Managing Knee Pain: What Has Worked for You?

[peregrino_tom]

I recently returned from the camino. I’ve been getting increasingly sore and crackly knees over the last 5 years, but now it’s becoming an issue. I don’t tend to experience much discomfort while walking, except the usual, on long steep downhills – or worse, whole days on the flat. But at night I lie awake in my bunk trying to deal with the pain. It used to recede around midnight, which was OK, but on this last trip it was often still present until 3-4 in the morning. Sometimes I’d take a little Ibuprofen and other times not, as there didn’t seem to be much difference. X-rays on my return (for some camino-sustained fractures, unrelated) show arthritic wear to both knees, so I can no longer ignore that it’s really happening.

What I’m interested in hearing about and exploring with other forum members is how their knee journeys are working out. I can see that my knees are only going in one direction and that ultimately I will probably need to access that Developed World luxury of knee replacement surgery (if I can find the money…). But what happens between now and then? Do many people go down the Synvise/Orthovise injection route first, or is that enough for some to stabilise their birth knees’ usefulness and never need the replacement surgery?

I’m particularly interested in hearing from people who felt their knee pain was becoming a significant issue 5-20 years ago, and what has happened since.
I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?
I’m hoping we can steer clear of repeating all the usual strategies people take while actually walking, as I think those have been covered extensively already, whether it’s using walking/pacer poles, having impact reducing shoes like Altras or Hokas, employing kinesiology tape or knee braces or compression sleeves etc etc. But if you feel these or others are an integral part of your successful stabilising strategy then do say so.
FYI, before posting I did a search on knee journeys on this forum. Here are a couple of related threads, mainly about surgery
https://www.caminodesantiago.me/community/threads/walking-after-knee-replacements.65173/

https://www.caminodesantiago.me/community/threads/new-knees-user-experiences-please.58857/

Cheers, tom

 

[JabbaPapa]

Ibuprofen is suitable for short-term pain, but not chronic.

Please don't consult forum members for self-medication solutions, but instead please consult with your doctor, and if necessary a specialist, for a properly adapted prescription antiinflammatory.

Glucosamine is a food supplement, which provides some degree of relief to only a minority of people.

Other natural food supplement possibilities are ginger, green tea, spirulina, hops, grapes/raisins.

But these can only be supplemental, and for a basic antiinflammatory solution, see your doctor

 

[Bill's_Walking]

I'm sorry to hear about your knees.

My knees issues started more recently but after going to the doctor's including an orthopedic surgeon, my journey goes like this. Initial right knee pain that is consistent with a torn meniscus and Xray showing that I also had arthritis in the right knee. after a mandatory 6 weeks of physical therapy, the MRI confirmed the torn meniscus and found a stress fracture in the right knee. My orthopedic surgeon has me wearing an unloader brace until the fracture heals. However he has told me that I have to wear it when I hike or walk anywhere with hills. This mean I will almost always be wearing the knee brace when doing outdoor activities here in hilly New England. He does not think I need surgery right now, but it is an option if the pain does not abate.

At the end of the day the best person to give you guidance will be a medical professional.

 

[JabbaPapa]

The non-medical basic strategy will be build up muscle mass and diminish your excess body fat.

But this too has its limits, so it's still : see your doctor.

 

[Rick of Rick and Peg]

Over pronation of the foot can cause knee pain. Uneven wear between sides on the the soles of your shoes can be a sign of over pronation. Research this and see if this could be a cause of your problem and bring it up with your doctor.

 

[TMcA]

My right knee started troubling me when I was about 28. I don't know the cause. Maybe a fall I took while skiing. The knee would become swollen, but the inflammation would disappear after 24-36 hours.

At 42 I saw an orthopedic surgeon because my knee was staying inflamed longer - after I played basketball. That doctor asked me what I liked to do for physical activity and advised me to stop running and to absolutely stop playing basketball. So I did. And I was good for about 20 years. At least my right knee was.

Around the age of 60 I started to do some aggressive day hikes. I only carried a light pack, but some of the hikes were well over 10 miles and included 2,000'-3,000' of elevation gain. And then descent. The inflammation started again.

So, I went back to another orthopedist. X-rays were taken. Arthritis was the culprit. I tried glucosamine, though my doctor at the time was skeptical about its efficacy. It seemed not to help. I tried injections in the knee before 3 Caminos. Once I started hiking, relief lasted only a week at the most. Sometimes just days. I tried an elastic knee brace. Not much help. Ibu to reduce swelling and pain helped a little. Physical therapy - strengthening the supporting muscles; maybe helped a little. Acupuncture, a long shot, had no effect.

I eventually had a TKR (Total Knee Replacement), but the results were disappointing. My range of motion post-op was disappointing. And still is. However, I did 3 more Caminos easily even with my lousy range of motion. And my right knee is solid; I can carry somewhat heavy loads of wood from my woodshed to my garage as well as other activities that put a strain on my knees.

There is arthritis in my left knee also, but it is "fine" for a 78 year old knee. Doctors with whom I consulted thought I must have had an injury in the other knee when I was young, but I recall no such event.

Good luck with your knee.

 

[Elle Bieling]

Hey Tom, I don't have trouble with my knees, thank God, but my hands have arthritis, started about 6 years ago. I finally looked at remedies after they ached at night, keeping me awake.

At the risk of sounding like a commercial, I finally found Instaflex. (https://www.instaflex.com/) Don't know if you can get it anywhere but in the USA. They offer a 2 week free trial, so it's worth it to give it a try.

My hands barely ache now and are more functional, so it worked for me. They claim it works for knees too, so hopefully I'm protecting them as well, since knee surgery has been necessary for my older siblings! Good luck!

 

[USSusan]

I recently returned from the camino. I’ve been getting increasingly sore and crackly knees over the last 5 years, but now it’s becoming an issue. I don’t tend to experience much discomfort while walking, except the usual, on long steep downhills – or worse, whole days on the flat. But at night I lie awake in my bunk trying to deal with the pain. It used to recede around midnight, which was OK, but on this last trip it was often still present until 3-4 in the morning. Sometimes I’d take a little Ibuprofen and other times not, as there didn’t seem to be much difference. X-rays on my return (for some camino-sustained fractures, unrelated) show arthritic wear to both knees, so I can no longer ignore that it’s really happening.

What I’m interested in hearing about and exploring with other forum members is how their knee journeys are working out. I can see that my knees are only going in one direction and that ultimately I will probably need to access that Developed World luxury of knee replacement surgery (if I can find the money…). But what happens between now and then? Do many people go down the Synvise/Orthovise injection route first, or is that enough for some to stabilise their birth knees’ usefulness and never need the replacement surgery?

I’m particularly interested in hearing from people who felt their knee pain was becoming a significant issue 5-20 years ago, and what has happened since.
I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?
I’m hoping we can steer clear of repeating all the usual strategies people take while actually walking, as I think those have been covered extensively already, whether it’s using walking/pacer poles, having impact reducing shoes like Altras or Hokas, employing kinesiology tape or knee braces or compression sleeves etc etc. But if you feel these or others are an integral part of your successful stabilising strategy then do say so.
FYI, before posting I did a search on knee journeys on this forum. Here are a couple of related threads, mainly about surgery
https://www.caminodesantiago.me/community/threads/walking-after-knee-replacements.65173/

https://www.caminodesantiago.me/community/threads/new-knees-user-experiences-please.58857/

Cheers, tom

Do you use the hiking poles? I also have bad knees (meniscus tears in both). I found that the poles are a huge help on the steep downhills, which are the hardest on my knees. I found from hiking on the AT that Altras and Hokas actually make my knees worse because they lack the necessary support and glucosamine chondrotin supplements are a waste of money. I am planning my second Camino with my same knees this fall. Poles, non-steroidals as needed and hyaluronic gel injections helped me last time…. Everyone is different and respond to different things. Good luck finding solutions that work for you!

 

[Scott Fraser]

I won't bore you with the all the details but my knees have been up and down over 4 Caminos. Camino 1: Full Frances, age 71, swelling and some minor pain on days 4-10, probably caused by a very heavy pack and an overweight pilgrim. Issues resolved with ice, Ibuprofen and Jacotrans. After Burgos all was good. Camino 2: Full Frances, age 72, no issues. Camino 3: Puy to Pamplona, age 73, right knee clicking a week before SJPdP. Resolved with frequent quad stretching. After six weeks off I returned to Pamplona to finish the Frances. All good until 10km from Logroño when right knee went out. Intense pain. Flew home immediately. After four week wait to see ortho-doc knee recovered. Agreed with the MD that for the next Camino he'd inject steroids before departure. Camino 4: Salamanca to SdC, age 76 and 20 pounds lighter. I switched from boots to Altra Olympus 4 high cushion trail runners. That and cortisone shots did the trick. No issues other than minor morning stiffness for the entire route. Now planning Camino 5 at age 76, June start León to SdC. Saw Ortho-doc in November. X-rays reveal I'm at or very near bone-on-bone in both knees -- severe osteoarthritis. Plan is PT (so far so good) to strengthen muscles, then gym - weights and bike/treadmill , then lots of long walks. If all is good, we'll do more cortisone injections before departure and hope for the best. If pain gets too bad during training or while walking...we'll, I guess I'm done, until I get new knees .

