knee braces and backpacking

[sacco]

this letter is pretty self explanitory. i sent it a dozen or so personal trainers, sports medicine writers, ect that i found online.

in the interest of science - for those that care, i'll post any and all responses i get from these experts.

in the meantime, anyone on here have an opinion ?





hello,

my friend and I have a disagreement and I was hoping you could lend your professional opinion.


my friend believes that since backpacking is very tough on the knees, you should wear a knee brace all the time.
whether you go a lot or a little, regardless of age, he says that it can only help prevent injuries and "wear and tear" over time.
since, in his opinion, there are no detrimental effects of wearing one, everyone should wear one all the time while backpacking.



I believe that backpacking IS hard on the knees, but by wearing one ALL the time you are not doing yourself any favors, and could in fact, put yourself at more risk of injury over the long term by depending on them all the time.
my opinion is that only when you are pushing yourself extra hard such as wearing an unusually heavy backpack, climbing (or especially descending) a tough, steep mountain, or some similar situation should you wear one.
also if you have a knee injury or are getting up there in age - which would mean that regular backpacking would put you under the "pushing your limits" situation I guess.


thanks in advance,

scott

[Martin]

As a Orthotherapy and Human Kinetic Graduate, I can say there are 2 sides to this. Climbing down a mountain's slope put alot of pressure on the Patellar tendon and ligaments that restrain forward/backward movement of the articualation. The Femur(thigh bone) has the tendency of wanting to slide forward on the Tibia(leg) plateau. For sure a brace would help strengthened the articulation. Someone with a bad knee or knees, this could slow down the problem of a knee injurie getting worse.

On the other hand, for someone who has good knees, a brace would probably not cause any problems, except that some stabilizing muscles might not be used to their maximum capacity. For hiking once in a while, it's not a probleme. But take the example of someone who always wear a brace and decide suddenly to take it off, the stability of his knee will more than likely not be as strong.

But I think that someone who generally has good knees, all he needs is a good pair of poles. My friend had a painfull runner's knee when she hiked without pole at the beginning when climbing down. Now she hike with poles, and never complained since. Poles absorb alot of pressure when going down and takes part of the strength needed going up.

*Another major player are the boots or shoes we put on. Not every boot is made for every foot. Too much or not enough arch in the sole can make the ankle tilt one way or the other and refer pain to the knee due to uneven pressure.

[Neil]

Every time a patient asks me a question I always start with, it depends......

Just exactly what do you mean by a knee brace? There are plenty of different species. Nevertheless, as a chiropractor/hiker/minor knee sufferer my opinion is that in order for a knee brace to signifigantly decrease the destructive forces brought to bear on the joint during a downclimb it would have to be one hell of a contraption. Most braces serve to control rotational or lateral forces which are not such a big deal in hiking vs. playing basketball for instance. I agree with Martin re: poles and orthotic devices. As a matter of fact, I use both. Does that settle the argument? I didn't think so.

P.S. Martin, Cool avatar.

[fvrwld]

Usually after a weekend of hiking I can feel it in my knees when I go up and down stairs. A few weeks ago I started taking a combo of glucasamine, chronditin and msm. I just did probably my heaviest weekend of hiking(30+miles, 22 with a full pack) and what a difference. It is amazing...I highly recommend this herbal remedy.

P.S. Martin...I figured you would be more excited about the world cup starting this month

[Martin]

P.S. Martin...I figured you would be more excited about the world cup starting this month

We take car of one thing at a time... although we never have been very good in the Summer Olympics. Our politicians have this weird idea that they should put more money into our Health Care than our Amateur Sports.

[nattie bumpo]

I would hesitate to use a brace all the time.. I feel you would be to dependant on it . If you hike and workout to strengthen your knees I wouls think you would be fine. If you have acondition or surgery that requires a brace.. well then wear a brace

I basically hike, mt bike and ski for my work and except for several months with an elastic brace after arthroscopic surgery.. I have lasted a long time without braces
(thought I do have a partial bridge )

Hiking poles especially on the descent are great assists.. they relieve a a lot of knee pressure... they make some awkward moves somewhat safer and they offer tremendous assists in balance ...


