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Knee Troubles

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DallinW
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Knee Troubles

Postby DallinW » Nov 22 2015 1:27 pm

Last weekend my outer left knee (on the left side) started to hurt coming down Flatiron, but it was mild enough to ignore. I don't remember twisting it or landing on it weird in any way.

Yesterday I was out doing my usual rounds at South Mountain. The pain started within the first mile and gradually got worse over the course of the uphill portion of the hike. I took 2 tablets of ibuprofen about half way through the hike and took a brake at the bench near the Buena Vista trailhead for about 10 - 15 minutes to let the Vitamin I take effect.

On the way down the pain continued to get worse and it felt like the Vitamin had very little effect on the pain. Going downhill, particularly when having to perform a stepping down motion over rocks and ledges causes the most pain. This is the leg I usually use to support my weight on those "down steps."

This feels a bit different than the usual pain and aches I can get after strenuous hikes. I've never had pain stick around this long or get worse on the next hike a week later.

After searching the web I suspect I have Iliotibial Band Syndrome or Patellofemoral Pain Syndrome, both of which are very common in hikers and runners. Anyone have experience and/or tips for dealing with it and/or speeding up the recovery of it? I'm little worried it won't be healed by this weekend, when I have plans to go backpacking. An even scarier thought is that this could become a reoccurring problem.

For now, I'm taking it easy. But i'll get out and see how it feels right before the trip this weekend.

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Re: Knee Troubles

Postby lindaagm » Nov 22 2015 1:59 pm

I get a somewhat similar pain in my right knee, but only going downhill. Anytime it feels like that knee is supporting my body weight "ahead" of that leg while stepping down, my knee kills. Now, when I hike, I use a level 2 brace all the time, and trekking poles most of the time. That eliminated more than 95% of the pain.
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Re: Knee Troubles

Postby AZLumberjack » Nov 22 2015 2:44 pm

My knee problems are Arthritic in nature but none the less, just as painful and gets worse on the downhill stretches. For pain relief while hiking I use Thera-Gesic creme rubbed in well and then slip on a Tommy Copper compression tube. The two of them used together are usually good for a day-hike. I have also started using a single hiking stick for added support.
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Re: Knee Troubles

Postby outdoor_lover » Nov 22 2015 4:01 pm

Might look at it not actually being your Knee at all, might be your IT Band...I had some Major Trouble with that on a Backpack about a Year Ago....If it's bothering you now and not getting better with Rest, you may very well regret doing the Weight of a Backpack with it...I really had quite the Time and had to use Alex's Hiking Poles for Crutches the last 3 Miles....
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Re: Knee Troubles

Postby wha » Nov 22 2015 4:11 pm

I've suffered from ITBS in the past. When it was bad, it felt like being stabbed with a knife in the side of the knee. Like you, it was on the downhill. Walking up hill felt almost ok. Or walking with the leg straight.

It started some years ago. What fixed it then was joining a roller hockey team. Great exercise for the legs and the ITB problems disappeared, but I had to give that up when I broke too many things (on my body). More recently it started again. Tried the various stretching exercises you can find online and none of them helped me. There is some research that says the ITB is too strong to stretch, and people that seem to benefit from the stretching are just strengthening the surrounding muscles. I think that is the answer, and it's what helped me. Lots of hiking but also exercises that work on the side to side motion.

I never found a quick recovery method. Ibuprofen and taking it easy, but some times it would still be a couple weeks before I could hike again.

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DallinW
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Re: Knee Troubles

Postby DallinW » Nov 22 2015 7:30 pm

lindaagm wrote:I get a somewhat similar pain in my right knee, but only going downhill. Anytime it feels like that knee is supporting my body weight "ahead" of that leg while stepping down, my knee kills. Now, when I hike, I use a level 2 brace all the time, and trekking poles most of the time. That eliminated more than 95% of the pain.


I use hiking poles almost 100% of the time while backpacking, and usually I do on the big day hikes with high AEG. But for Flatiron since there is a lot of scrambling I left the poles at home. Might take poles out on all hikes for a little bit to help take some stress off the knee.

Outdoor Lover wrote:If it's bothering you now and not getting better with Rest, you may very well regret doing the Weight of a Backpack with it...


