Some time, pretty much every bushwalker will have to deal with a knee complaint. So what are the ailments and what can be done about them?
Moving up the body, we get to another weak point – our knees. These won’t necessarily wait until you’re old before they give you problems and, while one pain in the knee may feel similar to another to us, there are a number of different causes – tissue, tendons or ligaments. So don't ignore what your body is telling you.
Chondromalacia patellae
Condition: Like patellar tendonitis, this is an anterior pain, but this time it’s been caused by the softening and breakdown of the tissue on the underside of the kneecap. It’s often experienced in young adults as a result of overuse or injury, but previous injuries, flat feet and our weight can also cause this problem.
Cure: To prevent this and other knee injuries, Fiona Hawke suggests taking extra care on downhill slopes and gradually increasing your pack load and walking distances. “As a general rule, hikers should increase distance or load by 10 per cent per week and not ‘push through pain’,” she says.
Iliotibial band syndrome
Condition: This syndrome is often spotted in marathon runners, either as a result of overuse – the repetitive extension and flexion of the knee – or a lack of flexibility in the iliotibial band. When this happens, the distal portion of the iliotibial tendon rubs against the lateral femoral condyle, resulting in inflammation, irritation, swelling and pain.
Cure: A common cause is wearing worn-out shoes, so this may be a good time to look at replacing them. Decrease your distance if you feel any pain, give yourself a rest and seek professional help if the pain continues.
Patellar tendonitis
Condition: Patellar tendonitis is also caused through overuse, especially through running or jumping, both of which cause us to impact hard with the ground. But in this case, it’s the tendon that connects your knee to the shinbone and helps your muscles extend your knee that’s been affected. It’s often called jumper’s or runner’s knee, but you don’t have to play basketball to suffer from it.
Cure: Like Achilles tendonitis, you’re looking at rest and physical therapy to get this body part working again – and there will be inflammation in response to the injury. “The area will be painful during and after movement, and then often feel stiff and restricted,” Teja says.
Strains and sprains
Condition: Also called a cruciate ligament injury, sprains in your knees are very similar to sprained ankles – only this time it occurs when the feet go one way and the knees go another, forcing the ligaments to extend too far or tear. And while it is often caused by an impact to the legs, it can be a risk for hikers on rough terrain.
Cure: Once again, this will depend on just how much damage you’ve done. The swelling, Teja says, can lead to significant pain, put pressure on the nerves and, if left long term, can slow down recovery time, so apply RICE. “Compression is an external means to achieve what the swelling is doing – i.e. immobilise the joint/tissues,but without causing undue pain. Elevating the injury will allow excess fluid to flow back towards the trunk.”
Meniscus tear
Condition: This common knee injury is caused by the two pieces of cartilage (the menisci) that act as shock absorbers in the knee being torn, either through a sudden movement during sport when the knee rotates while bearing weight or through eventual wear and tear as we age. Your knee may lock or give way and other parts may tear at the same time.
Cure: If the tear is small enough, it should not require surgical treatment; Andrew Lim says you can take anti-inflammatory medications. “If the injury is not disabling and not stopping you from your physical activities, then extra support of the knee and surrounding tissues is recommended from the use of bracing or taping techniques,” he says. “This is only for support, as opposed to treating the meniscus.”
Words_Laura Boness