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  1. #1
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    Default Knee problems on downhills only

    On two recent section hikes I have started to notice some pain in one knee only. Pain is not very noticeable until the afternoon hours after I have hiked 6-10 miles depending on the terrain. Only hurts on downhills. Ibuprofen helps some. Can anyone tell me the probable cause of the pain and what are the best ways to treat this problem. Interested in possible thru-hike in near future.

  2. #2
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    Do you use hiking poles?
    " Of all the paths you take in life, make sure a few of them are dirt. "

  3. #3
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    It may depend where around your knee the pain is. However, it sounds to me like it could be IT Band Syndrome which I've suffered from before. You should probably consult a physical therapist or doctor for a better diagnosis. It was fairly easy for me to rehab from it and there are some specific exercises and stretches that you can do to strengthen the IT Band and surrounding muscles.
    Last edited by SteelCut; 05-25-2016 at 14:18.
    Remote for detachment, narrow for chosen company, winding for leisure, lonely for contemplation, the Trail beckons not merely north and south, but upward to the body, mind, and soul of man.


  4. #4
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    Yes. And I meant to mention I am 62 years old.

  5. #5
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    You're probably experiencing iliotibial band syndrome. It won't go away unless you rest it: Get off the trail until it heals; or Less miles per day; or Ice it down when you can; or A cortisone shot from a Ready-Med will offer short term help. Or you can ignore all advice, take Vitamin I, and keep hiking on it.
    Hiking is the best teacher, it grades on a curve.
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  6. #6
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    I had the same problem on my first mountain hike--I don't get it on the flat lands, only hiking down mountains. I was hobbling so bad that was how I got my trail name (Old Man). I second the IT band syndrome because that was what I had, but you might want to talk to a doctor to be sure. Either way, strengthening the muscles in my legs helped me overcome the issue. I do a variety of squats and lunges and leg lifting exercises. Any time I'm standing in one place for a period of time, I will alternate standing on one leg and standing on my tip-toes, usually never more than a minute.
    "I am learning nothing in this trivial world of [humans]. I must break away and get out into the mountains to learn the news." --John Muir

  7. #7

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    This is very common. Many many hikers fear the steep down for that reason!

  8. #8

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    I see a lot of people use knee braces, elastic bands, etc.. what has anyone used successfully for general knee pain on the trail?...

  9. #9

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    There is no way to say with information given.

    Its likely tendonitis of some form.

    Is it the joint, is it muscles, ip it on side of knee, below, above, etc.

    What happens is one tendon gets sore from overuse, your gait changes to compensate, and other tendons get sore too. Pretty soon your darn near crippled.

    Itb band runs over bony protrubance on outside of knee. Is it sore when push on it? This can get the bad things started .

    Going downhill people tend to land hard on downhill foot, transferring shock to muscles. Tendonitis often develops when not conditioned to this. Slow down, land each step gently, use poles to brake and help do this.

  10. #10

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    This happens to me, too. The muscle/tendon on the side of the knee. Trekking poles help a lot, but still gets painful once you pack the miles on. Is this the IT band? Any tips on good methods of walking downhill?

  11. #11

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    Quote Originally Posted by Studley stomper View Post
    On two recent section hikes I have started to notice some pain in one knee only. Pain is not very noticeable until the afternoon hours after I have hiked 6-10 miles depending on the terrain. Only hurts on downhills. Ibuprofen helps some. Can anyone tell me the probable cause of the pain and what are the best ways to treat this problem. Interested in possible thru-hike in near future.
    Suggest slowing down on downhills, using hiking poles religiously, leaning on them to unweight both knees, but especially the one that bothers more. Don't wait for the end of the day when they hurt to do this, but just get into a knee-sparing habit. I've been doing this for the last >2500 trail miles and it's allowed me to keep on truckin'
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  12. #12

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    Downhills are the worst - trekking poles help to stabilize movement and transfer some weight to the upper body giving the knees a break. For me, its a world of difference.

  13. #13
    Registered User Maydog's Avatar
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    Yes, downhills are rough on my knees. I'm 56 and have had problems for about 10 years. I recently starting using trekking poles, and WOW. I told my wife that I wasn't going to call them trekking poles, but that I was going to call them "knee savers". They made a very big difference. I also take smaller steps when going downhill.

  14. #14

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    That's me! Excruciating pain on the downhills after some miles. Such pain that I had to bail out half way on a much anticipated section hike of the Benton MacKaye trial. My knees didn't look swollen but were hot to the touch and looked like they had been bruised but I hadn't hit them. My condition has progressively gotten worse over about three years. I went to the Dr. the next day. After x-rays and an MRI it was determined that I had "over-use" arthritis under both knee caps. Since they outdoors is not only my life but how I make my living as well, I've been determined to beat this (or at least manage it). I started going to Therapy South so I can learn the proper exercises and form for building the muscle around my knees and legs. It does seem like balance and alignment has A LOT to do with my issues. Today was my 5th visit and I believe that it is helping. I have not completed any long distance hikes yet to know for sure but I've completed several shorter distances with more weight and no problems. In general, I already feel much stronger and in overall better shape since starting therapy and exercising daily at home. I was also advised not to wrap or brace my knees. I purchased some good insoles and they seem to help as well. GOOD LUCK!!

  15. #15
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    Sometimes it's not IT band. I had overuse injury. Did some physical therapy, but even after just a few weeks I noticed a difference in my hikes. I can do 30 mile days with no pain in my knees now, just months after I was hobbling 3 miles in. Go see a doctor.


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  16. #16

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    Quote Originally Posted by Secondmouse View Post
    I see a lot of people use knee braces, elastic bands, etc.. what has anyone used successfully for general knee pain on the trail?...
    I've used a lot of different knee braces, none seemed to work routinely enough to wear outside of the Tommie Copper knee support sleeves. I wear these all the time and they tend to keep pain in my knees to a minimum. I also use trekking poles and slow down when doing steep downhills that lessens impact on the knee joints that aren't getting any younger. I am not sure which of these three things are more responsible for reduction or management of knee pain, but technique with technical fabric seems to work well together.

  17. #17
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    I have the same issue with my IT band, outside my right knee. Most of my section hiking through GA I had zero issue with it but the last couple of hikes it really came on strong, usually at the end of the hike and descending only. There are some specific stretches, as others have noted, and they do seem to help.

  18. #18

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    The OP did not mention where their knee was actually hurting.

    If indeed an IT band (outside of the knee) try a foam roller. I had chronic IT pain for years cycling and the foam roller was the only thing that helped long term.

    I had a wicked pain between my knee cap and shin. Nothing helped but rest.

    Good luck to the OP. Knee pain sucks.

  19. #19
    Registered User -Rush-'s Avatar
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    Quote Originally Posted by chall View Post
    This happens to me, too. The muscle/tendon on the side of the knee. Trekking poles help a lot, but still gets painful once you pack the miles on. Is this the IT band? Any tips on good methods of walking downhill?
    This could be your LCL if the pain is confined to the knee. The IT band will generally hurt farther up the leg.

  20. #20

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    I've had ITB issues similar to this in the past. I could fly on the uphill and level parts but then have excruciating pain on the downhill on the outside of the knee. Tried ibuprofen and knee braces but the best solution has been to do stretching exercises. Now, before I start hiking and then every time I start I make sure I stretch and massage that part of the knee and thigh. Problem doesn't bother me so much now.

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