I am inspired by the words of Clint Eastwood. When asked how he kept going, he said, "When he knocks, don't let the old man in."

 

[jtc89]

I recently returned from the camino. I’ve been getting increasingly sore and crackly knees over the last 5 years, but now it’s becoming an issue. I don’t tend to experience much discomfort while walking, except the usual, on long steep downhills – or worse, whole days on the flat. But at night I lie awake in my bunk trying to deal with the pain. It used to recede around midnight, which was OK, but on this last trip it was often still present until 3-4 in the morning. Sometimes I’d take a little Ibuprofen and other times not, as there didn’t seem to be much difference. X-rays on my return (for some camino-sustained fractures, unrelated) show arthritic wear to both knees, so I can no longer ignore that it’s really happening.

What I’m interested in hearing about and exploring with other forum members is how their knee journeys are working out. I can see that my knees are only going in one direction and that ultimately I will probably need to access that Developed World luxury of knee replacement surgery (if I can find the money…). But what happens between now and then? Do many people go down the Synvise/Orthovise injection route first, or is that enough for some to stabilise their birth knees’ usefulness and never need the replacement surgery?

I’m particularly interested in hearing from people who felt their knee pain was becoming a significant issue 5-20 years ago, and what has happened since.
I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?
I’m hoping we can steer clear of repeating all the usual strategies people take while actually walking, as I think those have been covered extensively already, whether it’s using walking/pacer poles, having impact reducing shoes like Altras or Hokas, employing kinesiology tape or knee braces or compression sleeves etc etc. But if you feel these or others are an integral part of your successful stabilising strategy then do say so.
FYI, before posting I did a search on knee journeys on this forum. Here are a couple of related threads, mainly about surgery
https://www.caminodesantiago.me/community/threads/walking-after-knee-replacements.65173/

https://www.caminodesantiago.me/community/threads/new-knees-user-experiences-please.58857/

Cheers, tom

I'm 77 and had to have both my knees replaced. TKR on both one in 2014 and the other in 2015. Find an orthopedic surgeon that has a great reputation for success and that does the minimally invasive surgery. Small incisions and less muscle displacement. The PT after the surgery is the most important part of the process. You MUST push yourself hard, it hurts, but that is when you get the range of motion back. After 6 weeks you have pretty much what you're going to get.

I did Sarria to Santiago in April of this year without any discomfort. I ride a bicycle both on the road and stationary and keep active. When your knees are worn out the only remedy is replacement. Don't wait too long as it takes longer to recover the older you get.

 

[Peregrinopaul]

I think I'm in the same category, or worse, as @Scott Fraser. My solution has been to get on a bike. It's worked so far.

 

[DyanTX]

My knees only occasionally twinge. I have taken glucosamine for years as I did have some issues when hiking in the past. Whether it works or acts as placebo, at least there is no pain. This article has recently appeared regarding injections. I would perhaps read the actual research studies before consulting with my physician. https://www.medicalnewstoday.com/ar...-steroid-injections-or-hyaluronic-acid-better

 

[LewSher]

I walked the Camino when I was 74. Ten and 15 years earlier I had partial knee replacements on my knees. When I started out on the trail my knees hurt like crazy. I bought stock in Voltaran (sp?)--just kidding--and it helped but not much. Halfway through the Camino, my knees began feeling better and eventually I could walk up and down steep hills w/o pain. I attribute this to building up muscle tone as I walked the trail. My advice to anyone with knee issues would be to walk as much as possible for as long as possible BEFORE beginning the Camino--and emphasize the hills. I know, I know, my experience would not be the same for everyone, but I think it's still important to train as much as possible for this wonderful experience. Almost 4 years later, there is not a day that I don't think about it.

 

[JulieandPeter]

Thank you for starting this thread. I've had knee pain off and on for years. Usually a shot would do the trick. We've walked multiple Caminos and usually I would only have pain on the steeper downhill stretches. In June 2022 (much heavier and a little older) we decided to have our packs transported on the steep downhills. We had never done that before and what a difference it made.

In October after pruning 146 lemon trees (we're farmers) my left knee and back were in excruciating pain. Got a shot and it only helped for one day. My right knee started acting up (horrible sudden pain) just before Christmas. Doctor said I'm a candidate for TKR in both knees so this thread is especially interesting to me and it's good to know folks have had success with TKR.

I know weight loss for me is key; I'm basically carrying an extra 50lbs "in my pack" with the weight I've gained and that's hard on the knees. It happened so quickly; I can barely walk and yet I plan another Camino for 2023. In denial, but motivated.

 

[peregrina2000]

So sorry to hear this, Tom, but your post has shown there’s a lot of common misery here on the forum. My knee problems have never been as bad as you describe, but I have had bad pain on descents at least twice — once it started with the descent from San Juan de la Peña and I hobbled all the way to Santiago. The second time it started with the descent to Errezil on the Saiatz variant of the Vasco. My walking buddy told me to start doing several stretching exercises religiously and immediately, and within a few days it had totally subsided. Since that camino, I have stretched my legs every day when I get up (pulling heel to touch the butt is one, another involves putting my leg straight on a table, squeezing my quads and pulling back my toes, and bending forward a bit, and two hamstring stretches).

This may not be helpful for someone with your degree of pain, but in my case there’s no doubt that the pain was caused by weak muscles. Thankfully no arthritis - I assume the exercises have no effect on that. Good luck with this, it’s a pretty awful affliction for a camino addict like you.

 

[JabbaPapa]

FWIW, my need for knee braces vanished away at the grotto in Lourdes.

Still in pain on a daily basis, but my erstwhile need for mechanical assistance to my joints simply vanished after that visit to that Marian Sanctuary.

 

[Lydia Gillen]

Tom, I have had a total knee replacement on my left knee, and it was like a miracle. However I had been advised by my surgeon to do pre-op physio. But because I had other things lined up so I put off the operation for 11 (eleven weeks) and did the physio faithfully for a few minutes every morning and night strengthening the muscles need for afterwards. The healing was amazing, nurses used to say "you cant do that, you are only day 2 or 3," but I had just done it, thanks to the pre-op physio.
A few years later when I wanted the right knee done he said "No that sometimes when a person had a very good result of first knee they came too early for the second and could be disappointed". he told me "LOSE WEIGHT. I lost 10 kilo and was much the better for it. Unfortunately in the last few months I have put on 6 kilo, so now I face a few lean months before a Camino in May!!!

 

[Gadflyparexcellence]

You may find the following interesting

https://www.nytimes.com/2022/06/08/well/move/walking-knee-pain-relief.html?unlocked_article_code=kjPju_0mWivW-zVVMgc-_AGCizQqR_2b5CAbpc8_n8F2iDVUl3ZMzb3YUDdOrtan1hCQ0eCBqUL7SGAHP21c64uGfkxRXWR6CK1xusDzB86qLU1hxy1SWAzRlY-FVzOBU8o5Sn8iatXyMXxUp1Zj_ud1Dv0Ja2LpnS6Y9CqTaIvH9EZsWU-g1mUVbVQtFAKc8Zp_dUqMxy7P6Oz6Cu-opU4On1DZUkkP2VgkxMykb2xsdDXF66Y_19QaRpi6s-q72VwhppKxwyjOyRDKwfHg0k39RLEbPg3oEOOI0DnIuawL1OTHFeAfC3voegKVXsS3Yi4k_u67Qn4r5D-FLSvyyd4xego&smid=share-url

 

[CarrieJL]

I have “minor” knee issues so far. What helped me on Camino Frances is
prior training & conditioning, used day
Pack instead of backpack, cross trained on bike and PT exercises. During Camino
Frances, I exercised end of day, every other day. Multi prong approach included adding powdered collagen in drinks daily. I’d focus more On PT exercises rather than doc unless Pain is unbearable where surgery is needed. Docs’ jobs are
To medicate and lacerate but PTs jobs are to strengthen and return to some
Range of motion. Best of luck!

