View Full Version : Knee Problems
2009ThruHiker
11-07-2005, 16:55
My wife and I hike at about the same speed with one exception... we've known for a while that her knees and behind the knees bother her. After a ten mile, steep hike this weekend her knees hurt her so bad she walked un-naturally the next day. I'm pretty sure the behind the knees syndrome is sore muscles, but the actual knee pain is something more. We recently bought hiking poles and this has helped a good deal... she also plans to lose some weight even though she is in good shape.
Just wondering if anyone knows any other things we can do before our attempt at a 2008 thru hike to help strengthen her knees...has anyone had success with glucosmine (sp) or the new supplement advertised in backpacker a few months back?
Footslogger
11-07-2005, 17:07
....has anyone had success with glucosmine (sp) or the new supplement advertised in backpacker a few months back?
=====================================
I have, with Glucosamine
In 2001 while accompanying my wife on her thru-hike for a month I developed considerable pain and grinding in my knees. I was able to hike "through" the pain but with my own thru-hike on the 2003 calendar I really wanted to do something about it. I began taking 2000mg of Glucosamine Sulfate a day at the end of 2001. At first I really didn't think it was doing much but I nonetheless stuck with it. In preparation for my thru I did a number of shake down hikes and noticed that there was no pain. Still a bit skeptical, I began my thru-hike in March 2003. I made it all the way and never had a knee problem. Sure ...I felt it the next day when I attempted a 20+ miler but a little motrin took care of those aches and pains.
I can't comment on the compounds that contain Chondroitin though, since I've never taken them. There just wasn't enough good science available to convince me there was any benefit and I wasn't willing to pay the extra $$ for the Gluc/Chond combinations.
Aside from my knees I believe that the Glucosamine has also helped my elbows and shoulders which were also beginning to show signs of age.
'Slogger
soulrebel
11-07-2005, 18:03
Try squats, leg presses, lunges, leg extensions w/ the toes pointed out (develops vastus medialis/inner quad) and all one legged variations of the above. The only "real" way to get rid of knee pain is to strengthen connective and muscle tissues. Glucosamine will help as well as a diet rich in magnesium. Work hard you've still got time...
Also look into a Cho-Pat knee brace: http://cho-pat.com/ I have known of women with knee trouble for who they helped immensely.
There are a variety of knee problems and the treatment for each can vary. I would say that you should start out by having your wife evaluated by an orthopedic specialist who focuses on the knee.
Once the Knee doctor makes a diagnosis..read about it and compare the prevailing wisdom with what the doctor recomends.
Depending upon the cause of the problem there are several things that may help.
weight loss
strengthening the muscles
shoe inserts to correct gait problems
Stretching to reduce load on the petella when resting
Glucosomine and Chondrotin
I think that depending upon the the problem these and other nonsurgical treatments may have benifit. However sometimes surgury is the best option. So go see a Doc and find out what the problem is before trying a treatment.
NoKnees
My first attempt at a thru-hike was in 2000. I got as far a Fontana Dam and left the trail with knee and leg problems.
X-rays showed a bad stress fracture in my lower leg. The doc said that the knee pain was from over use.
After the stress fracture healed I started to take glucosemine & chondrotin, 1500 mg a day and doing leg lifts to strenghten my quads.
I attempted a thru in 2001. it was very sucessfull with no knee problems.
I swear by the glucosomine & chondrotin. I was 66 when I did my thru.:p
orangebug
11-07-2005, 22:26
Get a sports med doc to look at her while the knees still hurt. If they recover in 2-3 days, probably the problem is weak quads, especially if the biggest pain was on the down hills.
Walking stairs is probably the best single exercise, but squats, knee extensions, walking, weight loss and other strategies are likely to help. Lunges are evil but excellent. Glucosamine can't hurt. Neoprene knee braces seem to provide just enough aid with quads and ilio-tibial muscles to help keep knees stable and less painful.
saimyoji
11-08-2005, 01:02
Agreed. Weak quads or quad strain has been the bain of my existence ever since the 'unpleasantness' a while back. Arch supports have also helped me.
MedicineMan
11-08-2005, 01:41
well this year its the knees....i agree with some of the posts above but not all.
