Difficulty Hiking with Bad Knee Pain
Difficulty Hiking with Bad Knee Pain
Dr. Lox has treated many patients who engage in Hiking and complain of bad knee pain. What is really meant by hiking, and what effect does it have on your knees?
A leisurely stroll should not be included. A patient once stated he was walking the beach in Malibu, but it was not difficult enough, so he wanted to go straight up the Santa Monica mountains. Not the same activity at all, and clearly that would be hiking. The incline, and often the decline places stress on the knee. Normal knees are unaffected. Injured or arthritic knee will experience pain. The same with climbing stairs is frequently cited.
Another patient was traveling in India and Tibet. He had trouble getting to Mount Everest’s basecamp. Not your typical hiker statement. We conversed on all the great Mountain climbing films, neither of us wishes to expose our knees or other body parts to The Summit or K2. He was considering Mount Kilimanjaro. However, a good Sports and Regenerative Medicine specialist should be prepared for all patients desires and goals. Including, discussions about what is reasonable or not. Thus his appointment with Dr. Dennis Lox was timely.
Knee Pain with Walking Uphill
Not all knee pain is the same. Different people will experience different knee pain dependent on a variety of factors. Walking uphill may be just one of many factors that trigger knee pain. The load of uphill walking may be transferred to the kneecap, throughout the three knee compartments, place undue stress on torn ligaments, or may be lateral to the iliotibial band. Common types of Knee Pain with Walking uphill. Knee ArthritisPatellofemoral PainIliotibial Band SyndromeTorn Ligaments
The knee is a complex joint. It is often referred to as a tri-compartment. The medial, lateral compartment and the undersurface of the knee cap or patella comprise the 3 knee compartments. This is misleading, as the knee is really one open compartment allowing free communication of cell signal, and fluids to flow between all 3 compartments. Patellofemoral Pain may be associated with knee cap or patellar arthritis. This is referred to as chondromalacia patella. This can be made worse going uphill, on an incline, or even with high heels. Knee arthritis is not stagnant. Knee arthritis is progressive over time. Understanding this concept helps to make informed decisions.The iliotibial band may be an isolated finding or present with other knee pain symptoms. The iliotibial band syndrome is an overuse injury of the connective tissues that lie on the outside of the knee and thigh, running from the pelvis to the tibia bone in that crosses the knee joint. The iliotibial band can become inflamed or develop irritation as the result of rubbing across the femoral condyle above the knee joint. The iliotibial band is an important knee stabilizer. Overuse can occur in repetitive sports such as running or cycling as the iliotibial band continues to rub with repetitive motion of the knee joint. Specific iliotibial band exercises may help.
Knee Pain with Walking Downhill
Downhill walking may be the predominant factor in knee pain, or just another symptom of many. It is non-specific, however, it may indicate several areas of more stress in the knee.Knee ArthritisRunners Knee is a nonspecific term. It may be referred to the knee cap or patellofemoral syndrome, however, as it is sometimes used as a catch all term specific should be used instead. If it is patellofemoral the strength of the surrounding muscles may be an important variable that can be addressed. Arthritis of the underside of the kneecap, the patella is important to understand. If it is severe chronic friction cannot be overcome by strength it of the surrounding muscle groups. Iliotibial Band Syndrome
Regenerative Medicine Treatments
Often patients have already had knee surgery or are looking to avoid it, especially knee replacement surgery. This has often led to researching Regenerative Medicine treatments. Knee stem cell therapy and Platelet Rich Plasma (PRP), are Regenerative Medicine treatment options that can be discussed with your physician when appropriate. An experienced Sports and Regenerative Medicine specialist such as Dennis Lox M.D. is capable of guiding patients through the various disorders and treatment with specific goals.
Platelet Rich Plasma (PRP)
PRP is a Regenerative Medicine option that utilizes concentrated blood platelets collecting from the patients own blood. Using a simple technique peripheral blood is collected and concentrated to give a platelet enriched concentration of plasma. Thus the term Platelet Rich Plasma or PRP as an abbreviation. The platelets are a rich source of growth factors which have healing properties, and can counter the bad effects of inflammatory cytokines. PRP contains no stem cells, therefore the response is limited in healing capacity. Many factors go into deciding if PRP is the first or right choice for a patients condition. There are many ways PRP can be derived, and scientifically not all PRP is the same. An experienced Regenerative Medicine specialist can answer your questions.
Stem Cell Therapy
No other topic has become more confusing for patients than this. There are so many different answers from so many people who give non-scientific statements, and often contradictory merely to push their agenda. Patients need to be aware there are many new clinics stating various things often incorrect. Stem cell therapy by virtue of the name implies there are stem cells. Platelets and Plasma are not stem cells. Perinatal tissues are tissue products. They are derived from newborn tissue. These include amniotic fluid, placenta and cord blood. Tissue products contain many things. They may or may not have stem cells. In the United States stem cells must come from the patients own body and be used the same day or it falls into the category of drug therapy, and it is not FDA approved for this. To get around this perinatal tissue of amniotic, placental or cord blood is a tissue therapy and considered a medical device, not a drug. Most have no stem cells that are left or viable. That is why the FDA has made a crackdown on the manufacturers making claims it is a stem cell product. Careful examination will see it listed as an acellular product. Acellular=NO Cells. Yet many clinics continue to claim it is a stem cell product when it is not. The FDA has announced it is going to further enforce inaccurate statements in this regards. The future is clear FDA approved stem cell therapies derived from anything not the own patients will be a drug.It can be confusing, but not to the doctors who truly understand this. The doctors who do understand this fully, are the ones typically willing to take the time to explain everything.
Patient Centered Treatment
Treat the patient in front of you. Listen to the patient. Question the patient. Examine the patient. Discuss goals, expectations and outcomes. This patient-specific approach allows for the best outcome. There is no cookie cutter template for everyone. Be wary of one size fits all treatment approaches. This Patient had Specific Hiking Goals
This Patient had Specific Hiking Goals
Basecamp Everest, Mount Kilimanjaro, Nepal, and Africa. These goals are kept in mind when treating the patient. He has vivid memories of each place and his desire to achieve his goals are understandably important to him. Not everyone has such lofty goals. Dennis M. Lox M.D. is an expert in Sports and Regenerative Medicine. No matter what the goal, Dr. Lox will give personalized medicine and a personalized approach to each patient.
Tampa Bay, Florida (727) 462-5582
Beverly Hills, California (310) 975-7033
Whether you are a professional athlete, weekend warrior, or have arthritis from aging, Dr. Lox can help.
Dennis M. Lox, M.D. is an internationally renown Sports and Regenerative Medicine specialist. Dr. Lox incorporates Regenerative Medicine techniques such as cell science applications, Platelet Rich Plasma (PRP), and Tissue Engineering aspects, to help patients from around the world with a vast array of problems. Dr. Lox is board certified in Physical Medicine and Rehabilitation. Dr. Lox lectures extensively and has edited two PM&R textbooks, the prestigious A State of the Art Review (Star) on Low Back Pain, and Soft Tissue Injuries: Diagnosis and Treatment.
Dennis M. Lox, M.D. maintains an active practice in the Tampa Bay, Florida area, and in Beverly Hills, California.