 

[Walton]

This is a great topic.

Fourteen years ago, I developed a severe pain in my right knee in China after being forced to walk a couple of kilometres in 102 F heat carrying a laptop, and a backpack and dragging a heavy suitcase because the University that I was teaching at suddenly decided that taxis would not be admitted to the University grounds. It didn't matter that I had a flight to Australia to catch.

Anyway, cut a long story short, most of my right meniscus somehow disappeared to the extent that a workplace doctor after seeing the MRI's accused me of having previous surgery.
With excerise that knee resolved itself and I was subsequently able to walk the Francis and the Portuguese.

Two months ago, my left knee gave issues. The physiotherapist diagnised medial ligament damage and prescribed exercises to recover. I think there is a bit more going on though.

I'm now looking at how I'm walking - there are quite a few videos on Youtube while awaiting a doctors appointment to investigate further.

Supposed to be walking the Via del Plata in April but that is under a cloud and because I've transgressed somehow, my wife is not talking to me at the moment so that is thwarting planning.

I recon if you are lucky enough to live long enough, sooner or later you are going to have some kind of problem caused by wear and tear and aging.

All the best with your knees - they most certainly can be very painful.

 

[dougfitz]

I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?

@peregrino_tom, this is a great question, and I did a range of almost everything mentioned already in this thread over the years. Without trying to depress you about the effectiveness of any particular solution, as individuals we have no idea whether our personal approaches to this did much, if anything, to extend the life of our knees. That said, some posters have shared articles based on research that has some prospect of giving some indication of what works, although this subject still seems to have myriad treatments that might work well for only some people, and for others make no practical difference.

I reached the point where I had become so limited in the distances I could do that I had my second TKR, this time my left knee. The other knee was replaced a few years ago. Over that time I continued to do the things you already know about - walking poles, knee braces, OTC analgesics for pain management, supplements, and kept walking.

I walked the CP this in May this year having planned substantially shorter stages, typically 20 km or less. There were a couple of longer days. Whereas I had never regularly taken ibuprofen, I needed to take it every day to supplement the modified release paracetamol I routinely take for pain management of my osteoarthritis. I also took more regular breaks, at bars, cafes or to check out a grocery store mostly, but also just at some convenient roadside seat where there was one.

I was still able to walk around 20 km/day until late Sep, but with increased discomfort. For the next couple of months, I was finding it difficult to contemplate anything more than 10 km, which I could manage but needed to take ibuprofen to deal with the pain.

The only thing that I didn't contemplate was cortisone injections, an approach my GP had recommended against. Across several GPs and my surgeon, using supplements was seen as an approach where the evidence of good results was too uncertain to recommend it unreservedly, but no-one was prepared to say that it wouldn't work.

My approach was to try anything that might work, and only avoid treatments that were specifically not recommended. I consulted my GP and surgeon regularly over the years, as you should too.

 

[David Tallan]

I recently returned from the camino. I’ve been getting increasingly sore and crackly knees over the last 5 years, but now it’s becoming an issue. I don’t tend to experience much discomfort while walking, except the usual, on long steep downhills – or worse, whole days on the flat. But at night I lie awake in my bunk trying to deal with the pain. It used to recede around midnight, which was OK, but on this last trip it was often still present until 3-4 in the morning. Sometimes I’d take a little Ibuprofen and other times not, as there didn’t seem to be much difference. X-rays on my return (for some camino-sustained fractures, unrelated) show arthritic wear to both knees, so I can no longer ignore that it’s really happening.

What I’m interested in hearing about and exploring with other forum members is how their knee journeys are working out. I can see that my knees are only going in one direction and that ultimately I will probably need to access that Developed World luxury of knee replacement surgery (if I can find the money…). But what happens between now and then? Do many people go down the Synvise/Orthovise injection route first, or is that enough for some to stabilise their birth knees’ usefulness and never need the replacement surgery?

I’m particularly interested in hearing from people who felt their knee pain was becoming a significant issue 5-20 years ago, and what has happened since.
I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?
I’m hoping we can steer clear of repeating all the usual strategies people take while actually walking, as I think those have been covered extensively already, whether it’s using walking/pacer poles, having impact reducing shoes like Altras or Hokas, employing kinesiology tape or knee braces or compression sleeves etc etc. But if you feel these or others are an integral part of your successful stabilising strategy then do say so.
FYI, before posting I did a search on knee journeys on this forum. Here are a couple of related threads, mainly about surgery
https://www.caminodesantiago.me/community/threads/walking-after-knee-replacements.65173/

https://www.caminodesantiago.me/community/threads/new-knees-user-experiences-please.58857/

Cheers, tom

For what it is worth, I shot my knees completely on the Camino Frances. It was clear that they were going by the time we arrived in Puente la Reina. I needed knee braces, lots of ibuprofen, and hiking poles (which I picked up in Viana when everything else wasn't enough) for the rest of the Camino to see me through. I tried cutting back on the knee braces (because it was hot and they were sweaty!) but I needed all three right to the end. But over time, my knees recovered. I did lots of training, with hiking poles, for my 2018 Camino Portugues. And on that Camino, my knees were fine. I didn't need the ibuprofen or knee brances

 

[WanderingBrian]

My friend who walked the Sept Camino with me has a bad knee. If you watch my video I posted, you can see he is wearing a knee brace but also how weak and awkward the leg is. I asked him numerous times how was he able to persist with that knee. He told me: naproxin, his brace, using walking poles 100% of the time, some persistence, and, oddly enough, his Oofos shoes. He said the Oofos made a world of difference. I was like really? Oofos recovery shoes? He said he will never walk another Camino without them. So they must help. He has done the Frances and the Portugues with that knee.

 

[Sixwheeler]

I recently returned from the camino. I’ve been getting increasingly sore and crackly knees over the last 5 years, but now it’s becoming an issue. I don’t tend to experience much discomfort while walking, except the usual, on long steep downhills – or worse, whole days on the flat. But at night I lie awake in my bunk trying to deal with the pain. It used to recede around midnight, which was OK, but on this last trip it was often still present until 3-4 in the morning. Sometimes I’d take a little Ibuprofen and other times not, as there didn’t seem to be much difference. X-rays on my return (for some camino-sustained fractures, unrelated) show arthritic wear to both knees, so I can no longer ignore that it’s really happening.

What I’m interested in hearing about and exploring with other forum members is how their knee journeys are working out. I can see that my knees are only going in one direction and that ultimately I will probably need to access that Developed World luxury of knee replacement surgery (if I can find the money…). But what happens between now and then? Do many people go down the Synvise/Orthovise injection route first, or is that enough for some to stabilise their birth knees’ usefulness and never need the replacement surgery?

I’m particularly interested in hearing from people who felt their knee pain was becoming a significant issue 5-20 years ago, and what has happened since.
I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?
I’m hoping we can steer clear of repeating all the usual strategies people take while actually walking, as I think those have been covered extensively already, whether it’s using walking/pacer poles, having impact reducing shoes like Altras or Hokas, employing kinesiology tape or knee braces or compression sleeves etc etc. But if you feel these or others are an integral part of your successful stabilising strategy then do say so.
FYI, before posting I did a search on knee journeys on this forum. Here are a couple of related threads, mainly about surgery
https://www.caminodesantiago.me/community/threads/walking-after-knee-replacements.65173/

https://www.caminodesantiago.me/community/threads/new-knees-user-experiences-please.58857/

Cheers, tom

Many years of mountaineering and Morris Dancing wrecked my lead (left) knee and I had a half knee replacement eleven years ago which solved my problems. Now it seems the joint replacement was not correctly aligned and I'm back where I started and waiting for my knee replacement to be replaced...........hopefully this year. Fortunately my local hospital has a specialist knee physiotherapist whose exercises keep me going in the meantime.

If I were to offer advice it would be:
1. Don't ask on here, get advice from your doctor tailored exclusively to you.
2. If you have to have surgery it hurts like Hell but that soon goes but you will need to do hard physio post-op to get full joint movement.
3. Surgeons are good but physios are also very good indeed.

Good Luck.

 

[Tassie Kaz]

@peregrino_tom & others interested...

After many walks which, a few hours in turned into limping & tears, I thought my walking days were over...said she before her first foray into the world of long distance walking (CF in 2012).
My solution; not pills, poles, support braces/bandages or shorter distances...I changed the way I walk..the actual mechanics of it.
I discovered that if, with each step, I lift my leg to a 90degree angle (like marching) & then control placing my foot back on the ground through my upper leg muscles rather than just plonking it down, all the pressure was taken off my knees & I no longer experienced any pain or swelling.