The knee is incredibly complicated, much more so than the shoulder which in itself is complicated. Simply 'buiding your quads' is bad advice and can do more harm than good.
The BEST thing to do is find an MD who loves athletes/hikers, a sports-medicine guru who is in with physical therapists who are the same. Whatever you are doing STOP now until you find the sports-medicine man and see what is actually happening.
Glucosamine/chondroitin/MSM are good and now proven to be better than placebo BUT they aren't going to mend torn meninges in the joint.....get the x-rays, the MRI, then it wont be a matter of guesswork.
For me the x-ray/MRI showed no damage. It was just the patella mistracking, mistracking enough to cause a tear to run down the cheek after 4 or 5 miles.
One doctor, a typical orthopod who makes his gravy doing old ladies hip replacements wanted to do an immediate release.....sports medicine doc said 'you can fix this yourself'....so off to PT and walking back and forth in front of the therapist....then the explanation that the muscles on the side of the knee are disproportunate to the other side........IF i had simply gone to the gym and did 'quads' the same amount of disparity would only have been maintained. The PT gave me 5 excercises that specifically targeted the weak muscle ----VMO----and told me that it would take months to rememdy years of unequal muscle str.....OK fast forward to 2 months after beginning the excercises and going up and down stairs has much improved...so much I did a 34 mile stretch on the AT last week with no major pain. There is a big wonder here though....I use Cho-Pat straps on both legs....the PT said the straps should be doing nothing for what i've got....i'm still wearing them.
Hope this helps a wee bit...whatever you do dont give up....I was so down/depressed over the plantar fascitis of last year I thought that this too was the end but time has a way of easing some things.
I have arthritus, knees, elbows, fingers, etc. I have had good results with Glucosamine, Better results with a Glucosamine & Chondroitin supplement. The Chondroiten seems to boost the Glucosamine. Bear in mind this isn't a quick fix, it (for me at least, and others I have talked to) takes at least 7 to 10 days to "Kick In" & you need to take a higher dose (read the label) initially.
Also after warming up, be sure to stretch before and after excersize.
PT type excersizes at home should help [insert a "Consult you MD first" type warning here] start out slow. Also, frequent rest breaks during a climb seem to help me, especially during the first few days of a hike. SIT DOWN, possibly even prop up your legs WHILE SUPPORTING THE KNEE AREA.
Just maybe: an anti inflamitory agent would help, as would a bit of pain killer [insert a "Consult you MD first" type warning here]. Just rember that pain is the body's way of saying "DON'T DO THAT".
Doctari
fiddlehead
11-08-2005, 11:30
I agree. Glucosimine worked for me when i had a knee problem. I stopped taking it after it stopped hurting and my knees have been fine ever since. That stuff works. I'm glad to see it's worked for so many others too. I think you have to be on it for a few weeks before noticing a change though.??
I was so down/depressed over the plantar fascitis of last year I thought that this too was the end but time has a way of easing some things.
MedicineMan,
How did you treat the plantar? I have not been diagnosed, but am pretty sure that's my problem. I've tried stretching and that helps some. Best relief comes from 'taping' the bottom of my feet with athlete's tape, but although this gives immediate relief, changing the tape everyday is aggravating. I've read that this is a problem that comes with age, so although depressing, guess I'll have to learn to live with it. Or, maybe as you say, "time will ease?":rolleyes:
-Bolo
Footslogger
11-08-2005, 11:45
[quote=MedicineMan]Glucosamine/chondroitin/MSM are good and now proven to be better than placebo BUT they aren't going to mend torn ...meninges ....in the joint.....get the x-rays, the MRI, then it wont be a matter of guesswork.
==============================
You meant meniscus ...correct ??
And yes, Glucosamine is not going to mend a torn meniscus. However it does promote growth and health of cartilagenous tissue. Therefore it is more of a prophylactic than a cure. But hey ...we could all use a bit of prophylaxsis now and then.
In the end, provided that there is not already serious damage to the knee, a good regimen of stretching and resistance exercising of the legs is most likely the first choice.