Yeah, I've convinced the boys to go for an alternative plan this weekend. We were thinking the Mazzie Divide and Red Hills segments of the AZT, but those are so remote that it would be a disaster if my problem started acting up while we were in the middle. Were going to do Las Cienegas and Rincon Valley (which are essentialy flat) for day one, then if my knee is feeling alright we'll get our challenge by doing the Rincon Mountains segment over day 2 and 3, otherwise there are plenty of roads to bail on before Saguaro NP if my knee becomes a problem.

w h a wrote:When it was bad, it felt like being stabbed with a knife in the side of the knee. ..., it was on the downhill. Walking up hill felt almost ok. Or walking with the leg straight.


Pretty much 100% describes what is happening.

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Re: Knee Troubles

Postby Al_HikesAZ » Nov 22 2015 8:00 pm

See an Orthopedic surgeon. Get 100% confirmation that it is ITB.

If it is ITB syndrome The Doc will give you some powerful anti-inflammatory medicine. And recommend 6 weeks of rest. Hopefully Doc will also write a prescription for Physical Therapy. A good physical therapist will show you exercises you can start doing to stretch the band and keep inflammation down in the future. One of the primary exercises involves a "roller" that you will roll on with the outer side of your leg. Don't start hiking too early. The pain will be gone and you will even be able to do some 5-6 mile hikes and you will think that you can do a 12mile hike. At about 10miles the ITB can flare up worse that you have felt it so far and you will hop and crawl that last two miles to the car. Don't ask how I know all this.
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DallinW
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Re: Knee Troubles

Postby DallinW » Nov 22 2015 8:37 pm

Al_HikesAZ wrote:See an Orthopedic surgeon. Get 100% confirmation that it is ITB. If it is ITB syndrome The Doc will give you some powerful anti-inflammatory medicine.


I think i'll look into doing that within the next few days. I'm just afraid he's going to tell me I can't go this weekend... :cry: But I guess its better than missing out on a bigger trip I have planned for late December.

Al_HikesAZ wrote:6 weeks of rest.


That's not going to go over well at all... :lol:

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Re: Knee Troubles

Postby gummo » Nov 22 2015 9:03 pm

Where are you going backpacking? Pack light if you go. Also, get a cortisol shot if the pain doesn't improve. They didn't work for me, but they work for most people. Look up youtube videos on knee exercises. Biking is good for your knees, if you're able to bike without pain.

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DallinW
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Re: Knee Troubles

Postby DallinW » Nov 22 2015 9:44 pm

skillpore wrote:According to haz you hike at a 3.09 mph thats pretty fast in my opinion. I wonder if that may have contributed to the problem?


Possible, although I feel like the biggest contributing factor was the scrambling required for flatiron which may have caused a different kind of stress on my body than I'm used to, compared to the well-graded trails I'm usually on. But that's just a hunch.

gummo wrote:Where are you going backpacking? Pack light if you go.

Segments 7 and 8 on the AZT, and maybe 9. 7 and 8 are relatively flat (a few ups and downs), so I was thinking I could use them to gauge whether I should continue into 9. If the doc says that's ok, that is what we will do.

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Re: Knee Troubles

Postby The_N » Nov 22 2015 9:51 pm

I am familiar with this ailment. It hurts more on the downhill because your knee is turning inward and causing that band to flare up if that is indeed the problem. Hiking is still possible if you can tolerate the pain, although it will prolong symptoms. I think wearing a heavy pack will only worsen the problem knee because it will displace your hips a little and likely cause the knee to turn inward even more. Rest and an anti inflammatory regime have been mentioned. Exercises and stengthening can help in the long run as well as joint support supplements and maybe increasing omega 3's. Algae oil and flax oil have helped my joints tremendously of late.
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Re: Knee Troubles

Postby azbackpackr » Nov 23 2015 6:44 am

I used to have a knee ache, but it comes and goes less frequently now. I find that chiropractic care helps (gets your hips in line, which makes your legs become the same length, which in turn helps your knees.) I don't go to the chiro for the knees but it's a side benefit.
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Re: Knee Troubles

Postby CannondaleKid » Nov 23 2015 7:04 am

DallinW wrote:I think i'll look into doing (seeing Doc) that within the next few days. I'm just afraid he's going to tell me I can't go this weekend...

Now that I'm experiencing aches and pains that come with aging (probably most due to past injuries coming back to haunt me) I look at you situation something like this...

1. Go on that weekend trip and possibly suffer for years to come...
<or>
2. Go see the Doc, then listen to his/her recommendation.