It took some practice to become second nature but since then (over 10 years ago), with the exception of long, steep descents, it is no longer an issue, including with fluctuating weight & fitness & increasing age (I'm 56). In fact I don't even think about it anymore. If you look up my member profile, you'll see the trails I've done since.

Other contributors are saying don't ask here for advice on a medical issue...well, what harm can my solution do? You can start immediately, it's drug-free, requires no special equipment & will cost you nothing (except time)...either money or further risk to your knees.

Edited to clarify; I don't 'march' everywhere! ...I walk normally (still controlling foot placement through thigh muscles though) until for eg; a descent, tricky terrain, after many hours or a day on the trail, or I feel a twinge, etc... basically anytime I think could test my knees, I engage the march method before I feel any pain. As I said, it's second nature to me now, almost auto-pilot.

Give it a go...you have nothing to lose in trying & may well find the answer as I did.
Best wishes...I'd be interested to know if you try it, how you get on.

 

[Walton]

@peregrino_tom & others interested...

After many walks which, a few hours in turned into limping & tears, I thought my walking days were over...said she before her first foray into the world of long distance walking (CF in 2012).
My solution; not pills, poles, support braces/bandages or shorter distances...I changed the way I walk..the actual mechanics of it.

That's exactly what I'm doing now Tazzie Kas!

Asking myself -

Am I walking correctly?

And

What is most likely the correct way to walk?

The only thing different from you at the moment is that I'm leaning forward slightly.

I think any knee examination needs to look at the whole leg structure from a medical point of view, at the footwear, and at how one walks.

I'm also looking at knee strengthening exercises.

I'm hoping the ever knowledgeable Dave Bugg might have something to say here.

This a great thread!

Cheers

Graham

 

[Tassie Kaz]

That's exactly what I'm doing now Tazzie Kas!

Asking myself -

Am I walking correctly?

And

What is most likely the correct way to walk?

The only thing different from you at the moment is that I'm leaning forward slightly.

I think any knee examination needs to look at the whole leg structure from a medical point of view, at the footwear, and at how one walks.

I'm also looking at knee strengthening exercises.

I'm hoping the ever knowledgeable Dave Bugg might have something to say here.

This a great thread!

Cheers

Graham

Good on you @Walton!
I found this method out of frustration/desperation due to not wanting to just mask it with painkillers...I wanted an actual solution so, as @peregrino_tom puts it, I can hang on to my own knees for as long as possible.

My practice trials at Cradle Mountain NP did provide amusement for other hikers until I found a more subtle/second nature way to do it.
Oh...& my solution to those long, steep descents?...walk down backwards...if safe to do so!
Happy trails...& solutions!

 

[peregrino_tom]

Wow - thanks everyone!
For those of you that have shared your medical issues, trials and tribulations: muchos gracis, this is much appreciated and really valuable. From piecing together these various journeys I'm starting to get a better understanding of the kinds of strategies I can undertake now to reduce the arthritic wear as it heads towards the dreaded bone-on-bone scenario... (other than stop long distance walking altogether - although Peregrinopaul's sideways move to cycling is an interesting idea). Also a better idea as to what might lie ahead and how to prepare for it.

I hear those of you who say 'go and talk to your doctor' but I believe that the experiences shared here are informing me about the particular context and predicament of the camino thru-hiker - something I can take with me into any future (and apparently inevitable) medical conversations.

Arthritis was the culprit. I tried glucosamine, though my doctor at the time was skeptical about its efficacy. It seemed not to help. I tried injections in the knee before 3 Caminos. Once I started hiking, relief lasted only a week at the most. Sometimes just days. I tried an elastic knee brace. Not much help. Ibu to reduce swelling and pain helped a little. Physical therapy - strengthening the supporting muscles; maybe helped a little. Acupuncture, a long shot, had no effect.

I eventually had a TKR (Total Knee Replacement), but the results were disappointing. My range of motion post-op was disappointing. And still is. However, I did 3 more Caminos easily even with my lousy range of motion. And my right knee is solid; I can carry somewhat heavy loads of wood from my woodshed to my garage as well as other activities that put a strain on my knees.

TMcA - thank you. Still, despite the limited motion range you've managed three caminos on the TKR - sounds pretty amazing to me.

I finally found Instaflex. (https://www.instaflex.com/)

Elle, thanks, unfortunately I can't access that link at the moment: my internet provider says I have to register my details and confirm my age as 18+ before it will let me proceed! But reviews I've seen in my seach engine are pretty positive. PS Curious as to whether you are still an advocate for the Kinesiology tape you recommended a few years ago?

If all is good, we'll do more cortisone injections before departure and hope for the best. If pain gets too bad during training or while walking...we'll, I guess I'm done, until I get new knees .

Scott, thanks for the info. The cortisone injections seem to get a mixed reception but at least they've been working for you.

The PT after the surgery is the most important part of the process. You MUST push yourself hard, it hurts, but that is when you get the range of motion back. After 6 weeks you have pretty much what you're going to get.

I did Sarria to Santiago in April of this year without any discomfort. I ride a bicycle both on the road and stationary and keep active. When your knees are worn out the only remedy is replacement. Don't wait too long as it takes longer to recover the older you get.

jtc: very useful - thanks for the info.

I know, my experience would not be the same for everyone, but I think it's still important to train as much as possible for this wonderful experience. Almost 4 years later, there is not a day that I don't think about it.

I agree. Didn't used to have to do any prep at all in the past, but now it's very important

This may not be helpful for someone with your degree of pain, but in my case there’s no doubt that the pain was caused by weak muscles.

Hi Laurie, actually I don't notice the pain much during the day at all. I'm a little envious that you continue to power through so many caminos without apparent joint wear! I'm going to the gym now and enjoying doing various exercises for quads and glutes that the instructor has put together.

did the physio faithfully for a few minutes every morning and night strengthening the muscles need for afterwards. The healing was amazing, nurses used to say "you cant do that, you are only day 2 or 3," but I had just done it, thanks to the pre-op physio.

Lydia, that's great advice, thanks

Docs’ jobs are To medicate and lacerate but PTs jobs are to strengthen and return to some
Range of motion.

True that!

I reached the point where I had become so limited in the distances I could do that I had my second TKR, this time my left knee. The other knee was replaced a few years ago. Over that time I continued to do the things you already know about - walking poles, knee braces, OTC analgesics for pain management, supplements, and kept walking.

I walked the CP this in May this year having planned substantially shorter stages, typically 20 km or less. There were a couple of longer days. Whereas I had never regularly taken ibuprofen, I needed to take it every day to supplement the modified release paracetamol I routinely take for pain management of my osteoarthritis. I also took more regular breaks, at bars, cafes or to check out a grocery store mostly, but also just at some convenient roadside seat where there was one.

I was still able to walk around 20 km/day until late Sep, but with increased discomfort. For the next couple of months, I was finding it difficult to contemplate anything more than 10 km, which I could manage but needed to take ibuprofen to deal with the pain.

Doug, thanks. This is the kind of gradual decline in performance that I think many of us are working out how to deal with. Liking your strategies and tenacity here

But over time, my knees recovered. I did lots of training, with hiking poles, for my 2018 Camino Portugues. And on that Camino, my knees were fine. I didn't need the ibuprofen or knee brances

David, this sounds like me a few years back. But hopefully you don't follow the same deterioration path as me!

He said the Oofos made a world of difference.

Brian, thanks, I had heard about these before. Looking more like a worthwhile investment now.

I changed the way I walk..the actual mechanics of it.

Tassie thanks. Posture, gait, walking style, frequency and types of stretches and exercises are all things I'm reviewing!

Cheers, tom

 

[Elle Bieling]

Elle, thanks, unfortunately I can't access that link at the moment: my internet provider says I have to register my details and confirm my age as 18+ before it will let me proceed! But reviews I've seen in my seach engine are pretty positive. PS Curious as to whether you are still an advocate for the Kinesiology tape you recommended a few years ago?

Tom, sorry about the link. Don't know what to tell you there. That's never happened to me.

And yes, absolutely I still recommend kinesiology tape!! I still use it when I do long distance walks and mountain hikes at home. And poles. Anything to support the knees and take weight off them!

I also agree that walking long distances helps the arthritis in my hands! Keeping that circulation going seems paramount for all our joints.

 

[peregrina2000]

I'm going to the gym now and enjoying doing various exercises for quads and glutes that the instructor has put together.

