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Got Knee Pain, Read This!

How do you prepare for the rigorous physical requirements of high elevation adventure? Strength and endurance are key, but are only part of a more complex equation. How do you prepare for changes in altitude, exposure, diet, etc.? How do you mentally prepare? Learn from others and share what you know about training in advance for outdoor adventures.
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Got Knee Pain, Read This!

Postby maverick » Thu May 14, 2009 2:27 pm

I have been training several people who have had excruciating to mild discomfort
in the knees, especially when hiking down hill and these techniques have helped in
most cases.
I have been having them do squats, walking lunges, step ups, deadlifts, romanian deads
and bulgarian split squats to strengthen there hips, hams, and quads.
I also have them do yoga, there is a dvd "Yoga for Athletes" which has a section for a
specific sport, and a sub section for a specific body part(for example:hips, shoulders,legs).
Many folks at the gym have no idea how to use there hips during squats, deadlifts, rdl's
which can lead to improper lifting, muscle imbalance, and injury.
During squats and dead's the knee should be in line with your toes, and not extend
beyond you knees, which can be achieved by pushing back the hips instead of starting
the movement by bending the knees, and even worse using your lower back to lift
instead of your much stronger hips.
When descending a steep hill for example most backpackers are not conscious of where
there knee track is which can lead to pain and injury especially on descents, but can also
be bad on ascents, this is where lunges, and step ups, using proper form are very helpful.
Things besides strengthening the muscles around the knee is to engage the strongest
muscles of the body, your hips(glutes).
When descending bend your knees slightly and lean forward by pushing your hips back
and contracting your glutes like when you performing the above exercises putting your
weight onto the poles, which you'll have to extended to max on steeper descents.
Keep the elbows tucked into your sides.
Push your hips back so your shoulders are above or close to above your feet, don't
overdue this by making it look like your trying to do a good morning exercise.
The key is that you knees will not extend past your toes, and the weight of your upper
body should be supported by your much stronger hip muscles and poles.
To see the difference walk down a fight of stairs with your upper torso straight
and you will notice you knees will go past your toes when you sift your weight onto
your front foot while stepping down (with a heavy pack the knee moves even further
past the toes).
Now consciously push you hips back and bend your knees slightly and you'll feel a big
difference I guarantee!
Of coarse descending in a zig-zag fashion is all ways recommended where feasible
but this sometimes is not.
Slow down.
Also check your knees while your hiking during the day to see where your knees
are in relations to your toes especially during the end of the day, and over tricky terrain.
Employing these techniques may alleviate your knee pain after those dreadful descents
and extended your backpacking years.
Make sure if you try these exercises get a trainer to show you how to preform them
properly so you do not learn improper form, and that you do not injure yourself.



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Re: Got Knee Pain, Read This!

Postby Skibum » Sun May 17, 2009 1:53 pm

Good stuff Maverick. I'm just starting to experience lateral miniscus pain on steep downhill, or side sloping. Daily Yoga practice definitly helps. I am leary of using any kind of knee brace, my reasoning being, that the knee might lose strenth and become "dependant" on one.
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Re: Got Knee Pain, Read This!

Postby maverick » Sun May 17, 2009 6:32 pm

Hi Skibum

Have you seen a doctor to make sure its not a tear or due to arthritis?
Do you take glucosamine to help heal your joints? Make sure you take it for several
weeks otherwise you will not get any positive effects.
If you have swelling do the usual RICE (Rest, Ice, Compression, Elevation).
Do gentle exercise for you quadriceps taking care not to aggravate the symptoms.
See a doctor to get an exact diagnoses so you can properly address the underlying
cause if it continues to bother you.
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Re: Got Knee Pain, Read This!

Postby Skibum » Tue May 19, 2009 3:29 pm

Hi Maverick,

Yes, I do take a Condroitin/Glucosamine supplement. And I believe it has definitly helped.

No swelling. I only experience pain towards the end of a long day on the trail. No, have not seen a doctor yet, I'll mention it in my upcoming work physical. I'm thinking arthritus.

Take care,

J
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Re: Got Knee Pain, Read This!

Postby Rosabella » Thu Jun 04, 2009 5:54 am

Skibum wrote:...... I am leary of using any kind of knee brace, my reasoning being, that the knee might lose strenth and become "dependant" on one.


So, I'm wondering about this same issue. Last summer I hurt my knee in a dance class. It took a while to heal, but finally stopped bothering me. A few months ago I started doing my “stadiums” at the high school and re-injured it.

I finally went to the doctor and he said that I had partial separation of the patella. He told me it wasn’t bad and that I should wear a knee brace for a month or so to support the patella.

