Knee pain and descending

[trw0007]

On my last hike I started developing some IT band issues, specifically on steep, stair-stepped, downhills. Once they started, my strategy was to lean heavily on my poles and lead with my injured leg to try to avoid loading my hurt knee when it was bent. While this helped in the immediate, favoring the other knee created issues as well. I have trekking poles and I've lightened my pack weight; is there any specific way to descend to help prevent knee issues?

I realize that at its core, this is an overuse injury. I actually developed IT band issues in high school while running cross country; although, instead of treating the injury I just quit running. I have a high level of general endurance thanks to years of cycling, and both then and now my injuries have been the result of going too far too soon. I've started some general leg strengthening exercises, stretching, and light running. I just want to make sure I'm doing all I can to prevent my knees becoming a major issue on my thru attempt.

[Second Hand]

I have had IT issues before and I did a few things that really seemed to have helped.

1.) I lost weight. I dropped about 20lbs and that took a lot of stress off my joints.
2.) If you go on youtube, and type in IT band stretches, they will show you a # of exercises. Many involve a foam ball and yoga mat, but believe me, they make a differences.
3.) I started doing a lot of leg strengthening. Two days a week I hit the gym very hard. Light weight, tons of reps. I feel like this has really improved my hiking ability overall.
4.) Yoga - Although not specific to your knees I have found it has improved my balance and had an overall coordination. I don't do classes, although I would if it was a viable option with my work and home schedule. I watch videos 3 days a week for a half hour.

[Mobius]

I've struggled with IT Band issues on and off while running. Second Hand's list is pretty close to mine.

The things that worked for me were improving hip strength (leg lifts while laying on my side) and flexibility, increasing my hamstring flexibility, balancing out my leg strength (my inner quads don't seem to get used much, I found cycling helped). I also found self-massage/trigger point therapy to work very well. For me that's a combination of foam roller and tennis ball, not just on the IT band, but also the glutes.

Quite a few other things that work for other folks haven't worked for me. It's just a matter of finding the solutions that work best for you. Good luck!

[ChinMusic]

I just want to make sure I'm doing all I can to prevent my knees becoming a major issue on my thru attempt.

I too had some IT Band issues on prolonged downhills, typically at the end of a long day. That same downhill early in the day would be fine. Having to do it at 6pm was another story. I found that a simple knee (Ace) brace, which just holds things tightly together helped a LOT.

When I did my thru I took the brace with me just in case. On the start of my thru I did less miles than I did on section hikes. It turned out that I never got that knee pain. Once I got to Gatlinburg I sent it home.

[burger]

This exercise is fantastic for ITBS: http://www.youtube.com/watch?v=SE7uUVhMVkQ

If you want more videos/explanation just google: Walt Reynolds ITB exercise.

[1234]

I am presently in physical therapy from surgery where they cut my IT band. Lateral retinacular release is the name of the procedure. The IT band was so tight it pulled my knee cap out of the trochlear groove, where it was wearing on my knee was grade IV Chondromalacia, extensive. They have me exercising my hip muscles to pull the knee cap back into place. Abduction exercises.(I am sure my spelling is not so good here) The IT band is stronger than steel belted radials so all the stretching in the world may buy you a hundredth of a mm if any at all and you will suffer great pain in all this stretching. They tell me the key is strengthening the lower back and hip muscles which translates to a healthier knee. We will see. They are talking about partial knee replacement, replacing the trochlear groove and under the knee cap only.

[clb]

I'm with Mobius on this. Having strong hips and core is essential for avoiding most knee problems.

[Pedaling Fool]

Going downhill hurts so much because it isolates mostly the front muscles of the leg; it's basically a single leg squat (albeit you don't go down all the way like a actual squat). As opposed to going uphill which uses more of the leg, including a lot of hamstring, this is all because of how the body is positioned over the leg...

Anyway, if you know Mark Allen, one of the most accomplished triathletes, here is what he says about the importance of strength training http://www.youtube.com/watch?v=pDCN58oI6T0

Here are some good strength training exercises for a start: http://www.beginnertriathlete.com/cm...?articleid=691


Don't be one of them athletes that only do strength training as a rehab activity. Strength training is crucial for building a strong healthy body for life.

[Dogwood]

Whenever ascending/descending on steep stepped trail(like some of the AT) I attempt to reduce the vertical distance I must step up/down. I alternate my lead legs and plant my feet sometimes slightly different(toe pts slightly out/slightly in) on sections of ascent/descent. I'll also go slightly sideways down/up trails. Sometimes, I'll incorporate short sideways scissor type steps to ascend/descend to take load/stress off certain parts of my bod. I'll also reduce the length of my gait being conscientious to take two or more shorter steps rather than one longer step to reduce load on my knees, which I find especially import on ascents/descents. I try to tread lightly flowing in my hiking style rather than pounding or plodding heavily down the trail or fighting my momentum/center of mass. Flow. Fluidity. I try to be aware of common tripping/falling/ankle rolling/sliding/slipping hazards to avoid the consequences. It all adds up to less stress on the knees and ITB.

