PDA

View Full Version : Any specific training to help with knee pain from descents



john844
04-08-2018, 20:43
I was recently doing the Georgia section. I had trained quite a bit before hand building up to my planned pack weight. I increased intensity and steepness of hikes over a couple months.

I still encountered quite a bit of knee pain that got worse after descents. Is there any specific training or exercises that I can do to help alleviate this in the future?

devoidapop
04-08-2018, 21:03
I think long descents are the hardest thing to train for if you don't live and train in the mountains.

One thing I try to do is work it so that I'm tackling a long, steep downhill on fresh legs. If that means going a bit further or setting up camp early the day before, so be it. My knees and ankles will thank me for it.

JC13
04-08-2018, 21:05
I used a weighted backpack and the jump boxes you find in a fair number of gyms these days. I would stagger them at different heights and go up and down them making sure to switch which leg took the decent. Seemed to help, I would start out with maybe 5 lbs in the pack and work my way up to just slightly over the weight I was planning to carry.

MuddyWaters
04-08-2018, 21:17
Let it heal
Slow down next time

And take up running

Doing plyometric jumps at gym, I once induced tendonitis around knee that took months to subside. I dont recommend that ... At least not for older folks.

Huntmog
04-08-2018, 21:33
I used to end every trip with a locked knee from descending, I'm talking after 30 miles it was done. As in each step i wanted to cry. There is even a video of me hopping down humpback with my poles. Zero drops (lone peaks), knee wraps and stretching have helped me maintain my favorite past time. Just did 60 miles over 3 days from RT 60 to bear wallow, which is steep going SOBO and could have kept going. I don't credit any of the above as the sole solution. Its all 3 in concert altogether.

john844
04-08-2018, 21:45
Thanks for the suggestions. I am taking the week off from hiking and will see if discomfort eases up.

I think muddy might be onto something about the speed. I will really focus on that on my next hikes.

john844
04-08-2018, 21:47
I dont recommend that ... At least not for older folks.
I'm not sure, but I think I just got called old. Lol

Feral Bill
04-08-2018, 22:43
I'm not sure, but I think I just got called old. Lol No higher compliment.

Slo-go'en
04-08-2018, 22:47
Do you use poles? Those can help absorb some of the shock and slow you down. Of course weight has a lot to do with it too, body and/or pack. The lighter you are on your feet, the easier the load on the knees.

Personally, I do better on the really steep descents then the 9% grade stuff which goes on for miles in GA/NC. One of the reasons I don't like switch backs.

I'm really amazed I haven't worn out my knees yet but I have lost a lot of spring in my step.

Ethesis
04-08-2018, 23:11
Let it heal
Slow down next time

And take up running

Doing plyometric jumps at gym, I once induced tendonitis around knee that took months to subside. I dont recommend that ... At least not for older folks.


Same here. I’ve had nothing but grief from the box jumps.

NJdreamer
04-08-2018, 23:53
I was recently doing the Georgia section. I had trained quite a bit before hand building up to my planned pack weight. I increased intensity and steepness of hikes over a couple months.

I still encountered quite a bit of knee pain that got worse after descents. Is there any specific training or exercises that I can do to help alleviate this in the future?If you are back home, I suggest you see a sports doctor to find out more about which muscles might be causing it. I have gotten very bad itp which is the muscle on the side of the knee. With exercise and a foam roller, it has improved each time. I hope you get relief and can strengthen the muscles to have less pain.

Sent from my SM-G900V using Tapatalk

moldy
04-09-2018, 07:44
My opinion is that there is nothing you can do, exercise wise, to make the pain go away. On a thru hike almost any body part trouble will be made better by hiking. Legs, ankles, shoulders, backs even some feet problems can be made better by hiking. Not knees, you will never hear a story about how hiking 2 thousand miles made the knees better. So forget exercise, go for "pain management" and a lighter pack. One of the things that some people do is have rest breaks on the big downhills.

chknfngrs
04-09-2018, 07:48
Poles. They take significant force from the knees.

Leo L.
04-09-2018, 08:44
More damage than good can be done by training.
Use poles.
Never jump/jog/run downhill.
Reduce body and pack weight.
Stay hydrated.
Apply curd to swelling.

john844
04-09-2018, 09:51
Yes, I do use poles and they help a ton.

