Strengthening knees

[Ralph McNall]

I found it interesting when one of my knees started hurting backpacking, the first thing I thought was – time to get a pair of poles. So I got some and used them for the next 6 months or so and they never seemed to help. If anything they made it worse because I found myself relying on the poles to balance me and not my leg muscles. I felt like I was stumbling around always off balance and got lazy with my stride and how I walked. I got rid of the poles and worked my way up to running and then running stairs and cycling more and I haven't had a problem since. I'm not saying this is the solution to everyone's problem, sometimes you need the poles or the surgery. My brother had knee pain too and they ended up pulling a golf ball sized thing out of his knee, but now he is out riding his bike and getting stronger.

[Michael Skwarczek]

Keep in mind that while you're on the trail, posture is very important. This is tied mentally and physically. As I tire, my posture suffers and so does my gait, causing foot fatigue, missteps leading to ankle rolls and knee twists. Plus, being tired and slouchy, you bear your weight into every step, turning those mistakes into injuries, or aggravating already weak areas.

So, one thing I practice is raising my gaze to the horizon, and remembering to scan the landscape. Look around. This uplifts the spirit, pulling you out of your fatigue; it also lifts the chin, raising your entire posture and stance.

Again, regarding exercises:
I like Joe's ideas too. Additionally, these balance exercises will engage your core, which will improve the posture and its longevity under stress.

good luck,
-Michael

[Elena Lee]

Thank you all for posting helpful knee comments. This past summer, I hurt my pre-injured knee to a point where a simple one day 3,000 elevation gain hike is very painful. i think it's due to overuse of the pre-injured knee without proper prior physical conditioning. This extreme knee pain just happened suddenly (and i'm not talking about the regular knee soreness that goes away in a few days). This pain has manifested itself for about two months. The biggest problem is downhill. in the matter of fact, i have no pain going uphill, lots of strength – i can hike and climb uphill fast with lots of energy. but going downhill is completely the opposite. i'm the slowest hiker ever, and some people are amazed at how "fast" i go and are further in disbelief at the things i actually did considering my downhill shape. this is especially frustrating when hiking with other people who puff it uphill but literally run downhill because it is so much "easier" for them. of course these are usually casual dayhikers that don't do any serious long trips so their knees don't get trashed right away.

While hiking, my main cure at this point is experimenting with different muscle groups as i'm walking downhill. interestingly, if you walk slightly differently than usual, you can take a lot of stress off your knee muscles and ligaments just by altering your walking technique. poles are of a huge help, too.

now i'm considering seeing a knee specialist and would like to ask if anyone has had prior experience with knee doctors and various diagnostic tools. Should I ask for an MRI? I'm afraid they would either dismiss my concerns, or suggest wrong therapy and exercises that would exacerbate the problem. Is MRI the best diagnostic tool out there?

[Mark Stalbird]

I agree 100% with biking as possibly your best bet.

Its a smooth repetitious motion that strengthens the entire leg.
As mentioned…proper seat height is critical.

I'm not an expert and quite humble but did race mtnbikes for several years and had knees of steel.

[David Ure]

Some good commentary. Also don't forget the flexibility and strength of your hamstrings. The most neglected part of the lower body. Strong hamstrings offset some knee infelxibility.

[Anonymous]

"now i'm considering seeing a knee specialist and would like to ask if anyone has had prior experience with knee doctors and various diagnostic tools. Should I ask for an MRI? I'm afraid they would either dismiss my concerns, or suggest wrong therapy and exercises that would exacerbate the problem. Is MRI the best diagnostic tool out there?"

Elena,

The first step is to find a good sports medicine rehabilitation specialist. They are technically called physiatrists. The initial exam will go a long way toward determining what, if any, diagnostic tests are necessary. A good rehab doc can learn a lot from physically examining your knee and asking you a lot of questions. The first diagnostic test will likely be x-rays. MRI's are expensive and not likely to be prescribed unless absolutely necessary.
And, yes, physical therapy may well be recommended.

Since you are in the Seattle area, I can recommend an excellent doc. I don't know for sure if he is still accepting new patients, but you can give it a try. Tell the appointment staff you are an endurance athlete that does a lot of things in the mountains. That is one of his
areas of interest. Dr. Stanley Herring of UW Medicine Sports and Spine Physicians, 325 9th Ave, Seattle 98104. Phone: 206-744-0401. Best of luck, whatever you decide!

Tom

[Walter Carrington]

A standard biking injury is patellar chondromalacia, caused by misalignment of tendons in the knee. To prevent it do quad exercises. There are a lot of exercises caused by imbalances in opposing muscles. You want both quadriceps and hamstrings to be strong. It's a good idea to do exercises that strengthen both.

Poles are helpful for reducing stress on knees, but if you're already injured see a doctor.

[Elena Lee]

thanks Tom, I'd definitely take up on your advice and contact the said doctor. I'd let you know how it went.

[Anonymous]

"thanks Tom, I'd definitely take up on your advice and contact the said doctor. I'd let you know how it went."

Best of luck, Elena. In case you can't get an appt with Dr Herring, you might go for one of the other docs there. They all consult each other and Dr Herring is the one they all look up to for advice and mentoring. Top notch bunch.

And please do let me know how things go. I'll be rooting for you.

