Knee pain (severe) downhill

[Dogwood]

I've also previously posted about reducing the height to which you step down on descents. This should be recognized whether there is trail construction like steps or otherwise. MANY know this which is why you'll commonly observe a trail along side steps where folks choose to walk down more gradually on this path rather than take the steps. It's also commonly observed folks attempting to reduce a larger riser(step height) that could be taken in one deeper step with two or more lesser height steps. That is, instead of taking one deeper step breaking the step up into two or more shorter height steps. It's physics. It allows for less force on the knees and legs doing these things. Same as shortening the gait on descents or reducing the hard plodding downward on descents. Backpacking is an endurance event. It also can be an energy saver. It's why high impact aerobics are not the rage as it once was. Reduce the impact to your body on the down hills while also heeding wiser energy expenditure. This is exampled by stretching your gait out and picking up the pace on the flats. You don't always have to go balls to the walls. Vary your technique depending on the conditions and your personal situation. Do your hike not someone else's. This plays into why experienced LD hikers usually have fewer energy and impact related issues. Watch someone in this category! They floooow. Check out some online vids of some one like Andrew Skurka or maybe a TCer. they He have such a low impact and wise energy expenditure to their movements. You don't see Andrew fighting his momentum much either with herky jerky extremely high impact energy wasteful movements. I love being in the flow like that - one with my movements and the terrain changing as the terrain changes but staying in the flow and not sacrificing energy for little return. Zoom Zoom Zoom Actually you don't need to go fast. It's about being in the flow, loose but mindfully aware. Practice this until you don't have to think about it anymore. It's more than just walking as if we all know how to be efficient walkers or backpackers and walking is all we do. This is more than just knees too.

[MuddyWaters]

No idea if there are underlying issues, see dr.

But many find downhill harder, because its hard on knees

As alluded to above

The best advice is slow down on downhills to minimize impact, and hike low impact style, whatever accomplishes that.

What you can tolerate for 1 day, might cripple you if do 2,3, or 10 or more straight

Ive had ITB and broken leg before, both from going too fast downhill. I finally learnt to go downhill in slow motion, using poles to slow the downhill step.

No problems in years and thousand miles since.

[Dogwood]

How much wt is on your feet alone, and of course you're hauling, plays into the risks for knee problems as well. The type of shoe you're wearing for the specific terrain can play a role too.

[JeffreyH]

Consider buying hiking poles. You can get ultralight ones if worried about their weight.

[MuddyWaters]

I recently went out and hiked ~300 miles
On the first few days I was startled by knee discomfort and minor pain on downhill on one of my knees. Not good.
So I babied it. went pretty slow. Made for longer days to get in 20 miles, since my downhill speed avg was significantly reduced.

After about 4-5 days, it cleared itself up, never reappeared
But I still take it pretty easy on my knees when can.

[greensleep]

Homemade recipes: Try drinking a few teaspoons of nutmeg with a glass of milk. It sorted out the arthritis in my hand in less than an hour. Japanese karate dudes with all the black belts drink gelatin to improve flexibility.

back in my college days, we used a few teaspoons of nutmeg as an affordable and legal hallucinogen. Didn't always work.

[rocketsocks]

Homemade recipes: Try drinking a few teaspoons of nutmeg with a glass of milk. It sorted out the arthritis in my hand in less than an hour. Japanese karate dudes with all the black belts drink gelatin to improve flexibility.

Drinking large doses of nutmeg is toxic.

[yaduck9]

I'm an occasional section hiker (in other words, I do 20mi hikes 1-2x/year and train minimally in between).

Last month we did 20 miles in GA with some significant downhill (wearing 40lb packs), and I could tell we pushed ourselves a little too hard (again, minimal training beforehand).
By the end, my knee felt like I was smacking bone against bone and was in just the most severe pain. Walking was difficult for a few days.

By the end of the week, I felt minimal or no pain, but across the next month some movements brought back pain periodically.

