Descents and your knees

[RodentWhisperer]

How can you keep your knees from aching, when you need to hike downhill for many miles?

I ask because last week, I tested my thru-hiking gear/plans with a 32-mile loop through Colorado's Indian Peaks Wilderness Area. On the second day, when I had to start a 14 mile descent from a 12K-foot pass to reach the trailhead, my right knee began to ache... in the last miles of that descent, the pain was excruciating. I ended up using one of my trekking poles as a crutch/cane, which worked well to keep weight off the knee; I managed to complete the hike as planned, but the last 5 miles were no fun at all.

My doc tells me I probably over-used (then word was "abused") my knee and developed tendinitis. It took 2 days for my knee to feel normal again.

So back to my original question: what do you do to prevent this from happening? I suspect it had something to do with my balance, strides, posture, or motion, since I regularly strength-train my thighs and calves. Any advice?

[Pedaling Fool]

Here's a good blog that talks about walking downhill http://www.justroughinit.com/blog/hiking-downhill-is-exercise/

You say you strength train, but maybe you need to look at your routine and make sure it's not "too routine". Many people workout, but they get stuck in a routine and don't change it up and if you're in a routine your body will become very efficient at that routine, but once it's changed your body will become upset with you and "lash out" in the form of pain. The problem with a "routine" is that your body gets use to it and your "routine" may workout some parts of the body more than others, leading to an imbalance, or other parts overworked, which is exacerbated by the other parts being under used.


Also, even if you have a well-rounded workout, maybe it's just not enough for the task. I have what I consider a very well-rounded workout routine, but if I were to attempt to ride the Tour de France or run with Karl speedgoat Meltzer, I'm sure I would have some sore knees, to say the least.

[FlyPaper]

I've was born with bad knees. Not bad enough to count as a handicap nor get me out of gym class. But I would say I had a severe proneness to knee injury. My knee cap would pop out of place briefly at very inopportune times (e.g. jogging, playing basketball, etc). This would almost always cause me to fall, and sometimes would result in swelling that kept me inactive for a few days afterwards.

I tried therapy, but that wasn't enough. In 1993, I had bilateral surgery to realign the track of my knee caps. That has helped a lot. Without surgery, I would have not been able to hike at all. Backpacking on the AT would have been completely out of reach.

Thanks to surgery, I have been able to hike over 600 miles on the AT, but still I have a lot more difficulty going downhill than most guys I hike with.

I lean heavily on my poles.

Probably the best thing you can do is to do therapy just as if you were recovering from knee surgery. I still do therapy, especially as a hike is coming up even though my surgery was almost 20 years ago. You can find many examples on youtube. Here is probably the best exercise that works for me: www.youtube.com/watch?v=Vu2-fzb9810. Also this: http://www.youtube.com/watch?v=kmlgUonKebw. Do these with ankle weights on (you may need to build up). You should be able to tell if this is helpful for you. Knee stability relies a lot on quad muscles. Chances are this will help, but maybe this won't address your knee problem.


How can you keep your knees from aching, when you need to hike downhill for many miles?

I ask because last week, I tested my thru-hiking gear/plans with a 32-mile loop through Colorado's Indian Peaks Wilderness Area. On the second day, when I had to start a 14 mile descent from a 12K-foot pass to reach the trailhead, my right knee began to ache... in the last miles of that descent, the pain was excruciating. I ended up using one of my trekking poles as a crutch/cane, which worked well to keep weight off the knee; I managed to complete the hike as planned, but the last 5 miles were no fun at all.

My doc tells me I probably over-used (then word was "abused") my knee and developed tendinitis. It took 2 days for my knee to feel normal again.

So back to my original question: what do you do to prevent this from happening? I suspect it had something to do with my balance, strides, posture, or motion, since I regularly strength-train my thighs and calves. Any advice?

[RodentWhisperer]

Thanks for the reminder, John. I've forgotten how making your workouts into a routine is really a limitation.

The blogger makes some good points, but the link to his post on protecting the knees in descents ("My Knees Never Hurt Before") appears dead.

And I'll try those exercises today, FlyPaper.

[Pedaling Fool]

Yeah, the link is dead, but if you google it you can find it. http://www.justroughinit.com/blog/my-knees-never-hurt-before/

But the youtube links are good.


The "Ain't no mountain High enough" link does seem to be completely dead, unless it's here, I didn't check all of it http://www.justroughinit.com/blog/pre-trip-information-2/

[FlyPaper]

I'm also going to try the exercises John suggests. And I'm going to make myself walk downstairs more often (rather than take the elevator down).


Thanks for the reminder, John. I've forgotten how making your workouts into a routine is really a limitation.

