Knee braces while hiking

[BlackHatGuy]

Y'all have GOT to be reading a different thread than I am.

OP poses a question, and makes it clear he's getting a diagnosis from his doc (he's not relying on medical advice from the crowd, only doing some research, mainly, it seems, about braces).

First response says wait for a diagnosis from your doc.

Second response gives a personal example of his issues with a brace, and foot stomps the first response about there being a lot of different kinds of braces.

Third response, from a trained medical pro, says she's not a fan of braces, but to rest [do no more damage] and get to a medical professional (in this case a PT).

Fourth response says listen to the medical pros, but also listen to your body (I think this is great advice, personally).

Fifth response says exercises can help, but that it all depends on the diagnosis (back to the medical pros)

Sixth response – wait for the diagnosis.

Seventh response, simply a personal anecdote.

Eighth response, again, listen to your body. This seems to be the response that started all the negativity (which is ironic, since Justin is one of the more positive people here) because he infers he's had some less than stellar medical advice. I'll bet a lot of us have. And he simply said that "…education and a piece of paper doesn't always correlate to depth/accuracy of perception nor healing wisdom." Seems like an obvious statement to me. Lots of people get training, they don't all come out of the training really good at what they do. But notice he didn't say NEVER correlates to talent, he said it doesn't always (so, sometimes). Again, seems like a true statement.

From here it seems some folks went all the way to the left and took this as an attack on their profession. It wasn't. And the OP followed that post with his own follow up – saying he'd be visiting his doctor tomorrow! And even infers that he has confidence in his doc!

Chill, people, chill.

[Kattt]

We need you Doug! Please do this on every thread that starts to flounder.

Sincerely,
A flounderer.

[Jake D]

i'm out.

I agree that this whole thread should have stopped at B.G's post.

[Ed Biermann]

My point is that it's like trying to guess what's wrong with a car that's parked. Since the OP does not even give us any symptoms to guess with. Could be something. Could be nothing. Everyone has an opinion based on their own experiences. They may or may not be relevant to the OP.

[Ian]

Well reading this thread finally explains why I'm receiving targeted advertising for knee braces at the top o' the BPL page.

[Anonymous]

Perhaps i should have been more specific in my wording, but i was only speaking very generally and not directing it towards any individual here.

I wasn't trying to insult anyone here Jake.

[Greg Mihalik]

"Well reading this thread finally explains why I'm receiving targeted advertising for knee braces at the top o' the BPL page."

Just wait until they parse out "ED" from Ed Biermann's name. It could be interesting…

Please keep me posted. I don't see the ads, thankfully.

[BlackHatGuy]

"Please keep me posted. I don't see the ads, thankfully."

Interestingly enough, the ads seemed to have changed significantly. I turned my ads off a few days ago when they started serving the kinds of ads that, when you simply pass a mouse over them (without any click), they expand and cover (float over) your frontmost window. Bad form, in my book.

So I just turned them back on to see what they're offering these days – and no more large chested women selling language tapes, no more large chested computer generated women trying to lure you into adult gaming sites, etc. It seems someone had a discussion with google….

[Ed Biermann]

I got attention in high school and college with it… Means what it says. Family later switched to Marzipan manufacturing. I like Biermann better.

@Kevin Hope whatever is wrong is no big deal. Speedy recovery.

[BlackHatGuy]

"Family later switched to Marzipan manufacturing. I like Biermann better. "

Wow, I read that and immediately "Marzipan Man", to the tune of "Rubberband Man," began playing in my mind.

My brain really scares me some times…..

[Anonymous]

"@Kevin Hope whatever is wrong is no big deal. Speedy recovery."

Same here Kevin, meant to say this much earlier.

[Jennifer Mitol]

I actually DO criticize many of my orthopedic surgeon brethren, but the point I was trying to make here in this thread – as it pertains to the OP – is that I'm going to hazard a guess that the surgeon will want an MRI, the MRI will show a meniscal tear, and the surgeon will tell him it needs to be surgically repaired.

I absolutely may be wrong, and I hope I am. There ARE some good ortho docs out there. But just like PTs and every other medical practitioner, there are a ton of awful ones who just want to cut people open because for them it's the easy route, and you the patient/consumer really has no way to tell them apart.

But I was hoping to add to the discussion by advising the OP to NOT rush into an MRI, or surgery, even if that's what the surgeon recommends. Honestly…even if that is what the surgeon recommends.

There is WAY too much evidence out there that the advanced imaging/surgical route are wholly unnecessary as a first step, and should only be undertaken (including the MRI) when a course of PT has failed. Now, not many surgeons read that, or care, because meniscal tears are so easy to fix, and they make a lot of money in a short amount of time doing them. For the surgeon it's easy…for the patient, not so much.

So Kat, and everyone else I may have offended…I'm sorry…i probably should have just PM'd him that advice. But I thought it was good all around…..