1 month later we hit the trail again. I cruised up the hills no problem, but as soon as we did even a slight downhill, the stabbing pain returned. It only got worse as we hiked.

The pain seems to be deep in my knee (i.e., behind the knee cap) and possibly also slightly to the side (i.e., lateral).

Has anyone else suffered this kind of injury or anything similar?
What was the diagnosis? (I'm trying to figure out what this is).

• My initial thoughts were maybe either tendonitis or IT band syndrome

Any treatment suggestions?

Due to lousy insurance and employment, I can't see a doctor about this for another 3 months.

Your story reminds me of an old ( and terribly corny ) western joke;

The doctor was quietly reading the newspaper when a young inexperienced cowboy bursts into his office and exclaims: Doc, Doc I broke my arm, twice now, in the same place!!
The grizzled old Doc rubed his chin for a moment and yells at the young cowboy; Weellll, Stop Go'in In Dem Der Place's!!

The first thing you need to do is stop hiking.
The second thing is to see a doctor
After your better, start getting into better shape. You will live a fuller more enjoyable life.
As an old fart, I can tell you that it is better to get in shape and then stay in shape then it is to rely on your ability to get by.But, hey, its free advice so feel free to take whatever path you feel is appropriate.

[AllDownhillFromHere]

...As an old fart, I can tell you that it is better to get in shape and then stay in shape then it is to rely on your ability to get by.But, hey, its free advice so feel free to take whatever path you feel is appropriate.

Why be crappy about it?

[Traveler]

Originally Posted by yaduck9
...As an old fart, I can tell you that it is better to get in shape and then stay in shape then it is to rely on your ability to get by.But, hey, its free advice so feel free to take whatever path you feel is appropriate.

Why be crappy about it?

Not sure that was "crappy" as much as pretty direct, it even had a disclaimer of "take it or leave it". The OP stated they did some long mile hikes once or twice a year with minimal exercise in between. Since not many here are doctors and cannot directly diagnose the OPs problem, Yaduck9 simply offered some pithy post MD visit advice, "get in shape and stay in shape" as a means to prevent injuries that can develop trying to do too much with too little preparation. It may not be what one wants to hear, and it may not have flowers and unicorns all around it, but it does not lessen the wisdom of it.

Perhaps you have something you can offer the OP in response to their posted concern?

[Dogwood]

Hey, we can do all the training work outs we want to get a strong fit body but with bad technique and form, inconsiderately slamming fast down steep descents, slipping on gravel/rocks/roots/trail construction, plodding heavily with heavy load increasing impact, wearing heavy European style leather mountaineering boots when they aren't required, having too wide a gait, etc knees aren't going to be protected. Training our bodies should include training in good form with good techniques and consideration to reduce impact. Lifelong hard court tennis player 4 yrs in HS and another 4 at the University level and several more at the semi pro level. 8 yrs playing basketball. Runner, LD hiker. High Impact aerobics. Physical fitness is not enough to prevent injury. Diet also plays a big role in joint and overall health. Supplements can also offer assistance.

[yaduck9]

Why be crappy about it?

Well in my defense;

I would point out that you parsed my post down to two sentences.

If you would look at the totality, I think you will find that all in all it was rather well balanced.
It had a bit of humor. Some immediate direct advice for the present. Some advice for the future. A lament of some of my past failings. Finally, a repose that, would inform the OP, that it is really up to him.

Which, reminds me of an old joke

https://www.youtube.com/watch?v=DyOdbkXEx9k

[yaduck9]

Well in my defense;

I would point out that you parsed my post down to two sentences.

If you would look at the totality, I think you will find that all in all it was rather well balanced.
It had a bit of humor. Some immediate direct advice for the present. Some advice for the future. A lament of some of my past failings. Finally, a repose that, would inform the OP, that it is really up to him.

Which, reminds me of an old joke

https://www.youtube.com/watch?v=DyOdbkXEx9k

Dear Moderators; I may have posted something that violates the rules. I can only say that it was an oversight on my part. My apologies to all who may be offended and I trust you will do whatever needs to be done.