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  1. #1
    Registered User Jeremy hess's Avatar
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    Default Preventing Knee Issues

    Was wondering if anyone had any suggestions for preventing knee issues while on the trail. I had to leave the trail on April 24th and return home do to issues with both knees it got to the point where I couldnt walk. After being home for 3 weeks my knees are finally getting to the point where I can walk down a flight of steps without pain, finally off the Vitamin I. I cant wait to get back out on the trail will be going out next week for 5 days to see how things work out, I cant wait even though I know my thru hike dream is prolly unreasonable this year but i'll spend the summer hiking locally. Any help would be greatly appreciated

    Thanks

    J

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    See a doctor (orthopedist or sports medicine) and get a diagnosis. At this point you are injured. There are knee issues that respond well to exercises, but you need to know what the problem is first. The most likely treatment would be physical therapy, but without a diagnosis you might be causing serious further damage following my exercises.

    To prevent knee problems before they arise, strengthening the quadriceps and hamstring muscles so they are balanced in strength will prevent many knee problems.

  3. #3
    Registered User Jeremy hess's Avatar
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    thanks I was thinking bout going to see an ortho doc but without insurance it is rather expensive and with my knees feeling 98% better I may hold off . I know thats what I should do but I am hoping the issue will resolve itself.

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    Do you use trekking poles. These help many of us with old knees.

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    Registered User Jeremy hess's Avatar
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    Yes they became my best friend! Best money I had ever spent

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    Registered User MkBibble's Avatar
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    Cho-pat straps, poles, and frequent stops saved me.

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    Registered User The Old Boot's Avatar
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    The 'issue' may have to do with how you walk, how much you were carrying, how far you were pushing yourself each day, whether or not you used hiking poles, the footwear you use, etc, etc.

    Any problem is likely to reappear if you keep doing what you were doing!

    The bigger question is 'what are you going to do differently next time out?'

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    Registered User Nitrojoe's Avatar
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    Knee problems can be very complex. See a specialist who works in that area of the anotomy, sports doctors are the best to see. I had my right knee replaced after doing PCT thru hike. The replacement was done March of 2011. My problem was arthritus. The operation made all the difference in my hiking. I was even able to do the AT this year with no pain in my knee. I had to stop because I fell and fractured my femur bone. Will continue the AT in 2013. Good luck on your prognosis.

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    Excellent thread, I was just contemplating this issue this morning. I wonder what those who acquired bad knees on the trail would say to someone like me who doesn’t have a knee issue with wearing some form of light brace to prevent knee problems?

    I have read many folks who say that a thru-hike can make much of you feel like you’re 20 again, but can also age your joints 20 years. This is what concerns me.

  10. #10

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    My daughter is a runner. Many of her friends have ended their careers by not backing off when overuse injuries appeared. If you are hurting, don't push yourself so much.
    "It's fun to have fun, but you have to know how." ---Dr. Seuss

  11. #11
    CDT - 2013, PCT - 2009, AT - 1300 miles done burger's Avatar
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    I agree with the previous commenters who suggested you see a doctor (orthopedist or sports medicine would be best). You could have any of several knee problems, and the treatments will differ depending on what you have. It would be silly to suggest anything without knowing your specific issues.

    Also, just because you're not having pain now does not mean that it won't come back. If you have an underlying problem (arthritis, mis-aligned patella, weakness or tightness in particular muscles, etc.), rest may not cure those issues, and you might end up with more knee pain down the trail.

    You might be able to get your problem dealt with with one trip to the doctor and/or one trip to a physical therapist. Either could be well worth the cost!

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    Flip flop, flip flopping' LASHin' 2000 miler LDog's Avatar
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    I echo the sports doctor/orthopod recommendation, and would add that you ask the doc for a referral to a physical therapist. My PT found the underlying cause of my injury, and we're in the process of correcting that. If I hadn't taken that step, I'd have done the whole RICE/anti-inflammatory regimin till I felt better, gotten back out on the trail, and have the same problem crop back up.

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    Jeremy, Philadelphia is large enough that there are many free care options. Call one of the local hospitals and ask. Some knee problems are pretty easy to diagnose and treatment is excersizes that are easy to learn. Also, the first item on a search for 'free clinics Philadelphia' is this: http://voices.yahoo.com/free-healthc...a-2415651.html

    Winds, if you don't have knee problems what's better than a brace is exercises that strengthen the muscles that support the knees and using poles. The older you are the more important specific exercises to protect joints and back become.

