Background

I’ve been a dedicated walker all my life. As a young person wandering the woods, a biologist tromping the Alaskan tundra, a nature center director leading groups of kids afield, and as a birder, backpacker, and cross-country skier I’ve put a lot of miles on my 70-year-old joints. My iPhone says I’ve averaged about 11,000 steps a day for the past four years. If extrapolated backward that’s about 240 million flexes on my knee joints!

Several years ago, my physician treated me for elevated blood pressure (BP) with meds that I didn’t like taking.  I asked her if increasing my physical activity might reduce my blood pressure. She said, “Give it a try.”  I did and expanded my walking and added some simple daily weight exercises.  It worked.  After about six months my BP fell into the normal range. I tossed out the meds and kept exercising.

Then an ironic problem arose. In early 2019 my left knee started to hurt. Really hurt.  A few months later the right knee followed suit. My doc prescribed an X-Ray that revealed cartilage worn thin. I was caught in a dilemma.  If pain caused me to reduce walking, my blood pressure would rise. Not good. Medical science started steering me toward knee replacement. However, I wanted to try other solutions first.  Sooner or later knee surgery may be needed but after almost a year of experimenting with ways and places to walk and what shoes are best, I’m able to stay physically active and reduce, but not completely eliminate the knee joint pain.

Pain Meds

My family physician suggested I try over the counter pain medications to reduce knee swelling and pain. I tried Ibuprofen, aspirin, and acetaminophen at different times.   None reduced swelling or seem to diminish knee pain, so I rarely use them during the day.  I do occasionally take them if my knee hurts at night when I’m trying to sleep.

Where I Walk

I usually walk in three distinctly different places. Cedar Rapids has several paved trails that circle two lakes and make for interesting walking. I found that the unyielding hard paved surface adds to knee pain. Other area trails are surfaced with crushed limestone.  It’s firm but less hard than pavement and seems to create less knee pain than asphalt.   My third walking area is nearby woodlands, grasslands, and lawns. It involves walking on dead leaves, grass or dirt pathways in the woods. These surfaces create the least discomfort: Lesson:   Where I walk has a bearing on knee pain.

How I Walk

When knee pain appeared each step hurt, and I walked gingerly.  I took shorter strides and climbed stairs slowly and deliberately. I eventually learned that a quicker pace and longer strides reduced knee pain. And, as I walk knee pain gradually subsides. It doesn’t completely go away but diminishes after the first quarter mile or so. It would be easy to simply give up after a few steps and retreat to a chair, but that’s counterproductive. Lesson:  Walk briskly and don’t give up if the first few hundred steps hurt.

 Footwear

For most of my life, I’ve worn hard-soled hiking boots, often with distinct and high heels, like a cowboy boot. After my knees started hurting, I began experimenting with many types of shoes, insoles, and boots. I believe that the hardness/softness of shoes and soles along with the angle the shoes create for the lower legs has a strong bearing on knee pain. The high heeled stiff boots I once wore produced the most pain. The most comfortable boots for me have soft cushioning soles and a shallow or no heel. Some shoes are very “squishy”. They have thick very soft soles. They made walking on hard surfaces more comfortable but have a major disadvantage. Whenever I walk on a side slope the squishy soles have some give to them and this puts side pressure on my knees. It hurts. I’ve also experimented with various insoles. Some make the shoes more cushioning and have helped. They also slightly change the angle where my lower leg joins the knee.

Footwear Lesson One:    The type of footwear and insoles I wear lessens or worsens knee pain.   Finding the right combination is by trial and error.  My favorite footwear for cool weather walking on hard surfaces is crepe-soled leather boots with only a shallow heel. These are often used by carpenters who spend hours every day on their feet. 

 Footwear Lesson Two:   Quality shoes and boots are expensive but they seem to fit better, are more comfortable and last longer than cheaper counterparts. Put money upfront. The cost of a quality pair is trivial if they reduce pain.

My Advice

My knees may continue to deteriorate to the point where I need knee surgery, but altering my shoes and boots and changing how and where I walk has helped reduce pain and may be all I need. I hope so but won’t hesitate to seek medical help if the pain worsens.

Everyone is different and what works for me to reduce knee pain may not work for others. However, I feel many people can reduce pain by finding the right combination of shoes/boots/insoles that produce the least knee pain and walking on the most comfortable surfaces at the pace that produces the least discomfort.

 How to Know When to Seek Medical Help

When My knees began hurting and I experimented with ways to reduce it, I wondered how to know when it’s time for knee surgery. I asked Matt Schmitz, Physical and Integrated Wellness Program Manager at the Nassif Community Cancer Center, and his advice was superb. “When pain causes you to not do the things you like it’s time to take action,” he said.  It’s good advice.

I’m not a physician and recognize that everyone’s body is different. What works for me may not work for someone else.   Over the counter pain medications, for example, might help others even though they seemed ineffective for me.  The trick is finding a combination of footwear, medication, and exercise that reduces knee pain.  

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