Poles. They take significant force from the knees.

john844
04-09-2018, 09:57
I am continuing to refine my gear to reduce weight.

I was carrying 29 lbs starting out. That included 5 days of consumables and cold weather gear.

CalebJ
04-09-2018, 11:29
Try to keep your knees slightly bent as you step so that your weight is carried by leg muscles rather than shock loading your knees.

Venchka
04-09-2018, 12:21
Can we get some details please?
Distance. Time. Elevation drop.
Thanks.
Wayne

BuckeyeBill
04-09-2018, 12:56
When people say old to me, I say experienced to them. I will concede that as we age, things that never bothered us before, now can cause us pain but if done in moderation can be handled without strong pain killers or surgery (unless something gets torn or damaged). I know that trekking poles help me on both the ups and downs. As pointed out in another thread, it's the downs that cause the most damaged. Take your time and learned to use trekking poles to absorb and carry a lot of your weight. Of course carrying a light pack helps, as long as people don't go stupidiot light. Don't let someone else dictate what you need to carry, because if everyone was the same, we wouldn't need such a wide selection of gear, as everyone would go for the same equipment. This is just my opinion, your mileage may vary.

BuckeyeBill
04-09-2018, 12:57
Can we get some details please?
Distance. Time. Elevation drop.
Thanks.
Wayne

Wayne, I have heard the average elevation gain and loss is 9%.

Puddlefish
04-09-2018, 13:00
Shorter steps downhill.

MuddyWaters
04-09-2018, 14:44
When people say "knee", it means different things.

Most time, its actually tendonitis of muscles around the knee thats the issue. No swelling with tendonitis.

If the knee swells up like a grapefruit....its actually the knee.

john844
04-09-2018, 14:46
My training hikes were typically up and down a mountain gaining 1200' over 1.9 miles and reversing. I did this hike about 4 times a week with longer hikes on Saturdays with similar climbs.

The recent multi day hike that had noticeable increased pain in descents was 4 days on the AT. Approach trail to unicoi gap.
Day 1: 12 miles Approach to just before Three Forks
Day 2: 12 miles Three Forks to Gooch Gap
Day 3: 17 miles Gooch Gap to a few miles past Neels Gap
Day 4: 17 miles a few miles past Neels Gap to Unicoi Gap

I don't have the profiles in front of me for the elevation changes over the 4 days.


Can we get some details please?
Distance. Time. Elevation drop.
Thanks.
Wayne

john844
04-09-2018, 14:54
No swelling. Pain was right below kneecap and behind kneecap. No popping like a torn meniscus or anything like that. Just annoying pain that would build during descents.

After being home for 3 days, I don't have any lingering pain.

My gut says it's overuse/over train issue. With the knowledge base here I figured I would get some valuable advise either way.

Thanks,
John


When people say "knee", it means different things.

Most time, its actually tendonitis of muscles around the knee thats the issue. No swelling with tendonitis.

If the knee swells up like a grapefruit....its actually the knee.

martinb
04-09-2018, 14:56
What footwear are you using?

john844
04-09-2018, 15:38
What footwear are you using?

Salewa trail running shoes. They are pretty light weight, but not Altra Lone peak light weight.

john844
04-09-2018, 15:43
Now that I wrote down the mileages, I am seeing some indicators of why I ran into issues.

The jump in mileage was more severe than I thought it was. Although I was hiking regularly and felt great, the increase in daily mileage was a bit drastic. I think my knee pain was just the first and most obvious symptom.

I will have to be much more careful when I do the JMT this summer.

If the pain returns on my next hike, I will make a call to see a sports Dr.

Venchka
04-09-2018, 16:01
My training hikes were typically up and down a mountain gaining 1200' over 1.9 miles and reversing. I did this hike about 4 times a week with longer hikes on Saturdays with similar climbs.