But then again I am not a doctor, nor do I play one on TV

[redhawk]

this letter is pretty self explanitory. i sent it a dozen or so personal trainers, sports medicine writers, ect that i found online.

in the interest of science - for those that care, i'll post any and all responses i get from these experts.

in the meantime, anyone on here have an opinion ?





hello,

my friend and I have a disagreement and I was hoping you could lend your professional opinion.


my friend believes that since backpacking is very tough on the knees, you should wear a knee brace all the time.
whether you go a lot or a little, regardless of age, he says that it can only help prevent injuries and "wear and tear" over time.
since, in his opinion, there are no detrimental effects of wearing one, everyone should wear one all the time while backpacking.



I believe that backpacking IS hard on the knees, but by wearing one ALL the time you are not doing yourself any favors, and could in fact, put yourself at more risk of injury over the long term by depending on them all the time.
my opinion is that only when you are pushing yourself extra hard such as wearing an unusually heavy backpack, climbing (or especially descending) a tough, steep mountain, or some similar situation should you wear one.
also if you have a knee injury or are getting up there in age - which would mean that regular backpacking would put you under the "pushing your limits" situation I guess.


thanks in advance,

scott

I'd be redundant and change that to "All the time when backpacking" or "whenever backpacking" just to be sure they have it right.

(Guess who the friend is that disagrees with Sacco?)

This argument replaced the Great Joe Namath, John Elway, Dan Marino controversy!

[sacco]

i have already sent out the emails, but if there is a reply that shows any confusion over the matter, i'll clarify at that point - deal?

[redhawk]

This debate started when I suggested to Lee that he wear a brace.

A little background for those who don't know my "history". I have backpacked pretty much since toddler age. I am now 62 years old. I have never had any physical injurys other then tennis elbow (tendonitis) and a torn rotator cuff, both in the last four years.

I have probably hiked over 40,000 miles in my life. I primarily bushwhacked areas west of the Missouri River and Alaska. I have hiked over a lot of peaks that were 12000 feet or over, when they were between me and a destination.
In my younger days I( averaged 15 miles a day with a moderate 35-45 pound pack, I have always done a lot of rock-hopping (not climbing) in the course of my backpacking. I also walk about five miles a day when I am home and not out hiking or kayaking, and I do about two-three miles a day on snowshoes when there is snow on the ground.

My thighs, calfs and ankles have always been strong and over-developed.

I began using poles about 10 years ago after being introduced to them by another lifetime backpacker. Prior to that I had often used a single staff.

Last year I was hiking the horse trail that parallels the Raquette River from Coreys down to Raquette Falls. The trail was in great shape. I was carying about 40 pounds. I took one step (just like all the others) and it felt as if my left knee buckled. For the next five minutes I put one foot in front of the other and took as much strain off my left leg as possible with my poles. I though for sure I was going to have to stop and wait for help (another reason I tell people not to hike alone!). Just as quickly as it happened, it went away. However I spent the rest of the trip very "wary" and was very cautious about putting any weight on the left leg. I was afraid that my hiking days might be numbered!

Once I got home, I began doing research on the net about the whole knee thing. I ran across one site run by a lifetime hiker in his late fifties who talked about how knee braces had extended his backpacking career. Like myself, he had never experienced any leg injuries, but at 45 his knees just began to pain him terribly when he hiked. His solution, (on someone's recommendation. I don't remember if it was a doctor or not) was to purchase two of the elastic support braces OTC from the drugstore. He now wears them whenever backpacking, and his knees don't hurt anymore.

I went to other sites, medical and those frequented by backpackers. I never found any information that said that wearing the braces whenever backpacking would cause any atrophy or weakness as a result.