Another contributor to knee (and ankle and hip and eventually the back) pain can be a congenital condition whereby the knee joint has an inward or outward curve. Orthopedists refer to these as Varus and Valgus deformities. If you have one of those conditions your upper and lower legs don't meet evenly at the knee. Some compensatory changes do occur with normal growth and aging which sort of balance out the irregularities, but many folks with these conditions experience pain with walking or exercise at some point in their lives. I've seen some of these conditions reasonably handled with orthotics, gait management and PT but not the extreme cases.
If exercise, stretching, Glucosamine and NSAIDS don't seem to help you'd be best to consult an Orthopedist (as has already been mentioned) who specializes in sports medicine and themselves are hikers or runners. They have the combined knowledge and personal experience to evaluate your condition and offer you the best range of options.
'Slogger
hammock engineer
11-08-2005, 12:10
Just wanted to throw in my 2 cents. Do as suggested see a Sports Medicine doctor and get their opinion. A regular doctor won't cut it. Then depending on their advice see a physical theriopist or persional trainer. A lot of people you will see in the gym (I used to be one of them), do their excercises and streches wrong and cause more harm than good. Just because you do something suggested here or somewhere else the way that you think it should be done or the way someone else does it, doesn't mean that it is the right way.
I think we all see that one guy at the gym doing something that makes you wonder why he isn't hurt yet.
flyfisher
11-08-2005, 12:16
One additon to all the good advice above.
Take small steps down hill. Don't clomp down a trail just because you can.
BTW, I also vote for glucosamine if it helps. It helps some and some it does not help. To give it a fair try, take at least 2 grams a day for two weeks before the hike.
And two hiking poles. Especially going down hill.
I'm a masage therapist and deal with people with knee pain. The first thing I look for is to see if the patella is tracking correctly.You can have her sit on a table and have her extend and flex her knees slowly. watch the knee cap and see if it is tracking straight or pulling to one side. If it's pulling to one side it usually means that the quad on that side is tight. The quads are made up of separate muscles and lot's of time one side or the other is tighter and is pulling the knee cap out of alignment. This way you know what needs stretching and what needs strengthening (the opposite side will need strengthening if one side is too tight)
This information is my personal experience and my opinion only and does not substitute for an orthopedic doctors examination but it can be a good place to start.
the glucosamine can't hurt and I've seen work. Good luck!!!
" Walking stairs is probably the best single exercise"
Stairs can do some serious damage to your knees, especially going down. Check with your Dr. Even healthy people shouldn't make a habit of running too many stairs.
lighten your load, a pack that is too heavy for your body makes your knees, and a bunch of other stuff, hurt.
Pringles
01-28-2006, 19:20
I have a bad knee, due to arthritis. It feels better when I wear a knee brace, but the knee braces I have are all neoprene, and after a couple of hours, my knee is so hot/uncomfortable/itchy that I have to rip the brace off. I'm wondering if there are other types of knee brace options for me.
I have a neoprene brace that is about six inches tall, and completely covers the knee. It feels great when I'm using my knee. I also have one about the same size that has a cut out for the knee, which still helps my knee stability, but it also causes my skin to overheat.
I also have one of those braces that are a little strap that just fits under the knee. The little strap kind doesn't seem to do much to help my knee feel better, so I don't use it, but it doesn't cause skin to get incredibly hot and then itch.
If anyone has a suggestion of another type of brace, or a brace out of an alternate material, I'd love to hear it. In the mean time, where did I put that Ibuprofen...
Beth
There is some stuff called DMSO you can buy online...it rubs on and is awesome for inflammation and joint pain...google and read about it. Also the Cho-pat or other strap for just below the patella should help alot. You can even roll up a bandanna and tie it tight under the knee or use tape and get some relief in a pinch.
Eat jello. Continue to use poles on every hike. If it persists then maybe you better check with a good Orthopedic that does the arthroscopic thing.
GolfHiker
01-29-2006, 10:20
At age 53 I just went through my first ever knee issue. While hiking around Bear Mountain in Harriman State Park, in snow, I did about 12 miles on day 1, and after 5 on day 2, I had to give it up. Turns out I aggrevated the IT Bank in my left knee. After about 2 weeks of anti inflammatory pills, it's starting to feel normal. I fully believe this was a combination of heavier winter pack, challenging trail, and the snow. If we had gone 7 miles vs. 12 on our first day, this may not have happened. I'm greatful it was not a torn miniscus or worse. No surgery, no rehab. Now I'm just a little nervious about my next hike. I plan to continue to work out for strenghth, but I'm also considering a knee brace. I see there are quite a few choices for the IT Band Syndrome. Anyone have a similar experience, and how did you treat it. Thanks.
