Knee problems and long-distance backpacking

[Canute600]

Greetings all,

I was wondering if any experienced hikers out there could give me some advice with regards to knees. I did a long section from Maine to Massachusetts in '05 and really fell in love with backpacking. However, during my hike I experienced some knee pain which has gotten worse since. I had to cut a week-long trip short two years due to severe pain which my doctor told me was due to patellofemoral syndrome. I cut my pack weight a bit and starting using trekking poles now, which seems to have helped for shorter overnight trips.

I would really like to get back out and try to do the AT at some point, but I'm not sure my knees will let me tackle something that big anymore. Has anyone faced similar problems? Any advice that anyone could give me to restore my knees or work around my problem would be most appreciated, because I love backpacking and want to get out there again for another long trip.

Many thanks in advance!
-Canute

[RiceKrispy]

I have arthritis in both knees and am using knee braces and hiking poles... and hiking VERY VERY SLOW. But I'm hiking, and that's what counts, right?

[shelterbuilder]

Shorter days, lighter packs, knee braces, muscle-strengthening exercises and glucosamine.

I've had bad knees ever since college (horseplay for one, a biking accident for the other). The first few years after the accidents, I didn't really notice any problems, but after 10 years had gone by, I began to experience a lot of pain. (That was over 20 years ago.)

The knee braces and exercises help to hold the knee structures in place, the glucosamine (which doesn't work for everyone) helps to re-build the joints, and the shorter days and lighter pack weights mean less strain on the joints. YMMV.

Good luck - remember, try anything that sounds reasonable.

[fiddlehead]

I have a bad knee. (football from High school)
I used to carry a knee brace and use it at the end of a long day or whenever i felt it necessary.
After a few thru-hikes, i found i didn't need it anymore. I suppose i just built up the muscles around the knee strong enough that i could even do big mile days, ski moguls again and jog long distances.

Now, i've been off from hiking for a few years now.
I am joining up with a friend in July who is thru-hiking the PCT. He will be half-way thru his hike.
So, i have started training for this already. I am doing 6-10 mile days now and hopefully add a mile or two a week.
Already, my old knee problem is acting up.
I do believe however that i will be able to do the 20+ mile days that he will be doing by July.
I think you just have to make a commitment to training EVERY DAY. And build up or slow down according to the pain.
Yes, getting old sucks. But, we have more time now, aye? Might as well use it constructively.
If people walked as much as they watch TV, we would mostly be stronger i think. (not sure as i don't watch tv)

[garlic08]

You say you lightened up your pack "a bit". Try "a lot". I quit backpacking over 10 years ago at age 40 with chronic tendon problems in the knees. I gradually reduced my pack weight a LOT, from 30 lb to under 10, and I'm hiking more than ever.

What about footwear? Last time I wore heavy leather boots for a snow climb, the old tendon problems came back and hurt for weeks. Now I climb snow in running shoes and no problems.

Best of luck.

[freefall]

Great advice so far. I have had knee issues since high school football and I found when I reduced my pack weight and started using poles, I was a lot better off. I keep my full pack weight under 35 pounds whenever possible and use aftermarket insoles in my boots. I don't always wear my knee braces but pack them for every trip just in case and they do help. That with a little vitamin I(buprophen) twice daily keeps me going.

[shelterbuilder]

Garlic08 is right about lighter footwear, and here's another thought. Since I hike a lot on Pa. rocks, I notice that the soles of my boots sometimes wear down (unevenly) faster than they should. This can throw the ankles, knees, hips, and lower spine out of alignment and cause all sorts of aches and pains.

[rainmakerat92]

I began my hike of the AT with the following words from my doctor still ringing in my ears: "No one with your knee problems has ever walked 2,000 miles." I thanked him for his advice and told him I'd send him a postcard when I got to Maine. He rolled his eyes and laughed.

Here are some of the things I learned on the way:

1 - When walking downhill, I avoid "galloping downhill momentum". I walk very slowly and put my feet down VERY gently, like I'm walking on thin ice or hot coals. I put my feet down in a very gentle heel-to-toe motion.

2 - Also when going downhill, I get my hiking poles out in front of me and use them like forearm crutches. If I'm not putting so much pressure on the poles that I'm afraid they are going to break, I figure I'm not using them correctly. For every ounce of weight I put on my arms, an ounce comes off the knees.

3 - The less I bend my knees when going uphill, the less they are going to hurt. So, I take very small steps and don't lift my foot any higher than necessary when I take a step. In my opinion, the shorter the step, the more the weight is going to impact the upper thigh muscle (where it belongs). The longer my steps are, the more the weight is going to impact the knee. The knee is a joint, it is not a muscle.

Hiking poles are like an extra set of knees. I don't hike anywhere without them.

I carried a postcard showing Mt. Katahdin with me all the way from Springer Mountain, then mailed to my doctor the day after I summited.

[Chenango]

I began my hike of the AT with the following words from my doctor still ringing in my ears: "No one with your knee problems has ever walked 2,000 miles." I thanked him for his advice and told him I'd send him a postcard when I got to Maine. He rolled his eyes and laughed.

