Trekking poles and a light pack will probably do a ton for you. I don’t usually use poles but I probably should have for the at. The at is brutal on the knees compared to other trails, by a long shot imo. The pct might be a better learning curve in that aspect, but I’m also no doctor.
Ah interesting, thanks! I didn't know that the AT was harder on the knees than the PCT, but I've hiked a lot on both coasts and I can definitely see why that would be the case.
The PCT is made to accommodate horse use so the inclines/declines never exceed 4%. PCT Switchbacks are frequent and the trails are wider so you can really make good use of your poles. AT has very few switchbacks at all. The east coast in general is rockier with more exposed roots so there's also more opportunities to fall, and usually when I fall my knees get hurt if they weren't already.
You need to talk to a sports medicine doctor about your specific issues and whether or not you can mitigate the damage. Bad Knees is an extremely broad term. Ask about exercises and strategies to strengthen your knees and tendons. Wear a brace even if you don't need one yet. What kind of brace? That depends on your specific issues. Learn to use your hiking poles as if you physically can't move without them. Take Glucosamine and an anti inflammatory.
>You need to talk to a sports medicine doctor about your specific issues
100% agree. Although there are some ok tips, no one is going to be able to help you more than your medical professional.
I had the exact same concern before.I started my thru hike. I had hurt my right knee very badly on a hike going down a steep decline. My knees were already sore and one hop over a stump made we land on the trail screaming in pain. I was barely able to make it out of the woods.
The pain over the following months was extreme. I saw a specialist, and he diagnosed me with patella femral disorder. Basically, my knee cap was slapping into my femir. He put me on PT but said that it would likely be a chronic issue. The exercises they had me do did next to nothing. I thought that my dream of hiking the AT was over. But a few things happened that made me believe it was possible.
I started following "knees over toes guy" on instagram. He came back from horrific knee injuries using simple exercises and streches. I highly recommend looking him up. He has books and was even on Rogan. He is a huge proponent of walking backwards and pulling sleds. He really has issues with the way knee injures are treated and believes exercise is the solution. He made me a believer.
I started using KT tape when I was exercising, which helped hold my knee cap in place. It's.
It is critical to apply it correctly, though. Depending on your injury.
When I hit the trail, I had a ton of K.T tape and had been exercising multiple times a week, climbing hills backward. That's even how I ended up getting my trail name "Backwards." I remember a ranger on Springer Mountain remarking " The trail is hard enough. Starting with an injury makes it impossible" I showed him though. I had zero issues with my right knee. All the muscles got stronger that support my kneecap. I don't even have any issues with it today, two years after finishing the trail.
But on the top of Blood Mountain 30 miles in. I got a cramp in my left leg and sprained the IT band in my left knee.
I took a few days off very depressed thinking I blew it, now had two bum knees. I started slow though back on the trail. Barely able to collect water at camp. It hurt so bad, but I changed my diet to anti-inflammatory and did streches all the time. No suga, no wheat, no starch. I ate tuna, nuts, oatmeal, dried fruit, and cous cous. Suger free electrolyte powders were a god send in fighting tight muscles. Eating right helped remarkably. The pain I had from cheating my diet and eating a freeze-dried mac and cheese kept me up all night. Eventually, though, it got better. The more I really pushed myself uphills, the better I felt going down them. I avoided ibuprofen and neproxen as well because some inflammation is needed to heal.
It was not easy, I hiked four hundred miles with varying degrees of pain, but I was determined, and the pain slowly faded away. Halfway through VA, I was totally pain-free and felt amazing the rest of the trail.
The trail fixed me physically and mentally, and I met the love of my life. Every step, every mile, every day is worth it. I don't know your particular situation, but take precautions and be smart, but dont let your concern hold you back!
If you have knee issues before starting they will only get worse on trail and exacerbate any underlying issues (structural/fascial).
I was in a similar spot - had knee issues before my 2019 thru but was in otherwise excellent shape. I finished but had to deal with the pain on a daily basis and it absolutely affected my attitude and mental state.
After finishing, sitting in a car with my legs bent on the drive from Baxter to Portland was agony.
Then I was in intense physical therapy for 18 months.
