Knee/Ankle Injury Tips

[jon]

I thought I’d pass on some tips for people who are having knee and/or ankle problems. I have found that cycling is a really effective way to build knee and ankle strength. This is actually a clinically tested fact. I’m a pretty avid mountain biker, and when not on the trail or road, I’ll ride a bike at the gym. It is low impact, but you can get an incredibly good cardiovascular workout and build really strong legs.

I have had both knee and ankle injuries. When I was younger I had what is called Osgood-Schlatter Disease, which is where basically where your muscles develop quicker than your tendons, and start tearing away from the tibia. Though my knees are much better now, they still can hurt after a hard climb or playing soccer. I’ve also managed to sprain my ankle more times than I would like to admit from playing soccer and basketball.

In cycling, the leg motion is centered on your knee, and although it is highly repetitive, the lateral and impact stresses are minimal, therefore gradually building up the tendons instead of overstressing them to where they are inflamed and struggle to recover.* Though the ankle doesn’t see as much movement, the down-pressure, especially out of the saddle, can really strengthen the ankle in all directions.

I can not only feel, but actually see the difference in my ankles and knees because of this. I have found that I’m much less prone to pain now when I hike and climb, and this isn’t from being in better shape. I also haven’t rolled my ankle in a long time. Obviously, riding a bike is not a substitute for doing training hikes or the Stairmaster, but for people with weak knees and ankles it can really strengthen your tendons while still getting a good workout, and make your outdoor pursuits much more enjoyable.

If anyone is interested in learning more about things like proper technique, the benefits of clipless peddles, good training plans, please reply to the post and I will reply with more detailed info.

One word of caution, because pedaling isn’t exposing your muscles to a full range of motion like running, it is really important to stretch to keep from losing flexibility.

*For those interested, a little science about inflammation. When you get inflammation in a joint, your body releases various hormones that trigger the production of destructive enzymes called metalloproteases, which, while breaking down the injured connective tissues for repair, can also destroy health tissue and cartilage if inflammation persists. A similar process happens in muscles. When you have a chronic injury and inflammation like what Patrick might have been suffering from in a previous post, your body is essentially fighting itself, breaking down while trying to rebuild at the same time. It’s like building a new skyrise while the wrecking ball is still swinging around from the old building. Your body also recruits immune cells, which get activated at sites of inflammation, release hormones, and do their own destructive tasks. A good example is the various forms of arthritis (typically caused by auto-immune response), as well as periodontitis (immune response to bacterial endotoxins in the gums). If you have a chronic injury, it is advisable to see a doctor to determine the extent of the injury. If you don’t feel like seeing a doctor, things like aspirin and benadryl can help suppress the immune response and lower the amount of inflammation, allowing the body to heal with proper rest.

 

[LhotseDreems]

Hey Jon,

Thanks for the tips! I, like you, am embarassed to admit all the stupid things i've done to my ankles (poor babys!). At this point, several years after my last sprain, i still don't find the dexterity in them i used to have, and of course the weakness level that they are still at.

I'll look into biking - {{lol}} yay! Another expensive sport... shall i mail you the bill??

[snowleopard_x]

I once had bad knees (from running, and trying to play football when not a big guy). They ached, and I could hear them "grind" when stretching. I was 18 years old, and my parents considered surgery. That didn't happen but they didn't get much better. A few years later, like a miracle, my knees were fixed. Almost totally 100% healed. How did I do it?

Bicycle.

[snowleopard_x]

I'd like to dispute one thing:

"Obviously, riding a bike is not a substitute for doing training hikes or the Stairmaster".

Here is why I strongly disagree, at least with the Stairmaster part:

Almost anyone can get out and ride a bike for one hour every other day or so. And with determination, 3-4 hour rides are not out of the question. Can you name anyone who has spent 3-4 hours on a Stairmaster? Also, riding a bike is much, much more pleasurable than standing on a Stairmaster for even 10 minutes.