What seemed to be the consensus of opinion (overwhelmingly so) was that carrying weight on ones back and walking for miles on a regular basis puts "wear on the knee" beyond what it made for. It is magnified because it is "long-term" as opposed to the type of strain that is put on a knee from sporting events (which puts a different type of strain in the knee anyway). Even with a brace, a backpacker will exercise the muscles and tissues of the joint more then a non-backpacker.

I have since begun wearing a brace on my left knee and will soon wear one on the right. One time I frgot the left knee brace and sure enough, at one point I stepped the wrong way and I felt my knee "on the edge" again. I was wearing a much lighter pack at the time.

The other common "point" that was also made by many of those who favored knee braces was that they wish they had started wearing them early in their backpacking career.

After my debate with Sacco, I spoke to Doctor Ryan who is an orthopedic surgeon and sports medicine doctor in Gloversville about the knee brace thing.
His answer? It can't hurt!

Now I have a lot of respect for Sacco but I have to say that he wears sneakers on the trail and he has some specific reasons that he states for wearing them. In his opinion he has enough support with the sneakers to avoid any ankle injuries and the way his feet are, boots just won't work for him.

MY defense of my argument is this: if those who argue that wearing the knee brace will weaken the muscles or that we will become dependent on them, how do explain the fact that every book and every expert on backpacking recommends boots for ankle support? Don't we then become dependent on the boots? Doesn't the boots weaken the ankle by supporting it? Doesn't the same argument apply to the poles? (Which I AM dependent on btw, and whats the harm in that?).

My argument is that by wearing the elastic braces early in like you will avoid some of the wear and tear that will make it uncomfortable or painful later in life.

That's my story and:drink: I'm sticking to it!

[sacco]

1] of course it will be difficult to find a page or backpacker to say that wearing a brace was bad. most people won't try one until they have an injury, and then they may help (mentally and physically) (that's why i sent out emails instead)

2] everyone an orthopedic surgeon talks to is telling them they have problems because who is going to schedule an appointment with a doctor and say,"hey, i've been backpacking for years and my knees are fine - i just wanted to say, 'hello."

3] to my limitted understanding, the type of brace your talking about works by helping to keep the femur and tibula (your bones) inline, lessoning the amount of work required (strain) by the local soft tissue (tendons, ligaments, and muscle)

4] all soft tissue will atrophy if not worked.

5] too much strain will cause injuires but-
the only way to strengthen soft tissue is through additional strain then it is used to. (increased stength = adaptation to the additional stress)




One time I frgot the left knee brace and sure enough, at one point I stepped the wrong way and I felt my knee "on the edge" again. I was wearing a much lighter pack at the time

eggg-xactly. your brace is now required by you, mentally? physically?
would it be required if you slowly, safely, strengthened your knee instead of using a brace as a crutch?
i don't know, and neither will you.


That's my story and I'm sticking to it!

i'm sure you will stick with your opinion- but if you remember, my biggest point was not whether you were right or wrong, but simply that there is another side to the issue, and that there are plenty of experts who will have different views on this matter.

[sacco]

martin, neil, anyone else:

please interject and correct me if i'm wrong on any point

[nattie bumpo]

Redhawk
Doesn't the same argument apply to the poles? (Which I AM dependent on btw, and whats the harm in that?).

Poles and knee braces are apples and oranges...

poles do not limit or restrict or support any part of the knee.. they assist and are a supplemental

What ever anyone is comfortable with, is the correct answer. If you are more confident and will lastlonger with a brece..then a brace is good for you!! no judgement or comment needed by anyone else.

If you don't feel the need then again .. by all means do what you are comfortable doing

[redhawk]

1] of course it will be difficult to find a page or backpacker to say that wearing a brace was bad. most people won't try one until they have an injury, and then they may help (mentally and physically) (that's why i sent out emails instead)

2] everyone an orthopedic surgeon talks to is telling them they have problems because who is going to schedule an appointment with a doctor and say,"hey, i've been backpacking for years and my knees are fine - i just wanted to say, 'hello."

