I highly recommend the simple nylon knee braces at Walmart or Target. They hold everything together and keep your kneecap from bouncing around, especially going downhill.
Lots of good input.............hiking poles for sure
Instaflex is a good product, took it after my knee surgery, friend in Philly who is an "Ironman" swears by it.
I have suffered 36 years of almost daily orthopedic related pain, what I have learned, where the pain is .....is often not where the issue is.
Knee?
Calves, ankles, feet, hips, overall alignment....................fixing or keeping the other areas in check and focusing there helps everything.
Example: Have been having knee and leg pain, last hike stupid calf pain, bought "The Stick", rolling my legs daily, almost all pain is gone!!!
I have bad knees. Two things that have helped me tremendously:
1. Trekking poles
2. Walk the downhill sections backwards to take stress off of the knees, especially the steep sections. This is a biggie, one I learned 15 years ago on the cables hike on Half Dome. I came down forward because that was the "cool" way to do it, then had an 8 mile hike out with painful knees. Since then, I hike anything more than a few degrees of downhill slope backward. You want to be careful of course, plant your trekking poles and always watch where you are going, but in 15 years of doing this I have never fallen while walking backward (maybe it's because I'm more careful when doing this) but it has made a huge difference in my knees. I am planning a John Muir Trail hike in late July. I would not be able to complete this hike without walking the downhill parts backward, it would be too painful.
Ok, Ill add one more thing. When I'm doing a hike that I know is going to be hard on my knees, I take a couple of Ibuprofen before I start out. Really helps.
I find that hiking downhill puts,the greatest pressure on my knees. Trekking poles help a great deal, but walking toe first rather than heel first contact puts your hips in the right place and takes some of the load off the knees and puts it on the glutes.
Lots of great advice here. I would counsel an overall strengthening program - strong quadriceps to be sure, but also strong core muscles, shoulders, etc. that will allow proper use of trekking poles to remove strain from your knees. I'd also focus on bringing down body weight to a fairly lean state, since every extra pound, either on your frame or in your pack makes a difference.
I favor naproxen sodium over ibuprofen as an anti inflammatory because it has a 12 hour half life (vs. 1.9 hours for ibuprofen).
Lastly,if pain persists, don't push through it. You could be dealing with a cartilage, ligament, or meniscus defect that won't go away with conservative treatment. Hence, the recommendation for a medical evaluation is sound if you've tried many of the remedies without relief.
I totally agree with the last 2 posts: Lighweight pack and practice (with short steps)
I watch the porters in Nepal go down a hill and learn from them. Short steps, knees bent, keep moving. Not seeming to put all their weight on any one foot at any given time.
I've learned to do this and it's almost like running, (but not necessarily fast).
Lightpack is so important also.
One other thing: I was having knee problems running and I switched to more minimalist shoes (No support inside), my knee pain went away.
I wore two pair of those shoes out and went back to some high-tech, shoes: knee problem came back.
So, perhaps the particular shoe you are using is causing part of the problem also.
Good luck sorting it out.
I imagine you can if you keep trying different techniques, equipment, speeds and packweights.
Don't let your fears stand in the way of your dreams
I'll pile on to the idea of figuring out what's wrong with your knees, but I think you can do a lot without seeing a doctor or physical therapist. Either way, you definitely need to figure out what's wrong with your knees if you're actually going to fix them and make them better than before. Most knee problems are due to muscle imbalances. The area of pain and its triggers do a lot to help you figure out what you need to strengthen.
With that in mind, I've been working to eliminate some of my own pain. It took me a while before I could describe my pain well enough to figure out how to find the problem. The problem is a very strong posterior chain, and not so strong quads. That problem matches up with the type of exercise I had been doing this year. Now I'm working more on the front of my legs, along with doing stretches for different parts of my posterior chain to loosen that up while improving my form during squats, and my knees have been feeling better. The pain isn't gone, but I feel like I'm going in the right direction.
Originally Posted by fiddlehead
Ya think one of them would like to come work for me on the AT?? Tell them: Equal pay; warmer weather!
