Setbacks...overuse knee injury

[KathyD]

Wednesday I hurt my knee, I think doing jump lunges. I didn't really notice until Thursday when I woke up with a stiff knee. By Thursday evening, my knee was pretty swollen. From what I can tell, recovery from an overuse injury takes 4-6 weeks. I'm stressing. For the next 4-6 weeks I can't train. I can't hike with my pack on. I can't jump rope. I can't do lunges or squats.

Would love to hear from others who have attempted a thru-hike following an injury?

[Kaptain Kangaroo]

If you want to recover as fast as possible, go and get professional medical advice on both a treatment & recovery plan, and a training program that will address the underlying cause of this injury & give you the strength & joint stability you need to avoid future problems.

There is plenty of time to recover, but the internet is not the best way to manage an injury.

Good luck ! (for your recovery & your hike)

[MuddyWaters]

I used to be big believer in plyometrics.
But, tendonitis seems to be a frequent problem.

The muscles may take it, but unnacustomed tendons cant always.

[egilbe]

How active were you prior to training for a through hike? Jump lunges are a pretty advanced exercise. Sounds like somthing a crossfit gym would want you to do.

[12trysomething]

I would also recommend seeing a DR. Having injured my knee on a hike on July, re injuring in in August and then not able to hike/workout until December....go see a DR.

Best wishes.

[Pedaling Fool]

Wednesday I hurt my knee, I think doing jump lunges. I didn't really notice until Thursday when I woke up with a stiff knee. By Thursday evening, my knee was pretty swollen. From what I can tell, recovery from an overuse injury takes 4-6 weeks. I'm stressing. For the next 4-6 weeks I can't train. I can't hike with my pack on. I can't jump rope. I can't do lunges or squats.

Would love to hear from others who have attempted a thru-hike following an injury?

What is your history with strength training, i.e. how much have you done?

Sounds like you tried to do too much too soon -- We all do it, so don't freak out... Plyometrics is really something you need to slowly work into, regular lunges are just fine and then add weight, followed by plyometrics...

Be patient and slowly build into these power movements -- be very conservative with upping your performance. You're going to be hiking the PCT, no hurry to become super fit for that, think of working out NOT for the trail, but for a healthy lifestyle, think marathon, not sprint, so slow it down, you got time.

You really don't even need to worry about stuff like plyometrics for the PCT.... Look at your workouts not as a way to improve your performance, rather as a way to prevent injuries, that's the real benefit of these exercises, to guard against those falls in life that would injure most folks. Again, think long-term health, not preparing for the trail, you're not a professional athlete, so there's no hurry in getting super fit, which almost always leads to injury.

If I could only start over again at 29 with what I know now


BTW, where exactly does it hurt, in the front of the knee, i.e. the patellar tendon or elsewhere?

[4eyedbuzzard]

Overuse equals sore. Swollen equals tissue damage - of some kind and to some degree.
Continuing to train through an injury could make things worse, not better.
See a doctor if you can to rule out any serious injury that rest and time alone won't heal.
Otherwise, just R(est), I(ce), C(ompression) and E(levation). And an anti-inflammatory like Ibuprofen or Aleve - ask you doctor or pharmacist, the dosage and duration that you take NSAIDS for an injury is much higher and longer than what is recommended on the bottle.
You will still be able to hike even if you live on the couch right up until your hike. It's just walkin'.

[Pajj]

I would just recover if I were you, training while helpful isn't my any means necessary for a thru hike. Just start slow and train on trail. You've still got two months or more till the season begins, get that leg rested up!

[Coffee]

Seeing a doctor can make sense but see a sports medicine specialist who "gets it" and won't come up with a default recuperation that is designed more for sedentary older people than for active people and who will not think that walking for months at a time is insane. I once had a doctor who told me that my goal of running a marathon was an "extreme sport". Yeah right, an extreme sport enjoyed by tens of thousands in a given race. I've since run six marathons after being counseled to limit my cardio activities to 30 minutes a pop.

[lonehiker]

Most of you didn't read the OP's post. She specifically stated she couldn't work-out for the next 4-6 weeks. What I would suggest is to continue to go to the gym but work on upper body strength. You don't necessarily need to work on the upper body, it can' hurt though, but, it will keep you in the habit of working out. Once able, start slow and build gradually.

[MuddyWaters]

From what I can tell, recovery from an overuse injury takes 4-6 weeks.

Sometimes
Sometimes a lot longer for full recovery where you have no discomfort and feel 100%.


Ive nursed minor injuries from weight training for 3-4 months.
Eventually, one day, you realize it doesnt bother you anymore.