  14. #14
    Registered User O'TOPA's Avatar
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    I have problems with my knees when I'm walking downhill. Fortunately I don't have any underlying problems. My legs just aren't strong enough and therefore my knees take the abuse. I've been told by my PT that strengthening my quads are especially important.

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    "After being home for 3 weeks my knees are finally getting to the point where I can walk down a flight of steps without pain..."

    just a guess, but this could be Illotibial Band Syndrome, (ITBS) a common injury with hikers and distance runners.

    http://orthopedics.about.com/cs/spor...ine/a/itbs.htm

    First remedy is RICE. (rest, ice, compression, elevation), and Vitamin I helps with the inflammation and pain.
    Pain and stiffness felt on the outside of the knee, particularly on downhills, is due to ITBS. The remedy is STRETCHING, STRETCHING, STRETCHING. Learn proper stretches for the achilles tendon, quads, hamstrings, and the Illotibial band on the side of your legs. Most guys have tight hamstrings, and this is one of the leading causes of low back pain and injuries from hiking and other physical activities. Your problem could be due to other causes too, but the brief symptoms you described sound like ITBS.

    if you can't afford a doctor, maybe you can see a Physical Therapist. Most ortopedic doctors will just want to do Xrays and give you drugs. One vist to a good PT and he could set you up with some home exercises and stretches. I do all the stretches while I'm on the trail, it makes a huge difference.

    good luck

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    Yah, I third the motion to have your knees checked out pre-hike. I work in healthcare, but I do anesthesia, NOT ortho...so, I'm in NO way offering medical advice here, but here's my recent experience. Last year I was doing a lot of 1-legged squats and biking to strengthen my legs. I was starting to get some unilateral knee pain and just backed down on my training. Eventually, I quit the squats altogether 'cause my knee was in pain regardless of training. After I quit, it got better. I'm planning a SOBO hike this year, so I've been training with a 30lb pack and kicking up the mileage quickly. Well, I ended up getting bilateral knee pain to the point it was crippling my hike (was doing 20+ mile hikes on consecutive days). So, I sat down and googled away and worked through some differential diagnoses and figured out what I thought it was. I hit up one of the ortho docs in the OR the other day and he confirmed my diagnosis and told me what the treatment plan is. I'm basically PTing myself at this point. The point of this too long story is you can't plan a treatment without an appropriate diagnosis. If you're feeling better after resting for a few weeks, it's most likely some sort of overuse syndrome; however, once you're back hiking you may quickly find the pain returning. I think it would be to your benefit to either see a doc, or spend some serious time researching common knee pain pathologies. PT is very specific and takes time to work. If you do return, slowly build up your mileage over time. Here's a link for ITBS (this seems to plague new hikers/runners) and I already clicked the differential Dx tab, so I'd work through those first... http://emedicine.medscape.com/articl...0-differential Again, I'm NOT offering medical advice, and actually seeing an ortho doc is probably your best bet...

  17. #17

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    I had more trouble with sore knees in my 20s and 30s than I do now at 64. I've been using trekking poles for 8 years which took much of the pressure off on the steep descents. But I also suspect that improved nutrition has helped. You know the usual - eat fresh fruits & vegetables and whole grains, cut down sodium, saturated fat, processed foods, soda & other sweetened drinks. I really think over the years it made a difference.

  18. #18
    Registered User Jeremy hess's Avatar
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    thank you all for your advice and comments thus far

  19. #19

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    Quote Originally Posted by Jeremy hess View Post
    thank you all for your advice and comments thus far
    Jeremy, when I was your age, I had frequent knee pain. I think it was from two causes, not keeping them in shape between hikes and attempting to carry too much weight in my back pack.

    Now, at age 68, I have no knee pain. Last week, I hiked to the bottom of the Grand Canyon and back without any knee problems.

    My recommendations:
    1) Keep your weight down (both your body weight and your pack weight.)
    2) Get a pedometer and walk 10,000 steps a day every day. Include some hills in your daily walk.

    Shutterbug
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  20. #20
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    Once you are healthy:
    1)Hiking Poles, but know how to use them. Plant poll with every step Right poll with right foot, left poll with left foot. Feels weird
    2)Lightweight pack
    3)Shorter miles
    4)Don't over-stride. take smaller steps, especially going downhill.

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