GolfHiker
01-29-2006, 10:36
Hey. Sorry I did not realize this thread was dedicated to Thru Hikers, I was just too excited seeing the "Knee Problems" heading. After a little more checking, I found another thread, with some very specific postings about my little problem......
Pringles
01-29-2006, 14:28
Thanks for the suggestions. I haven't found that the strap type of brace, like the Cho-pat, does anything to help, but I may try it again. As to the orthopedic surgeon, been there, done that. Got my steroid shot in the knee (sounds much worse than it was, but I didn't watch) and found that something "radical" was all he could do for me. I'm not really ready for "radical" just yet. I guess I'll go look for that strap-type brace and see about that creme stuff. Thanks for the ideas.
Beth
I have a bad knee, due to arthritis. It feels better when I wear a knee brace, but the knee braces I have are all neoprene, and after a couple of hours, my knee is so hot/uncomfortable/itchy that I have to rip the brace off. I'm wondering if there are other types of knee brace options for me.Beth
Get one of the fabric knee braces made of the same material as tha Ace wrap bandage. Put it on, then put the neaprene on over that. Not strong enough by itself but it might stop the discomfort the neoprene causes. For 5 bucks or so it's worth trying.
Pringles
01-29-2006, 14:38
Gee, Fiddler, I've never seen a brace made of anything but the neoprene. I live in a small town and we are rather sheltered. Considering what I see on the news, I usually consider that a good thing. I guess I'll have to start browsing the brace section of drug stores whenever I travel. Again, thanks for the advice.
Beth
During my first attempt to do a thru in 2000 I had to leave the trail with very sore knees. I started to take glucosomine & chondrotin. The following year at age 66 wearing heavy boots and carrying a pack that weighed about 35 lbs. I had a great thru-hike with no knee problems. I am a strong beleiver that glucosomine works.:)
I recommend climbing stairs with a full pack. I did it every other day for 3 months before my 2005 thruhike and it really strengthened my legs. I still had many days of knee pain on the hike, but Vitamin I really helped.
Can I get Glucosmine and/or Chondrotin over the counter or do I need a prescription?
Footslogger
01-30-2006, 12:44
Can I get Glucosmine and/or Chondrotin over the counter or do I need a prescription?
============================
It's totally OTC (over the counter). Be aware that the Glucosamine is also sold as a separate compound (Glucosamine Sulfate). The studies I have seen regarding the efficacy (effectiveness) of Chondroitin are still inconclusive however the efficacy of Glucosamine is pretty well established. Also ...the price of the combined suppliments (Glucosamine and Chondroitin) is significantly higher than the Glucosamine Sulfate formulation.
'Slogger
Knee braces such as the cho-pat are for specific knee problems--they will not help everyone. There is a third kind of knee brace that contains solid pieces with hinges. These are for people with more serious knee problems and are expensive--you'll probably need a perscription to get one correctly fitted and paid for by your medical insurance.
http://www.kneeshop.com/professional2.htm
Beth, did your ortho doc give you a diagnosis? Have you seen a physical therapist?
Pennsylvania Rose
02-01-2006, 20:43
I was reading this thread the other day thinking (in a smart alec sort of way, "Knee pain, I've had knee pain and it never slowed me down. Must be an old person thing." Well, yesterday, karma smacked me in the as. Tore my meniscus. Haven't had such excruciating pain since childbirth. I'll probably have to have surgery, and my week long hike over spring break is probably out of the question now. I'm sheepishly coming to you, hat in hand, to ask if any of you have ever done the same thing. What was your prognosis?