Oh, my how could I have forgotten the GLUTES?! After my hamstring injury in 2021, my physical therapist told me that the glutes are muscles that are missing in action for most people. (Maybe he was only talking about people in the US, but I suspect it’s more widely true). It took me months to even be able to identify when my glutes were “kicking in.” The day I could tell that I was “pedalling from my glutes” on my bicycle was one of those aha moments.

In fact, all this talk has spurred me to call my trainer and start in again on a two day a week regime for core, glutes, quads — all those moving parts that my daily elliptical and bike riding routine don’t engage with. I am not going to go away quietly into the night! And I do want to walk a few more mountainous caminos in the next few years, so keeping those muscles in good shape has to be a good thing.

Hope the exercise regimen helps with the knee problem, @peregrino_tom. Isn’t the camino a wonderful motivator?!

 

[Walton]

I just want to add something about crossing your legs. No funny ideas folks This is not one of those forums you read about. Seriously!

Anyway, if you read couple of my previous posts above, you will learn that I have developed a physiotherapist diagnosed medial collateral ligament issue (MCL) on the inside of my left knee.

So like Tassie Kaz, I'm looking at how I walk.

But there is one other thing that I missed that I just thought about.

I am a bit of a habitual leg crosser and its always my left leg over my right. If I cross my legs while sitting down, I have noticed that my left knee on standing, really hurts.

According to Doctor Google, crossing your legs can stretch your knee ligaments and muscles surrounding the knee. It probably doesn't matter so much when you are young, but if you are getting on in years like me, maybe it does matter.

I recall getting an injury in my elbow ligaments thanks to martial art sparring. The doctor explained that older ligaments never quite bounce back after injury in similar way compared to an old rubber band.

Leg crossing can also, apparently affect hips, pelvis and spine.

So stretching those ligaments and muscles unnecessarily. Maybe not a good idea for older folks.

Something to think about especially those of us who have knee, pelvis hip or spinal issues.

I shall immediately forthwith adopt an ungainly manspreading sit! - for medical purposes of course!

Cheers

Graham

 

[Former member 104756]

PS Curious as to whether you are still an advocate for the Kinesiology tape you recommended a few years ago?

Hi Tom. To add my two cents to the question of the tape. Like @Elle Bieling I recommend trying kinesiology tape.

After just 4 days on Camino Piemont in April 22 I exprenced debilitating knee pain (self diagnosed patella injury). Could barely put any weight on and up or down hills or stairs was excruciating. Painkillers and voltaren gel etc did not have any impact. With prospect of having to stop, I remembered reading about KT. So I thought there was nothing to lose by trying it. Luckily we were in a town big enough to have a pharmacy. So i hobbled there with my husband. Back in our room we watched a YouTube video of how to strap my knee. We watched it three times.

The difference for me was immediate and verging on miraculous. I was able to continue for the next three weeks inc some serious ascents and descents without any significant discomfort. I could leave the tape on for 3 days inc under the shower. My impression is that the positioning and tension of the tape are v important to its effectiveness. The video we watched went in to detail on this and I followed it to the letter.

I was hesitant to post about my experience with KT. I’ve done so before and was poo pooed by some on the forum including by one member who suggested it was at best a placebo effect and I was likely mesmerised by the pretty brightly coloured tape . For the record, the tape I used was black, as per photo below

Of course it’s not a ‘cure’ for our aging knees. All I can say is that it worked very well for me and i will carry it in my pack on my next camino … just in case.

All the best Tom

 

[BruceNZ]

Hi Tom... as a pom you may be in to tea so have you tried Rooibos tea ? Has strong anti inflationary properties.
I was finding increasing stiffness in fingers etc and started drinking 2 4 cups a day (no milk). After about 6 weeks I started realising everything just felt more agile. I use a Tea pot and get a couple of cups out of a bag mainly because then it's not too strong taste ... and I'm a bit er thrifty (i.e. mean ha ha!).
Friends found same result from hip n other issues. May be worth a try

 

[Betsybro]

Hi, Tom, Thanks for starting this conversation. Very interesting and pertinent to me, as both of my knees have arthritis. I had knee arthroscopy 10 years ago to repair a flipped meniscus. The surgeon told my husband my next surgery would be a replacement since there was so much damage. But here I am 10 years later with still functioning knees. Losing weight helped, but walking more, including the hills of Seattle, has strengthened my knees. I am a newly retired family doctor and recommend trying to avoid regular ibuprofen or naproxen for the two reasons that chronic use can hurt the kidneys or cause gastric ulcers. I personally would avoid the steroid injections- some compelling data shows that they may increase destruction of the cartilage faster. Glucosamine works in dogs and animals so is worth trying. I think using your knees and strengthening the muscles around them is really helpful. My biggest recommendation for you is to sleep with a small pillow between your knees. I do and I am amazed how much less knee pain I have at night. No ibuprofen needed.

 

[Lurch]

One more geezer here with knee problems. I injured my knees at work, so work comp covers the bills, thankfully, as you will see. Right knee replaced five times. , first four lasted less than a year, number five has lasted 6 years now! From experience, gels, pills, even arthroscopic surgery is a placebo. If it needs replacing, do it, do not procrastinate.

At this time, I am lying in bed with severe pain in left knee. It is bone on bone for three years now, but for some reason I have been reluctant to replace it. Now paying the penalty as I can’t bend it without extreme pain and it feels as if there is tendon damage. I see the orthopedic next Thursday and am sure he will recommend replacement. As he has done for three ears. I only hope that I have not done more damage by my procrastination. So yes, from experience, get it replaced. In my case this is going to cost me my planned Camino venture in mid-March.

 

[clarkandkaren]

I recently returned from the camino. I’ve been getting increasingly sore and crackly knees over the last 5 years, but now it’s becoming an issue. I don’t tend to experience much discomfort while walking, except the usual, on long steep downhills – or worse, whole days on the flat. But at night I lie awake in my bunk trying to deal with the pain. It used to recede around midnight, which was OK, but on this last trip it was often still present until 3-4 in the morning. Sometimes I’d take a little Ibuprofen and other times not, as there didn’t seem to be much difference. X-rays on my return (for some camino-sustained fractures, unrelated) show arthritic wear to both knees, so I can no longer ignore that it’s really happening.

What I’m interested in hearing about and exploring with other forum members is how their knee journeys are working out. I can see that my knees are only going in one direction and that ultimately I will probably need to access that Developed World luxury of knee replacement surgery (if I can find the money…). But what happens between now and then? Do many people go down the Synvise/Orthovise injection route first, or is that enough for some to stabilise their birth knees’ usefulness and never need the replacement surgery?

I’m particularly interested in hearing from people who felt their knee pain was becoming a significant issue 5-20 years ago, and what has happened since.
I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?
I’m hoping we can steer clear of repeating all the usual strategies people take while actually walking, as I think those have been covered extensively already, whether it’s using walking/pacer poles, having impact reducing shoes like Altras or Hokas, employing kinesiology tape or knee braces or compression sleeves etc etc. But if you feel these or others are an integral part of your successful stabilising strategy then do say so.
FYI, before posting I did a search on knee journeys on this forum. Here are a couple of related threads, mainly about surgery
https://www.caminodesantiago.me/community/threads/walking-after-knee-replacements.65173/

https://www.caminodesantiago.me/community/threads/new-knees-user-experiences-please.58857/

Cheers, tom

I can speak to your question from the perspective of someone who has had knee issues for more than 37 years.
Before going any further, I will say the Euflexxa, SynVisc, and shark cartilage derivatives prior to those synthetic materials, have literally saved my knees and extended both my hiking and cycling abilities FAR BEYOND what I would have experience without them.
At this point in life, I’m 64, had my 4th and last knee surgery in 2007 (torn ACL at 49 yrs old.. playing Baseball), I have as close to bone-on-bone (no cartilage) in both knees.
For the last 14 years I have taken injections of SynVisc, or the various iterations, every 6 months.”As a consequence, I bicycle more than 10,000 miles a year and walk more than a few hundred every year!
Over the years I have recommended this treatment to more than a dozen people, mostly cyclists, all have had the same experiences I’ve come to expect.
All I can say is that you give it a chance. If it doesn’t work, the material will slowly compress out and, unless some underlying issue you’ve not stated, your normal “ state-of-pain” will return. For me, and those I ride with who continue the injections, these have been excellent in terms of preventing complete knee replacements.
As for the other aspects to consider, good quality hiking boots, the best inner soles and a light-weight carbon fiber hiking pole are absolute necessities. However, without the injections, they would be of little use.
Good luck with whatever you do.

