Caving with knee pain

[Cat 🦇]

Hi all!

Currently struggling with patellofemoral pain (knee pain caused by overuse and or patella maltracking, actually common in young people and more in women) which has progressed into cartilage damage (chondromalacia) and Hoffa’s fat pad impingement as I kept caving. Doing physio and all with a good physio, and consulting a surgeon soon for possible injections. I’m 35F. The pain is fine but it just flares up really easily, like walking all day would cause a flare up that would take a week to settle.

Has any caver out there already had these issues and successfully gone back to caving regularly? If I could I’d go several times a week…

Or has anyone had cartilage repair surgery or knee replacement and is still caving regularly?

Or any single-legged / no-leg caver out there?

Looking for hope…

 

[kay]

Not the same issue as you, and I haven’t had surgery, but I have an arthritic knee. One caving trip involved crawling in cold water, at a time when my knee was playing up. After an afternoon in cold water, I was surprised to find my joint felt it was lined with softly padded silk. Not surprising when you think of the number of times it’s suggested you apply an ice pack, but it’s a more enjoyable way of doing it.

 

[Stuart France]

I'm afraid that you might just have to accept that the answer to many sports injuries involves much resting and patience. There is one of those silly acronyms that helps doctors to remember what to say next - RICE - rest, ice, compression, elevation. To that I'd append D for anti-inflammatory drugs to calm it down. In the meanwhile, find something else to keep you active without stressing your knee any further. Swimming, cycling without hill climbs, rowing - none of these bother your knees because you're sitting down or effectively weightless.

Complaints to the local hospital about an "ongoing sporting lifestyle catastrophe" may meet with a response along the lines of "orthopedic injuries do take a long time to resolve and 9 months is nothing". Joint replacement surgery can help in cases where a joint is clearly beyond natural redemption, but I also know people where surgery has made their bad situation seriously worse and it is irreversible.

Cortisone etc injections treat the symptoms but not the cause. Simple Ibuprofen and Naproxen tablets also reduce inflammation and injury pain with less of a drama. Rest is frustrating at first but after a while you get used to doing different things and you can come back to caving or running or whatever you used to do when your recovery is beyond all doubt.

 

[Jenny P]

Hi all!

Currently struggling with patellofemoral pain (knee pain caused by overuse and or patella maltracking, actually common in young people and more in women) which has progressed into cartilage damage (chondromalacia) and Hoffa’s fat pad impingement as I kept caving. Doing physio and all with a good physio, and consulting a surgeon soon for possible injections. I’m 35F. The pain is fine but it just flares up really easily, like walking all day would cause a flare up that would take a week to settle.

Has any caver out there already had these issues and successfully gone back to caving regularly? If I could I’d go several times a week…

Or has anyone had cartilage repair surgery or knee replacement and is still caving regularly?

Or any single-legged / no-leg caver out there?

Looking for hope…

That brings to mind my late husband who, a keen caver for 5 years, was diagnosed at the age of 20 as having "housemaid's knee".

 

[ZombieCake]

Hi, have had the odd knee issue where it decided to stop working properly . I found things like collagen (e.g. beef broth type things), hyaluronic acid pills and glucosamine help. Was told pain killers don't actually fix things, just hide the pain for a while. Of course best to check with a doctor.

 

[mrodoc]

Some years ago (16+) I had a knee that 'blew up' when standing in a lava tube in Lanzarote. I took my own advice on managing it ie wait 6 weeks and see how it is. After a chat with my GP who suggested the same it was still clicking and clonking. Managed to avoid having an arthroscopy and went for a MRI scan. Apart from the cartilage tear I had chondromalacia patellae probably as a result of all that caving. It flares up occasionally giving retropatella pain making cycling tricky but I declined any surgery as the knee was almost back to normal after the MRI. Ironically it now seems to be a race between by hip and my knees as to which will really need sorting out first. Chondromalacia patella is a common diagnosis. It flares up and settles down. I would certainly avoid surgical intervention. I got twitched a few weeks ago though when I had infected prepatellar bursitis. That was bad news and sent me to MIU at speed for two weeks high dose flucloxacillin (even retired GP's cannot see GP's easily) so had to queue in the MIU clinic at our local community hospital that when I attended had a collection of people who would have been in my waiting room 15 years ago. The guy at reception was tearing his hair out!