Pringles
02-02-2006, 09:57
bbanker, The cartilage is pretty much gone in the one knee. I had played on the dorm football team as a college sophomore and was running along and felt something pop and within a week and a half I had surgery… the old fashioned kind where they actually used a knife and made an incision about 2-3 inches long. At that time the surgeon said I’d have arthritis when I turned forty. Being 19, who cared? Then I turned 40--43, actually. I was hiking on the NJ/NY border and my knee threw a fit about the rocks, and I ended up at an orthopedic surgeon’s office. The x-ray of the good knee shows a space between the bones. The x-ray of the bad knee just has a fuzzy white section. I didn’t see the MRI results. The surgeon said, “Tsk, tsk, tsk... and so young." I liked him at that point. He said that if we did something, it would have to be more radical, and at that point I figured I’d think about it for a while. Later that summer I did the Teton Crest Trail and have done plenty of weekend backpacking since. With Ibuprofen it’s mostly ok, though my knee certainly tells me its opinion about the terrain. It feels stronger and more solid when I wear a neoprene brace, but the heat, or something, from the brace makes me rip it off after an hour or two. I didn’t realize you could get knee braces of the old ace-bandage stuff, so I’ve got one ordered, and I’ll give that a shot. I had considered using an ace bandage, but let’s just say that I’m not so good at fussing with things, and that in my experience an ace bandage needs some fussing with to make it work well.
Ridge, what is jello supposed to do? I’m rather fond of jello—when it’s served with its friends, fruit cocktail and whipped cream. :jump
I have been taking fish oil, which is supposed to lubricate the joints, and that seems to help. The glucosimine didn’t seem to do anything, so I stopped taking it.
In the meantime, Ibuprofen is my friend. Maybe my *best* friend.
Beth
Beth......Try a medical supply store. I have one but I am not sure exactly what it is made of. I have worn it for 10 hours at one time before while playing and walking 2 rounds of golf. In Texas heat. It is very lightweight.....same size as a neoprene brace.....yet it gives more support due to thin metal braces on the sides.
KirkMcquest
02-03-2006, 20:15
I have little problem with my knee, it hurts and sometimes gives out when to much strain it on it, or when I try fast movements like jumping, etc..
I was able to eliminate this by hard work in the gym. Specifically working movements that effect that area, squats ( with real weight), lunges, leg presses. The pain went away, and I was fine, ...until I stopped lifting. In about 5 months or so it came back. Before a Thru-hike I would work it hard, the exercize on the trail should be enough to keep it limber
Jello is boiled from collogen, the stuff cartilage and other parts of joints are made of. So it provides raw material for the body to make repairs.
handlebar
02-03-2006, 23:31
I was reading this thread the other day thinking (in a smart alec sort of way, "Knee pain, I've had knee pain and it never slowed me down. Must be an old person thing." Well, yesterday, karma smacked me in the as. Tore my meniscus. Haven't had such excruciating pain since childbirth. I'll probably have to have surgery, and my week long hike over spring break is probably out of the question now. I'm sheepishly coming to you, hat in hand, to ask if any of you have ever done the same thing. What was your prognosis?
Yep, hurts like the dickens. Don't know how it happened, but whenever I'd torque my foot counter clockwise on a root or rock, I'd about jump out of my skin. Also, found sleeping on my side caused it to ache. Find an ortho that's an artist with arthroscopy. I had right medial meniscus tear and had it fixed in outpatient surgery. Got up and walked away from recovery with a little bit of my weight on crutches. Was riding my bicycle within 3 weeks. The pain is gone. :)
Pringles
02-04-2006, 17:19
Wow, thanks for all the advice. I've looked a little more closely at some of the knee braces that are available, and have bought a couple of types that I had never seen before. We'll see how they work out.
The Jello will be easy! I remember a section hike starting at Dick's Creek Gap. My friend's husband had packed us a lunch to eat before we started our hike. One of the things Ed had packed was one of those Jello cups for each of us. Mine was orange. We sat in the parking lot and ate our sandwiches and Jello. Mmmm. Isn't it amazing the foods we remember from our hikes?
The orthopedic surgeon said that there wasn't anything that arthoscopic surgery would do for me. The last surgery and 20 years of walking up and down stairs as an exercise plan seems to have taken care of the cartilage. It's not torn, it's mostly gone. Now I ride my (stupid, boring) recumbant bicycle and x-country ski, instead of doing the steps. Based on the fact that it's bone against bone (at least that's my understanding) I had thought that a brace wouldn't help, but it does seem to make things feel more stable. Ultimately, my knee slows me down, but it doesn't keep me from going outside to play. When it *does* keep me from doing things that I really want to do, then I'll go back and see exactly what he meant by a "more radical" treatment. Until then, I'll eat Jello!