 

[HeidiL]

Oh, how nice to have found My People! I have had knee problems for many years, and after having a stroke, cannot use Arthrotec, which was a miracle cure for me. Currently, poles, taping, exercises taught by physiotherapist and avoiding hilly terrain is enough - along with learning a new style of walking, particularly walking up and down stairs and the odd unavoidable hill: toes land first, which means that there is no uncomfortable jolt inside the knee when the heel lands. After a while, it stopped feeling odd and I always do it.

 

[peregrino_tom]

And yes, absolutely I still recommend kinesiology tape!!

Cheers Elle. See Pelerin comment below

Hope the exercise regimen helps with the knee problem, @peregrino_tom. Isn’t the camino a wonderful motivator?!

Laurie, yes - I guess it's the equivalent motivator to people who try and lose a few pounds before going on a beach holiday ;-) It seems it can certainly give some purpose around an exercise regimen and help us not to backslide when idleness beckons..

Leg crossing can also, apparently affect hips, pelvis and spine.

So stretching those ligaments and muscles unnecessarily. Maybe not a good idea for older folks.

Interesting! Might look into this one a bit more.

Like @Elle Bieling I recommend kinesiology tape.

I was using a knee compression sleeve after my recent fall on the camino. It strikes me that the way the cross-straps bind around the knee cap is very similar to the positioning of the KT.

have you tried Rooibos tea ? Has strong anti inflationary properties.

I don't drink as much as you, but I like it, no big lifestyle change necessary here!

But here I am 10 years later with still functioning knees. Losing weight helped, but walking more, including the hills of Seattle, has strengthened my knees. I am a newly retired family doctor and recommend trying to avoid regular ibuprofen or naproxen for the two reasons that chronic use can hurt the kidneys or cause gastric ulcers. I personally would avoid the steroid injections- some compelling data shows that they may increase destruction of the cartilage faster. Glucosamine works in dogs and animals so is worth trying. I think using your knees and strengthening the muscles around them is really helpful. My biggest recommendation for you is to sleep with a small pillow between your knees. I do and I am amazed how much less knee pain I have at night. No ibuprofen needed.

Betsy, there's so much here that I'm already aligned with. The whole walking thing is a bit of a conundrum: walking wears out our joints, but hills can both strengthen our legs to prevent wear, as well as induce discomfort on the downhills (as presumably what goes up must come down.. but perhaps ageing camino preppers could get a discount on ski lifts, by only coming down the mountain in them? )
The pillow thing is fascinating - I'd already started doing that without anyone's advice, because I'm a side sleeper and the two knee bones against each other sometimes hurts, particularly after a big walk.

At this time, I am lying in bed with severe pain in left knee. It is bone on bone for three years now, but for some reason I have been reluctant to replace it. Now paying the penalty as I can’t bend it without extreme pain and it feels as if there is tendon damage. I see the orthopedic next Thursday and am sure he will recommend replacement.

Lurch, this sounds grim. I really hope you manage to make the right decision next week on whatever the professional recommends. While missing your March camino is tough, the right therapeutic interventions may put you in a better longer term frame for future, further away caminos. Fingers crossed.

I can speak to your question from the perspective of someone who has had knee issues for more than 37 years.
Before going any further, I will say the Euflexxa, SynVisc, and shark cartilage derivatives prior to those synthetic materials, have literally saved my knees and extended both my hiking and cycling abilities FAR BEYOND what I would have experience without them.
At this point in life, I’m 64, had my 4th and last knee surgery in 2007 (torn ACL at 49 yrs old.. playing Baseball), I have as close to bone-on-bone (no cartilage) in both knees.
For the last 14 years I have taken injections of SynVisc, or the various iterations, every 6 months.”As a consequence, I bicycle more than 10,000 miles a year and walk more than a few hundred every year!
Over the years I have recommended this treatment to more than a dozen people, mostly cyclists, all have had the same experiences I’ve come to expect.

clarkandkaren - I'm hoping that not ever having torn anything myself, this is a route I won't need to go down! but it's interesting. Really seems to be working for you.

I have had knee problems for many years, and after having a stroke, cannot use Arthrotec, which was a miracle cure for me. Currently, poles, taping, exercises taught by physiotherapist and avoiding hilly terrain is enough - along with learning a new style of walking, particularly walking up and down stairs and the odd unavoidable hill: toes land first, which means that there is no uncomfortable jolt inside the knee when the heel lands.

Heidi - I very much like that since putting aside the Arthrotec you are making more natural adaptations and they seem to be working for you.

Wow - thanks everyone! A wide range of experiences and views once again. I definitely don't have the level of pain and severity that some of you are experiencing. But I appreciate that some of that may lie ahead - or not, because at this point it feels like there's quite a lot of self-determination in play, quite a few forks in the road where I can still decide to take the high road or the low road (in camino-speak).
I'm more focused right now on the little walking/lifestyle-changing measures that have worked for some of you. These might alleviate immediate discomfort while in the act of walking (which I actually experience very little of at the moment) and/or prevent slow down further joint wear.
Actually I'm amazed at what some of you are prepared to put up with in order to walk the camino - be careful out there!
Cheers, tom

 

[Lurch]

Cheers Elle. See Pelerin comment below

Laurie, yes - I guess it's the equivalent motivator to people who try and lose a few pounds before going on a beach holiday ;-) It seems it can certainly give some purpose around an exercise regimen and help us not to backslide when idleness beckons..


Interesting! Might look into this one a bit more.


I was using a knee compression sleeve after my recent fall on the camino. It strikes me that the way the cross-straps bind around the knee cap is very similar to the positioning of the KT.


I don't drink as much as you, but I like it, no big lifestyle change necessary here!


Betsy, there's so much here that I'm already aligned with. The whole walking thing is a bit of a conundrum: walking wears out our joints, but hills can both strengthen our legs to prevent wear, as well as induce discomfort on the downhills (as presumably what goes up must come down.. but perhaps ageing camino preppers could get a discount on ski lifts, by only coming down the mountain in them? )
The pillow thing is fascinating - I'd already started doing that without anyone's advice, because I'm a side sleeper and the two knee bones against each other sometimes hurts, particularly after a big walk.


Lurch, this sounds grim. I really hope you manage to make the right decision next week on whatever the professional recommends. While missing your March camino is tough, the right therapeutic interventions may put you in a better longer term frame for future, further away caminos. Fingers crossed

Thanks…one way or another, I WILL finish the Camino on foot…no guts, no glory. Been preparing by only buying Spanish wine at the liquor store…Buen Camino.

clarkandkaren - I'm hoping that not ever having torn anything myself, this is a route I won't need to go down! but it's interesting. Really seems to be working for you.


Heidi - I very much like that since putting aside the Arthrotec you are making more natural adaptations and they seem to be working for you.

Wow - thanks everyone! A wide range of experiences and views once again. I definitely don't have the level of pain and severity that some of you are experiencing. But I appreciate that some of that may lie ahead - or not, because at this point it feels like there's quite a lot of self-determination in play, quite a few forks in the road where I can still decide to take the high road or the low road (in camino-speak).
I'm more focused right now on the little walking/lifestyle-changing measures that have worked for some of you. These might alleviate immediate discomfort while in the act of walking (which I actually experience very little of at the moment) and/or prevent slow down further joint wear.
Actually I'm amazed at what some of you are prepared to put up with in order to walk the camino - be careful out there!
Cheers, tom

 

[HeatherL]

I recently returned from the camino. I’ve been getting increasingly sore and crackly knees over the last 5 years, but now it’s becoming an issue. I don’t tend to experience much discomfort while walking, except the usual, on long steep downhills – or worse, whole days on the flat. But at night I lie awake in my bunk trying to deal with the pain. It used to recede around midnight, which was OK, but on this last trip it was often still present until 3-4 in the morning. Sometimes I’d take a little Ibuprofen and other times not, as there didn’t seem to be much difference. X-rays on my return (for some camino-sustained fractures, unrelated) show arthritic wear to both knees, so I can no longer ignore that it’s really happening.

What I’m interested in hearing about and exploring with other forum members is how their knee journeys are working out. I can see that my knees are only going in one direction and that ultimately I will probably need to access that Developed World luxury of knee replacement surgery (if I can find the money…). But what happens between now and then? Do many people go down the Synvise/Orthovise injection route first, or is that enough for some to stabilise their birth knees’ usefulness and never need the replacement surgery?