 

[TheBitterEnd]

I'm neither young nor female but was diagnosed with a patella tracking problem in my left leg a number of years ago and I have dislocated my right patella twice whilst caving. TBH I've been doing less caving as the years have gone by but I've never stopped, for me it was about finding physio that worked, which took a lot of trial and error, and then sticking to doing the physio which I find to be a chore but I really notice if I don't do it.

Peg leg pot is always an option

 

[Pitlamp]

From memory Pegleg Pot was named after Dick Hylton (who also gave his surname to the entrance chamber in Link Pot, posthumously) but he only had one kneecap to worry about, after having been badly wounded at Dunkirque in the war.

 

[JustinG]

Hi Cat, sorry you’re dealing with that, it sounds really frustrating.


I’ve had a couple of friends struggle with patellofemoral pain and flare-ups while still trying to stay active outdoors. What seemed to help them most wasn’t stopping completely but adjusting the type and length of trips for a while, and building back up really slowly. A few of them still cave regularly, but they’re much more careful with long walk-ins and anything that puts a lot of pressure on the knees when carrying kit.
One of them had cartilage damage too (not replacement), and after a mix of physio and pacing themselves they eventually got back to doing most of the trips they enjoyed, just not as many in a week as before.

Everyone’s different of course, but there are people who’ve managed to get back into caving after knee issues. Hope the surgeon gives you some clear options, and fingers crossed you’re back underground without the flare-ups soon.

 

[David Rose]

I had quite bad pain in my right knee that made an expedition I went on in 2016 something of a trial. I managed to get an MRI scan and was given a diagnosis of osteoarthritis caused by wear and tear and injury - a climbing incident when I whacked it into the the slab below an overhang over which I tumbled (the gear held). I was then 57 and told I'd have to have a knee replacement, but also to wait as long as reasonably possible by taking Ibuprofen. Aware that isn't great for the stomach, I tried a natural anti-inflammatory - high concentrate turmeric extract capsules with bioperine (aka pepper) to make the turmeric more easily absorbed. Since then I've done a lot caving, including some fairly demanding, multi-day trips, and skiing. My knees do twinge a bit. After a week or so in the Picos in June they felt somewhat sore. But they're still working, and not causing anywhere near the level of pain that would lead me to opt for surgery yet.

 

[Maisie Syntax]

A quick heads up on the use of turmeric supplements, particularly in high dosages. There is the potential for liver damage of which you should be aware. Whilst refraining from posting links to 'sensationalist' posts on the web, both pro and against turmeric supplementation, of which there are many, a quick summary from the independent advisory UK Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) gives a good outline of the issues involved: https://cot.food.gov.uk/ Statement ...urmeric and curcumin supplements: Lay summary

You need to remember that it appears that your pain is coming as a result of an overuse injury, with actual mechanical changes (damage) to various areas within your knee. As with high dose use of NSAIDs, high dose turmeric supplements 'may' offer you a degree of pain relief, however, by using these to reduce the pain so that you can carrying on undertaking the activity which caused the damage in the first place (caving/walking), you are almost certainly going to cause further damage, or at the very least, not let the damage heal. The case is similar for using steroid injections to the knee; they may reduce swelling and reduce pain, but they can't repair an impingement or cartilage damage.

If you have a good physio (as in technically good, not just someone who appears friendly and talks a lot), then they should be advising you honestly as to when you may or may not need the input of a surgeon. As for surgery, you need to make sure that you are consulting with a surgeon who is acknowledged as being an expert in this field (sports injury specific to knees), and understands that you will be wanting to return to things such as caving. These surgeons are out there, but you may need to do a bit of research.