3] to my limitted understanding, the type of brace your talking about works by helping to keep the femur and tibula (your bones) inline, lessoning the amount of work required (strain) by the local soft tissue (tendons, ligaments, and muscle)

4] all soft tissue will atrophy if not worked.

5] too much strain will cause injuires but-
the only way to strengthen soft tissue is through additional strain then it is used to. (increased stength = adaptation to the additional stress)




One time I frgot the left knee brace and sure enough, at one point I stepped the wrong way and I felt my knee "on the edge" again. I was wearing a much lighter pack at the time

eggg-xactly. your brace is now required by you, mentally? physically?
would it be required if you slowly, safely, strengthened your knee instead of using a brace as a crutch?
i don't know, and neither will you.


That's my story and I'm sticking to it!

i'm sure you will stick with your opinion- but if you remember, my biggest point was not whether you were right or wrong, but simply that there is another side to the issue, and that there are plenty of experts who will have different views on this matter.

1. Actually some of the backpackers that offered opinions were wearing braces and had not had an injury or problem, it was "preventative.

2. Actually that's exactly what I did with the exception of making an appointment. I happen to know the doc through a mutual organizaton and interest.

3. I would take that to be correct

4. Of course it will, but wearing the brace when backpacking is not wearing it all the time, thus the knee will get the "normal" exercise in everyday use, and with the amount of use and the weight being applied when backpacking it is still "being worked".

5.With the amount of hiking I have done in my life and continue to do, I think that we can safely assume that my knees are very used to much much more stress then the knee of an average person. I think that a non issue in this case.

I do sometimes hike without it. (I forget to wear it!) and when I realize it, there is a mental thing because of what happened on the raquette. I still walk 3 to 5 miles a day when not backpacking (to kep the legs in shape, the lungs working and avoid boredom) and if I am not carrying a pack I don't wear the brace.

So I think I do know!

Finally, In most sports, athletes tape joints that are subject to stress. Why would backpacking be any different?

[redhawk]

Redhawk
Doesn't the same argument apply to the poles? (Which I AM dependent on btw, and whats the harm in that?).

Poles and knee braces are apples and oranges...

poles do not limit or restrict or support any part of the knee.. they assist and are a supplemental

What ever anyone is comfortable with, is the correct answer. If you are more confident and will lastlonger with a brece..then a brace is good for you!! no judgement or comment needed by anyone else.

If you don't feel the need then again .. by all means do what you are comfortable doing

No, I think that the use of poles will also save wear and tear on the knee. I am not talking about "avoiding injury", I am talking about saving "wear and tear" on the knee.

And their IS a "Right" answer if it extends the lifetime of the knee!

In that respect the function of poles and braces (OTC) are the same in my opinion. It's not really about "comfortable" to me, it's preventative maintainence". If I knew what I knew now (or think I know), I would have used the braces 50 years ago.

I also think that if my assumptions are correct, it's important to pass them on for others to perhaps extend their backpacking lives.

[Martin]

Well first off, unlike muscles, tendons and ligaments don't atrophy. They're not made from the same fibers.
Secondly, the flexion/extension of the knee requires several different muscles to work together, brace or no brace. So you won't get muscle atrophy because you are wearing a brace. To push up a 125-200lbs body, all the muscles have to work in harmony. Never herd of a brace that will do the movement for you. Like Neil said, a knee brace's main function is to prevent side movement. Depending on the brace, it can also stabilize the patella's movement, thus reducing unnecessary friction on the anterior tendons of a unbalanced knee.
Now that's my view, I'm no expert on braces.

Sacco brought a good point about the mental aspect of this. Someone who is used to hike with a brace, may feel vulnerable if he or she goes on a hike without it. You'll be contious about every move.


All this said, If I had a knee problem that could be diminished by wearing a brace, I'd wear it on every hike. Heck, if it can help you going for a couple of extra years...