[pct-l] knee problems

[hudsom@us.ibm.com]

In addition to the glucosamine supplements and the trekking poles, a
lighter pack always seems to help. I'm not an ultralighter yet, but as I
get older my back gets lighter...
Also, visit http://www.sportsmed.md/injury/injury3c.html for some good info
on knee injuries...

Skeeter


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Cc:            pct-l@backcountry.net
From:          Jeffrey Olson <jjolson@uwyo.edu>
Date:          Wed, 11 Oct 2000 06:56:50 -0600
Subject:       Re: [pct-l] knee problems
Content-type:  text/plain; charset=us-ascii

I've mentioned this before, so pardon my repeating.  I too had knee
problems that were exacerbated by going downhill.  It made hiking less
enjoyable than it was.  

I went to a sports medicine doctor at the University of Washington who
spent an hour pushing, pulling, twisting, having me bend, squat, and
elongate.  His diagnosis was that the problem with my knees was "tight
buns."  

After we had a good laugh he explained what he meant.  I not only did a
lot of day hikes in the Cascades and sections of the PCT during the
summer, I played tennis two to three times a week for two hours.  What
had been happening is that my hamstrings and gluteus minimus muscles had
tightened up to such a degree that they were pretty much dysfunctional. 
The knees had tried to do the job that these muscles weren't, and
because they are not designed to do so, were exhibiting lots of
symptoms.  

He gave me two stretching exercises that I performed for two weeks until
knee pain disappeared.  A month later the knee pain reappeared and I
started the exercises again, which resulted in loss of pain.  

I went back to him a year later for what I thought was a form of plantar
fascitis.  He put me through the same contortions and pronounced my
hamstrings and gluteus minimus muscles weren't so tight, but that I had
not performed the exercises long enough.  My foot pain was a function of
these muscles being tight as well.  I did them fairly religiously for a
month and the footpain went away.  

A byproduct of these two exercises is that flare ups in lower back pain
disappeared while I was doing them.  This summer while hiking a part of
the CDT it flared up so that deep breaths were painful.  I spent ten
minutes an hour for a coupple days stretching.  The pain receded to the
stage where I didn't notice it.  A day without stretching and the pain
began to come back.  

I offer this story not to recommend specific exercises, but the power of
a good sports medicine doctor, in my eyes a "witch doctor."  He actually
had three or four magic wands in his tongue depressor container given
him by grateful patients.  I've gone to "bad" sports medicine doctors
who generalized from their own experience in their assessment process. 
One was a marathoner who "recognized" my knee problems as something he'd
experienced.  He prescribed anti-inflammatories.  This was in the middle
of a 75 day section hike and I had to leave the trail.  

I recently blew out an ankle on the CDT and went to a local bone and
joint clinic.  I wanted to know if I had broken anything or was it just
a bad sprain.  The doctor didn't ask me what I wanted from the visit. 
He began with suggesting surgery because this ankle had been sprained
numerous times, basketball and tennis the culprits.  When I told him
what I wanted to know, he suggested rehabilitation, in his shop.  I told
him I was doing everything he suggested and asked if my problem was
acute, requiring more than what I was doing.  He backed off a bit,
confused and out of his patter.  He suggested I use a brace while hiking
rather than heavy boots.  I exhorted his insight and suggestion, and
went to the rehab section of his shop and was given the brace he'd
prescribed, this monstrous thing that would have had me limping.  I
apologized to the rehab guy for acting angry and told him it was
ridiculous.  He said it was what the doctor prescribed.  I was getting
up to walk away when the rehab guy asked me to wait, and brought out
something I could use.  I'm still burning.  

I don't want to commit the fallacy of generalizing from my own
experience, but do suggest that you investigate a sports medicine doctor
before paying what will be many hundreds of dollars for his ignorance. 
Perhaps magic wands in the tongue depressor jar is a marker!!!

Jeffrey Olson
Laramie, Wyoming...
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