Hiking With Bad or Injured Knees

Bad KneesIf there is one thing that you can expect to be punished when you hike, it is your knees. The two biggest things people complain about on the trail are knees and feet, and the two are somewhat related. Over the last 15-20 years, I have had to worry greatly about my knees every time I step onto the trail.

A small bit of history. I had my first knee surgery at 18 when I tore my ACL and meniscus in the left knee playing in a basketball tournament. The rehab was long and arduous, but I eventually was able to get back to normal activities including basketball and hiking. However, with very little cartilage in my knee, the joint easily ended up rubbing bone to bone. Also, once you damage your knees, the range of motion is never the same. Hyperextending the knee or over flexing can send you off trail in a hurry. I have hobbled down a trail several times due to this problem. The other problem is that I tended to favor my good leg, so that leg was often hurting by the time I finished a hike. Then, I tore my second ACL in my left leg playing backyard football. Again, a long rehab followed. I had two more surgeries to fix torn cartilage in the 8 years that followed.

To make a long story short, I have very little cartilage in either knee, and hiking is an endeavor that needs knee support. The worst off I have ever been is realizing just starting back down from LeConte that one leg had given out. It took nearly 10 hours for me to get down to the car. To this day, I still worry about my knees making it through a trip, but I have found strategies that make it work. Whether your knees are strong or have been weakened over time due to damage or arthritis, there are things you can do to help yourself out:

1)  Take Glucosamine-Condroitin- This supplement is supposed to help give lubrication and elasticity to the joints. Some tests say that it absolutely works. Others are inconclusive. Still, I have used it for more than a decade and it seems to work, if just modestly, for me.

2)  Protect your knee. There are hundreds of different types of knee braces, and I have nearly all of them. Some braces will protect the sides of your knees from movement, some hold the patella still, while others simply cushion and keep the knees from swelling. Try what works best for you, but this is one piece of gear I never leave home without.

3)  Use trekking poles. To this day, I get strange looks on trail with my poles. I find this strange since so many people use hiking sticks and trekking poles, but many day hikers seem to think I will be skiing somewhere on the mountain. These poles can take a large percentage of the weight off of your knees and put it on your arms. Your arms could end up a little sore the next day, but you will at least be able to walk. Some poles are designed as anti-shock poles that absorb forces from the trail, but I’m not sure about this claim. My regular poles seem to function about as well as my anti-shock poles.

4)  Stretch before AND after your hike. As a sports guy, I know how important stretching is to help keep away injury. The same is true for hiking. Your feet, ankles, and knees will move and turn in ways that are different from any other activity you do. Warm the legs up and do a series of stretches to help minimize injury. Also, remember that stretching afterward is also important. As the joints and muscles are overused, they get tight and can atrophy. A good stretch keeps the blood flowing correctly and the joints from freezing up.

5)  Take breaks. This is the hardest part for me, because I am a results-oriented guy. I want to reach my goal as quickly as I can. However, the joints need a break occasionally. Take at least a 2-5 minute break every mile or more often in extreme uphill or downhill. Don’t rest longer than this or the muscles will start to tighten up or as a friend put it to me….rigamortis sets in. Once you reach your destination, take at least 10 minutes to rest, but move around some while there to keep the blood moving.

6)  Don’t fly downhill. It is easy to pick up a fast pace coming down a mountain. You are anxious to get done, your lungs aren’t working as hard, and you aren’t stopping to see the scenery since you saw it on the way up. BUT, downhill is far harder on knees that uphill. Many of us only take breaks when we feel tired. That feeling wont come much on the downhills. You have to plan your breaks, and plenty of them. The quad muscles and the patella take quite a beating on downhill. They need to be rested. The direct impact on the knees will atrophy the joint quickly. Use your poles to take the brunt of the force and move slowly. I often hike in a zig-zag pattern to help this process further. Don’t let the extra time dissuade you. Your joints will thank you for it. I take as much as twice as long coming down as going up, which is exactly the opposite of most people. But it is what works for people with bad knees.

7)  Have proper footwear and socks. Make sure that your boots fit and have plenty of cushion. Boots that are too big/small can transfer impact directly to your knees. Also, if the soles have worn out you are not helping yourself. Insert soles can be helpful if they stay in place. The best in the business is an insert called Superfeet which actually contours to your foot. These can make a huge difference on the trail. They are not cheap at around 60 bucks, but it is well worth keeping your feet and knees functioning. Don’t neglect the socks. If you are wearing cotton Walmart socks, you are asking for trouble. You should get a sock that is synthetic that will breathe and has cushioning to further help you up and down the trail. The important thing here is not to just buy the most cushiony sock in the store. Big socks will often bunch up and give you blisters. When you are walking with a tender foot, that also will hurt your knees, and likely give you shin splints.

8)  Keep your pack weight down. Extra weight obviously goes straight to your knees during the tough ascents and descents. Don’t take materials you don’t need, and buy quality lightweight gear whenever possible. Quality plus lightweight=expensive, but your knees will thank you later. In addition to pack weight, try to keep your own weight down. This is one I have struggled with up and down over the years. The times I have been the heaviest, I have had difficultly hiking. When I got down to being slightly underweight, I flew up the mountain without breathing heavy or pain.

9)  Stay hydrated. Carry enough water to keep things working right inside your body. Muscles will cramp or seize without enough water. Keep blood moving properly and toxins moving out. Water is a wonder with aiding in this process.

10)  Finally, know your limits. When I know I haven’t been active in a while and have put on a few pounds, I do not attempt to do a hike like Mount LeConte, Rocky Top, or the Ramsey Cascades. Instead, I will start small like Henwallow Falls, Alum Cave Bluffs, or even Laurel Falls. Like I’ve said before, I try not to get myself into any situation I can’t get out of. Just like working out, start small and work your way up. You will have better success, and enjoy yourself a whole lot more.

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