Nagging Leg Problem three weeks before my thru-hike

[JeffBliss]

Hey everybody. I am scheduled to start the approach trail on April 1st and I have been having this nagging leg problem that I wanted to seek advice for on this forum. Before I start going into detail though, I did make an appointment with my doctor next Monday so ultimately I'll have some sort of diagnosis then. I was just hoping to see if anyone else had experienced anything like this and what I can do to mitigate this in the meantime.

So, it all started probably sometime this past Summer. I went on a 90 mile hike in upstate NY and during the hike I started experiencing what can be described as a tightness behind the knee. It was never painful just uncomfortably tight at times. I then went hiking for a week out in Utah this past September and ever since then I have been experiencing that tightness off and on.

Lately though, it seems to be getting worse and spreading to different areas. My left calf is persistently tight and sore and I have been starting to experience a pins and needles effect in my left foot at times too. I don't distinctly remember injuring myself anytime lately and I have even been on plenty of hikes in the past couple of months without too much discomfort.

In the last week I have gone on a full stop with exercise and have been taking ibuprofen and icing my calf/hamstring a couple of times a day. I have also stopped drinking alcohol entirely because I'm starting to realize I don't have the best relationship with it. I'm not an alcoholic by any means but I could certainly classify myself as an alcohol abuser. I try to do daily stretches too and keep myself limber with massages but that doesn't seem to be leading to any real noticeable improvement.

So, with all of that said... has anyone here experienced anything like this? My left leg is persistently and uncomfortably tight. It's not really painful and I can walk/hike on it for the most part and it is tolerable. If it was this level of discomfort the entire thru-hike I could manage and deal with it as necessary. I am just afraid that this is going to be one of those nagging injuries that only gets worse and never gets better. Could alcohol be playing into this at all? I've read that with alcohol abuse one can become vitamin deficient among other things which can lead to tightness and that pins and needles I'm feeling. So to offset that I have been taking a b-complex the past few days and starting up on a multivitamin again.

Thank you everyone. I appreciate any and all suggestions.

[rwhat]

I am awaiting knee surgery after having many of the same symptoms. Torn meniscus ( I have no idea how I tore it.), bone spurs, and a cyst. My whole leg would get tight and painful after walking or jogging a mile or so. Initially I got cortisone shots thinking it was just arthritis but the pain never went away. Delaying my AT trip by at least a month. Maybe I was lucky considering the winter weather on the trail this year.

[jjchgo]

last summer when i was up in MN, i started experiencing some tightness behind my knee during a hike. when i got home i made an appointment with an orthopedic doctor. after a few xrays, poking and twisting my knee he said that i just over did it and "your just getting old"...lol. he recommend a patella tendon strap/brace. it made a world of difference. i hope its nothing more serious then that and you feel better soon!

[ChinMusic]

The most important thing is what you and your MD come up with. If it is "just one of those things" only you can decide whether you want to put up with it or not.

Most thrus have issues pop up during 2000 miles. Some of these issues end their hike while some you just put up with.

[perrymk]

I had some similar but not exactly the same symptoms recently. Mine was more a combination of spasms and cramps, often localized and almost feeling like a bruise. It started in my thigh a spread from there. Hiking exasperated the problem. After some online researching I started taking a potassium supplement in the morning, and a potassium-calcium-magnesium supplement in the evening. The problem almost ceased within a couple of days. I've decided to finish off the bottles of supplements (about 2 months) and then see of the problem returns. It could be a coincidence, but that's one weird coincidence.

Good luck!

[burger]

I would say to go to a physical therapist ASAP. Routine muscle tightness can probably be remedied with the right stretches. Also, the issues behind the knee could be a sign of runners' knee (which is potentially a problem with all the climbing on the AT). Make sure that you tell the PT what you're getting ready to do and that you're looking for exercises/stretches that you can do on the trail if need be. Good luck with it. FWIW, I had minor or major injuries (back problems, bad shin splints, and a bad case of patellar tendonitis) a month or two before each of my long-distance hikes. None of those issues ended up being a problem once I got hiking, but I had to do work before the trip to get healthy.

[JeffBliss]

I am awaiting knee surgery after having many of the same symptoms. Torn meniscus ( I have no idea how I tore it.), bone spurs, and a cyst. My whole leg would get tight and painful after walking or jogging a mile or so. Initially I got cortisone shots thinking it was just arthritis but the pain never went away. Delaying my AT trip by at least a month. Maybe I was lucky considering the winter weather on the trail this year.

