Knee pain when going down but not up

[1step@atime]

Went with some friends to the Ozark Highland Trail and we had a great hike Friday & Sat. My legs are strong but my knees started hurting whenever we decended.

No previous injuries to them or any other pains anywhere else. Others mentioned the uphill portions being more difficult but not for me, only going down.

Any thoughts, ideas or suggestions?

[littlelaurel59]

Where is the pain?

I have experienced problems with Iliotibial Band Syndrome (which is lateral, or on the outside of the knee) with downhill backpacking. This syndrome has been previously discussed on WB, or you can google and get loads of info for strengthening the area.

Many of us in the Half-Century Club find that hiking poles are helpful.

[papa john]

Do you use hiking poles? I find that they take the weight off the knees when going downhill.

[Footslogger]

Based strictly on the information you shared I would suggest to you that the problem may be early osteoarthritis (OA) and some degenerative joint disease (DJD). We're born with shock aborbing tissue called Meniscus, that sits between the upper (Femur) and lower (Tibia) leg bones. In addition there is some articular cartilage that lines the outer surface of the bone. As we age the meniscus thins and the articular cartilage can erode. The end result is that under load bearing conditions (like hiking downhill) we are essentially putting "bone-on-bone" pressure on the joint.

That said ...if you're otherwise healthy, your problem may be related to a straining of the ligaments that stabilize the knee or even just a small tear in the meniscus tissue. In other words, it might be an early sign of a bigger problem just waiting to happen.

My suggestion would be to make an appointment with a good orthopedic/sports med doc who has some experience working with hikers/backpackers. The solution might be as simple as some medication for pain relief and inflamation and a regimen of physical therapy.

I am personally a huge proponent of Glucosamine when it comes to joint health. I started to have some discomfort and clicking in my knees about 4 - 5 years ago. Went on Glucosamine Sulphate and have noticed a marked decrease in the symptoms.

Anyhew ...just some thoughts on your post. I work in the orthopedic/sports med field and see these types of problems frequently.

All the best ....

'Slogger

[burger]

I'm not so sure about osteoarthritis. If your pain is on the outside of the knee, it's probably iliotibial band syndrome (ITBS). If you're experiencing pain right behind the kneecap, then you might have runner's knee (or patellar tendonitis). Pain when going downhill is a very common symptom of this injury, caused by the kneecap not tracking properly.

The good news is that if you have either ITBS or runner's knee, there are a lot of stretches and exercises you can do to start treating it. A good starting place is here: http://www.coolrunning.com/engine/2/2_5/194.shtml

And if you need any specific suggestions on exercises, PM me. I've had successfully gotten past ITBS and runner's knee in the last few years. Good luck.

[1step@atime]

Thanks for all the replies, I did use treking poles and they really helped. I will do some checking to find a good sports med. Dr. because the old knees do make a popping noise which can't be a good sign.:eek: Sounds like what you were talking about Slogger.

[Just Jeff]

Were you locking your knees on the downhills? It makes it easier in the short term...you're transferring the force from your muscles to your bones, which allows worn out muscles to relax for a bit, but it also puts a jarring force on your bones that can cause joint pain.

So if your knees were really tired on the downhills, you might just need to have a good look at your form. In the meantime, Vitamin M, start looking for some hiking poles, cut your pack weight, and call me in the morning.

(I'm not a doctor, don't use hiking poles yet, and didn't stay in a Holiday Inn Express last night...but I had that same problem until I realized what I was doing. It's an easy first fix that may save you the hassle of going to the doctor.)

[FatMan]

Welcome to the club. It's called old age. I'm forty-eight and the knees started to go last year on the downhills. Get yourself a set of hiking poles and take glucosamine for six months and your knees will hurt a little less on the downhills.

[Chantilly Lace]

In addition to the Glucosamine and trekking poles try making those steep descents sideways. I find side-stepping takes alot of the stress off my knees and actually makes me feel more in control, less slipping possibility.
Pokemom

[SteveJ]

"Old knee syndrome" - for me, pain on the outside of the knee that could get excruciating when going downhill. I used to suffer from this on every hike. My solutions:

1) Lower pack weight. This bothered me most when I was 40, and carrying a pack that weighed 40 lbs or more! Since I've lightened my base weight to less than 10 lbs, I virtually never experience this particular pain;
2) 2 hiking poles.
3) As I lowered pack weight, I converted from heavy hiking boots to trail runners (for 3 season hiking, anyway)
4) Began walking more! Get out from behind the desk / steering wheel / etc. - and walk more.

[orangebug]

I anticipate that this was simply exhaustion of your quads, and unlikely to be an arthritis. This is a common injury/pain combination until you have obtained real trail legs. It can occur under full or day pack. You can frequently reduce the pain by walking sideways down the hill. You can avoid it with a rest step as you go uphill, or by keeping the initial mileage relatively low.

