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Offline GrandCanyon

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Pain after hiking/running
« on: June 07, 2004, 01:22:49 AM »
I am training for a hike through the Grand Canyon.   Recently I was hiking with a couple friends and for some crazy reason we decided we would jog the trial.  There were some steep inclines and decents.   I was in hiking boots and running flat footed, trying to control my downward speed.  I had about 20 lbs of food/water on my back.   At about 11 miles we decided to walk the rest of the way.  At approximately 15 miles, I had an enormous shooting pain in my knee.  It was another 7 miles back to our car, so I just kept walking.  

I felt find going up stairs, just normal stiffness...but going down was very painful.   I stayed off it for two days and it was back to normal.  Someone told me to take Glucosamine-Chondrotine, I started taking that.  Not convinced it will do any good, but it is probably too early to tell if it does.

I took it easy the rest of the week, and the following Saturday I ran a 10K race on a flat concrete course.  At about 2.5K the pain came back, but I just put it out of my mind.   At 5K, it came back again...I put it out of my mind again and finished the race.    It hurt walking to the car but was fine when I sat down.   It took almost 2 hours to get home, my leg was in the same position, didn't even think about it until I got out of the car to go in the house.  I didn't think I would make it in the house.  It was VERY painful and the only way I could walk on it was to lock my knee fully extended and put weight on it for a very short time.  

It's been resting and almost feeling better again.

I have 34 days until the Grand Canyon trip.  We're planning on hiking 45 miles in two days, from South Rim to North Rim and back, with an elevation change of 25,000 feet.   I don't want to miss the trip.  Someone suggested a brace.

The knee is my left knee, and the pain is greatest on the left side of the knee.   I feel the pain now when I bend it and if I put pressure on it while bent at a 90 degree angle on the left side behind the knee cap.

Any suggestions?

Offline Heather M.

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Re: Pain after hiking/running
« Reply #1 on: June 07, 2004, 02:37:22 AM »
You've got to see a doctor about this.  The Grand Canyone is no place to get stuck with knee issues.  My folks recently did a rafting trip and were struck down with 24 hour stomach flu on the 2nd day of the journey.  They almost had to be airlifted out.  The climate in summer is simply too demanding to do anything if you are not in tip top shape.  Knees can and will ruin your hiking...I used to do 9 mile jaunts in Sedona where I'd be tired and get spaghetti legs at the end; since I was a chronic dislocator, it was sobering to say the least.  It served to remind me how dangerous
these remote places can be.

I urge you to see an orthopedic surgeon who specializes in knees.  If you wish to post where you live, I'm sure someone here can recommend a good doctor.  

The symptoms you describe could be many things--from a torn meniscus to a loose body to chondromalacia to tendinitis to the catch-all 'overuse' injury.  None is life-threatening unless it puts you in a situation where you can't rely on your body to get you out of a tough physical environment.  I would not take on the Canyon without full medical clearance and a good understanding of what is going on in your knee.  It just wouldn't be responsible, to say nothing of potentially ruining your trip of a lifetime.  I, too, plan to do the Grand Canyon (it's only 3.5 hours from my house), but at this point figure I'll be doing it with a knee replacement....

Please consider seeing a *knee specialist* to get clearance to do the trip.  He or she may put you in a short physical therapy program with taping or bracing, and that could help control symptoms.  You just never know...but you really don't want to have your knee lock half-way down the canyon and have to be packed out of there by a search and rescue team.  Or worse, to do the whole trip absolutely miserable because your knee is killing you.

Let us know what you decide to do.

Heather  
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline jathib

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Re: Pain after hiking/running
« Reply #2 on: June 07, 2004, 04:21:39 AM »
You could have torn a meniscus. My lateral meniscus is gone completely and I have a very hard time walking down hills or stairs. Going up is not nearly as painful. If you did tear a meniscus you're going to be in a world of hurt on a 45 mile hike.

Offline GrandCanyon

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Re: Pain after hiking/running
« Reply #3 on: June 08, 2004, 01:33:58 AM »
Good points Heather, thanks  I appreciate it.   I am from S.E. Michigan, Northern Oakland County.     I hate going to the doctor.  

Also, thanks Jathib.

The feedback from both of you helps me to self-diagnose.   Thus avoiding the doctor, but Heather does bring up some good points about being stranded in basically the desert with no good way out.  