[Jennifer Mitol]

"So it's the "physician brethren" that we are supposed to question?"

Yes, actually, you should. You should question all your medical professionals. Ask a lot of questions to them, and if it is at all serious get a second or third opinion. Never undergo surgery on any orthopedic problem without a second or even third opinion.

I see way too many surgeries that were done unnecessarily…I just had a lady yesterday who was on her FIFTH lumbar fusion and had 2 cervical ones already…I asked if she had every had ANY intervention for her back pain that wasn't surgery…and she said "well no, should I have?"
No PT, no injections, no medication, nothing. And now she's pretty much an invalid.

Knee surgeries left and right for meniscal tears…but the pain was under the kneecap…not at all pain from a meniscal injury…the tear was most likely an incidental finding that never even hurt. And now the patient has the surgery to recover from…and still has the same pain.

So yes, Kat and everyone here, always question your medical professionals. There is a lot of differing opinion out there, and unless it's an emergency, don't assume your md got it right in the 15 minutes he or she is spending with you.

And again, no bitterness, but yes, a fair amount of anger. I could simply not believe how badly we mess up with our patients…….and the only solution I see is a better educated patient. So that is all I am trying to do; just give you information. Do with it what you will.

[Kevin Schneringer]

I apologize to those who maybe offended that I reached out to my online BPL family. Yes my knee is jacked up, yes the trip I had planned for almost a year ended in day 2. Yes it sucks. My post was more for info on what lies ahead of Dr. Appt. PT and possible surgery for my hiking. ARE BRACES OUT THERE LEGIT? Are people still enjoying the outdoors after multiple knee injuries.

My doctor has repaired a throughly blown out shoulder and a useless knee. Got 7 years on the shoulder still going strong. 4 on the knee. And if I had worked my desk job and came home and watched TV until bed for the next 30 years I would have never damaged it.
So yes I trust him.

I guess since most of my friends and family think I am crazy for my outdoor activities! I reached out to BPL for knowledge and to have virtual OUTDOORS thru others adventures while I am down.

Thanks to the people who hopefully inferred what I was reaching for. Thanks Jen as your posts were what I already knew but enjoyed hearing again from someone who has some credibility.
Thanks to Justin, Doug and all who seem to know I was only looking for info and not. It's silly, my doctor sucks and so on.

This is not a pity party. But some how our group of faithful posters can tear up a legitimate post in matter of minutes.
In the future I think I will not jump into a post so quickly. But stop and think about how I would handle or feel if I was in the other persons predicament. Maybe then I could give more targeted advice or info. Some will always be condescending and just want to show their own perceived awesomeness. Oh well.

Kevin,

[Kattt]

My question was rhetorical Jennifer.
I think anyone that knows me, even just from BPL would have an idea that questioning is something I do. More people should try it; not just as far as medical professionals, but all around. Imagine that.

[Kevin Schneringer]

Well while I was posting I see that Jennifer elaborated on a previous post. Very timely!

Jennifer I will definitely ask questions and PT might well be the best route.
Thanks for the info and although I trust my Doc I will surely ask these types of questions.
I guess what I am hearing is the some knee issues clear up with PT?
Being I have mechanical back ground it seems like if part is bad you repair it? Does PT strengthen the are and then help you live with
the discomfort? Or does it actually allow the body to heal on its own?

I know after surgery PT gets the joint and surrounding tissues strong again. Never really thought of it for more than that.

[Greg Mihalik]

Kevin,
Think of a "tensegrity" system.

Your "knee" is more than one part, and some are elastic.

Do you have a blown strut, cable, anchor, or …

… do you just need to tighten something?

I have avoided "must have" knee surgery on several occasions thanks to a PT. And, no offense intended, not all PTs are the same. I went through three before I found someone who was "performance" oriented (or whatever the term is these days).

[John West]

I tore my meniscus and strained my MCL a few months before hiking season last year. We decided against surgery (which would later turn out to be a bad idea), and the ortho said that just with PT it would eventually get back to normal.

When hiking, I went with one of the spandexy type braces with thin metal bars on each side. It helped a lot, and when I didn't have it on, my knee felt "loose" and wobbly. I could walk around town fine without it, but with weight on my back and uneven terrain, I definitely needed a brace for backpacking.

[Jennifer Mitol]

While PTs certainly do help stengthen after a surgery, the fact is that pain is WAY more complicated than most people realize. The reason I posted what I did is because most people do think rather methodically, that broken part = pain. Most ortho docs do as well. But the point is that a broken piece doesn't always mean that is the cause of pain…it might have been just an incidental finding.

An engineering analogy (I love analogies!): your house is cold. You see that you have a bad seal in the windows in the living room letting in a bit of cold air. So you spend a fortune replacing the windows…but your house is still cold. You see, the furnace was actually out, but you never looked there because you saw the windows and just fixed them.

