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  1. #1
    Registered User AfghanVet's Avatar
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    Default Another knee question

    Hello,

    I know this is a topic that's probably been dragged out, shot and then revived and beaten to death again. However, I feel like mine is a little different scenario than most. So, allow me to set up the story if you will:

    While I've never been an official "hiker," I spent the entirety of my adult life (from the age of 17 up until 29) in the military and was no stranger to the military's love affair with ruck marches. All of that running and rucking surely didn't do me any favors. That being said, in May of 2010, I was in an IED strike which caused damage to my left shoulder, left ankle, left knee, lower back and c-spine. Now, fast forward to the current time and I've been sedentary for the better part of 2 years now and I'm gazing all starry-eyed at the AT and a possible thru-hike but I'm not entirely stupid and know there's some train-up involved. So yesterday on my day off, I took my little brother and we decided to see how close we could get to Springer. We started at the visitor's center which proves that, while not entirely stupid, I am at least a little dim-witted because they charted us on a course right for all of those dadgummed steps.

    Now, my point is, we made it roughly what I think was 7.5-8 miles back up the approach trail and back down and near the end (coming of the creek trail) my knee starting killing me and it has carried over to today. It's mostly on the lower left side of the knee (right if you are looking at it head on.) There is some slight swelling in the area as well.

    My real question is, I didn't have the proper gear (just some Under Armour tennis shoes/trainers) and I did all those cursed steps, so do you think that's a contributing factor to the knee pain and should I just go ahead and put to rest my hopes of the trail if this is part of trail growing pains? Or is this typical and with perseverance and patience, can be overcome?

    Thanks in advance for any advice to my poor, noobie self,
    Richard

  2. #2

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    Before you give up on your knee, try using two trekking poles and a slower pace when going downhill. It's the downhills that are hell on knees. Other ideas would include a light pack and losing xs body fat (if any).
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  3. #3
    Registered User AfghanVet's Avatar
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    I figure poles were going to figure in heavily on my needs and I'll have to reevaluate that part before I go out and be stupid again. While I personally feel like I have excess body fat, I'm about 175 pounds and 5'9" so it's not as if I'm terribly out of shape. The light pack I had but I appreciate the input. I'm thinking a brace or chopat strap might not be an entirely terribly idea either. I was told that my knee cap doesn't track properly anymore because of the fat pad below my knee cap before I got out of the Army. I greatly appreciate you taking the time to reply.

  4. #4
    Registered User AfghanVet's Avatar
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    How ill advised is a single pole setup? I work in a pawn shop currently and we have a Yukon Charlie's in here now. But it's just one.

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    Google IT Band Syndrome. I have the exact same symptoms as you, which is, it hurts going downhill. One thing I am not sure of with you is, did the pain go away when you stopped hiking down? If not, it may be something more than IT Band. My pain typically only happens going down, never uphill, and never on flat ground. Foam roller, exercising and naproxen are slowly helping me get over it.

  6. #6
    Registered User AfghanVet's Avatar
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    Well, the knee pain is continuing into today. It's not to the point that I can't bear it, I'm at work today and I do a lot of traversing the store and such. It's uncomfortable though and by the end of the hike yesterday it was approaching unbearable on the downhills but let up considerably on the flats. Didn't really go uphill once the pain began. I was a little surprised that my back and ankle held up but my knee was the first to start problems.

  7. #7
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    You really took on a tough hike for your first day after 2 years being sedentary, the Approach Trail and back to AFSP visitor center in one day is quite a bit for a first day, even if you were just hiking with a daypack. From your background and what you said of your symptoms, my guess is you have some ITBS on that problematic knee, especially if the pain began on the downhill part of the trip coming back down to the visitor center. ITBS will usually only bother you on the downhills, I had it so bad on one hike years ago that my knee locked up and I had little range of motion. The immediate remedy is "RICE", rest, ice, compression and elevation. You can also take some NSAID's of your choice (e.g. Advil or Alleve). The long term solution is learn and faithfully repeat stretching and strengthening exercises for ITBS. I suffered through it back in 2009 on a hike from Woody Gap to Neels Gap, had to limp all the way down from Blood Mtn to Neels Gap. Spent 3 weeks in physical therapy getting over it. If there are other symptoms, and you feel inclined, you could visit an orthopedist and see if there is are any issues with the meniscus or ligaments, but my guess is that it's ITBS, which can be fixed usually with Phys therapy. Also agree, get some good hiking poles. Black Diamond or Leki both make great poles for hikers. I also wear a Cho-Pat dual action knee brace on all my hikes on the problematic knee. Good luck buddy, just hang tough and you'll be on the AT in no time. I may see you on the AT next spring, I'm tentatively thinking of doing a nobo thru hike in 2015.

