Actually I’m 36, and feel that this shouldn’t be happening yet:
I like to hike, nothing too hectic or mountaineering-like, but anything up to 20-30km in a day.
Over the last year or so, however, my knees seem to not be up to the job anymore. This has got steadily worse to the point that I can’t do much more than 10km now. The sensation is of my knees seizing up (they seem to swell a bit) up to point that walking is intensely painful. It seems to be worse if I do a lot of downhill. If it gets bad then I am out of action for the next few days.
I have tried some cheap elastic tubes round my knees and these help a bit, but I worry that relying on them makes my knees weaker.
I have tried using a friend’s (good quality) walking pole. It again helped slightly, but I find it pretty awkward.
The shoes (not boots) that I hike in have seen better days.
Any advice on equipment and / or exercises I could do to improve the situation?
Thanks.
I had (hopefully) a similar problem with my left knee when hiking, especially downhill. I would get a sharp stabbing pain every step.
Binding the knee tightly helped for a while, but was not a real fix.
A few months ago I visited a physiotherapist who said that the problem was the muscles in the backs of my legs. Apparently they are slightly too short for my leg length, which puts extra stress on the joints.
I’ve been doing stretching exercises twice a day since then and my knees do feel stronger. Remains to be seen if they hold up to some skiing this winter.
Yes, I should, but they’re a bit thin on the ground where I am (rural Greece), so I will have to wait until I’m back in the UK (April, maybe).
That’s a good link, though. I will try the exercises. I was also interested in what it has to say about avoiding too much pronation (foot flattening). My feet have very little arch in them so this might be a factor. Maybe new boots or medical insoles are the way to go - if I can find them!
PS Only on the Dope would I be getting hiking advice from a Culture ship!
Knees are extremely tricky (as I assume you know) so take any advice you get from someone who has never met you, never examined your knees, and has no medical degree with a huge grain of salt. It’s really hard to tell you what to do aside from extremely general advice such as to stretch, and use hiking poles to take the weight off your knees.
But my access to good medical advice is extremely difficult, so any general advice or suggestions are much appreciated. I’m not going to attempt self-surgery I assure you!
Having done a bit of googling it seems that my flat feet are more of an issue than I had thought . Corrective insoles could help. I looked at these which I could get sent over from the UK, but they seem expensive at around £35. Anyone got any experience of this type of thing?
I struggled with hiking-related knee pain for several years before discovering that tight calf muscles and hip flexors were to blame – not the perennially tight hamstrings that I’ve struggled to loosen for most of my life and which I had previously thought to be the problem.
I mention this only as anecdotal support for the notion that, if you decide to employ a stretching regimen to help with your knees, you should employ a broad approach that targets all of the muscles in your legs, butt, and back. You never know which muscle(s) might alleviate your pain if properly loosened.
A walking pole is a half measure. A pair of adjustable Lekis will take a surprising amount of strain off of your knees. It’s like spreading your weight across four limbs vs two. You’ll develop a rhythm in a few miles. Also, use the wrist straps. It’s hard to describe, so you should have someone knowledgeable show you, but you want to put your hand through the strap and grasp the pole so that the strap runs kinda across that lumpy wrist bone area. When you push off of that hand, don’t let your grip bear all of that load - shift some to the strap. If you’re white-knuckled you’re doing it wrong. Most people give up on poles because they’re doing all the work with their grip.
That’s pretty much what I’ve got - an adjustable, sprung pole with a strap. I’ve only got the one and have only used it once (favouring the knee that tends to be worse). I also think I know what you mean about using the strap. But it didn’t help that much and was extremely awkward - I’m quite a fast walker and it just seemed to disrupt my rhythm.
Figaro, an overall stretching regime sounds like a good idea (and surely can’t do any harm). I know I don’t do enough of this kind of thing - I’m a writer and tend to be fairly sedentary, followed by a 2 day blast of climbing mountains (not the way to do it!). Have you, or anyone else, got a good link to a suggested set of exercises?
Even simple things like stretching can cause problems if you are doing them wrong, or if there’s an underlying condition that stretching will aggravate. Insoles, knee braces, stretching, will all work for some issues, and won’t work for others. Again, take all the general advice you get with a huge grain of salt, we’re just guessing at this point and some of us are bound to guess wrong.
