Knee pain / downhill technique

General discussions on hiking in Oregon and the Pacific Northwest
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Knee pain / downhill technique

Post by phoenician » August 1st, 2011, 4:15 pm

Question for those that do the bigger hikes regularly... is there a particular technique for preserving your knees when descending?

I've never had a single bit of knee pain on hikes like Dog, Nesmith, and even Defiance. Coming down Larch Mtn a several weeks ago, though, I started feeling a twinge on the upper part of the outside of my right knee. By the end of the hike it was less of a twinge and more of a pain. I didn't think much of it and figured I had just tweaked it hopping around in the snow. A week later on Nesmith, though, I felt the same thing almost immediately after starting my descent (never a problem going up). Since then I've only done small hikes, but I can tell that it's still there. It's much better if I turn my body a bit to the right so that when I'm coming off of my right leg I'm making more of an angled sideways step than a forward step. Previously, I had pretty much just charged downhill as if I was coming down stairs.

All that to say this: is side-stepping a preferable technique in the first place? Or should I be locking my knees more and letting my toes take the impact? Or should I be seeing a doctor?

...or do all of you use hiking poles, and I'm the only idiot who doesn't? :)

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Re: Knee pain / downhill technique

Post by Crusak » August 1st, 2011, 4:39 pm

I have tried a few methods to avoid knee pain. Poles do help in many situations, giving you additional points of contact with the ground and reducing fatigue.

I have found that when going downhill on good terrain (when the trail isn't slippery) if I take shorter, quicker steps it helps. I've also noticed that if I alter my steps by putting my toes down first, then heels, it reduces the jarring on my knees.

Best thing has been working my quads and hamstrings like crazy and hiking at least once a week. I hiked 27 total miles over the past two weekends and had no soreness the day after.
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retired jerry
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Re: Knee pain / downhill technique

Post by retired jerry » August 1st, 2011, 5:03 pm

Trekking poles to put some of the weight on your arms?

Weight lifting to make your legs stronger?

Combination of hiking and resting long enough to recover?

I did maybe 12 miles and 5000 feet elevation loss one day and my knees were really sore, aborted my trip a little. Then rested a couple weeks. Then did about the same and didn't feel any pain.

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Re: Knee pain / downhill technique

Post by geographics » August 1st, 2011, 5:20 pm

Last edited by geographics on February 23rd, 2012, 10:03 pm, edited 1 time in total.

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Re: Knee pain / downhill technique

Post by mayhem » August 1st, 2011, 5:59 pm

...or do all of you use hiking poles, and I'm the only idiot who doesn't? :)[/quote] probably this :). I cannot hike without my poles 2 bad knees not just bad but really bad, not TomRoy bad but bad! There is no way I can even begin to think about turning sideways going down. I use my poles at every step and my steps are straight and short. I use gravity & my poles to control most of my speed..much easier on my knees. Your issues sounds like either an inflammation of the Bursa sack ( not sure of spelling, or LCL) hmmm but still poles can help!
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Re: Knee pain / downhill technique

Post by Grannyhiker » August 1st, 2011, 6:08 pm

I just got back from what should have been an easy hike, to Dorothy Lake in the Alpine Lakes Wilderness, about 8 miles south of Skykomish. Unfortunately, the Forest Service rather overbuilt the 2-mile trail. It consists of log steps, many of which are quite high (at least twice the height of the steps on an indoor staircase). Coming down this trail completely did in my knees, even with trekking poles and a brace on the bum knee. This is definitely not a trail for short-legged folks with bad knees! We came down Friday afternoon and today the swelling on my bum knee has finally started to go down. Obviously it will be a few more days before I can do more than walk on the level.
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Re: Knee pain / downhill technique

Post by texasbb » August 1st, 2011, 6:41 pm

Your symptoms sound an awful lot like IT Band friction syndrome. The IT Band is a long tendon (mostly a tendon--it's got a small muscle in it too I believe) that runs from the outer hip, along the outside of the thigh, and attaches both above and below the knee. It rubs over the knob of the femur on every step. If yours is tight, that rubbing can irritate and inflame the tendon, causing pain on the upper outside part of the knee. There may also be some tenderness on the upper outside of the lower leg, where the IT band attaches to the tibia.

I know this from experience. When mine's flaring up I can lessen the pain on downhills by "leading" with the hurt leg. That keeps it from bending as much, which minimizes the friction of the tendon rubbing by the knee. It also helps to walk a little stiff-legged with the hurt leg, which means it feels better when the bad leg is on the downhill side.

The cure is the one nobody wants to hear--RICE. Rest (stay off it for a while, probably a longer while than you want), Ice, Compression, Elevation. For the long term, stretching it is supposed to help, but the location of the thing makes it very hard to effectively stretch.

Google it and see if this sounds like what you're dealing with.

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Re: Knee pain / downhill technique

Post by Charley » August 1st, 2011, 7:08 pm

I use poles. I also step toe first, and bend the knee only slightly. It's not locked (too much pounding), and not way bent (too much leverage). I find that this has helped clear up knee pain I used to get! Can't tell you how valuable that is to me.

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Re: Knee pain / downhill technique

Post by Eric Peterson » August 1st, 2011, 10:12 pm

Dislike those weird twinges too on my right knee. Been applying analgesic cream on my slightly
sore right knee before hiking the last few times out and managed to get up and down
Dog MT. 4 times with very little knee pain, just over all fatigue and general discomfort was
my experience. Usually after just 1 normal hike, I'll be limping around the next day but not
this time. Really caught me off guard as if I overcame my LCL issue or it just finally loosened
up enough to stop bugging me. Also did not use a knee brace as I was for last 6 weeks or so, so that
may have helped buy not holding in the inflammation?

I also hike with poles most of the time, but for a few hikes I was thinking I was relying
too much on them. Also changed the way I step like Crusak just mentioned, using more of the
fronts of my feet rather than just clomping down hard with the heels.

Also, I'll pop 1 or 2 Aleve during a big outing. I insanely document my right knee and what
I do for it when I log my hikes on Reminds me, I have to update my latest hike
with what exactly I did for my right knee!

Happy hiking :)

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Re: Knee pain / downhill technique

Post by drm » August 2nd, 2011, 7:06 am

I do a lot of the things mentioned here: use poles, take short steps. But I have to put in a word for prevention - if you have bad knees, do you really need to do quite so many huge hills? (I'm speaking in generalities here - I don't know what the original poster hikes) In recent years, I try and make my hikes on the big and steep gorge trails occasional. I want to stay in shape and visit some of the great places they lead to, but I hike them in limited quantities.

My knees aren't that bad, and I want them to stay not that bad. I've met people who tell me that they used to do what I do but can't any more because of their knees. I want to keep hiking for decades, and so precaution is the word of the day for me. There are many hikes that my fitness and circulatory system are up for, but which I don't want to put my joints through.

Remember that despite all the methods to protect yourself on steep hills, a slip or an awkward step can undo it all. So avoidance to the degree possible is really the best way to protect your knees. It's not a question of avoiding steep hills completely, but in being judicious in what you put your body through.

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