Oh yeah, NOT following #2, it may take even longer than...
6 weeks of rest
To fully recover (if ever)
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Re: Knee Troubles

Postby ALMAL » Nov 23 2015 9:49 am

Good point from Skillpore, you do hike pretty fast. IDK about his trail side remedies?
I recently had knee pain out on the West Pinto trail, from hiking too fast, but I was racing back to the truck before dark, and taking strides larger than usual...
What is the usual loaded weight of your backpack? Sometimes knee, calf, shin, or other pain can be a sign that certain muscles are more developed than others, the weaker links may get sore first. What other types of exercise do you engage in? Bike riding for an hour 3X a week and ab exercises may help. Going to see a Doc is not a bad idea.

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DallinW
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Re: Knee Troubles

Postby DallinW » Nov 23 2015 10:34 am

ALMAL wrote:What is the usual loaded weight of your backpack? Sometimes knee, calf, shin, or other pain can be a sign that certain muscles are more developed than others, the weaker links may get sore first. What other types of exercise do you engage in? Bike riding for an hour 3X a week and ab exercises may help. Going to see a Doc is not a bad idea.


My base weight is around 16 lbs, add two days of food and water and I'm around 25 - 35lbs (high side for "dry" trips which require me to carry all of my water). I occasionally run/jog, but I primarily just hike and backpack.

Going to see the doc in a few hours.

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Al_HikesAZ
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Re: Knee Troubles

Postby Al_HikesAZ » Nov 23 2015 11:01 am

Don't start chewing bark off trees. Carry some extra M&Ms (Motrin & Move Free).
Anybody can make a hike harder. The real skill comes in making the hike easier.
Not if we can help it UNCLE JACK. http://www.sleepingdogtv.com/reel/Uncle-Jack.aspx Not if we can help it.

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ddgrunning
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Re: Knee Troubles

Postby ddgrunning » Nov 23 2015 2:22 pm

Sounds like a classic case of IT (illiotibial) band syndrome. I'm a runner and have dealt with this a few times over my running career. It usually rears its ugly head when you ramp up in miles/activity level too quickly. Also, some people's IT bands are just naturally tighter (less forgiving) and more prone to inflammation. The good news is: It gets better :-). But, the key is to rest it completely and then get back into full activity SLOWLY. During the "acute" phase (active pain): rest completely (no running/hiking) and ice often (several times a day). Do the stretches you can find through internet searches, and buy yourself a foam roller (at a running store) and roll that baby out at least a couple of times a day. Once past the acute phase, do the exercises (e.g., clam shells), etc. to strengthen the surrounding muscles. Most important, don't try to just "push through the pain" or rush the recovery--it will only prolong the condition. Take at least 1 to 2 weeks off of all running/hiking activities. Then, when you first go back out, take it easy (and short--1 mi. max on level terrain). If you feel no pain, increase slowly from there. If you feel the pain return (often it will feel ok for a little while, then bam, it hits again), stop immediately and take another week off. Keep doing the stretches even after pain subsides (I do an IT band stretch after every run). If you are worried about your cardio fitness in the meantime, I suggest riding the bike (unless it causes you pain as well). When I come back from IT issues, I'll often mix a short run with a longer bike and then gradually increase the running and decrease the biking till I'm back to normal.

When I first had IT band issues (and didn't know what I was dealing with), I went to an orthopod. Given what I know now, I consider it a waste of time and money, unless you can't get any results from something along the self-help lines recommended above. Just my :M2C:

Good luck.

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DallinW
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Re: Knee Troubles

Postby DallinW » Nov 23 2015 3:16 pm

I just came out of my appointment and the IT Band is the problem, but they took x-rays and said it wasn't enough of a concern that I would have to stay off of it this weekend, within reason, as long as I rest and ice it until then. No damage or swelling.

I asked specifically if there was any significant risk of further damage if I went out this weekend, and she said it was unlikely, but if it does start to hurt I should get off the trail and that I'm likely to be more sore than usual.

Pretty much all the same advice and common sense in this thread was given, IT Band stretches, bigger dose of Vitamin I, icing, and "come back if it gets worse", but there is a little more piece of mind having the x-rays done and knowing I won't jack myself up.
Last edited by DallinW on Nov 23 2015 8:03 pm, edited 1 time in total.

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Re: Knee Troubles

Postby Widowmaker » Nov 23 2015 4:52 pm

Oxycodone and beer help a lot for me. and I always take few extra Oxycodone on the trail just in case I need back up.

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ALMAL
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Re: Knee Troubles

Postby ALMAL » Nov 23 2015 6:55 pm

Add toe clips to your biking and work another muscle on the upstroke too... But since you're 23 and except for Skillpore, most of us are or are close to twice your age, you should do the doctor thing first...


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