By all means, talk with an orthopod if one is easily available, but anticipate advice to strengthen your quads further.

[Mr. Clean]

I went to poles (said I'd never do it), glucosamine, and lower pack weight, but there was one thing better. I spoke with my Dr about it and he said I simply needed to build up the muscles around my knee. Walking on flat ground and going up/down hills uses different muscles, so he gave me an excersise. While sitting, lift one leg at a time with the foot straight up and hold for ten seconds. Do it with the other foot. Repeat over and over. I do it at work, watching TV, etc., and found that it has strengthened my knee muscles. Try it.

[1step@atime]

Thanks again for all the replies. As I said I did use treking poles and they did help a lot. Thought the legs were in great shape as I would walk up & down climb a 60 story building daily before the hike. Total pack weight was less than 30lbs. We averaged a mile every 30 minutes. I'll try the knee exercises too.

[Frosty]

While sitting, lift one leg at a time with the foot straight up ??? Does the foot point straight up? Or the toes? Or what? I can't picture this.

[Green Bean]

knee brace might help you out.
I had problems with me knees descending also. So I went out and bought some knee braces and they work out great. they cut down on most of the pain but not all of it. ~GB

[orangebug]

??? Does the foot point straight up? Or the toes? Or what? I can't picture this.Flex the ankle, which is the opposite of pointing the toes. Extend your knees, using your quads. You can add ankle weights to make this even better.

Another technique is to hold a ball between your feet and raise and lower them together.

[vipahman]

I would like to add that while stepping down, you should try to slow your descent (poles will help) instead of falling down. Let the calf muscles do some of the work.

[Jaybird]

Went with some friends to the Ozark Highland Trail and we had a great hike Friday & Sat. My legs are strong but my knees started hurting whenever we decended. No previous injuries to them or any other pains anywhere else. Others mentioned the uphill portions being more difficult but not for me, only going down.Any thoughts, ideas or suggestions?


FIRSTLY...use hiking poles...secondly, if you want to continue hiking...might wanna add some knee braces.

another suggestion is carefully (i know this sounds too simple to be true..but it works)..to land your foot properly & walk properly...heel then push off with ball...heel then push off with ball....

if your "flat-foot-ing"... youre killing your knees & eventually ankles.

i know these things from experience!

Good Luck with your hike.



Section-hikin' PEARISBURG-GLASGOW,VA (w/ "Jigsaw")
APR 22-MAY 3

[nhalbrook]

I, too, have had knee problems on trail decents. Use a trekking pole and wear trail runners. Believe that most of my problem, apart from poor conditioning, is pronation related. Found that when I consciously paid attention to which side of my foot I was using and tried to flatten the landing out it helped. Probably need some corrective insoles. To get a quick handle on whether you might have a pronation condition look at the soles and heels of your everyday street shoes - look for uneven wear on inside or outside edge then get insoles designed to boost the side of the foot/heel on which the wear is noticed.

[fiddlehead]

I had an old football injury and thought i couldn't hike.
The pain went away with experience. Now, that I've hiked a lot, i can even ski moguls anymore. My knees are stronger than they've been since that football injury happened when i was about 17 or 18.
I think you'll be fine if you just hike more.
By the way, my brother had the same injury and had it operated on when he was young. Now he needs replacement (Plastic) knees. I never had mine operated on and now...........well, i'm 55 and just ran a half marathon here in Phuket last week with no problems. (and marathons can be worse on your knees than hiking because of the constant pounding on cement or blacktop.

[Ridge]

I remember the first time going into NOC from Wayah Bald the long steady descent caused my knees to ache. The trip out of NOC to Stecoah Gap was just the opposite, its much better going uphill than down.

[bfitz]

If you wrap something tight around and just under your knee it should give some relief...they even sell knee support products (patella-somethings or cho-pat...) it's amazing how much they help.

[Blue Jay]

If you wrap something tight around and just under your knee it should give some relief...they even sell knee support products (patella-somethings or cho-pat...) it's amazing how much they help.

Never thought I'd say this, but I agree with bfitz on this one.

[MaineMud_Hiker]

I have read a lot about this being an "old knee" problem. i am 28 and while descending Saddleback via the AT south bound (Maine). i found myself in near tears because the pain in both my knees was excruciating! they felt like they were on fire ( the entire joint not just the outside)! i had some visible swelling and once the pain started it continued the entire hike back to the car. Even in the flat spots. the next day i had to elevate my right knee due to residual pain and swelling.
i also found landing my foot correctly was hard due the uneven surface and wet roots and rocks. i do know i am prone to pronating my feet. i guess it is a matter of practice?

i do know I need to invest in a high top good quality hiking boot and possible leg braces.

p.s. the Vitamin I (ibuprofen) didn't work worth beans...took it pre, during, and post hike. i am sure my kidneys loved me.

Hike on!