Speaking of the winter weather, how is the snow pack in Georgia, Tennessee, and North Carolina? Is this map accurate? http://www.intellicast.com/Travel/We...now/Cover.aspx

I know it's been a brutal winter so I'm expecting snow well into May this year haha.

[Berserker]

Speaking of the winter weather, how is the snow pack in Georgia, Tennessee, and North Carolina? Is this map accurate? http://www.intellicast.com/Travel/We...now/Cover.aspx

I know it's been a brutal winter so I'm expecting snow well into May this year haha.

I looked at the NOHRSC interactive snow map (which I have found to be quite accurate), and there is no snow as of today on the AT South of PA according that map.

[Weather-man]

I can only relate my experience and please don't construe my comments to be, in any way, a diagnosis or medical advice....

My history with L lower leg pain and tightness goes back about 20 years. At that time I attended a military selection course in the mountains of W. VA and ran up and down those mountains for about a month with various loads on my back, 25-55 lbs not including water and weapon. At the end, after a 40 mile "hike", both of my legs exhibited signs of severe pitting edema (20mm x 30 secs) and generalized pain in the calves. Eventually this all went away.

About 5 years later, still running around with stuff on my back, I had a partial calf separation in my left leg. Eventually all of this resolved as well but slowly I began to experience the same symptoms that you mentioned. These were severe tightness in my left calf, pain to the point of limping, distal paresthesia, etc...

Based on the history above as well as many more years of having run around with heavy stuff my Doctor began to Tx for Intermittent Claudication and suspected compartment syndrome. He suspected that years of trauma to the capillary beds had compromised my circulation to the point where I was suffering from insufficient venous return at the Venule level. Essentially I had just torn too much stuff up for too long.

This went on for 10 years or so. I was even treated at one time with Coumadin, after a long flight, because the symptoms were so severe and they suspected DVTs. Also treated with Pentafin and some other circulatory drugs for years. All to no avail.

In Nov of last year I herniated a disc (L4/L5) and underwent laser surgery in mid Jan of this year. Low and behold all of my lower leg circulatory problems are gone! I mean 100% gone.

So this was a long way of saying get an MRI done with some dye studies to see if they can detect nerve impingement or compromised anatomy. In my case I would think that I suffered from a combination of repeated trauma as well as compressed discs.

Suffice to say it took a blown disc to fix my leg. I guess I should be thankful for small things!


Edit: prior to getting this resolved I used a compression sleeve on my left calf and it worked wonders. It was one of the newer sports sleeves and pretty tight...30mm Hg.

[q-tip]

Pins, needles and tightness can be circulatory or neurological, a doctor will get you a diagnosis. I have had 2 knee surgeries and had a slightly torn miniscus during my hike but it was ok. I do use patellar knee braces...

[Shonryu]

I am by no means a Dr. But would recommemd that you talk to your about some of the options I've listed below.

Lighten your base weight as much as possible while still allowing yourself to be comfortable for your thru hike if your not going UL you may want to take that into consideration.

Check with your Dr. and see if they may recommend a specific type of knee brace to help eliminate your pain. A knee brace does wonders for me. I personally use a muller patellar knee strap. I also use a good pair of trail runners since my pack weight is light and monorail enduro inserts. The inserts are amazing. Also if you havent considered treking poles I would also suggest looking into getting a pair. That and vitamin I will be your friend.

[pipsissewa]

Sorry for your pain, JeffBliss! Here are FOUR different causes of tightness behind the knee that you may want to discuss with your doc.

Click HERE

"Livestrong" (Lance Armstrong's foundation) has an article about it too. Click HERE

Best of luck to you!

[jbwood5]

The good thing is that you show your age as 28 which means you have a very good chance of overcoming this soon. The bad thing is most people your age tend to "go at it" without gradually building up (ask me how I know this ).

Since you are going to a doctor soon, you should be getting the right information to follow (hopefully). Personally, I would see a sports massage therapist because, in my experience, they do pretty good at loosening up those areas in calf and behind the knee, assuming there is no serious injury or biomechanical anomaly. As a side note, you might try different shoes or try heel lifts. Run it by your Dr to see what they say.

I think I can safely say that you will need to start your hike with very low daily mileage and try to build up gradually. Don't try to keep up with the enthusiastic hikers that are going to want to fly up the trail the first few days. The general consensious is that you don't want to keep taking anti-inflamatories (ibuprofin or other meds) for the purpose of pushing on through the dull pain that is masked by the meds. The end result could be a serious injury that will take months or years to cure.