knee problems

[takethisbread]

I'm leaving this weekend to Georgia, and have done a few shakedown hikes. I have a history of knee injuries, and after the last shakedown my worse knee blew up like a tick. I had a round of silicone injected into it, but it hasn't helped much. I decided to stop pushing it, and just let it heal till Springer. I'm scared it may knock me out, anybody have any experience with bad knee injuries on the AT? I think the ACL is healed , but the cushion is gone and I hope it doesn't blow up too bad . thank u.



Sent from my iPhone using Tapatalk

[fredmugs]

Based on what you provided it doesn't sound good for you. GA is pretty, pretty steep. I have bad knees but not as bad as yours. The only thing I can tell you is to go downhill as s-l-o-w-l-y as possible. Baby your knees. You should see a specialist and consider delaying your hike.

[Pedaling Fool]

Yeah, it's not looking good. You say, "...and just let it heal till Springer.". That seems to indicate at least a month away; however, at the beginning of your sentence you said this, "I'm leaving this weekend to Georgia...".

Three or so days is hardly rest for what seems like a fairly serious problem. Actually, even a month isn't long enough if this is as serious as it sounds.

I'm no doctor, nor knee expert, but silicone injections sound serious. What was that for, exactly? Makes me think of something to do with the Menisci.

How long is that [the injections] suppose to last? Did you run it [hiking] by your doctor?


My tentative recommendation would be to drop the hike and start a physical rehabilitation program using weights, because the best way to protect the knee is to build up the surrounding muscles/connective tissue. People think that only the menisci absorbs life's impacts and protects the joint surfaces. However, it can NOT do it alone, it needs strong muscles/connective tissues or else it gets torn up.

After you're done with the physical rehab, then you gotta start up a maintenance program, just like anything esle the body needs regular maintenance. Walking is not enough on its own.

[Pootz]

I thru hike in 07 with bad knees. I had menisci surgery in 04. As my legs got stronger the pain was greatly reduced. I wore knee braces everyday regardless of weather my knees were hurting. I used the wrap around type braces. Start off with low miles 8-10 mile per day and work up to bigger miles. Give your legs time to get strong.

[Koozy]

I'm leaving this weekend to Georgia, and have done a few shakedown hikes. I have a history of knee injuries, and after the last shakedown my worse knee blew up like a tick. I had a round of silicone injected into it, but it hasn't helped much. I decided to stop pushing it, and just let it heal till Springer. I'm scared it may knock me out, anybody have any experience with bad knee injuries on the AT? I think the ACL is healed , but the cushion is gone and I hope it doesn't blow up too bad . thank u.

I can relate to your dilemma...I will be starting my hike in less than 2 weeks and have had past knee injuries, and had 3 ACL reconstructions and 3 arthroscopic surgeries on my left knee. All of my surgeries took place between the ages of 16 and 21 (7-12 years ago). Since then I haven't had any problems that put me out of commission, but do get occasional swelling after a long hike or significant impact (going downhill).

I'll echo what Fred said....take it very easy and slowly to begin. My approach is that I will begin slowly, and put in less miles/day than I know I can handle. It will probably make me somewhat antsy, but until I know my daily limitations (especially in an area I've never hiked) I do not want to take myself out before I get my trail legs. Consciously think about foot placement and try not to favor one leg over the other, and after a while you will subconsciously hike that way.

Another thing is to keep your pack as light and possible. This was my main concern over the past year while planning the hike, and I set an April start date to hopefully reduce the amount of clothing I'll need. Warm weather will reduce my clothing weight by more than 50%.

Lastly, there are things you can bring or do on the trail that might help. Trekking poles reduce impact (if used correctly) and have saved my knees a number of times. I'm bringing a synthetic knee compression sleeve that I will use either while hiking, or at the end of the day. This will help reduce swelling and stimulate blood flow to help my body naturally repair any damage. And I've also heard of using streams or other sources of water for "cold treatment" in place of icing.

And bring plenty of ibuprofen.

Good luck.

[burger]

Just a thought: the PCT is much, much less steep than the AT. I can't recall anyone I met on the PCT having knee problems--lots of people do on the AT. Maybe think about heading west instead. The completion rate for thru-hikes is a lot better on the PCT, too.