Point 2: Bicycling is terrific cardio exercise (and great for your). It taxes your heart in a variety of ways. Running, hiking, even a program on a Stairmaster is hard to match for riding a bike (pushing it at least somewhat hard) as on the bike you work, then rest, then go anaerobic, then easy, then hard, then rest, etc. Also, unlike those other sports (except hiking) it can be done for 3-4 hours in one stretch (or more), as noted before.

Now, my big secret that no one believes, because they won't even try it: Bicycling is arguable the best way to train for climbing. Providing you are willing to ride through the winter, every day. Why do I say this? Because of the elements. When it's cold, and wet, and windy outside walking in the city, it's always double or triple that bad out in it on a bike. The wind chill is much colder, the rain (or snow) is right in your face, and you head into the wind from every direction. Plus you are working. Sometimes hard, sometimes light. So it's a constant heat/freeze cycle. Just like climbing.

Start now and see if you agree come March. Ride every day. In the cold, in the wind, in the rain, and even snow. No matter how bad it is. By the time March rolls around, you'll be conditioned, both your body, and your mind, to almost anything mother nature can throw at you.

Also recommend a road bike. It's faster, thus colder, and streets and paths are less protected from wind and rain (like Mtn Bike trails).

Old Danish proverb: Ride into the winter, and you can ride through the winter.

[Courtenay]

Hey there Snow,

you write: "biking is arguably the best way to train for climbing" --

I'd like to shed some insights on this statement. First off, I think there is a lot of value to biking, especially in the off-season, for developing balance in the legs. Biking will predominantly strengthen quads, which are important for the downhill portion of climbing. However, there's no substitute for getting out there with a pack on your back and walking or hiking over hills -- in all sorts of weather (as you pointed out: braving the elements is important.) Remember that the powerhouses for climbing UP hills are the glutes and hams, whereas quads get taxed on the descents -- hence I'd disagree that "biking is the BEST training for climbing."

Having said that, I think the "best choice" for training is whatever you will actually do on a consistent basis. If you'd rather bike in the elements than drive an hour to get to some elevation, go for it. If you'd rather run trails without a pack, that has merit as well. But there's nothing better than preparing for climbing/hiking by ... climbing/hiking!

Courtenay

[snowleopard_x]

Actually, we could go one step further:

The best training for climbing...is climbing! Don't let a little rain and snow get you down! Get out there and enjoy the sport in every season!

Part of my point regarding the bike: If it's kept in your home, you're 15 minutes (dress, stretch) from getting out on a long training ride. No need to drive anywhere to hike or do anything. I also prefer it over any gym. Though others might not, I'm just not a gym rat.

Courtenay, I know you will agree with me here. Cardio fitness is the great equalizer. If your body is used to having your heart pound inside your chest for hours on end, when it really counts, you will hold up. Bicycling (and I don't mean a jaunt around the neighborhood) is a great daily way to make that so. Yes, there are other ways for high cardio, and I have probably tried them all (cross country skiing being maybe at the top) but even with hiking hard I have not found a better way to continuously get a sustained high level of cardio fitness than on the bike. Key on "continuously", as in almost every day. I know your very knowledgable at this, but I'm older than I look, and speak with a hell of a lot of first hand experience.

Totally agree with what you said on the "best choice" being whatever you'll do. That is the real key above all else. Even walking in the city park with a pack is better than sitting at home surfing the net.

And on that note...

[forrest_m]

I have to agree with the pack carrying advice; (alpine) climbing is such a full body workout because nothing beats on your whole body like climbing with a pack. (Imagine how much less far you could run/ride/stairmaster with a pack on...)

Maybe Courtenay can answer a related question: what is the physiological basis of "base fitness?" Let me give you an example of what I mean. After being a very active climber and maintaining a fairly high fitness level for years, a few years ago I lived in Europe for 15 months, got no exercise and basically ended up in the worst shape I'd been in since I started seriously working out back in high school. I returned to the US and immediately went on a month long climbing expedition. Within a week, I was carrying huge packs that I know would have crippled me when I was 18 and on a nationally competitive crew team. I suffered some, but less than I expected to. The only explanation I could come up with was that years of hauling big packs around had strengthened my muscles in such a way that even after being ignored for such a long time, they reached some point below which they would decline no further. Is this true? Or was it only willpower overcoming good sense?