I pass on this information as someone who has in the past (2010), sustained a significant trauma injury to a knee (non sports or alcohol-related I might add), necessitating the need for various 'assaults by surgeon' to reshape/remove various squelchy bits within the knee joint, although not the joint itself. On the whole, I have managed to get back to caving, both in the UK, as well as what some simpler folk may consider 'exotic' caving in remote lawless and Godless areas of the planet, as well as Matienzo

Food for thought anyway

 

[Duncan Price]

I'll add my name to the list of knee pain sufferers. A few years ago I had it in my left knee which seems to have resolved and now its the right knee which gives me grief when climbing stairs. Losing weight and avoiding carrying heavy things helps but not completely.

 

[bagpuss]

On a knee related note does anyone use double knee pads for extra cushioning? Considering adding some of the volleyball ones straight onto leg before furry. If so, any recommendations, there's quite a few on amazon..

 

[rm128]

On a knee related note does anyone use double knee pads for extra cushioning? Considering adding some of the volleyball ones straight onto leg before furry. If so, any recommendations, there's quite a few on amazon..

I sort of use double knee pads. I buy deWalt knee pads (https://www.diy.com/departments/dew...6ND2FPFE_SW0OykMd4kyxdeesWYUc-9RoCOVYQAvD_BwE)

These are completely useless in a cave environment on their own. So I rip out the padding, which is nicely knee shaped. I then glue this padding onto the inside of a pair of relatively cheap caving knee pads. Works a treat.

 

[Maisie Syntax]

With regard to wearing an additional set of knee pads such as the volleyball type, or indeed any type, under your oversuit; this is feasible, but with the caveat that the extra bulk may easily end up creating more pressure on the back of your kneecap, with the result of creating more even problems. Wearing extra thick knee pads over your oversuit, whilst lessening the risk of excessive pressure on your knee cap, often has the irritating problem of making the pads slip round to the side of your leg, which is annoying when crawling, and somewhat dodgy if you are jamming with your knee when using against a wall on a traverse or thrutchy climb. From experience (at least for 'sporting' trips), a thinish piece of closed-cell type foam, either fastened to the back of your knee pad, or better still, inserted into a pocket on the knee of your undersuit, is reasonably user-freindly. Some undersuits have such pockets for inserts, but it's relatively easy to add your own.

 

[andrewmcleod]

I glue a pad of 10mm neoprene on the inside of my Warmbac kneepads. It is true that these never stay at the right height (mine seem to just go up and down rather than round and round), but I'm operating under the belief this is normal?

 

[bagpuss]

I glue a pad of 10mm neoprene on the inside of my Warmbac kneepads. It is true that these never stay at the right height (mine seem to just go up and down rather than round and round), but I'm operating under the belief this is normal?

Do you wear them under or over the suit? I wear mine under the oversuit which seems to prevent slipping.

 

[Maisie Syntax]

I glue a pad of 10mm neoprene on the inside of my Warmbac kneepads. It is true that these never stay at the right height (mine seem to just go up and down rather than round and round), but I'm operating under the belief this is normal?

No hard and fast rule re what direction they can move, which I suspect depends on what you're doing, but the main point is that they invariably move from where you want them to be, once you've added another layer of padding.

 

[andrewmcleod]

Do you wear them under or over the suit? I wear mine under the oversuit which seems to prevent slipping.

Over, or I would destroy my oversuit fairly quickly (based on all the holes I put in the elbows and everywhere else)

I've occasionally debating gluing some velcro (or other similar non-slip surface) onto the kneepads and knees to keep things where I want them.

 

[mrodoc]

Regarding turmeric this is a good overview: https://pmc.ncbi.nlm.nih.gov/articles/PMC7812094/. I am currently taking Naproxen which is a Non Steroidal Anti Inflammatory Drug (NSAID) for primarily hip and knee OA. With regard to knees I was diagnosed by MRI as having a three way menisceal tear some years ago but elected to leave it as was asymptomatic. Both knees and hips hurt but I can manage a Swildons trip although I am reluctant to do any jumping about primarily because the jolt and pain can cause the knee to give way. How long I can keep moving without surgery I don't know. It is a race between alternative (not alternative medicine) treatments that are in the pipeline and straightforward joint replacement.