I’m particularly interested in hearing from people who felt their knee pain was becoming a significant issue 5-20 years ago, and what has happened since.
I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?
I’m hoping we can steer clear of repeating all the usual strategies people take while actually walking, as I think those have been covered extensively already, whether it’s using walking/pacer poles, having impact reducing shoes like Altras or Hokas, employing kinesiology tape or knee braces or compression sleeves etc etc. But if you feel these or others are an integral part of your successful stabilising strategy then do say so.
FYI, before posting I did a search on knee journeys on this forum. Here are a couple of related threads, mainly about surgery
https://www.caminodesantiago.me/community/threads/walking-after-knee-replacements.65173/

https://www.caminodesantiago.me/community/threads/new-knees-user-experiences-please.58857/

Cheers, tom

I wish you well with your ongoing treatment of your knees.
Not related directly to you or knees and without giving the full story. After 2 hip replacements in 2021 my orthopedic surgeon told me to do lots of 'self medication'. With his sense of humour he was telling me to lose weight. I didn't need to be told but it took him to say it. In 2022 I lost 12 kgs. I wasn't overly overweight,. BUT let me tell you and all who read this, controlling weight was life changing. All my joints have thanked me including knees, ankles, hands. Not a cure but certainly a HUGE benefit of mobility. And yes as we get older more maintenance needed.
Walked Leon to Santiago 2019 and Leave SJPP mid April 2023.
Blessings to everyone who follow this Way.

 

[mattythedog]

I recently returned from the camino. I’ve been getting increasingly sore and crackly knees over the last 5 years, but now it’s becoming an issue. I don’t tend to experience much discomfort while walking, except the usual, on long steep downhills – or worse, whole days on the flat. But at night I lie awake in my bunk trying to deal with the pain. It used to recede around midnight, which was OK, but on this last trip it was often still present until 3-4 in the morning. Sometimes I’d take a little Ibuprofen and other times not, as there didn’t seem to be much difference. X-rays on my return (for some camino-sustained fractures, unrelated) show arthritic wear to both knees, so I can no longer ignore that it’s really happening.

What I’m interested in hearing about and exploring with other forum members is how their knee journeys are working out. I can see that my knees are only going in one direction and that ultimately I will probably need to access that Developed World luxury of knee replacement surgery (if I can find the money…). But what happens between now and then? Do many people go down the Synvise/Orthovise injection route first, or is that enough for some to stabilise their birth knees’ usefulness and never need the replacement surgery?

I’m particularly interested in hearing from people who felt their knee pain was becoming a significant issue 5-20 years ago, and what has happened since.
I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?
I’m hoping we can steer clear of repeating all the usual strategies people take while actually walking, as I think those have been covered extensively already, whether it’s using walking/pacer poles, having impact reducing shoes like Altras or Hokas, employing kinesiology tape or knee braces or compression sleeves etc etc. But if you feel these or others are an integral part of your successful stabilising strategy then do say so.
FYI, before posting I did a search on knee journeys on this forum. Here are a couple of related threads, mainly about surgery
https://www.caminodesantiago.me/community/threads/walking-after-knee-replacements.65173/

https://www.caminodesantiago.me/community/threads/new-knees-user-experiences-please.58857/

Cheers, tom

Hi Tom, anything you can do to reduce the load on your knees will help increase Camino comfort and postpone those operations.

Number 1 is lose body weight.

Get pack base-weight + food and water to 5 kg or below.

You didn't want to hear about poles, and maybe you are among the very few who use them to best advantage. However, having accomplished 8 caminos, I observed over 90% of the people who had them were not using them to full advantage. Use them 100% of the time while trekking, even going up stairs, in town, etc. Most people have them lashed to their packs, carry them in hands, drag them, etc., at least some of the time. Use proper technique; most don't. YouTube has plenty of videos on this. They can easily take 25% of your weight load. Train your upper body to be able to handle that 25%. This usually means hitting the gym. Push ups, pull ups, dips, tricep and lat exercises. Use lightweight poles. They have less inertia and can be nimbly and quickly swung around for accurate positioning just before or at the instant your foot hits the ground to take the load. I prefer the older model Black Diamond Distance Carbon Zs. (don't know if they still make them) They are 3 piece fixed length and weigh about 8 ounces/230 grams per pair. Plus they go through Santiago airport in my pack....which I carry onboard....and have never been caught. Thank you Elle for your advice on this so long ago.

 

[dougfitz]

They can easily take 25% of your weight load.

There is good advice in this post about using poles, but when I see claims like this, I wonder. The most downwards force I can generate standing on a normal set of bathroom scales using two poles results in a 20 kg reduction in my measured weight. That might be close to 25% of my body weight, but that is not how one uses poles, and I don't think 25% reductions in weight loads are realistic.

That said, even a more modest reduction in loads on ankles, knees and hips is going to be a significant benefit on any camino.

 

[mattythedog]

There is good advice in this post about using poles, but when I see claims like this, I wonder. The most downwards force I can generate standing on a normal set of bathroom scales using two poles results in a 20 kg reduction in my measured weight. That might be close to 25% of my body weight, but that is not how one uses poles, and I don't think 25% reductions in weight loads are realistic.

That said, even a more modest reduction in loads on ankles, knees and hips is going to be a significant benefit on any camino.

Happy New Year Dougfitz,

I like the way you think. Francois, who I met on on the hill to Roncessvalles in 2016, told me the poles reduced 25% of the load on his feet. He had come from Le Puy wearing a kilt the whole way. I figured he knew what he was doing. Upon return to USA I bought a set of adjustable poles and researched their use. The 25% load reduction came up in some of the "official" instruction. However, I never actually verified the claims, although my own perception was about 25%.....until reading your response last night. I immediately got on the scales with poles. At my present winter weight of 83 kg I could exert 36 kg with 2 poles and 18 with each arm individually. Not quite 25%, but close; and you are correct. That is not how we use poles. I will loose 5 kg before my April Camino this year. I will also be training back up after 2 months last fall doing no gym or trekking pole workouts due to travel and pulling something in my back (don't get old)! I will stand by my 25%, but I will have to retract the "easily."

One thing I probably do differently than most trekkers is that I have the length a bit shorter to put my forearms less than parallel to the ground. That increases arm leverage and transmits more force to ground. Also, my fixed length poles cause my arms to be much straighter (with much more leverage) descending. Ascending I plant the pole tips behind my feet as they hit the ground, again with straighter arms.

 

[dougfitz]

One thing I probably do differently than most trekkers is that I have the length a bit shorter to put my forearms less than parallel to the ground.

I started doing this to avoid rain getting into the arm of my rainjacket and pooling at the elbow. It gives one a nasty surprise if you forget to empty the arm before raising it for some reason!

I'm not an advocate of fixed length poles. They might work reasonably well when there aren't too many variations in the slope. But I use poles regularly bush walking here in Australia, and prefer to be able to adjust the length of the pole to suit the circumstances, particularly going downhill.

 

[JudyWanaWander]

I recently returned from the camino. I’ve been getting increasingly sore and crackly knees over the last 5 years, but now it’s becoming an issue. I don’t tend to experience much discomfort while walking, except the usual, on long steep downhills – or worse, whole days on the flat. But at night I lie awake in my bunk trying to deal with the pain. It used to recede around midnight, which was OK, but on this last trip it was often still present until 3-4 in the morning. Sometimes I’d take a little Ibuprofen and other times not, as there didn’t seem to be much difference. X-rays on my return (for some camino-sustained fractures, unrelated) show arthritic wear to both knees, so I can no longer ignore that it’s really happening.

What I’m interested in hearing about and exploring with other forum members is how their knee journeys are working out. I can see that my knees are only going in one direction and that ultimately I will probably need to access that Developed World luxury of knee replacement surgery (if I can find the money…). But what happens between now and then? Do many people go down the Synvise/Orthovise injection route first, or is that enough for some to stabilise their birth knees’ usefulness and never need the replacement surgery?

I’m particularly interested in hearing from people who felt their knee pain was becoming a significant issue 5-20 years ago, and what has happened since.
I’m keen to find out whether there are any actions I can take now to prolong the usefulness of my birth knees in my day to day activities, like Glucosamine supplements. I’m already doing a range of exercises.
Or maybe there are some of you that just revised your walking expectations downwards and now do slower, shorter stages and appear to have stabilised at that level?
I’m hoping we can steer clear of repeating all the usual strategies people take while actually walking, as I think those have been covered extensively already, whether it’s using walking/pacer poles, having impact reducing shoes like Altras or Hokas, employing kinesiology tape or knee braces or compression sleeves etc etc. But if you feel these or others are an integral part of your successful stabilising strategy then do say so.
FYI, before posting I did a search on knee journeys on this forum. Here are a couple of related threads, mainly about surgery
https://www.caminodesantiago.me/community/threads/walking-after-knee-replacements.65173/

https://www.caminodesantiago.me/community/threads/new-knees-user-experiences-please.58857/

Cheers, tom

Have you considered prolozone injections. It works for my shoulder and my girlfriend's knees. It's a common procedure not to be confused with steroids which are not recommended because they break down your joint even more. Here's a link to the science.