The recent multi day hike that had noticeable increased pain in descents was 4 days on the AT. Approach trail to unicoi gap.
Day 1: 12 miles Approach to just before Three Forks
Day 2: 12 miles Three Forks to Gooch Gap
Day 3: 17 miles Gooch Gap to a few miles past Neels Gap
Day 4: 17 miles a few miles past Neels Gap to Unicoi Gap

I don't have the profiles in front of me for the elevation changes over the 4 days.
Thank you! That’s way more miles and elevation change than I’ve done. I’m no help. Hope you get well soon.
Wayne

Deadeye
04-10-2018, 08:12
Wall squats

john844
04-10-2018, 10:23
Wall squats

I was doing these as part of the my workouts, but have fallen out of the routine the last month or so. These are tough, but I will get them back in the rotation.

john844
04-10-2018, 10:31
When people say old to me, I say experienced to them. I will concede that as we age, things that never bothered us before, now can cause us pain but if done in moderation can be handled without strong pain killers or surgery (unless something gets torn or damaged). I know that trekking poles help me on both the ups and downs. As pointed out in another thread, it's the downs that cause the most damaged. Take your time and learned to use trekking poles to absorb and carry a lot of your weight. Of course carrying a light pack helps, as long as people don't go stupidiot light. Don't let someone else dictate what you need to carry, because if everyone was the same, we wouldn't need such a wide selection of gear, as everyone would go for the same equipment. This is just my opinion, your mileage may vary.

Getting "experienced" sucks. LOL But it definitely beats the alternative.

I not getting any younger and am definitely not happy sitting around. I also try not to use pain relievers unless absolutely needed. I have had back issues for many years and know that pain meds allow you to ignore what the body is telling you. That pain to a certain point is what keeps me from pushing things too far. Luckily, I am not anywhere near needing pain meds to manage this pain.

My goal is to minimize the pain and/or damage being done so I can keep doing this as long as possible.

Thanks again for all the advice given by everyone on this thread.

MkBibble
04-10-2018, 14:42
Knee pain, mainly downhill, cut my first section short. I resorted to going downhills backwards (oddly that helped), and it took me ALL day to go 6 miles to Woody Gap. While waiting for a ride back to Atlanta at the Hiker Hostel, another hiker introduced me to cho-pat straps; they helped immediately. Before going back the next year I found exercises to increase strength around the knee; I think that helped. Central Texas, where I live, is dreadfully flat, so I practiced going up and down bleachers - first without a pack then with a pack; I think that helped. What i KNOW helped was using poles. The next section, and subsequent sections, I have used poles and had no more issues.

Night Train
04-11-2018, 22:58
Yoga, kick board, trail running.

Traveler
04-12-2018, 07:28
Now that I wrote down the mileages, I am seeing some indicators of why I ran into issues.

The jump in mileage was more severe than I thought it was. Although I was hiking regularly and felt great, the increase in daily mileage was a bit drastic. I think my knee pain was just the first and most obvious symptom.

Just as a thought, I had a similar problem some years ago when I wanted to increase my mileage. In doing this I also lengthened my stride a few inches to shave some time off each mile. For a while this strategy seemed to work, however I started noticing small problems in my legs and feet and eventually my knees. These were minor problems that came and went but mostly showed up when I was hiking. It was the downhills is where pain in knees and surrounding muscle area eventually increased to the point it took me off the trail for a while.

Returning to trails after a few weeks off, I found my normal stride did not present any issues but when I tried to stretch out my stride for speed my knees and lower legs started letting me know this wouldn't work long term. I later found out from a Doctor that changing one's natural stride like this will impact other areas of the body to accommodate the change. Problems can appear in the ankles and feet, shins, knees, hips, and/or the lower back. When I used my normal stride and used an extra hour or two I reached my mileage goals within my body's tolerance, as opposed to trying to increase the miles per hour that exceeded my body's tolerance. Since then I use a bit more time to make the distances I want. Downhills being the biggest challenge to impact related problems, instead of picking up speed and increasing the footfall impact I shorten my stride, use poles, and use foot placement or use short switchbacking to ease the impact of each footfall.

I'm not sure if this applies to your circumstance or not, however your description reminded me of what I experienced and thought it may be useful information.

MuddyWaters
04-12-2018, 08:07
Just as a thought, I had a similar problem some years ago when I wanted to increase my mileage. In doing this I also lengthened my stride a few inches to shave some time off each mile. For a while this strategy seemed to work, however I started noticing small problems in my legs and feet and eventually my knees. These were minor problems that came and went but mostly showed up when I was hiking. It was the downhills is where pain in knees and surrounding muscle area eventually increased to the point it took me off the trail for a while.