Tom

[Nate Davis]

On a related note, I've recently started running on trails rather than simply hiking them. I enjoy the exercise and love being able to cover the distance so fast, but it's been bothering my knees a bit this week.

Is this to be expected? Should I lay off for a bit? When I first started hiking on a regular basis, my knees tended to hurt a bit. My pain eventually went away, I'm guessing as a result of strengthening my legs.

I'm 25, but I've never done much running before this, so I've got zero experience and don't know what to expect.

[Anonymous]

"I'm 25, but I've never done much running before this, so I've got zero experience and don't know what to expect."

You might consider doing some running on relatively flat terrain, soft surfaces are best, before jumping too heavily into trail running. This would give your soft tissues(ligaments and tendons) and also muscles a chance to adapt to running before graduating to trail running, which involves rough upredictable surfaces and steep ups and downs that put a lot of stress on joints and soft tissue, as well as your leg muscles. This is based on the assumption that you are doing your trail running in the hills or mountains. Disregard this post if this is not the case.

[Nate Davis]

I'm lucky enough to live on the edge of a state park with 20+ miles of interlocking trails, so I tend to just head out my back door and hit the trails.

I usually take the trails that lead to the tops of the peaks and cliffs, just because the views are pretty incredible (see the below picture).

Those trails do have quite a few steep ups and downs, but there are flatter options in the park with only a couple of steep sections. For those steep sections (both up and down) that I can't avoid, should I just make a habit of walking them for now, until the muscles and tendons around my knees have more of a chance to build up strength?

[Jonathan DeYoung]

I was in the same boat as Cory and what seems like many many others. My knees would almost always start to bother me and take days to fully recover. I went to doctors, physical therapy, pain killers, custom insoles for my running shoes and work shoes. These were all very expensive things to try and did not work very well.

The best thing I could have done to help correct my situation came from an article a few years ago about barefoot running (I have seen this a few more times on other posts during the past few days and seems to be a growing trend). I am not recommending that you just start running barefoot. But maybe give a minimalist shoe a try. Something like the INOV-8 shoes seem to work great given your foot width (they tend to run narrow and don’t work for everyone).

I have been using INOV-8 Roclite 315s for a little over a year and have had zero knee pain once the initial break in has occurred. The minimalist nature of the show almost forces your foot to do what comes natural to it and corrects the stride. if you run incorrectly your foot is going to feel it because there is no cushion in the shoe.

The idea behind it is if you get your foot to do what it is supposed to it corrects much of the issues with your legs from the ground up literally…

I have been thinking of taking this barefoot running theory another step and getting the Vibram Five Fingers shoes to test out around the local trails for short runs.

this has just been my experience with knee pain and running/backpacking and how corrective actions worked for me and by all means see a doctor in case something is really wrong and its not just poor running stride.

[Jeremy G]

I have the exact same story as Jonathon, except I have taken it a step further. I was still getting a lot of pain running in my Inov8 Roclite 295's although now I know it has much to do with my poor form than anything. After learning about barefoot running this summer, I started going barefoot around my house and yard whenever I wasn't needing protection for my feet (construction/landscaping). This made a good transition to strengthen my feet before I started running barefoot.

However, I just wasn't quite bold enough to actually go barefoot, so about 6 weeks ago, I bought a pair of Vibram Five Finger KSO shoes. Besides my calves being really sore in adopting this new running style, I have had NO knee pain. My balance and core strength is way better and most importantly, I now LOVE going out for a run. So much so that I have put a couple 25K trail runs on my schedule for next spring and a 50K trail run for the middle of the summer.

Last weekend I went for a hike with my 30 lb kid (plus 5-10 lbs of carrier and gear) on my back and literally ran down a big hill with him on my back (in my VFF KSO shoes!). I couldn't believe how good that felt to be able to do that with no pain!!! I was ecstatic!

Primal running is defined by using a minimalist shoe like Vibram Five Fingers, Feelmax or a racing flat type shoe. Barefoot running (I've only done this for very short distances a couple times) is just as it says.

One BIG note, you need to modify your running style when you run this way. AND, give yourself some transition time… i.e. TAKE IT SLOW. It's like learning how to run all over again. If something hurts, you are doing something wrong!!

Check out these three websites for some great instruction and dialogue on barefoot/primal running:
http://www.runningbarefoot.org,
http://www.barefootted.com,
http://www.barefootrunner.com

I also agree with Jonathon's last statement that this is my experience and to go see a good doctor either way.

I also highly recommend getting the book "Born To Run". This has a great story that is centered around minimalist running.

Good Luck!!!

[Anonymous]

"For those steep sections (both up and down) that I can't avoid, should I just make a habit of walking them for now, until the muscles and tendons around my knees have more of a chance to build up strength?"

Excellent idea!

[Michael Skwarczek]

tracked this guy for 45miles…

[W I S N E R !]

Those look like 5 fingers prints- you can barely see 4 notches radiating out from the inside heel as well as the circular cut where the heel meets the midfoot.

He was definitely right handed. And had a cold. Probably ate pastrami for lunch.

How are you Michael?

[Michael Skwarczek]

Shoot, Craig. Look at us fools. We're virtually there. Lets GO man!

That said, I'm heading for an overnighter tomorrow before a Utah/Idaho roadtrip next week. Heard you have to be in town Saturday but can ya get out Friday for the night?

[W I S N E R !]

Tomorrow night?
It's on! I'm calling you right…now.

[Author]

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