We will have satellite phones with us and teams waiting for us on both sides, but the reason they are waiting is because they are not in shape to do the hike...so I guess they would not be of much help in rescue attempts as well!   I hear it is expensive to be lifted out.   $2000, and insurance does not cover it.  

I know someone else who broke his ankle while hiking through the canyon.  Due to forest fires, he could either wait 3 days for a helicopter or walk out on his own.  He chose to walk out.  They did have gear with them that they could have lasted three days.

On our journey we're only planning on taking as much fluids and carbs we estimate will be needing for the journey (and a first aid kit, gps, sat phone..etc, but nothing specific for an overnight stay in the canyon or extra food/water).

We had a team of 8, but 4 dropped out due to various reasons.   I'd hate to have to cause the team to dwindle further..of course, they probably do not want to carry me out too!

Thanks for your input.  It is appreaciated.  

If anyone knows of a good doctor in the S.E. Michigan area, let me know.


Offline Heather M.

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Re: Pain after hiking/running
« Reply #4 on: June 08, 2004, 01:53:55 AM »
Dr. Wojtys in Ann Arbor (Univ. of Mich) is one of the very best knee doctors in the whole country.

I strongly urge you to see him before going to the canyon.  You can't undertake something of that magnitude knowing that it's a possibility your knee will fail you.  A satellite phone won't help except to tell people where your knee gave out!  You'd still have to either hike up to the top or down to the bottom for an airlift.  It's not only cost that's involved, it is incredibly risky to fly a chopper in those conditions with the incredible thermals that can occur in summertime.  So it's not just you that would be affected....

If I were doing the trip I'd honestly rather have someone drop out than know that I might have to pack them out on my back.  If you can't do an equivalent amount of miles on flat ground  at home, I don't know why you'd consider doing it in the desert during the hottest part of the year with an incredibly steep grade/elevation thrown in for good measure.  At this point, can you walk 22 miles a day for two days on flat ground?

It would be a good idea to see Dr. Wojtys and have a checkup.  Janet from this board has had surgery with him and says he's wonderful.  He's a great diagnostician, and his job is to keep active people active, so that philosophy would be very helpful to you.

Let us know what happens.

Heather

« Last Edit: June 08, 2004, 01:54:07 AM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline GrandCanyon

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Re: Pain after hiking/running
« Reply #5 on: June 14, 2004, 07:48:23 PM »
Some good news...   I ran 11.1 miles of a 76 mile relay race this weekend along the North Country Trial that runs through the Manistee National Forest.   My first leg was 6 miles, I ran it and was in pain.  My good leg was compensating, so now the toe on that leg hurts.   But, as soon as I finished I iced it.   My next run was 5.1 miles, and this time I wore a brace.  At about 3.2 miles, my kneecap was killing me, so I loosened the top of the brace and that made it bareable.   By the time I finished I was in so much pain I was laughing.   I iced it and it was stiff yesterday, but I'd consider it normal running stiffness.   I spoke to someone who had knee problems last year in the Canyon and he gave me two exercises his doctor gave him.   Symptoms sounded the same.     So I'm doing those exercises now..basically you bend the knee so it is right over the toes, not too far, and that's supposed to strengthen it.  

I've been doing that.  Today it feels fine.   I think it may be just an over use issue, not anything torn or broken.   I'm still keeping my eye on it .   I have this week to work it out, and an 11 mile run this weekend.

If I go in on the Canyon hike, we have made some contingency plans.   I think if I use the brace going down the south side, that will help.  I am also going to get walking sticks to take some of my weight off of it.   I do not think I will have a problem the first day.  Depending on how that goes, I can get a ride from the North Rim back to the South Rim and just not go the second day.

There is still a good month before the trip, so we'll see how things progress between now and then.  

Offline GrandCanyon

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Re: Pain after hiking/running
« Reply #6 on: June 21, 2004, 03:43:29 PM »
Well, I went to see a specialist, and apparently I am flat footed.  So, some arch supports are being made for me.

My knee feels fine otherwise.  This past weekend we hiked up and down a ski slope to simulate the Canyon.  Not quite the same in terms of elvation changes, but the angle is approximately the same.   The knee survived fine.   Minor pain which I would consider normal stress, but no the crippling pain I was getting when I first posted.

Recovery time has been a lot faster too.   So I think it was probably overstressed from running hills in hiking boots instead of trail running shoes in combination with being flat footed already.  