Here are some of the things I learned on the way:

1 - When walking downhill, I avoid "galloping downhill momentum". I walk very slowly and put my feet down VERY gently, like I'm walking on thin ice or hot coals. I put my feet down in a very gentle heel-to-toe motion.

2 - Also when going downhill, I get my hiking poles out in front of me and use them like forearm crutches. If I'm not putting so much pressure on the poles that I'm afraid they are going to break, I figure I'm not using them correctly. For every ounce of weight I put on my arms, an ounce comes off the knees.

3 - The less I bend my knees when going uphill, the less they are going to hurt. So, I take very small steps and don't lift my foot any higher than necessary when I take a step. In my opinion, the shorter the step, the more the weight is going to impact the upper thigh muscle (where it belongs). The longer my steps are, the more the weight is going to impact the knee. The knee is a joint, it is not a muscle.

Hiking poles are like an extra set of knees. I don't hike anywhere without them.

I carried a postcard showing Mt. Katahdin with me all the way from Springer Mountain, then mailed to my doctor the day after I summited.

Great advice and great story Rainmaker. I very much agree with your thoughts on the use of poles. I know it helps me.

[Cannibal]

I'm sure I'll get blasted for this, but I feel it saved my hike very early on. I used a product called DMSO (Dimethyl Sulfoxide). A trainer from one of the Florida Sports teams told me about it about a year before my hike, then I saw it mentioned (maybe here) a couple of months before I left for the hike.

I have two rotten knees from high school and college football and a few other stupid things from my youth. Point is, they are old injuries. The trainer told me they use this on the athletes immediately following a joint injury and it seemed to work very well. I bought a couple of bottles and took one with me. Before I got to Dahlonega my knees had swollen to about twice their normal size and become very painful. I started using the DMSO and took two zeros in Dahlonega sitting in a hotel room with ice bags on my knees.

When I got back on the Trail I went slow for a couple of weeks, but I went. After a month of using the DMSO twice daily, my knees felt like they did when I was a teenager. I used the product a few more times over the course of the hike on a twisted ankle and again had excellent results. Here is the really great part; my knees don't hurt anymore. After 20 years of pain, they are for the most part pain free. I can strap on the pack and hike as fast and as hard as my lungs allow now. There is a big trade-off concerning weight. Because it is a solvent, it has to be carried in glass. Plus, it takes pretty thick glass to survive in a pack. Well, my pack anyway.

There ARE some very serious issues with this stuff; your skin has to be very clean. Read about it before you use it, but if you do decide to use it I think you'll be pleasantly surprised. I ordered mine from here.

[Chenango]

I'm sure I'll get blasted for this, but I feel it saved my hike very early on. I used a product called DMSO (Dimethyl Sulfoxide). A trainer from one of the Florida Sports teams told me about it about a year before my hike, then I saw it mentioned (maybe here) a couple of months before I left for the hike.

I have two rotten knees from high school and college football and a few other stupid things from my youth. Point is, they are old injuries. The trainer told me they use this on the athletes immediately following a joint injury and it seemed to work very well. I bought a couple of bottles and took one with me. Before I got to Dahlonega my knees had swollen to about twice their normal size and become very painful. I started using the DMSO and took two zeros in Dahlonega sitting in a hotel room with ice bags on my knees.

When I got back on the Trail I went slow for a couple of weeks, but I went. After a month of using the DMSO twice daily, my knees felt like they did when I was a teenager. I used the product a few more times over the course of the hike on a twisted ankle and again had excellent results. Here is the really great part; my knees don't hurt anymore. After 20 years of pain, they are for the most part pain free. I can strap on the pack and hike as fast and as hard as my lungs allow now. There is a big trade-off concerning weight. Because it is a solvent, it has to be carried in glass. Plus, it takes pretty thick glass to survive in a pack. Well, my pack anyway.

There ARE some very serious issues with this stuff; your skin has to be very clean. Read about it before you use it, but if you do decide to use it I think you'll be pleasantly surprised. I ordered mine from here.

I thought DMSO was only used on race horses. Seriously. I did not know people used it.

[Reid]

Glucosimine Chondrition

[Blissful]

I carried a postcard showing Mt. Katahdin with me all the way from Springer Mountain, then mailed to my doctor the day after I summited.

Yeah I should have done that with my first so called sports dr who said I wouldn't be able to hike after my ankle injury.

[skinewmexico]

I know a lot of people who used to get DMSO from the farm supply, and raved about it. I thought that was illegal now; maybe just in Texas. I'm always afraid of anything I can rub on my skin, and smell on my breath,whether it's DMSO, DEET, or what ever.

[Kneegrinder]

I was a fairly serious runner (1500-2000 miles a year for 20 years) and a big guy. Finally, one knee and then the other went with chondromalacia of the patella in my mid-30s. Had one scoped to remove loose chunks and then rehab but the rehab didnt help much. After a few years of fairly constant pain was referred by a friend to a weight trainer who knew his stuff. Instead of doing 20 of a particular exercise to strengthen the various leg muscles we worked up to a couple hundred. It all hurt like hell and I had my doubts but after a few months this guy accomplished what the rehab people had been aiming for which was to strengthen all the muscles supporting and surrounding the knee joint and the pain went away. Running really builds some muscles but others atrophy and everything gets misaligned and grinds which was my issue. Running or just doing one exercise also makes you very tight so stretching actually is important I discovered.