Thanks again for all the advice!
Beth
Blissful
02-04-2006, 22:56
I've been getting pain around the knee cap (patella), esp hiking downhill. In fact it went out just yesterday when I turned quickly in my home! The cartilage in the knee tends to wear down as we get older and the patella slips, causing pain. I have a runner's sports guide that talks about doing hamstring stretches and exercises to strengthen the thigh muscles (and they all connect at the knee). You really need to stretch as hiking is exercise - and stretch during the course of hiking, esp for us forty and older. I do calf stretches also for my ankle that I injured a few years back. Look up Runner's knee on the Internet if this is your problem for exercises and stretches. I'd rather do that than rely on a knee splint for this condition if I can slowly strengthen my knees without weakening them.
MedicineMan,
How did you treat the plantar? I have not been diagnosed, but am pretty sure that's my problem. I've tried stretching and that helps some. Best relief comes from 'taping' the bottom of my feet with athlete's tape, but although this gives immediate relief, changing the tape everyday is aggravating. I've read that this is a problem that comes with age, so although depressing, guess I'll have to learn to live with it. Or, maybe as you say, "time will ease?":rolleyes:
-Bolo
I dont have this "problem" but found this relief product in a catalog I subscribe to, not sure how well it works...
http://www.improvementscatalog.com/product.asp?product=277533lgezz&dept%5Fid=10711
Spiritual Pillgrim
03-04-2006, 11:10
My left knee is notorious for causing pain in the ligament that runs over the knee cap. In the past I've used a knee brace which has helped a lot. For this thruhike I started using glucosamine and fish oil (found a great deal at a resupply in an Ingles, a 2 for 1 buy on bottles of glucosamine chodroitin). Good news is that something seems to be working. I've had minimal knee pain, except for being cripple after hiking down into NOC. Sometimes I feel a little "pop" and then the knee feels better, as if the fish oil is allowing something to get realigned. I had run out of fish oil before getting to Blueberry Patch and that was my worse knee pain day. So I don't know if its the gluco or oil that is helping but I intend to keep using both (plus vitamin I)
Footslogger
03-04-2006, 12:15
[quote=Spiritual Pilgrim - formerly AKA Taz]My left knee is notorious for causing pain in the ligament that runs over the knee cap.
=====================================
I work at an orthopedic/sports medicine clinic and other that outright injuries involving the major ligaments (ACL and PCL) and the meniscus, the single most common ailment involves the Quad and Patellar tendons. The muscles above the knee terminate into the Quadraceps Tendon. It houses the knee cap (patella) and then continues below the knee cap as the Patellar Tendon. That set of tendons is exercised every time the knee joint is flexed. It takes a lot of beating. Aside from the Glucosamine, which really does seem to help, the one thing our physical therapists stress is stretching of those tendons before serious exersise. Slow deep knee bends or gently pulling the lower leg up behind you is the best way to warm up those tendons and get them ready for hiking.
'Slogger
Spiritual Pillgrim
03-13-2006, 14:07
Thanks for the tip, Slogger. have more trouble now with tendinitis in the achilles because i am not using my size 9 orthotic insert with 5mm heel lift in my size 10 boots. Still minimal knee pain even after coming out of the Smokies and into Hot Springs
gsingjane
03-13-2006, 14:47
On the cartilage issue, I heard something amazing at the gym the other day. A guy there told me that his knee cartilage was almost completely gone (apparently he'd had several surgeries, dating back to serious athletic injuries in his youth) but his ortho tried a brand-new therapy involving removing some of his cartilage cells, growing them outside his body, and then re-injecting them. (This was done through Yale-New Haven Hospital.) The guy said this procedure/operation had just recently been authorized for use in this country, and that so far he was doing better than he had over the past 20 years with his knee - that his knee cartilage had actually successfully regenerated. Obviously this is a pretty drastic remedy but I had never ever heard of it and thought others might be interested to learn that there might, in fact, be help out there, even for very serious cases of cartilage deterioration.
Jane in CT