I dont think theres much better to condition the muscles and tendons of knee and lower leg to avoid overuse injuries by hiking, than plain running.

[Puddlefish]

I'm about two weeks into my 4-6 week recovery period for my foot injury. The first week I put on a few pounds instead of taking the needed pounds off. The second week, I fixated on my diet. This week, I'm working on my core and upper body, just trying to keep up a bit of the cardio. The worst part is that instead of training hikes, I'm spending far too many hours a day on this website.

I still have time to slowly start training again before my hike. The worst thing that will happen is that I might walk less miles per day to start. Won't effect my enjoyment of the hike at all, as long as I don't re-injure it.

[greensleep]

After a serious knee injury 5 years ago, requiring extensive surgery, I used swimming as part of my recuperation and am convinced that I healed and became mobile faster than if I had just walked and ran to rebuild muscle. YMCAs and some health clubs have indoor pools for winter use as do the wealthy.

[Malto]

I did a 57 mile day hike less than two months before my start date. My ankle came up gimpy. Took a couple of weeks off, did a low 30s day in GSMNP and a cortisone shot and a few weeks later hit the PCT.. You can see the blow by blow here.

http://www.postholer.com/journal/Pac...g-Hike-8/20576

Take it easy, eat good food and change a routine a bit to give your knee a break. This is good opportunity to listen to your body. This will be helpful because in all likelihood you will experience something similiar on the trail. I could hardly hobble my way into hikertown yet was back to normal a day later. Good luck on your recovery.

[burger]

1) As mentioned above, see a PT as soon as possible. You can try to go to a sports medicine doctor, too, but it's probably going to take you weeks to get in, and they may not be able to give you a good diagnosis without an MRI. A PT might be even better for diagnosing what's wrong, and since the "cure" for a lot of different knee ailments is the same, you'll be getting started on the recovery sooner than if you wait to see a doctor.

2) This is important: when your knee starts to get better, DON'T DO ANY MORE STRENGTH TRAINING! Too late now, but strength training is of minimal use when training for a thru. All you need to do is walk a lot. For future hikes, by three months before your thru starts, the only exercise you should be doing is walking. Too much risk of injury with other exercises. All the lunges in the world are not going to help if you are not regularly putting in 10-20 mile days with a full pack in the months before you start your thru.

3) If you can't get in to see a PT soon, give it a few days for the swelling to go down. Once you can walk without pain, resume walking, even without a pack. Even just walking on flat ground can be helpful. Start off at a shorter distance that you can manage without any pain, and gradually increase your distance. If you have pain or swelling, cut back on the exercise.

4) This is painful, but accept that you might have to cancel your thru hike. Or maybe switch to a SOBO. Personally, I would rather start a thru 100% healthy than head to the trail with a high probability of not finishing (+ doing more damage to my joints + wasting all the money and rearranging my life for a hike that's over in 3 weeks).

FWIW, I strained my patellar tendon (the tendon below the patella) badly about 2 months before my PCT thru started. I went to the doctor, who was totally useless. I spent about 2 weeks on total rest and then spent the next couple of weeks doing flat walking up to 10+ miles. After that, I was able to hike again, first without a full pack, then with. I completed the thru with no knee pain or any other injuries.

Good luck.

[bemental]

I'm a big fan of physical therapy. If you see a specialist and this is their suggestion, I'd go for it.

But, considering this sounds like an overuse injury, they'll probably just tell you to RICE it (Rest, Ice, Compression, and Elevation - also, an anti-inflammatory drug might be helpful).

[Water Rat]

First, receiving a medical diagnosis and plan of action via the internet... Not necessarily a good idea. Yes, you want to hear this can be overcome and you can hike - Who wouldn't want to hear those things? However, having it seen by a sports medicine doctor (preferably) and then physical therapy could potentially save your hike, save yourself from impacting future hikes.

Second, women's knees are not designed like men's knees. The anatomy and the biomechanics of our legs is just a recipe for disaster. In addition, we have weaker muscles to hold our knees in alignment... *sigh* What all this amounts to is that our knees are easier to injury and easier to re-injure. You need to make sure you are completely healed or you (as a woman) run a higher risk of re-injuring your knee. This is said by someone who has had 5 knee surgeries.

Do yourself a favor and rest your knee while waiting to see a doctor. Physical therapy will likely be prescribed and that is a good thing. A good physical therapist can help you get back on track (faster) with your training, as long as you heed their advice. Speak with them about pool therapy - That is actually one of the best non-impact things you can do for your body. It allows you to use different muscle groups, work on your cardio, and not stress your joints.

