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  1. #1

    Question How to kick the knees into gear?

    Okay, I haven't been hiking all that much for too long, but recently been trying to tackle the 4000' peaks in New England, so far bagging two of them. If anyone is around that want to bag some with me, let me know!

    However, I've been having a terrible time with the downs. Mount Mansfield along The Long Trail pushed me to my limits and I could barely walk for the week after. Admittedly that was a bad first choice even if the 5 mile round trip was reasonable, the 2500ft elevation gain/loss destroyed me. So I waited two weeks, did some 1 mile hikes in that time, then tackled Camel's Hump along the Burrows Trial, 5 miles with 1500ft elevation gain. I expected this to be okay as I also grabbed poles and downsized the day pack weight... but it really wasn't great. Better certainly, but still much more painful than I'd deem it should be.

    So, how to get my knees into gear for this? I quite need hiking in my life right now.

  2. #2

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    It would help to know how old you are. Some folks including myself have found some relief with joint supplements like glucosamine with MSM to work but they take months to kick in. Knee issues can be made worse if you use poor inserts in shoes. Many athletic shoes have really poor quality inserts. I use the Columbia (formerly Montrail) heat moldable inserts in all my trail runners. Getting the full use of poles takes awhile to get used to on the downhills. Its a slow pace, if you are rock hopping it can really pound on the knees. Ideally I "palm" the top of my pole as I descend putting much of my weight on the pole which means I need a pole that will not collapse at a bad time. If you have existing damage in your knees from thru hiking you may need to take Ibuprofen several hour prior to your hike and continue with them during and post hike.

    I personally have not found any knee exercises that work for me but there are all sorts of them out there that may work for you. It takes a couple of weekends of hiking to get much conditioning in and if you skip a weekend the level of conditioning drops quickly. Probably best to go visit the trails around Lake Willoughby and work up gradually.

  3. #3
    Registered User JNI64's Avatar
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    Yeah good advice and agree about knowing age . I'm 57 and doing pretty good considering a ACL reconstruction.
    I've been using fish oil for years seems to help. Just walking everyday 10,000 steps or more and some stretching. But like mentioned if there's cartridge damage not a whole lot can be done.
    Knee sleeves with the hole, ibuprofen, ice.

  4. #4

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    I'm 35, I would guess they are more just out of shape and I'm asking too much. On the second hike I definitely got great use of the trekking poles, including the palm on top of many descents. I would say it is mostly the act of "braking" that causes the pain, but not in any muscle. I'm not landing hard or impacting. It is also strange how it can come and go, like after the descent on Camels Hump it was mostly fine walking the parking lot to the car, then suddenly painful for 5 steps or so. My best description of that was the knee doing some weird movement or over extending, but I don't even see how either of those were possible on the flat ground with very easy walk.

    I will look into the knee sleeves and also walking a bit more regularly even off trails might help overall! I don't like the idea of taking vitamin I before/during a hike as I worry that is a good way to do more damage than not taking it would prevent. Good advice on the Willoughby area as that has been my plan this week and next, to take evenings for a mile or two when I can.

  5. #5
    Registered User JNI64's Avatar
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    I think you might want to go to your doctor for your knees to be looked at. They can do a pulling test on your knees to assess the cartridge damage. You're young to be having these issues.
    I'm also thinking it might be the cartridge slipping in and out of the meniscus .

  6. #6
    Registered User JNI64's Avatar
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    Which would explain the sudden pain and then the sudden relief from pain.

  7. #7

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    I agree see a doctor first. I am just working on your Thru Hiker GA>Me label. Its highly likely even if you were a "young buck" when you hiked the trail that you may have some damage in your knees. Frequently the pain is caused by the inflammation response so vitamin I, just knocks down the inflammation.

    Many of the AMC hut crews who worked the whites summer in college have joint issues in their thirties. Those 100 pound packs slowly extract their revenge

  8. #8

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    Well, certainly not what I was hoping to hear! But, I guess it is the right call.