Returning to trails after a few weeks off, I found my normal stride did not present any issues but when I tried to stretch out my stride for speed my knees and lower legs started letting me know this wouldn't work long term. I later found out from a Doctor that changing one's natural stride like this will impact other areas of the body to accommodate the change. Problems can appear in the ankles and feet, shins, knees, hips, and/or the lower back. When I used my normal stride and used an extra hour or two I reached my mileage goals within my body's tolerance, as opposed to trying to increase the miles per hour that exceeded my body's tolerance. Since then I use a bit more time to make the distances I want. Downhills being the biggest challenge to impact related problems, instead of picking up speed and increasing the footfall impact I shorten my stride, use poles, and use foot placement or use short switchbacking to ease the impact of each footfall.

I'm not sure if this applies to your circumstance or not, however your description reminded me of what I experienced and thought it may be useful information.

Walk longer, not faster

Haste...makes waste.

Most eventually learn this the hard way.

I broke pole before because I went too fast and slipped on slick rock. Had repetitive motion injuries too. Eventually i learnt....sort of.

Bansko
04-12-2018, 09:22
Is there any specific training or exercises that I can do to help alleviate this in the future?

As for prevention; I never did any specific exercises, but I did do a lot of walking with a 30 lb. pack for several months prior to my hike. I was in pretty good shape, but I allowed myself to get a little too confident, taking exuberant, bounding leaps on one particular downhill about 70 miles North of the Springer. I knew I screwed up as soon as my foot hit the ground on one particular leap. I ended up with pretty bad knee pain that lasted for weeks, causing me to consider (briefly) giving up my thru-hike attempt. My advice, for what it's worth, is don't let gravity get the best of you on the downhills. Take them in stride and don't rush things. Fortunately, I healed up. Use those poles. They are pointless on the flats but invaluable on steep inclines and declines.

john844
04-12-2018, 16:04
I've always been a competitive person, so I think a lot of the comments are hitting home on that area. I have been working to increase my endurance, strength and speed and have lengthened my stride on flats and uphills. I never experienced any issues directly from that, but the problems could have building in the background and showing up on the downhills. I would imagine that unconsciously I lengthened my stride a bit on them too even though I was trying to focus on controlled steps and lessening impact by keeping knees a bit bent.

This is a wake up call to slow down more and enjoy the trails while I still can.

Thanks again for all of the input.
John

sethd513
04-12-2018, 18:11
My knee pain is fixed with running and biking, but also most simply is stretching my calf’s,shins quads IT band hips pretty much everything I know how to below my waste.


Sent from my iPhone using Tapatalk

sethd513
04-12-2018, 18:12
Oh yea and more bananas


Sent from my iPhone using Tapatalk

egilbe
04-12-2018, 18:46
I started doing Tai Chi. Seems to work pretty well for strengthening and loosening leg joints.

MtDoraDave
04-13-2018, 06:47
As others have said, slow down and take shorter steps down hill.
On moderate uphill, or downhill, where there's a temptation to go quickly, "place" your feet down, don't stomp! This requires effort at first, but will become habit after a while.
I was practically crippled by knee pain half way through a section, but stopping early and resting - and taking 2 ibuprofen that afternoon, that evening, and the next morning, I was able to continue the next day - and did 19 miles up and out of Hot Springs!

QiWiz
04-13-2018, 15:20
I was recently doing the Georgia section. I had trained quite a bit before hand building up to my planned pack weight. I increased intensity and steepness of hikes over a couple months.

I still encountered quite a bit of knee pain that got worse after descents. Is there any specific training or exercises that I can do to help alleviate this in the future?

What I do: [1] carry a lighter load to the extent possible; [2] use trekking/hiking poles to take weight off knees on descents; [3] slow down, smaller steps; [4] quad-strengthening exercises can also help

NSHSDad
04-14-2018, 18:39
I do curls and lunges with barbells. It's good for strengthening parts of the quads close to the knee. If you use those muscle in descent, you'll be helping your knee out. Also, the lunge and curls will force you to use lateral muscles to stabilize the knee, which is useful in real-life when you need to also provide balance on uneven surfaces. Finally, it connects through the core, which is always a good thing.