So, it’s been a well over a month, now, and I’m really torn on whether I should continue to wear the brace. On one hand I think that I’d just as soon keep wearing it because I don’t want to take a chance hurting my knee again and possibly affect my JMT hike this summer… “what can it hurt”. But I’m also concerned about exactly what skibum said…. Is there a chance that I’m actually weakening the knee by wearing the brace for support now?

I’m really conscious of where I place my knee (over me toes)… years of ballet has reinforced that awareness. I guess my question is this – if I am going out every day and walking/hiking/climbing to strengthen my knee as well as training, is it beneficial to continue to wear the knee brace?
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Re: Got Knee Pain, Read This!

Postby maverick » Fri Jun 05, 2009 4:41 pm

Hi Rosabella

For a partial sep of the patella you need to give it 6-8 weeks to heal with the
brace on.
Tell your doctor about your plans for the summer, and voice you concerns about
wearing the brace, and ask about what exercises you should be doing for a full
and speedy recovery.
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Re: Got Knee Pain, Read This!

Postby quentinc » Sun Sep 13, 2009 12:21 pm

Hi Maverick,

I have just recently been experiencing knee pain on the uphill. I think this is the result of recently being goaded into (i) cycling up a steep hill after not been on a bike forever, and (ii) descending from the Matterhorn on a scree slope instead of the rock I came up on (as you can see, I'm disclaiming any personal responsibility). I have a history of knee problems, but have long since developed my own peculiar technique for descents which has worked fine. But uphill pain is something new. Does the same technique (hips back) help going up?
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Re: Got Knee Pain, Read This!

Postby maverick » Tue Sep 15, 2009 12:31 pm

No, you should try to keep your torso as straight as possible.
Check to see whether your knees are in line with your toes and not veering off track.
Also when you plant your lead leg don't just use your quads, but forcefully contract your
glutes to move up/forward, glutes/hips are the strongest muscles in our bodies and we
should take advantage of this.
Just as a reminder that when we compensate for some weakness in our muscles by
altering the natural gait/stride/form we throw off our muscle/bodies natural
balance which will come back to bite us in form of an injury/inflammation.
I am sure you have heard that you should not only work out your quads but also
your hams otherwise our quads/ham strength ratio will be out balance causing
patella pain.
Step ups, and lunges onto a platform should not cause knee pain while strengthening
your glutes/hams/quads.
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Re: Got Knee Pain, Read This!

Postby quentinc » Wed Sep 16, 2009 2:15 pm

Thanks Mav. On a hike yesterday I discovered I could avoid pain by doing two things. First, pointing my right foot out a bit. I understand what you are saying about the dangers of compensation, and that will be a temporary thing only (although I am naturally a bit pigeon toed anyway). Second was squeezing the muscles of my right leg right before landing on my right foot. That probably involves my contracting the glutes too, whether I'm aware of it or not.

I'll try step-ups after this bout subsides. Also, what about a weighted leg raise (strapping a light weight around the ankle, lying on the back, raising the leg without bending the knee)? My orthopedist once told me those can help stabilize the knee joint.
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Re: Got Knee Pain, Read This!

Postby maverick » Thu Sep 17, 2009 1:01 pm

Hi Q

Leg raises are okay, but leg extensions should be avoided unless they are done properly
and even then it definitely would be near the bottom of my recommended exercise list.
When taking a step up hill and your front foot comes into contact with the ground and
you prepare to take another step contract your glutes and push thru your feet like
if you were trying to smear something of the bottom of your shoe.
Same goes for cycling, when you reach the 6 o'clock position you should do the same
smearing action with you foot to activate you hams and glutes, a lot of people try to
grind/push thru using only there quads.
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Re: Got Knee Pain, Read This!

Postby quentinc » Sat Sep 19, 2009 9:50 am

Thanks Mav.
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Re: Got Knee Pain, Read This!

Postby whrdafamI? » Sun Mar 06, 2011 9:55 am

This last summer a friend of mine I grew up with and me teamed up and did a backpack together for the first time in many years. We did A North Lake loop via the Larmarck Col. Very cool trek and I reccomend it highly. When we got back it wasn't more then a few days and I had severe knee pain. I figured that I did some damage on the trail. Wrong conclusion. It must have been a coincidence but Osteo/Arthiritus had made its presense known. Not a happy camper about this at all. I thought that was for older people and I'm only 57. What I am trying to do for this is weight reduction in the pack and on my body as well as trying to walk 3 to 5 miles a day. Doesn't always happen but I have good intentions. Any other suggestions?
Better to have it and not need it than it is to need it and not have it!

Get busy living or get busy dying.
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