  9. #9
    Registered User JNI64's Avatar
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    Like peakbagger suggests ibuprofen can help with the inflammation, pain,swelling most doctors will start with this type of treatment. Typically every 8 hrs a day for a couple weeks, and if there's no relief after that they'll start looking deeper.
    Or at least after exercise or walk take 800 MG and put a pillow under the knee for support with ice for 20 minutes.

  10. #10

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    It may not be your knees that are the problem. It could be IT band tightness, which often presents as knee pain on downhill strides. There are stretches you can do to relieve the pain somewhat and continued stretching over time can mostly eliminate the problem, along with gradually increasing your activity. If you search around on YouTube for IT band pain or IT band stretches you'll find way more than you need. I'd check with a doctor or physical therapist to confirm that it's not something more serious, however. Self-diagnosis doesn't always work (as I should know ).

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    When I started running seriously in 2003, I was 30 and experienced the full range of ailments including knee problems but by first scaling way back and then gradually increasing increasing my mileage, I worked through the issues without medical attention to the point where I ran several marathons from 2012 to 2017 and around the same time got into long distance backpacking. Youth provides the advantage of a more forgiving body for many people. Of course, seeking medical care is a good option. A couple of years ago, I had a flare up of plantar fasciitis and physical therapy helped greatly. Not being able to get away for a long hike due to family concerns this year, I’m again planning fall marathons and up to around 45-50 miles per week with no issues. At age 47, I feel in better overall shape than at 30.

  12. #12

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    Without more specific information, knee pain is such a generalized category it's difficult to sort out if there is a mechanical problem in the knee joint or if there are other complications from a hip or ankle issue to poorly fitting footgear. There are a remarkable number of issues that can present in the generalized world of knee pain. Even doctors can have a tough time figuring out what can be wrong if there is no apparent trauma to the knee itself. "Not hiking much" then heading out to tackle serious terrain is a somewhat common issue that is typically accompanied by new aches and pains.

    If your knee pain is only in one knee, it may be wise to consult an MD. If in both knees, Coffee's suggestion is pretty much spot on for a conservative treatment regimen that will help in the long run, but requires a bit of patience. Presuming both knees were sore, especially in the area just above and to the upper sides of the knee joint (often called "Runners Knee"), which can be caused or exacerbated by steep downhill hiking straining muscles unaccustomed to the activity, conditioning is key to solve the pain issue.

    Like Coffee, I have had this experience a few times and found the following beneficial. Stop hiking for about 2-3 weeks and see if the pain diminishes to the touch or when walking (especially going down stairs). If it does, it is probably a muscle conditioning issue that may need a little more time to heal up, if not seeing a doctor would be the next step. To condition the knees after pain diminishes, start doing some gentle terrain walking, adding some stairs to the route and see how the knees feel. Repeat until the pain threshold lessens, then add more stairs to condition the knees. Once the knee pain has ebbed, start hiking on gentle slopes and continue until the pain is barely noticeable before escalating the terrain. As we age, this process will take longer than in our younger days, however, if you want to do big mountains you need to approach it in workman-like fashion without shortcuts so your knees are better prepared. I found compression sleeves for the knees help me when I am doing serious terrain hiking but I did not use them in the conditioning phase in case they negated the effect of the conditioning walks.

    This, of course, will take time and discipline to stick to it, even at risk of losing the summer season. The full program to get back onto steep, difficult terrain will take several weeks (MD's typically recommend 3 to 4-weeks of resting the knees before transitioning to conditioning to as many as 8) to be rid of the "runners knee" pain before addressing conditioning issues. If you do see a doctor and it turns out to be a conditioning issue, see if they will prescribe a few visits with a physical therapist so you can get some sound advice, put together a conditioning program, and progress monitoring. The good news is, if this is a conditioning issue and you follow a conservative regimen of conditioning, I can promise you this will be put behind you in a relatively short time.