Consult someone getting started but do a program that builds up those muscles. I still do a routine of squats, leg presses, adductors, abductors, leg curls, leg extensions and calf raises. Dont forget the ice when doing this and I still take some ibuprofen if I get twinges. Oh, and I love hiking poles!

Kneegrinder

[Cannibal]

I thought DMSO was only used on race horses. Seriously. I did not know people used it.

I know a lot of people who used to get DMSO from the farm supply, and raved about it. I thought that was illegal now; maybe just in Texas. I'm always afraid of anything I can rub on my skin, and smell on my breath,whether it's DMSO, DEET, or what ever.

Some truth in both of these statements. Yes, horse trainers swear by it; for good reason. As for the legality, that's a little grey. The FDA does not support its topical use in the health industry (which is why it is labeled as a solvent). However, it is used in internal medicine with the blessings of the FDA. I think it is used as a direct injection into gall bladders for some reason; can't remember exactly.

My understanding, is that the FDA banned its use as a topical because of the characteristics of it....like transfer of heavy metals thru the dermal layers. Again, the skin has to be clean. Anything (deet) on the surface will be absorbed into your system. A few seconds after applying it you do taste a little garlic-like flavor; very weird. The taste goes away pretty quick, but yeah it's there.

I was exceptionally skeptical about this stuff when I was first told about it and did a little research, but I can't argue with the results. I keep a bottle at the house now for use on minor twists and sprains. IT DOES NOT REPLACE A DOCTOR, nor is it intended to. I use it as part of my wellness plan, not as my wellness plan.

P.S. Works amazing on bruises. Rub a little on a bruise and it's gone in a day or two.

[Tenderheart]

When your doctor tells you it's time to stop running or hiking, it's time to get a new doctor. There was a thru hiker in 2000 named "Eike" who swore by cho-pat straps. He claimed the difference was like night and day in eliminating the pain in both knees. He was a young guy, too. If I remember correctly, it looked like a surgical strap he wore just under each patella.

litefoot 2000

[walkin' wally]

Greetings all,

I was wondering if any experienced hikers out there could give me some advice with regards to knees. I did a long section from Maine to Massachusetts in '05 and really fell in love with backpacking. However, during my hike I experienced some knee pain which has gotten worse since. I had to cut a week-long trip short two years due to severe pain which my doctor told me was due to patellofemoral syndrome. I cut my pack weight a bit and starting using trekking poles now, which seems to have helped for shorter overnight trips.

I would really like to get back out and try to do the AT at some point, but I'm not sure my knees will let me tackle something that big anymore. Has anyone faced similar problems? Any advice that anyone could give me to restore my knees or work around my problem would be most appreciated, because I love backpacking and want to get out there again for another long trip.

Many thanks in advance!
-Canute

I am going thru therapy right now for the same thing you have. They also called it a synovial plica. Named from the synovial fluid in the knee.
I was told that one side of my thigh was stronger than the other side which is pulling my knee cap to the right as I look down on it. Tissue behind the knee cap is being pinched between the knee cap and the joint on the opposite side. It hurts sometimes and gets my attention.

Here is why it happened to me. I stand a lot on cement floors or rubber mats where I work. When I turn I tend to put a twisting motion on my kee which isn't natural. I stopped working out regularly at the gym a while back because I was just getting too busy I thought. That was a mistake. I am back to the gym now and have finished twelve visits to the therapist. That involved electro therapy, stretching, strength building, counseling, etc. 12 one hour visits. Now I'm going back to the doctor.

Another contributing factor is that I tend to hyper-extend my knee backwards when I am standing which put a lot of pressure on the tissues in the knee.

I don't know if someone can hike their way out of this problem but I need to solve it before my thru next year. I did not note your age if it was on your post but I am 60 and I do want to beat this completely. I think I will.


You can PM me if you want.

[Surplusman]

Shorter days, lighter packs, knee braces, muscle-strengthening exercises and glucosamine.

I've had bad knees ever since college (horseplay for one, a biking accident for the other). The first few years after the accidents, I didn't really notice any problems, but after 10 years had gone by, I began to experience a lot of pain. (That was over 20 years ago.)

The knee braces and exercises help to hold the knee structures in place, the glucosamine (which doesn't work for everyone) helps to re-build the joints, and the shorter days and lighter pack weights mean less strain on the joints. YMMV.

Good luck - remember, try anything that sounds reasonable.

I couldn't have said it any better. I have arthritis in both knees with the added bonus of bone spurs in my right one. But I hike, and I have found that the exercise and Glucosamine/chondroitin have worked wonders...oh yes, plus the knee braces and hiking poles and the lighter pack.

[Wise Old Owl]

Yea see a doctor! Do the Glucosamine, bring extra pain killers, and above all get a perscription.