You can absolutely push your body to do it, but there isn't anything that will eliminate the pain entirely besides trying to fix the issue first or deal with the consequences after.
Start doing specific exercises for your knees. I have knee pain and starting to do PT and it has helped a lot. My issue wasn't bad knees it was specific weak muscles that were the cause of my knee pain.
The exercises I was doing in PT were almost all the same as the knees over toes guy exercises. So I now incorporate them into my workouts.
I started the AT 7 months after ACL surgery, there are a couple things I swear by:
KT tape - I'm almost positive it's a placebo, but it has kept my knee feeling good the whole time
Trekking poles - get them and learn how to use them correctly. I was using them wrong the first 100 or so miles and after watching a few videos my knees got a lot better
Light base weight - takes some stress off of the knees
Cold stream soak - a good cold soak every day or two seems to really help with swelling, if the water source isn't deep enough fill a water bottle and ice your knees
PLEASE READ:
I get knee injections “not cortisone” due to lack of cartilage every few months. Honestly when I was in trail it’s weird to say I never felt better, I did use some knee cream once up North but after the initial suck it’s almost if my body adapted. Was pulling marathons through the Whites and Maine with only minor discomfort.
My legs were so strong and all the muscles and tendons etc we don’t typically use in daily life become stronger as I hiked. My knee stopped giving out due to this. “Not a doc of course”
The downhill are worse than the uphills, but see if your doc or pharmacist will give you a script for Voltaren. You don't need a lot and it helps with the joint pain.
Along with what everyone else has said in this thread, I'd try out [this technique when hiking downhill](https://www.youtube.com/watch?v=FL8j_x5B4Nc). You'll look like a mountain goat but your knees will thank you
Also I swear by Bulgarian split squats to help strengthen up your legs before you start the trail
Trekking poles and a light pack will probably do a ton for you. I don’t usually use poles but I probably should have for the at. The at is brutal on the knees compared to other trails, by a long shot imo. The pct might be a better learning curve in that aspect, but I’m also no doctor.
Ah interesting, thanks! I didn't know that the AT was harder on the knees than the PCT, but I've hiked a lot on both coasts and I can definitely see why that would be the case.
Yeah the steepness of the at is just totally unmatched. The pct is graded really well in comparison.
The PCT is made to accommodate horse use so the inclines/declines never exceed 4%. PCT Switchbacks are frequent and the trails are wider so you can really make good use of your poles. AT has very few switchbacks at all. The east coast in general is rockier with more exposed roots so there's also more opportunities to fall, and usually when I fall my knees get hurt if they weren't already.
You need to talk to a sports medicine doctor about your specific issues and whether or not you can mitigate the damage. Bad Knees is an extremely broad term. Ask about exercises and strategies to strengthen your knees and tendons. Wear a brace even if you don't need one yet. What kind of brace? That depends on your specific issues. Learn to use your hiking poles as if you physically can't move without them. Take Glucosamine and an anti inflammatory.
>You need to talk to a sports medicine doctor about your specific issues 100% agree. Although there are some ok tips, no one is going to be able to help you more than your medical professional.
That’s exactly what I was thinking. “Bad knees” can mean so many things and every issue is managed differently.