The blogger makes some good points, but the link to his post on protecting the knees in descents ("My Knees Never Hurt Before") appears dead.

And I'll try those exercises today, FlyPaper.

[Not Sunshine]

I, too, struggle. I had my left knee reconstructed (ACL repair/ MCL torn & allowed to scar/ both meniscus torn/trimmed 17 months ago after a traumatic skiing accident. My left knee had been doing GREAT on my 40 mile 3-4 day section hikes this spring/early summer, but my right knee started hurting (2 days of rest, ice, and it felt better).

My thought was that I was babying my left knee when stepping down steps (lowering my body with my right leg), so this past 25 mile section hike from Erwin to Carvers Gap, I was careful to try alternating both legs downhills so I didn't over-do it on one side or the other.

I haven't had any pain - am completely pain free - but I now have a swollen left (surgical side) knee. Back to the icepack.

It's completely frustrating, but par for the course: suppose I'm not getting any younger [or lighter, for that matter].

The only additional suggestions I can make for generalized knee pain are this: decrease your pack weight as much as possible, and when going downhill, tighten up the shoulder straps so your pack is snug around you - and if you are at all able to - trot downhill. I've heard from more than 1 thru -hiker that the secret to decreasing knee pain downhill is to go as fast as possible. I think when you do, your heel strikes when your knee is bent (and the force gets picked up by your quads instead of your straight knee).

Hope it makes sense and helps. I'm focusing on icing, modifying my diet in hopes to burn off a few pounds off the trail, and getting my pack weight down.

Not Sunshine & Andy the ACL

[peakbagger]

Stay off of statins (as they can cause joint pain), make sure that you arent jumping from one rock to another as you descend and use poles.

[WingedMonkey]

So back to my original question: what do you do to prevent this from happening? I suspect it had something to do with my balance, strides, posture, or motion, since I regularly strength-train my thighs and calves. Any advice?

I did two weeks in Yosemite followed by two weeks in the Grand Canyon before I ever did my tru-hike.

I don't remember whose lessons it was (maybe Colin Fletcher), but for me the "waddle" works. I bend my knees a little, avoiding locking them and walk downhill a little bowlegged, and with a little bounce.

It might look silly, but it worked for me on the AT.

I'm sure there is a better description of the method somewhere.

And it's loads of fun when there are three or four of you doing it.

:sun

[RodentWhisperer]

Ah, now the link works, John. Interesting, in that it recommends 1) not locking the knees (which I tried very hard to do), and 2) leading your downward steps with your heels (which I was finding difficult to do the other day). Perhaps my knee overcompensated for #2, as I was taxing my calves by stepping down with my toes? I'm not a kineseologist, but that seems... like a plausible explanation.

Trotting downhill felt impossible, since the trail was littered with loose rocks... I've sorta trotted before, where the trails were smoother and more compact (and, come to think of it, the descents weren't as steep).

No statins here. And my TPW on day 1 (prior to consuming the consumables) was 17 lb, 12 oz.

[Drybones]

You may want to have an MRI done. I've had knee issues that come and go for a long time. After having to leave the trail at mile 414 I decided to see an orthopaedic surgeon and find out if there was a fix or not. An MRI determined the cartilage was torn badly. The choice is to have a large portion of it cut out or live with. Whatever God gave me I want to keep as long as possible. I believe I would have been okay if I had know I had the problem and exercised some good judgement (not what I'm known for) going down hill. I learned a lot hiking the first 400 miles and plan to return March, if not October, and continue where I left off. I plan to slow the downhill pace down and minimize the pounding. I can still do 20 mile days, it'll just take 10 hours instead of 8. Also plan to take Celebrex and eat better, which I believe contributed to the problem.

[rocketsocks]

Someone mentioned "Rocking the Down hills to town", while I love the saying, I'd do just the oppisite on the down hills, take it easy, keep the knees bent a little bit, and do squats and stadium seats before hike for trianing, it gets the knees on the same page as your down hill wants. Good luck with the knees, of coarse every hikers knees have different problems that only a doctor can and should diagnose and recomend treatment and or type of work out, but all the threads here are certainly a good jumping off point. I always take everything with a grain. If the body doesen't like something, it usally lets us know pretty quick. cheers

[leaftye]

Doing exercises sounds like a great idea. I've read in a few places that being exhausted changes your form and puts more pressure on your skeletal structure instead of your muscles, which is bound to cause pain. Makes sense to me. I've definitely noticed that my knees get less sore when I'm in better shape. If you have weight to lose on your body or pack, surely it'd help to lose that. I also take fish oil to reduce pain and inflammation. If I remember, I take it before I start going downhill.