[takethisbread]

I thru hike in 07 with bad knees. I had menisci surgery in 04. As my legs got stronger the pain was greatly reduced. I wore knee braces everyday regardless of weather my knees were hurting. I used the wrap around type braces. Start off with low miles 8-10 mile per day and work up to bigger miles. Give your legs time to get strong.

this is my plan, tentatively. the ACL is now good but the meniscus on the bottom half of knee is reduced by 60% since surgery, the silicone was supposed to help. I figure if I do low miles and simply stay out there , I will lose weight thus reducing knee impact. actually I'm a strong hiker . I generally do 15+ miles to 25 mile days, In the AT, even I'm not known as "svelte". I am going to have to learn to slow down and deal with diminished abilities, the rest is in God's hands. I'm gonna go for it. if I can't handle it, I can table the hike and go do something easier on the knee, like the Camino or bicycle or whatever. I have this window to hike in , I got to give it 100% before I give in. leaving April 1 if I average 8-10 pd miles for a month 10-12 for the rest of the trip, I'll be right there. I've done 130 AT miles in shakedown hike, so if need be I can skip those. I'm just concerned about a few areas frankly early on : Hightower gap to Gooch is a killer, and I should know then how I stand.


Sent from my iPhone using Tapatalk

[Trance]

Take your time... dont get caught up in a group that will force you to move faster than you should... especially on the downhills.

The downhill to the NOC crushed my knee.... 5 miles downhill is rough.

[Spirit Walker]

It may depend on your pain tolerance. DH has had bad knees since high school. On the AT, his knee would swell the size of a cantaloupe, but he continued hiking regardless. He used hiking sticks, but he also ended up taking a lot of Advil. We did two thruhikes out west without too much trouble, aside from a broken toe and phlebitis. As others have said, the trails aren't as steep. Then his right knee got bad again and he had Synvisc injections, which helped for about 6 months. On our second CDT hike he was in constant pain from his knee, but he was also determined to finish, so we did. His right knee was replaced in 2008. In 2009 we were on the PCT and he tore the meniscus on his other knee badly, so we returned home for surgery. In 2010 we went back to the PCT and this time his artificial knee gave him huge problems: it filled with fluid and they ended up draining about a quart of synovial fluid out of it. He decided the pain was too much, so we left the trail.

[sadlowskiadam]

I had severe tendonitis in my knees after one week. I could not straighten or bend my left leg, and feared I would have to get off the trail. A friend recommended a patella tendon band. I bought one for each knee and started wearing them while hiking. Within two weeks, the pain had gone away. I wore both bands everyday all the way to Katahdin. Here is a link:

http://www.mikereinold.com/2011/06/p...on-strain.html

[Praha4]

get a Cho-Pat dual action knee brace

[takethisbread]

Take your time... dont get caught up in a group that will force you to move faster than you should... especially on the downhills.

The downhill to the NOC crushed my knee.... 5 miles downhill is rough.

here's the rub, if I go slow I need to use a regular backpack. I've been using a golite dawn on long distance trips now for awhile. love the pack. 14oz . if I go slow I need to carry more food I need to use a real pack, I have a osprey exos which without the lid weighs 2lbs. it carries 5 days food easy, but the old GL dawn holds 2.5 days max. that extra lb actually feels like more because I'm not used to things like waist belt and side pockets. I have a ULA pack as well but I like the osprey exos better and it's lighter. I'm scared to hike without my baby (the Dawn). I know it's an old pack but I just like the way it hangs off my shoulders.

as far as that descent at the NOC; I done it. I've done all but 200 miles of the trail, including well over half in 2010. I fear Albert mountain climb and the descent out of the smokeys most with my bum knee. of course I fear the first encounter with the whites, but by that time I'll be too close to care . God willing, of course


Sent from my iPhone using Tapatalk

[eghama]

Your knees will take a severe beating. As Pootz says, start off with low miles. To add, I would say, be disciplined about keeping your miles low. There's a strong urge to keep moving when you pull into camp at 2pm, but you gotta be smart about it and keep thinking about the hike in the long term. My very best to you.

[JumpMaster Blaster]

Are there any alternative methods to tackling some of the downhills? I've heard of ppl suggesting walking backwards (when possible). One time, many many moons ago, we were climbing down Mauna Kea on the Big Island of Hawaii, and the downhill was killing me so much (in my early 20s) I started zig-zagging (switchbacking) down the hill for about an hour. Took longer & burned more energy, but saved my knees (for the time being).

[bflorac]

My advice, talk to your doctor. There are all sorts of braces but they are all for different problems. For example the Cho-Pat won't help at all with MCL , ACL, can help a little with IT band problem but works well on kneecap problems (runners knee). Some could actually make things worse. There are lots of different techniques that can be used while hiking to help prevent knee issues but without knowing exactly what your doctor says, anything suggested would be just guessing.

I would not start a hike with a hurting knee. Hiking will just make it worse. And once better, as suggested above, take lots of smaller practice hikes. The AT can be brutal. Take it slow. Stop BEFORE your knees hurt and plan on extra zero days along the way. Do not hike with knee pain, wait for it to go away. Take lots of Advil with you to keep swelling down (hard to find along the way for some reason).