    Good luck!
    Last edited by Traveler; 07-16-2021 at 07:50.

  13. #13

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    Oh perhaps some more info could have been helpful; the pain goes away entirely after just a few days in the case of the first hike. The the second hike wasn't so pushy so the knee was fine the next day, including up/down stairs. It does seem the left knee is worse, but both will begin. I honestly think it is that I tried going from 0 to mountains, and that I need to condition myself with smaller hikes first. So as advised above I'll go out to the Lake Willoughby area some evenings to get myself going stronger.

    Also going to grab one of the knee sleeves, seems to be highly recommended!

    Thanks everyone for the help!

  14. #14

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    FWIW - I have tried a number of different knee compression devices and found Tommiecopper to be the best in terms of support and longevity. The silicone strips used to keep the sleeve in place work best with a bit of water on the leg where the strip wants to be will keep it in place for hours.

  15. #15

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    I am happy to report whatever magic of compression sleeves have, it works! I hiked Mount Abraham on Saturday without any of the knee issues I was talking about. I did do a bit more evening hikes to prepare, but I suspect something magical with compression sleeves helped a bit more. The knees felt so good after that I decided to go on a short 2m hike in the Willoughby area (Haystack Mountain) and they are still feeling good!

    Thanks everyone!

  16. #16

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    Adding to the supplements Peakbagger stated in his first post I regularly find relief in as short as one week with low molecular wt hyaluronic acid(low molar HA has greater bioavailabilty rather than it passing through or not entering joints) like the Hydroplenish brand with collagen and a bit of MSM, Natural Factors brand turmeric & bromelain in one capsule, SaME(400 mg daily), NOW brand Boswellia serrata extract, and/or Solgar No.7 joint support that has some of these other supplements included. On an empty stomach I also find relief with the #1 selling supplement in Germany,, the proteoletic emzymes in Wobenzyn N. If I had to narrow it down to the two that make the most difference it's teh Solgar no. 7 and Wobenzyme N.

    I also find having translated to a low-non inflammatory dirt and lifestyle to make a BIG difference.

    Yet another way to assuage descending knee pain is to shorten stride length and step down/step up/ riser ht proceeding deliberately mindfully at not a run away freight train pace practicing these more ergonomic movements/techniques on both ascents and descents. The way we ascend can lead to pain on descents! The worse for me was when I slipped because of bad footing while descending hastily. The second worse was stopping suddenly on descents putting most of my load on one knee.

    These approaches have mitigated consequences of yrs of high impact aerobics, hard court tennis, basketball, road and trail running, and LD backpacking.

  17. #17

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    To add I find it imperative as a backpacker to be muscoloskeltal balanced. That's why physical exercises I like are hiking on soft sandy beaches and dunes where legal, jumping on a trampoline, and hiking in waist deep water. It forces me to develop any weak sides. And, it is less impacting to joints if healing from a past injury or if over wt when beginning such exercises. I also go to The Joint Chiropractics weekly and twice weekly to the Stretch Zone to make myself aware of any imbalances and addressing them. I feel this is a more proactive take responsibility for my conditions rather than simply taking a pill that masks pain or succumbing to surgery that may be addressed with non surgical approaches.

  18. #18

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    Oh, when I hike on a beach with slight slope or in water I work both sides of my body hiking both parallel ways to the shoreline on the beach and in the water. Out and back. Out and back.
    I also spend time on the elliptical.

    That's most of my physical backpacking/hiking training in a nutshell.

    We dont need to hike on maintained trail up and down mountains to get in shape for hiking or simply get fitter and healthier.

  19. #19

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    Quote Originally Posted by blackbird04217 View Post
    I am happy to report whatever magic of compression sleeves have, it works!
    Good news indeed!

  20. #20

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    Great news. The bonus is you get to spend some time in the mountains around Lak Willoughby. When I was hiking around there 15 years ago during the summer, there were not a lot of locals on the trails and quite a few Europeans. The biggest challenge is getting to some of the trailheads.

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