Knee braces while hiking

Kevin, until you have a diagnosis from the physician or orthopedic surgeon, discussion of a knee brace would be silly. Yes, there are knee braces, but there are different kinds for different kinds of knee problems. When somebody has a mild knee problem, then often they just wrap it with a wide Ace elastic wrap. That keeps a loose knee joint from rattling around very much, and it also helps keep the soft tissues warm, which leads to improved flexibility. Wide Ace wraps like that are more useful than a pull-on brace, since you can make them tighter or looser quite easily. The doctor-prescribed braces are very expensive, but they are more specialized.

I have been known to carry an Ace wrap with me, and that mere fact makes me think about what I am doing a little more so that I never reinjure my knee. I had both knees repaired back in the 1980's.

–B.G.–

I've just gone through this and will comment on my experience. After having the cartilage in my knee cleaned up for a second time (first time was 20+ years back), I was advised by my surgeon to try a knee brace. As Bob said, there are many different types of braces and in my case the brace wasn't to stabilize my knee (my knee feels strong), it was prescribed to buy me time… basically to re-align my knee joint to wear in a different spot and hopefully delay the inevitable knee replacement surgery.

Unfortunately for me, the $800+ brace is stored away in my gear closet collecting dust. I tried using the brace many times (I gave it a fair chance) but found that having a tight brace squeezing on my leg muscles for hours and hours during hiking actually really tired out my leg muscles and left my knee feeling sore (my knee is pretty good without the brace). I've had the brace "tuned" several times to see if it would help but I think it is just the way my brace works, it needs to be tight enough to torque my knee a little and that squeezes the muscles and causes problems for me. It might be fine for around the house but that's not what I bought it for.

It would be great if you could "try before you buy" but I don't know of any place that does that. I tried the "sampler" walking up and down a hallway but that doesn't equate to hiking. It was an expensive mistake in my case (I wish I'd spent the money on gear!!). That said, I know a couple of people that swear by their braces but they are for stability, so a very different type of brace.

Frankly I'm not the biggest fan of them…especially if you don't know the purpose, especially just those generic sleeves. They honestly don't do much except help hold down swelling (which is about their only benefit), but as for actually supporting the knee not so much. Except, of course, those massive metal external braces that block extension or flexion to protect surgical repairs…

The full skin contact of a neoprene sleeve (or an ace wrap) helps with proprioceptive input, which may help actively stabilize your knee by giving your muscles more feedback about what they are doing. But for a knee that's pretty minimal in terms of any real benefit.

My advice is relative rest – which means stay away from things that aggravate your knee but be as active otherwise as you can. Then get thee to a good PT. But I'm biased.

Listen to the doctor, listen to the PT, but… listen to you knee most…

I was having knee problems. My doc told me there was nothing cold be done, that it was typical for my age and was most likely degenerative arthritis. He said an ace bandage would not help and that if I continued backpacking it would likely 'blow up'. I was bummed. Then I though to ask him if doing knee exercises to strengthen the muscles, tendons, etc around the knee would help. He seemed surprised by the idea and say, well, YES that might help.

So off to the gym I went. Thousands of backpacking and day hiking miles later my knee is very good. Once in a while it's a bit sore, but fairly rare.

Another story: A friend and I climbed Whitney via the Mountaineer's route last summer. After the descent his knees were sore and swollen (mine no problem at all). With a couple of days of rest his knees felt normal. But we had a second climbing trip scheduled two weeks later. He went on the internet and researched his symptoms. He found a recommended brace for his problem and bought them not far from the trail head for our climbs. Though the problem for his knees seemed to be the long descents, the decided to wear the knee braces going up trial also. Results: he had zero problem with his knees this time.

I would definitely talk to a doctor… orthopedic guy and physical therapist, but don't turn off your own brain… no one knows your body as well as YOU.

Last spring I got tendonitis in my elbow… bad new for that same climbing trip… could not grip without pain and the grip was weak. About 3 sessions with acupuncturist and problem was solved… Doctor wanted to give me dangerous anti-inflamatories…dangerous when you heart is working so hard pushing a pack up at high elevations…

Good luck… maybe try some light knee exercise, and maybe some glucosamine/chondroitin supplement, calcium supplement, acupuncture?

Bill D

Doing exercises to strengthen muscles around my knees has helped tremendously, both for backpacking and my every day life. It didn't take long either. Jennifer has some good suggestions for this. I do simple wall sits complemented by hamstring and gluteus exercises.

But it all depends on your diagnosis.

As stated above you need a diagnosis to get the right knee brace.

I had trouble with patellar tracking. The Cho-pat "Dual Action Knee Strap" works perfect for me (they have other knee products). I wear it going up and down muddy mountains. Not only does it work but it's comfortable and even under extremely wet conditions has never rubbed me raw. I tighten (usually going downhill) and loosen it as needed. It's easy to get on and off. They have other products as well but I have never tried them.

http://www.cho-pat.com/

I'm no P.E. or PHD or anything in between. FWIW I blew out a knee descending the east side of Whitney in 2009. I managed to hobble out to Whitney Portal in great pain. I consulted with a sports Chiropractor who immediately said I'd probably need surgery to repair a meniscus tear. He agreed to work on it before resorting to surgery. It took three months of his treatments and targeted exercises but it worked. I still occasionally feel a minor pain in the knee when hiking and always carry a Cho-pat single band brace to wear when that happens. I've since come off Whitney two times after 100+ mile hikes without issue.
YMMV but I hope you recover without having to resort to extreme measures.