While hiking I do stretches 3-4 times a day to help with IT band problems. Even before I start hiking, I do extra workouts and PT exercises on my IT band. I carry a full soft velco knee wrap. If a knee issue occurs, I use it to add compression and at least get me to a point where I can stop.

Surprisingly, some knee pain can be caused by wearing the wrong shoes/insoles. I was having some problems one day and switched from custom orthotic inserts to slightly modified green super feet and the problem was gone. The custom inserts were elevating my heal causing me to walk slightly different which, it turn, caused kneed problems.

[rafe]

Are there any alternative methods to tackling some of the downhills? I've heard of ppl suggesting walking backwards (when possible). One time, many many moons ago, we were climbing down Mauna Kea on the Big Island of Hawaii, and the downhill was killing me so much (in my early 20s) I started zig-zagging (switchbacking) down the hill for about an hour. Took longer & burned more energy, but saved my knees (for the time being).

If it's steep and craggy enough, yes -- I face into the hill and crab my way down. If there's a ladder, I face into into it, going up or coming down. Doesn't happen that often on the AT, but I can remember a few times. South Kinsman, North Carter, the descent just off Dragon Tooth, etc. It happens a lot on the northern part of the LT.

I do that more often than I'd like to, when walking down steep, wet rock faces. In the southern AT you deal with a lot of stiles -- short ladders over fences. Sometimes it's best to face into the fence on your way down.

[Sheriff Cougar]

Sadlow, I see you had a problem that sounds similar to what happened to me. I can say that it felt as though someone had put a nail through my knee from the outside of the knee to the inner side of the knee. Would you say your pain felt anything like this? I just bought 2 of these straps and I am praying I won't suffer the same fate again when I hike. Thanks for any info.

[Pedaling Fool]

Are there any alternative methods to tackling some of the downhills? I've heard of ppl suggesting walking backwards (when possible). One time, many many moons ago, we were climbing down Mauna Kea on the Big Island of Hawaii, and the downhill was killing me so much (in my early 20s) I started zig-zagging (switchbacking) down the hill for about an hour. Took longer & burned more energy, but saved my knees (for the time being).

If it's steep and craggy enough, yes -- I face into the hill and crab my way down. If there's a ladder, I face into into it, going up or coming down.

Yes, it is true. This is all because the muscles/connective tissues need strengthening.

It is easier to walk down hill backwards because you are keeping your body mass (weight) behind the bending knee, allows more muscles to be used, especially the hamstring, which helps the quads. However, when you walk downhill in the normal manner the body mass goes directly over the working knee with forward momentum, this isolates the quads making them do the bulk of the work to support the body.

Things like squats, especially front squats and single-leg squats helps to build up the quads to handle this. However, I'm not saying that's all one should do WRT leg strengthening exercises; the entire lower body needs constant work to keep all muscles/connective tissues strong and healthy.


Even if one does other things such as getting their pack as light as possible and using hiking sticks, hiking slowly, that's fine whatever; however, that should never be done in place of strenghthening exercises. Age and wear will catch up to you and without strenghthening exercises you would continually have to walk slower and slower with an increasingly lighter pack...

IMHO, knees are just too important to ignore.

[fredmugs]

here's the rub, if I go slow I need to use a regular backpack. I've been using a golite dawn on long distance trips now for awhile. love the pack. 14oz . if I go slow I need to carry more food I need to use a real pack, I have a osprey exos which without the lid weighs 2lbs. it carries 5 days food easy, but the old GL dawn holds 2.5 days max. that extra lb actually feels like more because I'm not used to things like waist belt and side pockets. I have a ULA pack as well but I like the osprey exos better and it's lighter. I'm scared to hike without my baby (the Dawn). I know it's an old pack but I just like the way it hangs off my shoulders.

as far as that descent at the NOC; I done it. I've done all but 200 miles of the trail, including well over half in 2010. I fear Albert mountain climb and the descent out of the smokeys most with my bum knee. of course I fear the first encounter with the whites, but by that time I'll be too close to care . God willing, of course


Sent from my iPhone using Tapatalk

I've discovered that by slowing my hiking pace to about 75% of what I'm capable of I can cover more miles in a day. If you employ something like a 50 minutes of walking, 10 minutes of rest, a long lunch break, and smell the flowers when you feel like it you can cover a lot of ground.

[takethisbread]

update:
went to orthopedist today, he said pretty much what others said here . go slow, take it easy and see how it goes. he thought with plenty of zeros I can manage for a spell. he shot me with some cortisone so I feel good now ! I know that won't last but, hey take what I can get


Sent from my iPhone using Tapatalk