I don’t have a good link, but I do like this book because it has a variety of stretches for each muscle that accommodate both flexible and inflexible people, it has some nice pre-fab stretching routines with illustrations, and it is indexed according to the specific muscles you can target.
I do agree with Telemark and others, btw, that you should see a doctor or physical therapist about your problem when you can. I have never had much luck getting physical problems like yours diagnosed by a doctor (even mine who has a sports medicine specialty), but you might have better luck, and it’s important to rule out serious medical issues that might be causing your discomfort.
Try a second pole. It really can make a huge difference. A key is adjusting the poles to be longer on the downhills, and shorter on the up hills, as well as leaning on the strap rather than your grip. I understand that it feels awkward to your rhythm. What is more important, feeling in the right pace, or walking without pain? You could try borrowing one, and not be out the cash if it doesn’t work for you. Once you get used to using them, your rhythm changes, and walking speed increases. Another point, is that if they are getting in the way during a flat stretch, life them and point them backwards, so you aren’t using them, and can swing your hands freely. On long flats, pack them away.
That said, I hiked long distances with a single pole, but it was more of an outrigger for me than an additional muscle provider. Running up or down hills in slippery conditions, it allowed me to pivot more quickly, and catch myself before a fall. I couldn’t use two due to carrying a banjo under my left arm and not having the mobility to use the pole properly.
If poles don’t help, see a foot specialist. Some people say that shoe inserts made special for them prevented knee, hip and back pains.
Generally speaking, the stronger your leg muscles are, the less load falls directly on your joints. I have found (generally speaking) that when I m in better physical condition, my knees do not bother me, and when I am in less good physical condition (at the same weight) they bother me more.
So, try some simple low impact exercises you can do to strengthen your leg muscles.
Also, aside from that, as soon as you get back from hiking or other strenuous activity, ice your knee. 15 minutes with ice on, take the ice off for 15 minutes, and then ice again for ice minutes. This will take the swelling away very cheaply & effectively.
First of all, I agree with everyone who said that you should take all advice with a big grain of salt until you see a doctor.
That said, I’m 35 and have had problems similar to what you describe off and on for the past couple of years. I ended up going to an orthopedic surgeon, who diagnosed it as osteoarthritis, basically microfractures in the kneecap cartilage from too much stress. At the time, I was playing basketball four days a week and hiking a fair amount on the weekends. I was also sitting in front of a computer 12 hours/day and in the car another hour and a half.
The solution in my case was to reduce the stress on my knees and let the fractures get smoothed out again (if this didn’t happen, he’d do laproscopic surgery to smooth things out), i.e. no hiking, esp. downhill, no stair climbing, no basketball, and then try to find a happy medium. One thing I didn’t know: sitting with your legs at a 90 degree or greater angle (i.e. your feet under your butt) puts a fair amount of stress on the knees. I was doing this both while working and driving. Extending my legs during these activities helped quite a bit. I also stopped playing basketball on an asphault court, which is very stressful on the knees.
Anyway, now I play basketball 2-3 times/week (indoor wood court) and hike up and down hills without a problem. No surgery required so far.
The stretches you will need to do are simple and well described online. The problem is that you need to see an expert to diagnose just what muscles are imbalanced / mis-aligned and causing the knee pain. So when you’re next back in the UK see the GP and get a referral to a physiotherapist.
Hiking really is a hardcore activity when you think about it. Very long days up hill and down dale, often on rough or non-existant tracks. I have similar problems with my left knee (diagnosed as illiotibial band sydrome, which is quite a common condition for runners), and it’s never a real problem playing football or even running. Hiking, though, brings out the pain like nothing else.
If you absolutely have to get out into the hills but are struggling with the pain I’ve found over the counter anti-inflammatories like ibuprofen make a big difference. If you take a couple just before the summit it can significantly ameliorate the descent. Not a long term solution, but it could tide you over until you get the knee properly looked at.
Bicycling, done properly, can strengthen the knees. It’s important to have a bike that’s the right size and adjusted to fit you well. It’s also important to stay in a low enough gear so that you can spin the crank at a rate of at least 60 rpm - 80 or 100 is probably better. Pedaling in to high a gear can overstress the knees and make them worse, so it’s better to not do it all than to do it wrong.