Well said Bill D. I completely agree. I've had enough experience in health with "experts" to learn and understand first hand that education and a piece of paper doesn't always correlate to depth/accuracy of perception nor healing wisdom.

Hence its very important to listen to ones own body and intuition.

Thanks for the feedback, looks like lots of us have bad knees and still get out regularly.
The question was originally asked to get ideas on braces that were available. Thankfully it morphed into a list of injuries and how they were overcome.

I am visiting the Dr. Tomorrow so hopefully within a few days we will have a diagnosis. I see some have got bad feedback from the medical community. However my doc has repaired my shoulder and knee. The knee has quite a few years of use sense so I hold no blame on his previous repair.

Thanks for comments and inspiration on recoveries and techniques on overcoming pain.

I'm another with a history of knee problems, ACL replacement and two surgeries to repair torn meniscus in the same knee. I also tried the "Prescription," knee brace, but found it very uncomfortable, even for a few miles. For several years I used the neoprene sleeves, but I think they provided more psychological support than physical. To echo what others have said, what has helped me most is sound physical therapy and regular exercise. It seems to keep the knee more, "Lubricated," if that makes any sense. I think, too, I've come to know my body better, and can tell the difference between normal knee pain and pain indicating I need to stop what I'm doing. Hope your doctor's appointment went well!

Did not work for me either. Do use a small stretchy sleeve called "Healing Tree" that is much less invasive than a brace. Honestly don't know if it helps or not.

A few things not mentioned that do help:

1-A rowing machine daily that is good for upper body exercise, but also flexes the knees without their being weighted. This seems to help a lot.

2-An exercise where you put your palms against a wall or bar, bend one knee, and project the other back as far as you can with the foot flat on the floor. This stretches the muscles on the bottom rear of the leg where pain often develops from knee issues. Done daily, it greatly reduces and prevents pain in my muscles just below the knee. See a physical therapist at least once to get it right.

3-Annual shots of hyaluronic acid in the knee, sometimes preceded by removal of some of the joint fluid. I do this every spring before starting backpacking, and it helps greatly all summer.

4-Sam-E, 400mg, from NatureMade. Try to avoid it, but when the more degraded knee gets painful right at what's left of the menisci, and won't come around for several days, I do a bubble pack of 6 for six days. Risky, but has always worked. My Dr. is OK with this.

Also use Osteo Biflex, CVS Reparagen, and an NSAID, Nabumetone (easier on the stomach), but as little as possible, and usually for other types of arthritic issues, not meniscal damage. It does help while backpacking taken after dinner for knee pain while sleeping.

Won't say my knee was injured because nothing out of the ordinary happened. Was just making a moderate ascent on a good trail above timberline and the knee started to grate like a rusty gate. But with all the above and much more, it took a year or so to backpack again, and several years more before didn't have to spend at least an hour daily working on the knee. Some providers told me that the meniscal damage would never heal, and a replacement was the only answer. Still functioning without one, but it does take considerable time and must not be rushed. A good friend, who rushes everything, ended up with double replacements. Could never persuade her to take it easy. But she's doing OK now, and may get back on the trail again.

"Well said Bill D. I completely agree. I've had enough experience in health with "experts" to learn and understand first hand that education and a piece of paper doesn't always correlate to depth/accuracy of perception nor healing wisdom."

I've heard enough Voodoo, superstition, and "my HS football coach told me this one time" BS from lay people with no clue about medicine to know that the "experts" tend to know what they are talking about within their field.

I find when people are not getting desired results they are either pushing too hard, not doing their exercises (not hard enough), are impatient (want immediate results) or ignore sound advice and do their own thing.

but I did go to school for 4 years learning to evaluate and treat injuries and spent another 10 working with athletes… so I probably don't know anything.

My sentiments exactly, but it have such a hard time trying to say it without angering a lot of people.

As for torn menisci, absolutely it will not heal if it is degenerated or torn. But here's the deal: that may not be the cause of your pain and dysfunction. Yes, you're right, you or your uncle or your football coach may have a torn meniscus on MRI. But the MRI doesn't show us how long it's been there, and I cannot tell you how many patients come to me after having the meniscus repaired, or debrided…and say their pain is exactly the same as before the surgery.

Here is a wonderful blog post that says it so well I give it to many of my patients to help spread the word:
http://www.bettermovement.org/2012/the-trouble-with-mris-and-my-brother/

So when you go to your doctor and he or she says you have a herniated or bulging disc in your back, or a torn meniscus in your knee…for the love of all things holy do NOT assume that structural deficit is the cause of your problems, or that fixing it will eliminate your pain and dysfunction.