Mine is 35# in each hand, so 70# total. It seems to help. I just did a rust-buster on some fairly steep hills and managed reasonably well - was doing the curl and lunges periodically over the winter.

jomo1983
04-15-2018, 04:57
I can only say what's worked for me. I lost 25 lbs, had a meniscus flap removed and never leave home without a generous supply of Vitamin I.

sadlowskiadam
04-15-2018, 08:27
I was recently doing the Georgia section. I had trained quite a bit before hand building up to my planned pack weight. I increased intensity and steepness of hikes over a couple months.

I still encountered quite a bit of knee pain that got worse after descents. Is there any specific training or exercises that I can do to help alleviate this in the future?
I had severe tendinitis in my knees from descending Blood Mountain in Georgia during my 2013 thru hike. I bought a jumpers knee band for each knee and wore them all the way to Maine. My knee pain went away within a week or so, and never came back because the bands kept the patella tendon in place during the descents and climbs.

Here is a link to the type of bank I used:

https://www.eastbay.com/product/model:234349/sku:992/mueller-jumpers-knee-strap/black/?SID=7726&inceptor=1&cm_mmc=SEM-_-PLA-_-Google-_-992&gclid=EAIaIQobChMImP652aK82gIVXbnACh0hgws6EAQYAiAB EgJglPD_BwE&gclsrc=aw.ds

kbstock
04-15-2018, 11:10
If the pain is on the outside of the knee and worse doing downhill....it may be your Iliotibial band (IT band)...which means the root cause of the problem is in your hip....but the pain manifests in the knee area. Google it.
IT band syndrome can be "fixed", but its not an overnight thing. Foam rolling helps, specific stretching and strength training exercises...and time.
It took me off the trail last fall after only 42 miles. I was devastated....but giving it another go next month.

Fredt4
04-15-2018, 19:49
I've just finished hiking the PCT last year and had no knee pains. I also did the AT in 2011 with the same results. Years ago I had tremendous problems with knee pains and was accustomed to dragging a leg after a weekend or week of hiking. Never figured out why the pain went away but have some decent suggestions. I switched from hiking boots to trail runners and I now use trekking poles. I can't say specifically that either provided the solution to my knee injury but I'm much happier with the results. In addition i also take Tylenol in the morning before I hike to also avoid the injuries but I've found that to be mostly unnecessary during my PCT hike. Had a few doctors talk about operating but didn't listen to them. Perhaps it was just bound to get better or perhaps it was natural improvements after years of hiking, but I believe the lighter weight of my pack along with the shoes and trekking poles made a difference. I also believe that people that use hiking boots are more prone to injuries, though I don't have definate proof thereof. During my AT hike many hikers that continued to use boots would advise me of the reasons for their use. A few of them then proceeded to injure themselves and would afterwards cite the boot as protection from a greater injury. Perhaps they were correct, but I didn't cross paths with any one using trail runners that subsequently injured themselves. There's probably sufficient data available for someone to show the probability of injuries but that's a bigger fish than im willing to tackle. I'll also note that most thru-hikers have ditched their boots and now also use trekking poles. Perhaps someone will choose to tackle these issues with some good data analysis.

mississippi_dan
04-15-2018, 21:45
Anyone mention arch supporting insoles? Sometimes they are helpful with knee pain.
I have found balancing exercises also helps, like walking across a small diameter log.
Dan

kestral
04-15-2018, 21:57
Some folks get needed support from taping. Perhaps you can go for a physical therapy apt and get the specific problem identified, then try strengthening and taping. We have PT offices around here that advertise for walk in, no insurance patients to get evaluated for $40 with treatment plans. Of course if you have insurance than use it.

At local races there are tables set up for free assessments and taping for marathoners. It seems to help.

https://barbend.com/kinesiology-taping-knee-pain-stability/

Adfischer
04-16-2018, 11:21
John,

I was in a similar situation and decided to go see an Orthopedic Doctor so I could be sure of the problem. With only knowing the symptoms, not the underlying problem, I knew I would not be able to fix it. In my case it turned out to be my IT band causing knee issues very similar to what you describe. I now do some stretching exercises prior to hiking and it has solved my problem.

My advice would be not to guess at the issue or try to solve your issues using the Internet, but go see a medically trained professional and get to to bottom of it. I hope all goes well.