[Editor’s Note: Preparing for a mass exodus requires planning, walking the bug out route and conditioning your body, and having the right big gear. As the author, Jeremiah Johnson will discuss in this article, the uneven walking terrain coupled with a heavy bug out bag can wreak havoc on your joints, especially the knees. Ensuring that you take the proper preparation and planning on the gear you choose will ensure you do not cause further strain to the body.]
How are all of you guys and gals out there in Ready Nutrition Land? I recently had a request from an elderly lady who is a hiker and backpacker for me to do an article regarding knee-problems suffered by elderly (as well as younger) hikers. Miss Gloria, this article is for you!
The specific disorder pertaining to the knee cartilage can be referred to as Meniscitis, and this is defined as an inflammation of interarticular cartilage, especially of the medial and lateral menisci of the knee joint. The Meniscus (the singular of menisci) is the interarticular fibrocartilage of crescent-shape, found in certain joints, especially the lateral and medial menisci (semilunar cartilages) of the knee joint. With the passage of time and stress upon the joints, these knee cartilages deteriorate, and the condition almost always progresses to Osteoarthritis.
Are You Wearing Your Joints Out?
Hikers and backpackers have a tendency to walk and hike on uneven terrain. Sometimes (especially if they are not equipped with good hiking shoes or boots), the compression resulting from different stress placed upon the feet results in problems with either shin splints or problems with the knees. The cartilage can generally take a lot of wear and tear, but with age there is significant deterioration that occurs leading to pain and loss of mobility.
The basis for the ailment is lodged within the structure and function of cartilage, defined as a specialized type of dense connective tissue consisting of cells embedded in a ground substance or matrix. The matrix is firm and compact and can withstand considerable pressure and tension. Cartilage has no nerve or blood supply of its own. In layman’s terms, cartilage functions as a shock-absorbing tissue that protects the ends of bones where they articulate (meet) in the manner of football pads and knee padding. Articular cartilage is a thin layer of smooth cartilage that is located on the bone surfaces of synovial joints, especially the knees and elbows.
Upon deterioration of this cartilage, Osteoarthritis (also known as wear-and-tear arthritis) occurs. Without the cartilage to “pad” the ends of the bone, the bones rub together and cause pain. The deterioration transforms the cartilage’s normally smooth surface into a rough, pitted surface; friction causes the breakdown, leading to weakness of the muscles, tendons, and ligaments. The deterioration is three times more common in women than in men.
An Ounce of Prevention is Worth a Pound of Cure
Prior to your excursions, select the best hiking footgear possible. You also may need to perform stretching exercises and perhaps give your knees a good rubdown. This warming salve  can used to massage and stretch muscles beforehand. A knee brace  can also be used to strengthen or support the knee joint. These braces can be made of ultra-flexible neoprene or they can be rigid and protective on their exteriors. Select one according to your needs, the load you may be toting in your backpack, and the distances you will be traveling across the terrain.
From a naturopathic perspective there are many options open that the sufferer of knee-cartilage degeneration may wish to pursue. Dr. Margaret Flynn, a Certified Medical Nutritionist with the Department of Family and Community Medicine, University of Missouri in Columbia, conducted a study of such helpful foods. Dr. Flynn found that Folic acid (Vitamin B9) taken 6400 mcg (micrograms) daily, along with Cobalmin (Vitamin B12) could relieve pain and tenderness of knee-cartilage degeneration.
When using the B-vitamins, they should be taken concurrently, as it speeds absorption. The Cobalmin is easily purchased for use in that recommended daily dosage; however, the Folic acid can be purchased over-the-counter (OTC) in a maximum dosage of 800 mcg. For the sufferer, it would be far more cost-effective to ask the physician for a prescription of Folic acid; this would give a three-month supply for three times the amount and perhaps 1/5 of the cost of buying it OTC.
Another very important consideration worth mentioning is Pernicious Anemia, a disorder that interferes with the body’s ability to absorb Vitamin B12; this can lead to permanent nerve damage if too much Vitamin B is taken in! You must check with your doctor to find if you have this condition prior to the B-vitamin uptake. Your physician can test for this prior to his prescription of and/or your use of OTC Vitamin B supplements.
Arnica tincture (Arnica montana) can be used as a compress on gauze pads or clean cloths, externally, to help relieve pain by using 1 Tbsp tincture per 2 cups of water. There is also an Arnica gel that will accomplish much the same results; follow the directions as per the manufacturer. These herbal remedies can be employed 1-2 times per day as needed. From a dietary perspective, the patient should take in herbal teas, vegetable broth, garlic, and extracts of carrots, beets, and celery. Concurrently, the patient should avoid refined sugar, alcoholic beverages, coffee, tea, and excessive wheat gluten.
Other helpful foods are numerous, although this list is by no means exhaustive. Gammalinoleic acid can be obtained in Fish Oil, found in your family-friendly Wal-Mart in 120 mg gelcaps, with 50 mg of the Gammolinoleic acid per serving. This fish oil also contains Borage seed oil and Evening Primrose oil; a 24-week study found that these substances reduced joint inflammation. Capsaicin (from Cayenne peppers) is also available in the form of creams and ointments rubbed topically on the knee joint for aching joints and muscles, and it has the effect of deadening local nerves.
Garlic (Allium sativum) is a powerful herb (as the reader well-knows from past articles of Beneficial Blog) that inhibits free radical formation in joints. Alfalfa (Medicago sativa) can be found in your local health food store or natural grocery concern for whole foods. Alfalfa contains all of the minerals for bone formation and helps with arthritis. The herb can be taken in tablet , ointment, seed, or sprouted seed  form. The herb is contraindicated in patients with gout and systemic lupus erythematosus, and it is not to be taken by pregnant women.
Sulfur-containing foods, such as asparagus, eggs, garlic (there’s garlic again!), and onions can help immensely. Sulfur is used by the body to repair and rebuild bone, cartilage, and connective tissue. Green leafy vegetables, oatmeal, brown rice, and fish as part of the patient’s diet are all excellent to aid with the condition, as they promote Calcium absorption. Finally, Tripterygium  (Thunder-god vine) is a Chinese traditional remedy. Coming in pill form (originating in the wild in China), it decreases inflammation with joint pain. Studies undertaken showed a decrease in pain with patients after 12 weeks, with side effects of mild rash and diarrhea, both of which did not interfere with the patients’ treatments. As the herb is difficult to find in the U.S. and is somewhat obscure, one may wish to consult a trained herbalist in the school of Chinese Herbalism.
Please keep in mind that all of the aforementioned naturopathic aids are supportive in nature and are an adjunct, not a substitute for a doctor’s care. Consult with your friendly and happy family physician prior to taking any actions regarding any information provided in this article. So, before your hike, take the proper preparations and ensure you have the right footgear, that you have stretched out accordingly, and that you “train, don’t strain.” Always know your limits and work within them for a safe and productive hike. Have a great day and enjoy those great outdoors!