I have nothing at all against my physician brethren, but I get so frustrated when an MD orders a test like this and then assume the structural deficit is the problem…and that it needs to be fixed. We need way more education in medical school about pain science…..

Ok I'm done ranting now. I think.

What i've learned on many different forums when medical advice is asked. The OP usually takes the easiest suggestion regardless of the knowledge of who gave it. For that reason I've pretty much stopped giving med. advice online because it is a waste of time. I think your blog is the way to go, people go there that want to learn. The folks who don't, won't bother. :)

Jennifer and friends,
I seem to detect something like anger, maybe bitterness, in your posts. A little counter-intuitive, because it's the patients not the treaters who do the suffering.

First, whatever you think about the quality of medical treatment, doctors are seeking to use the best evidence available to treat us. Like any other profession, there are great ones, good ones, mediocre ones and yes, bad ones. And that can vary from day to day depending on a whole lot of factors. So, as with any other professional, the first challenge is to find at least a good one, because the quality of your life, and eventually your life itself, will probably depend on it. That's not fair, but that's the way it is.

If you have a physician who's not a bozo, I recommend taking whatever they say very seriously, and if there is a conflict, yes, even more seriously than other healthcare professionals. I say this because in my own former profession, I studied hard for many years, taking some knocks that live with me still every day. What I have found is that there are many in fields related to my profession, but who have not undergone anything close to the extent of training and experience that I did. Logic suggests, and so it turns out, that with less rigorous, extensive and intensive training, they are not as qualified to treat a problem. This is fine, if they stay within the scope of what they are qualified to perform. Unfortunately, that is not always the case, and those are the ones I often hear putting down members of my former profession.

I suspect that's why I tend to be critical. Maybe it's different in the healthcare professions, but I suspect not.

let me quote him again…

" I've had enough experience in health with "experts" to learn and understand first hand that education and a piece of paper doesn't always correlate to depth/accuracy of perception nor healing wisdom."

now as it pertains to this thread

The OP has some sort of injury. He does not know what it is. He has not seen his doctor about it yet.

People with no medical degree of any type have put down a whole page of probably inaccurate "advice" that could make his condition worse. On top of that someone has posted to ignore the advice of a medical professional and "do what feels right"

you said " Logic suggests, and so it turns out, that with less rigorous, extensive and intensive training, they are not as qualified to treat a problem."

guess what, taking advice from people with NO qualifications on the internet is NOT logical. Depending on what it is, the advice could lengthen his healing time and cause more pain.

I went to school for 4 years to be an athletic trainer who can evaluate and treat athletes on the field and do some rehab, modalities, taping etc etc.

Jen is a physical therapist that takes 5-6 years of school to do what she does. It is actually a doctorate program. so I should call her Dr Jen ;)

It takes a few months to become an EMT that shows up at your car accident. Think about that.

Luckily, online i could care less what people do to themselves.

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

What's your point? I did not give advice, just related my own experiences, as did others. Hope you don't have a problem with that.

In fairness, I fully expected to get slammed for that last post, but felt it was something that needed to be said anyway.

Not sure if you are asking me….but I was not talking about you.
But just to clarify my point, it seems that we are being told to let the experts tell us how it is and also that the "physician brethren" are telling us the wrong thing.

B.G. wrote
"Kevin, until you have a diagnosis from the physician or orthopedic surgeon, discussion of a knee brace would be silly."

That this thread has continued past that point is also silly.

I know, nothing on TV tonight here either.

I have no tv, so there is my excuse…

The OP has an unknown injury. how can anyone give advice or relate to anything he has said without knowing what the issue is?

There are dozens of types of braces, for many different problems. Some help with some things. some are basically a placebo that make people think they are fine.

Jake, i'm not giving medical advice to the OP first. 2nd of all, neither am i saying that one shouldn't listen to trained professionals, but pointing out that it is important to self educate, listen to ones own body and intuition at times too.

In the quote from me that you have now twice quoted, notice i said specifically "doesn't always", that's a qualitative, relative statement that very much allows that sometimes trained experts DO know what they are talking about. There are very, very, very few black and whites in my perceptions.

For the record, i have much less issues with PT's, athletic trainers, etc. than i do with MD's who are much more apt to treat symptoms with drugs rather than address causes.

I'm speaking from deep, personal, and painful experience with this btw. I had to educate myself and treat myself very differently than mainstream western medicine and MD's were.

Perhaps if you had been in my shoes, you might have similar sentiments. Thankfully some people can and do think for themselves, and do listen to their intuition. If i hadn't, i would still be suffering with a rather physically painful issue trying to mask the symptoms with drugs, all the while not addressing the core causes and issues that were related more to diet and general lifestyle.

Ed,

Perhaps you were being facetious, and if so, my bad…

But, the points about going down the MRI path before working with a PT are good to know when the doc says "Well let's just get an MRI". At that point you ask about false positives, taking the "PT first" route, and keeping in mind –

"…for the love of all things holy do NOT assume that structural deficit is the cause of your problems, or that fixing it will eliminate your pain and dysfunction…"

– and then you decide if you are seeing the right doc (for you) or not.

All to often we are walked down the garden path …