Pain is a lot like that – in fact there is a growing body of evidence out there that most of us have meniscal tears, most of us have herniated discs…and no pain. Some of the worst looking X-rays I've ever seen belong to people who have no pain. The point is that pain is such an overwhelmingly complex system that involves input, transmission, processing, emotional interpretation…and on and on…we cannot simply look at an MRI and be confident that we have found the source of the problem.

The difference between what your md will do and what a GOOD PT will do (and I am the first to stand in a long line and disparage many, many of my colleagues for being very bad at their jobs) is that a PT is trained to look at the whole picture and piece together all the biomechanical and physiological components of your complaints and put together a bigger picture. You may have knee pain…but a good PT will look at how your hips work, how much mobility you have in your back, how strong your ankles are…etc. It allows us to design a program that addresses not only your current complaint, but to prevent it from happening again.

Yes. Sometimes is truly is blatantly obvious…but many times not so much. The big push now is to stop imaging knee and back pain for this exact reason. As I mentioned earlier, I'm going to repost this because it is so awesome:
http://www.bettermovement.org/2012/the-trouble-with-mris-and-my-brother/

[Bob Gross]

Over thirty years ago, I had a skiing injury. The medial ligament on my left knee was almost completely severed. Surgery. No PT. I had about 80% recovery within eight months, so I was able to go backpacking without too much problem. No braces needed. I missed most of the ski season that year.

Then four years later, I had an even worse skiing injury to my right knee. Medial ligament severed, ACL severed, medial miniscus was damaged. Complex surgery to rebuild it a little differently. Ten weeks in a hard cast. Then a month or two later, the knee was still getting worse. It was structurally stapled and tacked together, but the flexibility was bad and getting worse. So, I demanded PT. The first PT analyzed the knee accurately and made recommendations to the second PT, who was the person who actually forced the changes to be made (ripping up internal scar tissue). It got pretty ugly. Backpacking season was nearing, so I asked the orthopedic surgeon for a knee brace. I assumed that I needed one since my knee was so weak. He was reluctant, but eventually he got me a specialized brace. Then I discovered why he was so reluctant. I didn't really need any knee brace. My problem was that my knee was TOO TIGHT as a result of the surgical magic that they had done. Most knee braces are intended to fix up a problem when some aspect of the knee is TOO LOOSE. Real quickly I found the impracticality of the knee brace for my particular situation. The surgeon's plan was that he wanted my repaired knee to be TOO TIGHT initially and for a couple of years, and that eventually it would loosen up slightly to become fairly normal. That's what I eventually got, a knee that was fairly normal in function (if not in anatomy).

At about nine months after surgery, I dayhiked the Mount Whitney Trail, and I was only about 10% slower than my personal record time, so then I knew that I would get through it OK.

So, don't get too far ahead of yourself about knee braces. Just inquire to the physician, and get some physical therapy if he thinks it might help. It's worth a try.

–B.G.–

[Kevin Schneringer]

Well seems like the last couple posts were spot on.

I just returned from Dr. , same one who performed previous surgeries, and he recommended doing nothing but resting , ice and some anti-inflammatory meds for the next 2 weeks. He said my patella was not tracking very well and that from pain description I might have a meniscal tear and that I surely had some arthritis. so if the pain is worse in 2 weeks we will do MRI. And look at PT or "other" options.
He ask if I agreed with his recommendation and I said yes.

Not sure of the exact medical laws in other states but in OK you have to have a Dr. Referral to go to PT. it seems only 2 states still have such a law. Maybe Jennifer can elaborate.

I like the way I am going with this and hopefully no surgery is involved. Sometimes pain is just there and is a way of life.
An the Dr. Seems reluctant to jump right into a repair mentality.

The analogy of the window and furnace was perfect. I tend to think in a linear way of its broke fix it, I guess it's better to set back and examine every detail first.

[Jennifer Mitol]

Currently most states allow you just go to a PT on your own, but in a few holdouts you need a referral from an MD to go (I think the chiropractic lobby is behind most of that…and probably ortho docs as well – we PTs are so threatening…you may not want to get surgery or "adjustments" if you just saw a good PT first…)

If you'd like I can check with my professional association and get you a name or two of someone in your area…unless you had good results with someone already.

Good luck and I sincerely hope you feel better soon! At least this is a good time of year to be "cross training!" (In other words…rehabbing)

[Billy Ray]

"An the Dr. Seems reluctant to jump right into a repair mentality."

Sounds good. Personally, I would be reluctant to try to talk the doc into cutting on me :)

Bill D.

[Anonymous]

"Just wait until they parse out "ED" from Ed Biermann's name. It could be interesting…"

It'll be deleted before it has a chance to get interesting.

[Greg Mihalik]

"He said my patella was not tracking very well …"

You might find this interesting.

…about 1/3 of the way down the page.

[Author]

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