Prolozone™ – Regenerating Joints and Eliminating Pain - Journal of Prolotherapy

By Frank Shallenberger, MD, HMD, ABAAM ABSTRACT Prolozone is a technique that combines the principles of neural therapy, Prolotherapy, and ozone therapy. It involves injecting combinations of procaine, anti-inflammatory medications, homeopathics, vitamins, minerals, proliferatives, and...

journalofprolotherapy.com

 

[mattythedog]

I started doing this to avoid rain getting into the arm of my rainjacket and pooling at the elbow. It gives one a nasty surprise if you forget to empty the arm before raising it for some reason!

I'm not an advocate of fixed length poles. They might work reasonably well when there aren't too many variations in the slope. But I use poles regularly bush walking here in Australia, and prefer to be able to adjust the length of the pole to suit the circumstances, particularly going downhill.

Amen on the water down the sleeves! My first walking CF I also did Muxia/Finisterre and then Camino Ingles++ for about 1200 km with extensive experimentation on my adjustable poles to find one length worked well in all cases for me. Dumb luck. Now if I just put load cells in each pole along with 6-way accelerometers linked to a data logger........

I also wore out 3 pairs of rubber tips in 3 days leaving SJPP. Now I make my own using marine grade fuel hose. Only one pair now necessary from SJPP to Atlantic

 

[Trekker One]

You don't mention if you use trekking poles, if you don't consider getting them, I have one knee that bothers me periodically doing Camino daily distances. Poles if used 'correctly' (another entire subject) take alot of load off the knees, especially going down hill.
I use to walk with a long stride, I have forced myself to shorten my stride and my knee seems to thank me for it.
I have had both X-Rays and a mri done on the problem knee and it is just accumulated wear and tear of 62 years of use.
On days when my knee feels unhappy, I do wear a supporting knee sleeve which helps
In my case it would have to get a whole other level of worse before I would consider surgery.

 

[peregrino_tom]

Have you considered prolozone injections. It works for my shoulder and my girlfriend's knees. It's a common procedure not to be confused with steroids which are not recommended because they break down your joint even more. Here's a link to the science.

Hi Judy, I hadn't heard of this. Just been reading about it on a UK practioner's site - all looks very convincing and the cost seems quite manageable as well.
I'm on a roll at the moment, adopting lots of new non-invasive lifestyle/walking style changes. But if they don't make a significant difference or the efficacy starts to wear off, then I will revisit the prolozone option and research it in detail. Actually, it feels great to know about this option and log it as a backstop. Many thanks, tom

 

[freeflyer123]

I won't bore you with the all the details but my knees have been up and down over 4 Caminos. Camino 1: Full Frances, age 71, swelling and some minor pain on days 4-10, probably caused by a very heavy pack and an overweight pilgrim. Issues resolved with ice, Ibuprofen and Jacotrans. After Burgos all was good. Camino 2: Full Frances, age 72, no issues. Camino 3: Puy to Pamplona, age 73, right knee clicking a week before SJPdP. Resolved with frequent quad stretching. After six weeks off I returned to Pamplona to finish the Frances. All good until 10km from Logroño when right knee went out. Intense pain. Flew home immediately. After four week wait to see ortho-doc knee recovered. Agreed with the MD that for the next Camino he'd inject steroids before departure. Camino 4: Salamanca to SdC, age 76 and 20 pounds lighter. I switched from boots to Altra Olympus 4 high cushion trail runners. That and cortisone shots did the trick. No issues other than minor morning stiffness for the entire route. Now planning Camino 5 at age 76, June start León to SdC. Saw Ortho-doc in November. X-rays reveal I'm at or very near bone-on-bone in both knees -- severe osteoarthritis. Plan is PT (so far so good) to strengthen muscles, then gym - weights and bike/treadmill , then lots of long walks. If all is good, we'll do more cortisone injections before departure and hope for the best. If pain gets too bad during training or while walking...we'll, I guess I'm done, until I get new knees .

I am inspired by the words of Clint Eastwood. When asked how he kept going, he said, "When he knocks, don't let the old man in."

Very interesting and thanks for the info. I am hoping to walk part of the Camino with my husband later this year and am worried about my left knee which has arthritis and is close to bone-on-bone. Indeed, my doctor wasn't sure about doing another cortisone injection because of this. I have my name down for a knee replacement but this will be some years off - I live in the UK where the waiting list is very long and I'm likely to be lucky if it happens before 2025. So I have been reading what measures others have taken in order to walk without too much difficulty and pain. So far, I'm thinking a unloader brace, will definitely use sticks, and carry a lot of pain meds. We cycled the Camino de Santiago back in 2013 but I'm now off my bike because, at 75 (and a close-up bout with Covid) means I can no longer get on the bike easily and tend to keep falling off when I least expect it (!) We already go to the gym and are now trying *so far unsuccessfully) to lose weight. It will happen. I thought immediately of my husband when I read Clint Eastwood's quote. He still, at 81, thinks he's 50

.

 

[Lurch]

Very interesting and thanks for the info. I am hoping to walk part of the Camino with my husband later this year and am worried about my left knee which has arthritis and is close to bone-on-bone. Indeed, my doctor wasn't sure about doing another cortisone injection because of this. I have my name down for a knee replacement but this will be some years off - I live in the UK where the waiting list is very long and I'm likely to be lucky if it happens before 2025. So I have been reading what measures others have taken in order to walk without too much difficulty and pain. So far, I'm thinking a unloader brace, will definitely use sticks, and carry a lot of pain meds. We cycled the Camino de Santiago back in 2013 but I'm now off my bike because, at 75 (and a close-up bout with Covid) means I can no longer get on the bike easily and tend to keep falling off when I least expect it (!) We already go to the gym and are now trying *so far unsuccessfully) to lose weight. It will happen. I thought immediately of my husband when I read Clint Eastwood's quote. He still, at 81, thinks he's 50

my replacement taking place in 2 days, I understand where you are coming from. I will be 79 next year when I will try again, hopefully with a better grounding and knee. Hate to tell you, but from my initial meeting with the orthopod till my surgery, it has taken less than a month. Hopefully, yours will be sooner than later!

 

[dougfitz]

my replacement taking place in 2 days, I understand where you are coming from. I will be 79 next year when I will try again, hopefully with a better grounding and knee. Hate to tell you, but from my initial meeting with the orthopod till my surgery, it has taken less than a month. Hopefully, yours will be sooner than later!

It is just over three months since replacement of my left knee, and while I am frustrated, the objective evidence is that rehab physio, etc following surgery has been successful, or at least I am doing as well as at the same time after my right knee was replaced three years ago. Sticking at the rehab has been key. Keeping the exercises going has been more difficult since the end of the formal rehab program, and my walking speed has not improved quite so quickly, but it is getting there.

I have had good outcomes from all my joint surgery. Having a good surgeon is just the start of the process. You, and the support you get from your rehab team and family are just as, if not more, important. I wish you well.

 

[Scott Fraser]

Very interesting and thanks for the info. I am hoping to walk part of the Camino with my husband later this year and am worried about my left knee which has arthritis and is close to bone-on-bone. Indeed, my doctor wasn't sure about doing another cortisone injection because of this. I have my name down for a knee replacement but this will be some years off - I live in the UK where the waiting list is very long and I'm likely to be lucky if it happens before 2025. So I have been reading what measures others have taken in order to walk without too much difficulty and pain. So far, I'm thinking an unloader brace, will definitely use sticks, and carry a lot of pain meds. We cycled the Camino de Santiago back in 2013 but I'm now off my bike because, at 75 (and a close-up bout with Covid) means I can no longer get on the bike easily and tend to keep falling off when I least expect it (!) We already go to the gym and are now trying *so far unsuccessfully) to lose weight. It will happen. I thought immediately of my husband when I read Clint Eastwood's quote. He still, at 81, thinks he's 50If you can do the training without pain, you may well be able to do the Camino as well.

As they say in Oz, Goodonya! Just keep walking.

For my upcoming walk I have decided to ship my pack forward every day. I also have a Plan B. I didn't mention in my previous post that I'm doing this one with my grandson and two of his friends. If my knees give out I will rent a car and tag along with them. I'll carry their packs in the boot, do the daily shopping and have dinner ready for them when they arrive at the Alberque. There are many ways to do a Camino.