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Tucson Arizona spring 2015

Dealing with a Knee problem

Our Crazy Post Retirement Wanderings Hiking and Triking

All about my knee issues

I haven't ever had any issues in my life up until a few weeks ago, but when I hiked 13miles on January 3rd, I suffered an "overuse" injury of my knees, especially my right knee. The injury that I suffered I started to notice the pain at about mile 12 of the hike. For the next 1.5 miles, my right knee suffered quite a bit of pain, and to a much lesser extent, I noticed a little soreness in my left knee. The pain mainly went away when I got into the car and sat down, and removed weight from my knees. I went to my doctor, and described the incident, and he sent me to a very capable Physical therapist here in Tucson. The PT listened to my history and symptoms, and then made some measurements. She determined that I had several anomolies that contributed to my condition, but she commented that if I wasn't pushing the limits or "normal exertion, by hiking in excess of 13 miles, I probably would never notice the problems that I have. But then, who would have thought that one would get an injury because of muscle imbalance? The more significant things that my PT found from her measurements, was the following: 1) My right hip rotation was only about 12 degrees, while my left hip rotation was more than twice that. 2) My right hamstring strength was about half or less that of my left Hamstring. 3) My right lateral quad strength was significantly less than that of my left lateral quad. She had read an article talking about how the knee can be affected by hip rotation mismatches and strength mismatches between the hips and upper leg muscles. Apparently what can happen is the mismatch in hip flexibility and leg muscle strength can cause ridge on the back of the Patella to be pushed outside of it's groove where it normally resides resulting in stress to the articular cartilage on the sides of the femoral groove, where it normally slides without issue when the muscles are balanced and guiding the patella groove to the center of the Femur's femoral groove, where it should normally reside. The off center rubbing of the articular cartilage can cause inflammation or worse, severe injury to the cartilage. According to several sources, if the injury is not too severe, the body will heal itself in 4 to 6 weeks if one stays off their knees, and treats with a heating pad, hot showers, and plenty of sitting or bed rest. If on the other hand, the injury is more severe than this, you should see a doctor right away, and should probably see your doctor in either event, as your doctor can provide an object evaluation of what sort of treatment if any is indicated. OK, so if your knee heals by itself, if you still want to do that activity that caused the problem in the first place, then you still need to go see a professional physical therapist to help you determine exactly what mechanism is causing the problem, and more specifically, which muscles will need to be strengthend or stretched, in order to have a proper gait when you walk or hike, or whether you need to see an orthopedist to resolve the issue because it's more than something that muscle strengthening or flexibility training can resolve. I injured my knee(s) on January 3, and I didn't hike on January 10th, due to weather. On January 17th, I felt ready to hike again, but after only a 5 mile hike, my knees felt very painful. So my wife suggested getting knee braces and going to the doctor to see what else was needed. I went to the doctor, and with the braces he gave me permission to go on a hike on the 24th, but even with the braces on, there was some pain, although much less than from the hike on the previous week, and the original problem in early January. After my injury, I found that I couldn't even ride my recumbent trike, because of the pain after riding a short distance. So my doctor prescribed Physical therapy, but my knees still hurt. I was scheduled to hike on the 31st of January, but that hike was cancelled due to a big rainstorm. So my knees caught a break. I was scheduled to go to the PT on January 6th, a day before my hike on the 7th. The PT told me to NOT go hiking on the 7th or the 14th, but rather to give my knees time to heal, and for me to strengthen my muscles, and to increase my flexibility of my hip with stretches. So the next time I go to hike will be 4 weeks after the 24th of January, when I will be backpacking for 4 days and 3 nights. My PT thinks that I will be ready after 4 weeks of therapy and rest with a heating pad and bedrest. So I'm hoping that my Therapist is right, and I'm pretty confident that she is correct. She seems very competent, and is following most of the advice that I can find on the internet, for this kind of injury. Interestingly, I heard about this kind of injury on the hike on which I incurred the injury. My hiking buddy told me of a 70-something hiker that also rode his bike a lot, who developed an imbalance between the hamstring and quads muscle groups that was causing patella alignment issues, like mine. Go figure.

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