[Courtenay]

Hi Forrest_m--

Good question. I think your success after a substantial absence probably was due to a combination of things; 1) familiarity with the movements from years of having done it; 2) sheer determination, and 3) where there's a need, there will be fairly quick adaptation. You may also have the sort of body type that can just pick up and do what you wish -- my husband, a competitive power lifter, is that way -- he does no cardio whatsoever, but nonetheless has no trouble climbing mountains as strenuous as Rainier. Go figure--and for some odd reason (sorry, women out there!) in my experience it seems to be an easier thing for (MOST) men to just pick up and go, perhaps because they are inherently bigger and stronger to begin with. I'll see if I can find any more on this and post back. Thanks for the thought.

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Courtenay Schurman, CSCS

[jon]

The intension of my post was to inform people of a good way help their knees out. It’s sounds like Snow’s experiences parallel mine in curing the problem. Apparently though, this has turned into the “what’s best” argument. Obviously I will post my opinion.

Well I agree that biking is a great way to get in shape (I prefer mountain biking), I disagree that it is the best thing next to actual climbing for getting into climbing shape, sorry Snow. The same muscles are used, but at different intensities, movement ranges, frequencies, duration, and load. Biking works isolated muscles groups, while climbing tends to works all the muscles in the legs and lower torso. I think biking is one of the top training tools, but I wouldn’t just rely on that and the occasional training hike. So what do you do then?

I’ve very recently become a firm believer in aggressive cross training. Yeah, Bo Jackson’s commercials were cool and all, but I always had trained focused on the sport I was doing at the time. The revelation came four months ago when I started swimming to try to cure a persistent back problem. I hurt it a long time ago trying to play college football. I have seen five sports medicine doctors since the injury, having X-rays and MRIs done, and not a single one could tell me what was wrong. Their prescription, sit-ups and stretching. I was really taken back that was all they recommended. The tightness in my back was so bad that I had to start having message done to relieve the pain and tightness.

The woman I go to for massage is a triathlete and recommended that I start swimming to loosen up my back. My first impression, “yeah right”. My mom tried to get me to do swim team when I was younger, but I refused because I didn’t want to run around in one of those little suits. Eventually I gave into the swimming idea, though not the suit, and the results are amazing. My back no longer hurts, not one bit. I had lived with that pain for so long, and to not to have it anymore is incredible. But there was one more benefit that I eventually realized.

I train with a heart rate monitor when I bike or run. It allows me to train where it is the most beneficial, allows me to monitor my progress, and tells me when I need some rest. Awhile after I started swimming, I noticed that the heart rate where my legs really start to get taxed, called the lactate threshold, was going down significantly (down 15 beats/min). This is when I started to develop my theory.

When you are participating in an activity, whether you are climbing or training, there is always a limiting factor. Of the three systems, the cardiovascular, muscular, and energy producing (mitochondria/ATP), typically it is your cardiovascular that is the weak link. Normally when you are working out, you cardio and muscles are working at relatively the same intensities, and usually develop at the same rate. By cross training, you are constantly conditioning you cardiovascular while working aerobically (and anaerobically) muscles specific to the activity you’re doing. By doing this, as the theory goes, you strengthen you heart at a greater rate than the muscles if you were doing a single activity. It allows you to work certain muscles while the others are resting. You can lift weights to give your heart a slight break as well. One of the biggest advantages is it allows you to really work you muscles hard without taxing your heart. I think this is especially important when you are doing an specific activity for over an hour, whether it is biking or difficult hiking, because your heart and lungs are able to provide oxygen to hard working muscles, while removing lactic acid, enabling you to go longer/harder without the worry of damaging the muscles from too much lactic build up, the result of muscles not getting enough oxygen. This allows you muscles to recover and develop quicker.

