[Philmont] KNEE PAIN (am seeking non medical self-help advice)

I've had knee pain for a long time. I went from being a semi-serious
runner to a non-runner in about 3 strides, 20+ years ago. I just
completed a 100 mile, un-resupplied backpacking trip with a 15
year-old and a 16 year old, so it is possible to continue hiking.
Here's what I'd recommend:-

See an orthopedist, preferably one who specializes in sports injuries.
Their focus is on people who want to overcome a problem and stay
active. A sports orthopedist is less likely to suggest your hiking
days are over. Having a diagnosis is important because there are a
lot of things that can go wrong with knees.

For the most common knee problems (chrondomalacia AKA runners knee AKA
dancers knee) treatment consists of reducing the inflammation with ice
packs (20 minutes several times a day) and drugs like Ibuprofen.
Effective doses should be monitored by a physician because there are
occasionally serious side effects

Strengthening the muscles that stabilize your knee. Physical therapy
can help with this but personally, I found yoga to work much better.
The static poses of yoga don't irritate my knees but the positions can
be quite difficult while they are building strength and flexibility.

Improving the flexibility of your thigh muscles (especially your
hamstrings) and calf muscles. Physical therapy again, but I've found
yoga 3 or 4 times a week works better. Poses like warrior 1, 2, and
3, down dog, sun salutation, triangle pose, pigeon pose, standing
forward bend, chair pose, triangle pose, and half moon pose should all
help. In pigeon pose, grab your back ankle and pull it forward for a
great thigh stretch.

Improving the biomechanics of your foot. Many people who pronate
(have flat feet), find orthotics (prescription arch supports) helpful.
 A sports podiatrist can do this. For both the podiatrist and the
orthopedist, bring your hiking shoes and some used walking shoes so
that they can look at the wear patterns on the sole. If they don't
ask to see your shoes, that's a bad sign. Orthotics aren't cheap, so
try some non-prescription arch supports for a few weeks or months.
Spenco Orthotic Arch Supports are a good choice. When I got
orthotics, I went to the podiatrist with a homemade pair. If you
suprinate (the opposite of flat feet) orthotics might not help.

Many people, including me, find glucosamine helpful. Don't expect
fast results, i.e. you should see a small but noticeable improvement
in maybe 3 months. I also needed to take much higher doses (~6 grams
a day) than the bottle recommended (~3 grams a day) for the first 6
months or so. Glucosamine is available as a nutritional supplement at
Costco, health food stores, and drugstores. I've stopped taking it
several times during the last 20 years and have noticed a slight
change for the worse after 3 weeks or so.

Don't forget your shoes. Make sure that they fit, have great arch
support, and if they are like running shoes, that the interior padding
isn't worn out. Runners know that the padding in running shoes wears
out when running shoes show the slightest bit of wear. You're fairly
near the San Francisco Bay Area, so you may want to consider visiting
a Becks Shoe Store. Expect to pay full price for the shoes but also
expect shoe salesmen who know what they are doing.

Many people find hiking poles helpful but I don't. I use hiking poles
for other reasons.

I'd speculate that heavier boots might make things worse. My belief
is that a low top shoe with good arch support (I use trail running
shoes) is better than a stiff, heavy boot. I believe that having your
joints free to move and adjust to each step makes for a less
injury-prone trip.

Experiment with taping your feet. I've found that a light wrap of
atheletic tape around the ball of my foot helps stiffen my very loose
foot.
Use the foam buffer tape.

Lighten your pack. You should be able to get closer to 20 pounds for
a one night hike without too much trouble.

I've considered making a rule in my trip that if you pass anyone from
the troop while hiking, you have to take something from their pack.
:-) My ego is no longer involved in trying to hike fast.

Good Luck
YIS
Bob S

> Hello Phil Loop,
>
> The last time I went overnight backpacking, to my surprise, I had horrible knee pain during the end of a 6-mile/day-one hike. I packed about 30lbs (I'm 5'1, f, --early forties), and arrived at camp after a high elevation steep hike up slippery granite rock steps adjascent to wet waterfalls -- the last several hundred feet of which I was in mucho amounts of pain in my right knee. Part of the problem was simply attempting to keep up with over-eager, strong, and FAST Venture scouts without twisting an ankle in the process.
>
> I limped quite a bit while setting up my tent and cooking dinner; and was in horrible pain that evening if I put any weight on that knee. I had to sit and observe (not participate in) a lively game of Capture the Flag. I was, fortunately, able to make it out the next day under my own steam with the aid of several 600mg Motrins (throughout the morning), having an easier downhill grade, and slower scouts...but I had fretted about it so much the previous night, a peaceful sleep was elusive for me. This came as a surprise because I wasn't winded (much), nor having any other pain; and would have had otherwise a perfect, puffed-up <grin>, weekend.
>
> So...what can I do to prevent this from happening again? I'm very worried that my knee will give me problems again on our next hike, as a month later, it is still tender at times. Does anyone have any advice? I'm wondering if high-top hiking boots would make a definitive difference? Are there any specific knee conditioning exercises out there?
>
> Keep in mind that I am looking for self-help pointers from those who have been there-done that, not medical advice (of course). I will go that route if I feel I need to. Wer'e doing the Philmont Cavalcade in '09 (horses) so I'm not as worried, but do want to address this problem. Thanks in advance to all who want to share their pain (knee pain!) with me! LOL
>
> Caroline Paniccia
> BSA Troop 864, Cordelia, CA
> and Venture Crew 864, Cordelia, CA
>
>
>
>
>
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As you gather around this virtual campfire with fellow
Scouts and Scouters, do your best to be trustworthy,
loyal, helpful, friendly, courteous, kind, obedient,
cheerful, thrifty, brave, clean and reverent.
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Received on Fri Jul 25 23:06:18 2008