  8. #8
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    I was in a hike this past weekend on the BMT in Georgia. I experienced the same symptoms. It seems to be the IT Band as someone else suggested. There are several stretches designed to help strengthen this area. During the hike the pain was nearly unbearable. I tightly tied my bandanna just below the knee. This helped some but not as muck as I hoped.
    RIAP

  9. #9
    Registered User AfghanVet's Avatar
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    I really appreciate all of the feedback and responses. Today just stretching and flexing my knee, I'm getting some popping and what sounds to be grinding noises, it's a little weird. I was prescribed a Chopat strap that just sat below my kneecap and held it in place while in the Army but I found that it was prone to sliding down my leg. Looks like some reviews of IT Band videos on YouTube and see if I can stretch out some and alleviate some of it. Again, I can't express how thankful I am for having found this community and the folks around here that are patient with suckers like me.

  10. #10
    LT '79; AT '73-'14 in sections; Donating Member Kerosene's Avatar
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    The popping and grinding isn't good, especially if it occurs with the Cho-pat on. You might have torn your meniscus, which would explain the swelling and continued pain. Meniscus tears are fairly common, but they need rest to heal assuming it isn't too bad a tear. If in doubt, find a good sports doc.
    GA←↕→ME: 1973 to 2014

  11. #11

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    Quote Originally Posted by AfghanVet View Post
    How ill advised is a single pole setup? I work in a pawn shop currently and we have a Yukon Charlie's in here now. But it's just one.
    A single pole is better than none, but it really takes two poles to take weight off your knees. Costco has some good carbon fiber poles at an inexpensive price. I didn't really need another pair, but couldn't pass them up because they seemed so cheap. I tried them out last week and they compare favorably to my other poles that cost 4 times as much.
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    Ive had crippling knee pain.
    Ive never had swelling.
    Swelling, is not good in my book. Its a sign of damage.

    Simple tendonitis, doesnt result in swelling.
    Id have it looked at if possible.

  13. #13

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    IT band issues require RICE as described above to get better. Once better, STRETCH, STRETCH, STRETCH (search the internet). The IT band does not "want" to stretch and you have work on it. A common aid is a 6" foam tube that you can roll on (got mine at Target). There are also some hand rollers but they are hard to do yourself.

    Correct shoes/insoles can also help. I found that dropping my custom made insoles (to fix another issue) really helped my IT problems.

    Start with smaller hikes. I think you just bit off more than you can chew on the first attempt.

  14. #14
    Registered User AfghanVet's Avatar
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    So I'm a little more salty now, having done a few more hikes and way more miles. What I'm noticing is still probably related to an IT band issue on my left knee starting at the left side of my knee cap in the space immediately below my knee cap. Now, my right knee has developed a more concerning issues (in my mind at least.) Ever since two Sundays ago, the muscle or tendon behind my right knee has been hurting, probably at a 4-5 in pain level. I don't know what is causing it or anything but I do find myself wondering, at the end of a really long hike in my mind (13-16 miles or so) at least Amicalola to Springer I find myself wondering, if I were putting my head down in a tent tonight and had to do it again tomorrow, how the heck would I do it with my knees this way?

    So, I guess I'm wondering is knee pain something that, generally eases off or goes away the more you hike or is there potential for something really wrong?

  15. #15
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    I don't imagine knee pain that is being caused by inflammation will ease off by itself the more you hike; I would think it's the hiking that is causing the inflammation. I would guess that it would be better to get the inflammation under control first, then work on stretching and strengthening the muscles around the joint. The stronger the muscles are, the less potential impact and strain on the joint.