[clb]

Whenever ascending/descending on steep stepped trail(like some of the AT) I attempt to reduce the vertical distance I must step up/down. I alternate my lead legs and plant my feet sometimes slightly different(toe pts slightly out/slightly in) on sections of ascent/descent. I'll also go slightly sideways down/up trails. Sometimes, I'll incorporate short sideways scissor type steps to ascend/descend to take load/stress off certain parts of my bod. I'll also reduce the length of my gait being conscientious to take two or more shorter steps rather than one longer step to reduce load on my knees, which I find especially import on ascents/descents. I try to tread lightly flowing in my hiking style rather than pounding or plodding heavily down the trail or fighting my momentum/center of mass. Flow. Fluidity. I try to be aware of common tripping/falling/ankle rolling/sliding/slipping hazards to avoid the consequences. It all adds up to less stress on the knees and ITB.

Well said, I've learned to incorporate a lot of these in my hiking. Knee issues (like most nagging injuries) can be really demoralizing. I've had patella issues, meniscus issues, IT, before I began working on my hips/core...Seeking out a quality PT (AAOMPT)made a big difference for me, just to consult with, to point out what exercises to do and to make sure I was doing them correctly. YMMV :-)

[VTATHiker]

I had a real bad IT band problem in Maine during my hike. I had to put a lot of weight on my poles on downhill, and on really steep downhill stretches I hiked backwards - no joke. For whatever reason, it's much easier on the IT band stepping down backwards (very slowly of course). Eventually I picked up a knee brace and that did help a little.

[Lucy Lulu]

On my last longer hike, I had issues for the first time, on down hills mostly. A simple knee brace made a big difference. I hiked in it for about two weeks until everything strengthened up, and then was able to take off the brace. Stretching at the end of the day, and weight loss also helped me quite a bit.

[Glogg]

I also had some IT issues; I worked some stretches for it any time I stopped to rest for more than a couple of minutes. vitamin I and a very minimal knee brace (basically a neoprene and Velcro strap) helped as well.

[Pedaling Fool]

...and on really steep downhill stretches I hiked backwards - no joke. For whatever reason, it's much easier on the IT band stepping down backwards (very slowly of course). Eventually I picked up a knee brace and that did help a little.

I believe it; hiking backwards downhill is just like hiking up a hill, notice your center of gravity is behind the knee when walking downhill backwards, just like walking uphill. However, walking downhill in the normal manner places your center of gravity directly above the knee, with forward momentum in that direction, therefore it isolates the front part of the leg, getting no help from the back part.

I agree with Dogwood's approach, but much of it comes naturally with miles and miles of hiking; you develop a flow. However, strenght training is something that may feel like a waste of time for some young guys, but it's money in the bank for you as you age.

Fact is, hiking doesn't work every muscle/connective tissue, besides most of us don't get to do it every weekend. Your body requires maintenance, it's just a fact of life; you don't use it, you lose it. Ignoring weight training is like ignoring cardio. Everyone knows the importance of maintaining cardio health, the same with your skeletal system.

I would have a goal of developing the legs for hiking that can be done with no brace In most cases, braces are only doing what your muscular system should be doing naturally; them more use with a brace, the more the muscles atrophy.

[WILLIAM HAYES]

second what dogwood said I do the same never had a problem

[psyculman]

For down hill strength, I made a small box out of plywood, 13 inches high. I started out stepping up and down on the box with each leg, about 20 times. Gradually worked up to 3 reps of 50 a day, each day. Have no weakness now on down hill hiking. (I'm 62) Before using this routine, thought I was finished with down hill hiking.

[Kerosene]

I've got osteoarthritis in both knees (years of competitive soccer), so my only option is additional strengthening of the stabilizing muscles. A year ago I could barely jog a quarter-mile. I started doing more barbell squats about a year ago -- varying the weight and reps quite a bit -- and seem to be doing better as I can jog (ideally with a 2-3% incline) for 1-2 miles a few times a week. It helped to get a corticosteroid shot in my weaker knee to get the swelling under control first. We'll see how I do this fall in Central Maine (Rangeley to Monson in early September; who wants to join me?).

[ladytaz]

I have trouble in my hip area and my doc says its my IT band. I hear everyone else say it affects their knee. does anybody else have trouble with it in the hip area?

[josephweiler]

The major role of knee is to facilitate movement and to support entire weight of body.Hence the risk of knee injury is very high during hiking or playing sports like tennis, cricket, volleyball, basketball, soccer, football, rugby, hockey and wrestling.At the age of just 30 my friend had both knees replaced he has problem with Beating Patellar Tendonitis ,the right one is a conventional knee replacement and the left one is a journey knee and he is a good player of golf unfortunately just after 1 year of knee replacement he have to stop playing golf.

[Terry7]

http://www.cho-pat.com/products/dualactionkneestrap.php