Now my biggest concern is adapting to altitude and heat.  It's been about 70-80F here and our altitude is at best 1200 ft but often more like 700ft.  


Offline GrandCanyon

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Re: Pain after hiking/running
« Reply #7 on: August 17, 2004, 11:43:46 PM »
The end result...

Well...I didn't have knee problems in the Canyon.   On June 22 I got home and was freezing. I did not think anything of it, despite the fact it was warm outside, I just put on layers and went to bed.   The next morning I went to work and thought, "I think I am sick"...at 11:44 AM, I left work and went home.  Five days later, I am now 19 lbs lighter, still have a high fever, and still cannot eat.  I started drinking gatoraid and eating carb gels to at least get something in my body..though it kept coming out in undesirable ways.

I started feeling better enough to keep food down, but was very weak.  Getting dressed tired me out.   I went to work and people told me to go home, they said I look dead.  

I went to church and ran the sound system.  Everything sounded like feedback to me though there was no feedback.   I decided, "Maybe I should see a doctor".

My blood oxygen saturation was 89% and x-rays revealed double pneumonia.  Several drugs, breathing treatments, and shots later, they told me to come back the next day.  They were doing all they could to keep me from being hospitalized.  

I went back several days in a row.  More shots, more breathing treatments, more drugs.   I was improving though.  I told them about the Canyon trip a couple days away now, they said absolutely not.  I said, "What if I just go to cheer the team on and never leave the lodge"....they said the altitude alone will cause havoc on my lungs, but if I promise to not do ANYTHING physical, I could go.

Phoenix International, barely able to speak I assured the team I'd be able to hike with them in a day.  They laughed as I coughed up a lung.

The day of the trip I dropped them off at the South Rim and sadly watched them off.  I then drove to the North Rim.    I walked up to Bright Angel Point, and felt pretty good.   So I thought I woud go down the trail the guys were to come up on, and just wait for them.  

I got to the tunnels and waited.  In the distance I could see a bridge over a gorge.  I kenw I should not go any further, because coming out would be the hard part...but my mind kept saying, "it's not that much further...it's not that much futher".

Now at the bridge, I decided, "Okay, no more."  I sat there for a half hour before my other personality said, "Look over there, the trail levels out, it's not much further".    I reasoned I might be able to establish radio contact with them if I went there...so I did.

Then I reasoned the Canyon wall was blocking the radio signal...so I would just walk around it and wait...but there were three more walls.   At 6 miles into the Canyon, I got radio contact.  I decided to turn around and start out.   I bent down to place some stones so they knew where I had been.  As I stood up I started to black out.   Not a good sign.

I took it easy, got above the bridge and looked back...I saw them crossing below.  So I pushed myself harder.  My heart is racing to get blood from my lungs.  

By the time they caught up, I could barely move.  My knee felt great, just no oxygen to the brain and the sun was setting.  I would lay down periodically and put my legs above my head..but then it happen.  I started vomitting.  Down on all fours all that came out was gatoraid powder, slightly moist. Then it was dry heaves.

I just kept saying, "This is bad, this is very bad, this is not a good sign".

I made it out with some very small and slow steps.   It was the most physically challenging experience I ever had.

Last weekend I was in Colorado and hiked to the top of Mt.Princeton (www.kramerindustries.com/Colorado2004.ppt).   I started out at about 9,000 feet.  The trail ended at about 12,000 feet and the rest was a rocky climb to 14,197.  I felt good until about 12,600.  It took me a while to make it to the summit, but when I got down back to 10,000 feet, I was VERY exhausted.  

My knee feels great still, like I never had a problem.  I think now I need to go find a lunggeek site, or question my sanity/stupidity.  

The end of this month is a 10 mile race, Flint, Michigan's CRIM.  We'll see how that goes, but I do not anticipate any knee problems.

Thanks for all your insites and advice.  I learned a lot more about knees and appreciate their delicate nature much more!


ariel

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Re: Pain after hiking/running
« Reply #8 on: August 20, 2004, 03:15:39 AM »
Be careful though GrandCanyon - I recently injured my knee mountain running - I'd tend to hike a few thousand foot up then run along plateaus/horseshoes and downhills - I tended to find that because my legs where slightly tired after hiking up, I was then slightly flat-footed when running downhill (because of tiredness) and not using my quads as effectively when decelerating etc - just be careful man, and good luck with the mountains in future.