    But I'm not a doctor and I don't play one on the internet.
    fortis fortuna adjuvat

  16. #16
    Registered User AfghanVet's Avatar
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    But did you stay at a Holiday Inn Express last night? Lol it all makes sense though there's no swelling which is not always an indicator of inflammation. Maybe I just need to choke down a couple Motrin before hiking and eat me some bananas.

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    If you have any history of arthritis in your knee(s), you may have aggravated it...which, again, will need some rest and "de-flammation" before it's going to feel better. I had to learn that one myself the hard (and painful) way.

    I hope you can heal up well and soon!
    fortis fortuna adjuvat

  18. #18
    Registered User AfghanVet's Avatar
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    Well, small update, I have been doing more hiking with varying mileage. So far my trio's have been Amicalola to Springer and back with a day pack, BMT from Springer parking lot to Long Creek Falls and back via the AT with a day pack. A short walk to a place called the Indian Seats with a light full use pack. Finally, I did Springer summit to Long Creek Falls via the BMT and then somewhere close to Hawk Mountain shelter, then back to join the BMT until the first AT crossing and back to the parking lot at Springer. There has been some fierce debating over my pack weight between me and some guys at work. I think it has to be 50-60 pounds which would be a good thing because I can lighten it. The guy at work who ships our stuff thinks it's 40-45 which would be terrible because I don't know how I'd do it. Either way, official weight is forthcoming.


    That's neither really here nor there, the fact is, I'm still getting knee problems. This time I stepped down from a Rock and my knee buckled inward. The positive is, I have a referral to see ortho at the VA where they will do MRIs and see what's what. I was really hoping by hiking regularly that it would work itself away over time. It gets to the point that it gets very difficult to walk. I seriously though, it's a good thing I don't have a spot button or I'd waste someone's time lol.

  19. #19
    Registered User mcgrabo's Avatar
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    Thank you for your service. Seeing an orthopedist is the way to go. I am not a hiker. I take a 2 hour walk on the A.T. 5/6 days a week. The down hill parts are the hardest for me. My heels and back of my ankles really feel it the most. I have 2 artificial knees and 1 artificial hip. These are a result of bull work my entire life and getting old, no big deal. I wish you well on your journey and thank you again. Mike G.

  20. #20
    Registered User Just Bill's Avatar
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    AfganVet-
    You made the doc appointment- that's step one for sure.
    Packweight- Isn't there still a scale at the Amicalola Visitor's center, just to the left of the front door?

    Why are you carrying a full pack? Learn to pitch the tarp I sent you for emergencies and bring it along just in case- but stick to a daypack until you have things sorted out physically. This time of year you can go with pretty minimal gear.

    Are you wearing a brace, sleeve, ace bandage, anything? Support those knees. Cut some trekking poles for yourself too. Although many folks use them for no reason and I dislike them personally, for those that need them (you) they will help. You can wrap a little duct tape around a stick and cap it with Moleskin to make a serviceable set. Cloth athletic tape works well too and is cheap. A ten foot stick of electrical conduit is $3 at the Depot- cut it in half and you're in business.

    Tennis shoes- Did the one's I sent fit? If so, wear them. Boots immobilize the ankle, which is good for the ankle, but horrible for your knees. Something has to give. If you're ankles and feet aren't working to take up some of the force then it all ends up at your knees. A hundred miles or so in tennis shoes on easy stuff is likely enough for someone your age to build up the basic ankle and foot strength needed to wear low tops on the trail.

    Finally- why the hell are you tromping up the approach trail and coming sideslope up all the BMT loops? No sense punishing yourself seeking out the hardest sections of trail when you are still building your fitness. It will take time to develop all the support muscles you will need on the trail that you don't use in town. Drive up to the Springer forest service road and skip the approach. Stay on the easier springer shelter to Neel Gap section. Get up on the ridge and stay there! Seek out the other easy sections in your area and keep up the dayhiking. Not that it's the White's, but crisscrossing the ridge or tromping up and down 500 steps isn't exactly beginner terrain.

    Many of your knee problems may be taking on too much too fast.

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