Knee Problems

[2009ThruHiker]

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]

....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]

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...

[Mouse]

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.

[NoKnees]

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

[Grampie]

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.

[orangebug]

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]

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]

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.

[Doctari]

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]

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.??

[Bolo]

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?"

-Bolo

[Footslogger]

[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]

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]

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.

[BW2006]

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!!!

[ScottP]

" 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.

[general]

lighten your load, a pack that is too heavy for your body makes your knees, and a bunch of other stuff, hurt.

[Pringles]

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

[bfitz]

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.