While this might not be what you want to hear, it might be the best course of action toward getting your knee healthy and keeping it healthy for years to come. You are young. Reoccurring knee injuries suck.

Good luck!

[KathyD]

First, thanks everyone for your thoughtful and kind responses.

No, I don't expect to consult a hiking forum for medical advice, but it's nice to hear from you all. I don't currently have medical insurance, but my brother-in-law is a doctor. He evaluated my knee and determined it was an over use injury. I wouldn't say I'm in pain, but my mobility is limited and knee is swollen. If I had to pinpoint the "pain," I'd say the inside of my knee is most aggravated.

In response to the questions regarding my training history, I've been training pretty regularly for 2+ years, doing interval and strength training. I've been doing lunges for a long time, but I'd always avoided jump lunges out of fear of knee injury. Why did I decide to start doing jump lunges now?!?!?! I wanted to push myself in preparation for the PCT. Wish I had a time machine.

I know I don't need to train for the PCT, but I was hoping to hit the trail in good enough condition to hike 15-20 miles a day. But apparently the universe has other plans for me. Perhaps the training I need is what I'm dealing with now, mental and emotional fortitude in the face of adversity. I'll be RICE-ing, taking it easy and doing yoga/PT to stabilize/strengthen my knee.

Thanks again:-)

[Pedaling Fool]

First, thanks everyone for your thoughtful and kind responses.

No, I don't expect to consult a hiking forum for medical advice, but it's nice to hear from you all. I don't currently have medical insurance, but my brother-in-law is a doctor. He evaluated my knee and determined it was an over use injury. I wouldn't say I'm in pain, but my mobility is limited and knee is swollen. If I had to pinpoint the "pain," I'd say the inside of my knee is most aggravated.

In response to the questions regarding my training history, I've been training pretty regularly for 2+ years, doing interval and strength training. I've been doing lunges for a long time, but I'd always avoided jump lunges out of fear of knee injury. Why did I decide to start doing jump lunges now?!?!?! I wanted to push myself in preparation for the PCT. Wish I had a time machine.

I know I don't need to train for the PCT, but I was hoping to hit the trail in good enough condition to hike 15-20 miles a day. But apparently the universe has other plans for me. Perhaps the training I need is what I'm dealing with now, mental and emotional fortitude in the face of adversity. I'll be RICE-ing, taking it easy and doing yoga/PT to stabilize/strengthen my knee.

Thanks again:-)

Two years really isn't all that long when it comes to developing the musculoskeletal system, because there is so much involved with this system, far more complex than simple cardio conditioning. On top of that there are so many factors, such as how targeted your regimen is, what was your lifestyle before starting, issues of your genetics... And the list goes on....

Some people build up fast others not so much; I'm one of them slow pokes, I don't have the athlete gene, I know that for sure.

Just keep plugging at it and don't be in such a hurry, make sure you can see real improvements in your performance overtime. And do NOT look so much at your best performance and judge your conditioning off that, because we all have good days -- but those good days are anomalies. Rather look at your improvements on your bad days, i.e. what's your new normal (Rhetorical...).

Don't worry about the PCT, I'm sure you're much better off than most, besides like Lone Wolf says, it's just walking.

Weight training (for us non-professionals) should mostly be about helping us when things don't go as planned, like being hurled off my bike at 20mph, hitting the pavement headon and just jumping up as if nothing happened. That's why I lift.

Interesting article on that: http://www.mensjournal.com/magazine/...a-lie-20120504

Excerpt:

Muscle withers away if you're not constantly building it, and muscle withers faster as a man ages. Fading muscle mass gives way to fat gain, stiff joints, stumbling-old-man balance, and a serious drop-off in weekend fun, not to mention self-esteem. But if you fight back right, it can all go the other way. And this means getting strong. The bottom line is that not only can lifting weights do as much for your heart health as cardio workouts, but it also provides you with a lean-muscle coat of armor against life's inevitable blows – the way it did for my own father, who broke his back in a climbing accident at age 69, spent months in bed, and recovered strong only because he'd been lifting for 35 years.

Read more: http://www.mensjournal.com/magazine/...#ixzz3yvHyTK6L
Follow us: @mensjournal on Twitter | MensJournal on Facebook

[OCDave]

I'd be skeptical of the 4-6 week "No training" advice for a 29 yo athletic individual. If the nature of your injury is simply over use, pull back on the high impact and lower the intensity of your training. I suspect the 4-6 week window you are referencing is for shin splints when there are actual stress fractures that need mending.

Disclaimer: I am not a physician. I am an experience athlete with a fair medical professional background.