relief.

The latter would require some of that needle probing business (very unpleasant), but Orthodoc assured me he would “lead” the probe (and injection) with a potent local anasthetic to mitigate the hurt. The followup steroids would begin working immediately, to provide long-term relief.

Best of all, Orthodoc adivsed, if he was right about the tendonitis then the local would provide immediate relief from the searing knee pain I experienced when the joint was unsupported by the brace PLUS it would indicate a nearly 100 percent reliable diagnosis of irritated tendon as he had surmised.

The prospect of knowing immediately what really was wrong appealed to my impatient nature, which desires instant gratification. So I let Orthodoc go at me with that needle, which was GARGANTUAN. Like big.

I’d be a liar to deny that the needle made me flinch some at first, and then some. I could feel it grinding around in the joint as Orthodoc probed, but in truth there was little pain after the sting of the initial prick. A lot of my discomfort, I imagine, arose from just not liking the idea of somebody poking around in there.

Orthodoc did not speak with forked tongue.

When the local anasthetic hit the spot of its origin, the knee pain immediately dissipated and Orthodoc quickly shoved in the plunger to deliver the full syringe of stuff -- with sterioids.

It was like getting whacked up aside the head by a faith healer, (think Oral Roberts).

Almost instantly I could toss away my leg brace, and soon felt good enough to dance gaily out of the examination and treatment room and doctor's office (after doing the insurance be-bop and a little victory hop thing at the front desk). I flirted with the receptionist. The young man -- a son of a dear friend -- who rode with me that morning, “just in case,” was stunned in amazement. I was able to drive home and he learned a few new jokes along the way. After recovering from his fright.

Next day I took off on an 8-mile hike (pretty flat ground), solo, with no problems at all. The pain has not come back after (maybe) 3-4-5 years.

G.
 
hank,

i am interested reading your post because our situations sound somewhat similar. my history:

several years of competitive soccer, tennis and mostly recreational but hard skiing especially jumping and mogul skiing have most likely (my speculation) damaged my knees. due to a couple of injuries in college, our sports physician offered the option of scoping them which i refused at the time. this was a complex decision which partially hinged on his experience or lack thereof and my belief that the injuries were short term in nature.

now i'm 32, and last summer i was training 5 days a week with some mountaineering goals in mind. i ran 25-30 mi./week and lifted weights for nearly a year, but by august, my knees were suddenly so sore after running even short distances that i had trouble walking the rest of the day.

i saw an orthopedist and he x-rayed my knees and his comments were "the cartiledge in your knees are worn down like bald tires", and "stop running immediately". curiously, the cartiledgenous wear on both knees was markedly worse on the inner half of both knees joints.

i followed his advice and began mtn biking and hiking mostly for cardio. i do suffer acute pain on the downhills which the trekking poles alleviate to a degree. i have rehabbed the muscles around my knees to strenthen the areas, done ashtanga yoga to increase flexibility and blood flow, all of these have mitigated the pain. my knees are much better now, but i do miss the efficiency of running - especially living in NYC where there is plenty of running surface and interesting runs. i prefer the outdoors and nature to get my cardio, but under the circumstances i need to be training during the week to have the cardio output for weekend trips.

i'm curious about your path to recovery and whether you or anyone else has any other suggestions. thanks.
 
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