So what does swimming and all this mumbo jumbo have to do with climbing. Well, I used swimming as an example from personal experience, but the benefits of cross training have all to do with climbing. If you are serious about an activity like climbing or whatever you choose, I truly believe cross training is the key to unlocking your full potential, whether it is a marathon peak knockoff, climbing 5.12, or just making a summit that has previously eluded you. It also prevents you from burning out, which if anyone has been unfortunate enough to have this happen to them, really sucks and effects more in your life than just exercise.

So there is my theory, ready to be torn apart by everyone. Courteney, I’d like to hear what your thoughts are, whether I’m completely insane or should write a book.

-Jon

intensity@cascadeclimbers.com

“Oh lord, please let the white stuff fall from the sky so I can ski the freshies.”

 

[Courtenay]

Hey there Jon,

Nice post. I think more people will agree with you than will disagree -- and I for one believe 110% in cross-training (both for myself and all my clients), not only to keep your body in balance and work muscles that don't otherwise get used, but also to keep you mentally fresh. I've had several people recently tell me they've gotten burned out on their normal routine (good programs for climbing) and are looking for some new motivation and inspiration, and the very first thing I suggest we do off-season is get them doing something they haven't been doing lately -- such as biking, swimming, aerobics classes, yoga, Nordictrack, inline skating, basketball, rowing, or the like. If you are forever and a day doing treadmill, stairs, hills and running, you run the risk of burnout as well as potentially straining muscles in the ankles, hips or knees from overuse. Off-season is a great time to add a totally different sport for variety, and especially if you can use similar energy systems.

It's not always a question of "what's best for the sport"; sometimes the question is "what's best to prevent burnout and injury so I can keep my enthusiasm high." Hence the increasing popularity of triathlons and all forms of cross-training. Good post. Do others have thoughts to contribute?

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Courtenay Schurman, CSCS

[snowleopard_x]

Hey Jon, I said "arguably the best..." Well, I guess you were arguing, so it's okay.

Now that we're comparing which is best (all in fun, I honestly hope no one is getting bent out of shape) I've still yet to hear anyone refute my claims on:

1) winter biking conditioning the body to the elements as good as anything else.

2) You can bike 2-4 hours at a time, maybe each day. Who here is up for 2-4 hours of Stairmaster? Running? Or even swimming?

3) You can bike up to 7 days a week, if willing to tough out the weather. Much easier to pull off than hiking 7 days a week, with work and all.

4) Cardio is the great equalizer, and bicycling is great for this. (My belief and experience is that my exhaustion occurs here before muscle fatigue.)

Thus bicycling is "arguable" the best training.

Okay, have at me gang!

Yeah, I still agree with Courtenay though on doing what you like to do (and helps your health). That is far and away most important. If you don't want to ride a bike, by all means, don't.

 

[Courtenay]

Okay Snow,

Here goes! (You asked for it!)

Point 1) Seriously, I'd actually AGREE with you about the biking getting you ready for moving through any and all of the elements -- and then some (when else will you be racing through sleet and snow at 15-20 mph in the mountains, unless you're on a snowboard or skis?)

Point 2) I'd be up for 2-4 hours of pack work (hiking), step aerobics, or elliptical, but not the others (although there was a time when I was into marathoning...)

Point 3) True. I'd still issue a caveat here -- like any other activity you do, I'd suggest you put in AT LEAST one day of rest, in order to let your body fully recover, and also throw in at least one day of cross-training, for the same reason. If you do the same thing, day in and day out, you run the risk of imbalances -- which can lead to injuries.

Point 4) Don't forget strength training!

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Courtenay Schurman, CSCS

[snowleopard_x]

All true. No matter what sport one views as best, rest and strength (or should I say "cross") training are very important. Lance Armstrong would make a great mountaineer, he might never tire climbing. But it would be wise for him to do some training for it, to really get good at it. Though actually, with what he's been through I wouldn't bet against him even climbing Everest with no O's.

3-4 hours step training? Ugh! That's almost as crazy as the lunatic that rides his road bike in the wintery storms! Well, at least on the bike the view changes.

I only wish I exercised that much. I once did, I overdid it actually. But now I work too much, and deal with life's other complexities. Hmmmm, looks like tomorrow is a good day for a hike or bike ride...