Ditto on lightening the load. I stopped backpacking in my late 30s when it would take me months of limping to recover from a 100 mile hike. Ten years later I started my thru hiking career, hiking 2000 miles a year pain-free. The difference was about 30 pounds of pack. And about four pounds of footwear. The last time I wore my heavy leather mountaineering boots on a day hike, I limped for weeks afterward. Something about my knees will not accept hiking in heavy footwear.
"Throw a loaf of bread and a pound of tea in an old sack and jump over the back fence." John Muir on expedition planning
Jeremy's symptoms are also consistent with patellar chondromalacia, caused by a misalignment of the tendons in the knees. http://www.mayoclinic.com/health/cho...atella/DS00777 This is very common in bicyclists, where the quads and hamstrings aren't balanced in strength. Some sports strengthen one but not the other which can lead to problems.
I think the treatment for ITB and chondromalacia are different but not necessarily inconsistent (stretching and strengthening exercises are both good for everyone). However, rest is not a treatment for chondromalacia. As soon as possible you would want to start straight leg lifts on your back (quads) and on your stomach (hamstrings); a PT or orthopedist is very useful telling you when you can start.
With some knee problems you can cause permanent damage if you don't get proper treatment, and I know someone that happened to. What you really need a doctor for is ruling out the more serious problems that might be aggravated by the wrong exercise.
Just got done seeing the ortho doc no major problems cortisone shots in both knees feeling better already,.....be back on the trail very soon YES!!!!!!
Be careful. I went the cortisone route waited 3 weeks and could only hike for 2 days before recurrence.
Things I did to cure it (some things are repeated from above):
lighten the load (for me 37 to 17 lbs)
strengthen the quads, hamstrings, and calves
stretch the IT band
learn to use a wobble board for stability
ice works wonders for the knees, 4X a day
take it slow and build muscle endurance
hike the mtns if you can
Now a YEAR later the problems are solved. It was a very slow process and I have to be constantly aware of backsliding.
Not even the pole manufacturers make a prevention claim. Since they allow you to hike faster than you would without them they are certainly not preventing anything. Using your "logic" crutches prevent broken legs, which they might because you would have to hike SLOWER and are less likely to over use.
Hiking poles would be a preventative measure to a great many ailments if used properly.
Last year I broke my leg, clean through and dislodged. NOW, had I been using crutches, that wouldn't have happened for sure! Also, if everyone wore a helmet to bed, falling out and getting concussions would decrease as well.
Bottom line: Wear your helmet more to bed. Or, and I've yet to see cortisone shots actually play a major role to heal anything.
I use poles and love them they have saved me on many occasions. While i have been in recovery mode for almost two months i am anxious to get back out in the trail.....lighter and smarter than before.....cortisone seems to be working even after a few hours.....forgot what it feels like to not be in pain...awesome
AA
Amen to what you posted. Just got through with physical therapy after surgery on my left knee in April. Told the PT I wanted my therapy geared toward hiking and these things are what I did. The wobble board is especially helpful and something easy to build and use all the time to stay in shape for hiking-- along with the stretching. I found out that torn cartilage is not going to heal itself and cortizone is very temporary. Mega doses of advil will relieve the pain but just as soon as you try to hike any distance it will return.
Oh, amen to the relief in your pain Jeremy. I do wish you the best in your hiking endeavors. I've had cortisone shots in the past, just be careful to heal well.
Thank you i plan on making an attempt doing PA to ME in july. Doc says i should be good to go
Something that I just learned (over 60 now, but we never stop learning, aye?)
Shoe fit and type make a big difference.
I jog a lot (just ran the Phuket half-marathon 3 days ago) and switched to minimalist shoes about 2 years ago because I was having knee problems and these shoes helped a lot.
I got a new pair of tennis shoes and tried to run in them (I play tennis 3 days a week too).
My knee pain came back in only 4 kms of running.
So, I just ran the 21 km. half-marathon and guess what? no knee problems.
By the way, I skimmed over this thread and would like to comment that any doctor that tries to squirt cortisone into my knees would be the one that I would run away from. Fast.
Don't let your fears stand in the way of your dreams
I've had three cortisone shots in my hand/wrist after three surgeries,I can't say it helped much,or reduced any inflamation.
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