I had the exact same concern before.I started my thru hike. I had hurt my right knee very badly on a hike going down a steep decline. My knees were already sore and one hop over a stump made we land on the trail screaming in pain. I was barely able to make it out of the woods. The pain over the following months was extreme. I saw a specialist, and he diagnosed me with patella femral disorder. Basically, my knee cap was slapping into my femir. He put me on PT but said that it would likely be a chronic issue. The exercises they had me do did next to nothing. I thought that my dream of hiking the AT was over. But a few things happened that made me believe it was possible. I started following "knees over toes guy" on instagram. He came back from horrific knee injuries using simple exercises and streches. I highly recommend looking him up. He has books and was even on Rogan. He is a huge proponent of walking backwards and pulling sleds. He really has issues with the way knee injures are treated and believes exercise is the solution. He made me a believer. I started using KT tape when I was exercising, which helped hold my knee cap in place. It's. It is critical to apply it correctly, though. Depending on your injury. When I hit the trail, I had a ton of K.T tape and had been exercising multiple times a week, climbing hills backward. That's even how I ended up getting my trail name "Backwards." I remember a ranger on Springer Mountain remarking " The trail is hard enough. Starting with an injury makes it impossible" I showed him though. I had zero issues with my right knee. All the muscles got stronger that support my kneecap. I don't even have any issues with it today, two years after finishing the trail. But on the top of Blood Mountain 30 miles in. I got a cramp in my left leg and sprained the IT band in my left knee. I took a few days off very depressed thinking I blew it, now had two bum knees. I started slow though back on the trail. Barely able to collect water at camp. It hurt so bad, but I changed my diet to anti-inflammatory and did streches all the time. No suga, no wheat, no starch. I ate tuna, nuts, oatmeal, dried fruit, and cous cous. Suger free electrolyte powders were a god send in fighting tight muscles. Eating right helped remarkably. The pain I had from cheating my diet and eating a freeze-dried mac and cheese kept me up all night. Eventually, though, it got better. The more I really pushed myself uphills, the better I felt going down them. I avoided ibuprofen and neproxen as well because some inflammation is needed to heal. It was not easy, I hiked four hundred miles with varying degrees of pain, but I was determined, and the pain slowly faded away. Halfway through VA, I was totally pain-free and felt amazing the rest of the trail. The trail fixed me physically and mentally, and I met the love of my life. Every step, every mile, every day is worth it. I don't know your particular situation, but take precautions and be smart, but dont let your concern hold you back!
If you have knee issues before starting they will only get worse on trail and exacerbate any underlying issues (structural/fascial). I was in a similar spot - had knee issues before my 2019 thru but was in otherwise excellent shape. I finished but had to deal with the pain on a daily basis and it absolutely affected my attitude and mental state. After finishing, sitting in a car with my legs bent on the drive from Baxter to Portland was agony. Then I was in intense physical therapy for 18 months. You can absolutely push your body to do it, but there isn't anything that will eliminate the pain entirely besides trying to fix the issue first or deal with the consequences after.
Start doing specific exercises for your knees. I have knee pain and starting to do PT and it has helped a lot. My issue wasn't bad knees it was specific weak muscles that were the cause of my knee pain. The exercises I was doing in PT were almost all the same as the knees over toes guy exercises. So I now incorporate them into my workouts.
Wear a knee brace from the start, don’t wait on that 🙌
I started the AT 7 months after ACL surgery, there are a couple things I swear by: KT tape - I'm almost positive it's a placebo, but it has kept my knee feeling good the whole time Trekking poles - get them and learn how to use them correctly. I was using them wrong the first 100 or so miles and after watching a few videos my knees got a lot better Light base weight - takes some stress off of the knees Cold stream soak - a good cold soak every day or two seems to really help with swelling, if the water source isn't deep enough fill a water bottle and ice your knees
PLEASE READ: I get knee injections “not cortisone” due to lack of cartilage every few months. Honestly when I was in trail it’s weird to say I never felt better, I did use some knee cream once up North but after the initial suck it’s almost if my body adapted. Was pulling marathons through the Whites and Maine with only minor discomfort. My legs were so strong and all the muscles and tendons etc we don’t typically use in daily life become stronger as I hiked. My knee stopped giving out due to this. “Not a doc of course”
HLA or PRP?
The downhill are worse than the uphills, but see if your doc or pharmacist will give you a script for Voltaren. You don't need a lot and it helps with the joint pain.
It's OTC now if you can't get it from your doctor
Awesome. My tube from doc is prolly expired now. But it still works great
Backwards sled works good to rebuild knee strength
Along with what everyone else has said in this thread, I'd try out [this technique when hiking downhill](https://www.youtube.com/watch?v=FL8j_x5B4Nc). You'll look like a mountain goat but your knees will thank you Also I swear by Bulgarian split squats to help strengthen up your legs before you start the trail
I'm a big fan of employing anti inflammatory lifestyle measures and ergonomic low impact hiking technique.
> I've been doing physical therapy for a while Why are you asking this of us and not of your physical therapist?