Europe with tricky knees

The walking is the best thing. We were walking 3-4 M/D before the trip. On the trip, just in cities and towns, we sometimes put on 6-7 M. Some days I was quite tired (I am 70, wife is 73). If you can find the surface like European cities (cobblestones, not even asphalt/concrete), so much the better. Also an OTC pain reliever is good to take.

I am not slated for knee replacement, but the knees are not my most durable feature.

My friend fell and broke her right patella….fast forward 6 weeks ..the patella healed but in the previous 6 weeks her left leg twisted since her body was compensating for the right leg ….. her options were Steroid shot or Hyaluronic Acid shots and last but not least a knee replacement. She opted for Hyaluronic Acid shots.

https://www.mayoclinic.org/drugs-supplements/hyaluronic-acid-injection-route/description/drg-20074557

For me two best items for my bad right knee is a good quality compression sleeve like this:
https://www.amazon.com/dp/B078THCWFC
and lots of Ibuprofen.

Your doing the right thing, but once in Europe, probably being very aware of where you are walking is key. I tend to be looking around and misstep, twisting my ankle or knee. Of course, the cobblestones, uneven steps, steeper than typical walkways, all play a role, so do as my wife tells me...Be Careful!

We usually average 8 miles a day in Europe, but this is first trip since 2019. And since knee has been tricky.

Will definitely bring huge bottle of ibuprofen and knee compression sleeve!

Also my trusty Ecco hiking sandals, thick and sturdy. Unfortunately really ugly, haha.

The Hyaluronic acid injection is interesting! Something to look into for sure.

So true about watching where you step. I have seen so many people go down. Even worse when on a much longed for vacation!
I was actually in Puerto Rico last year when I broke my leg…hiking in the rain forest! I love telling the story now, makes me sound like an adventurer!

These comments remind me that in 2019, we traveled from May to June. In March, 3 M before the trip, I tripped in the basement, and came down hard on the right knee. So, the entire trip I was limping. When we returned, my unnatural motions translated into inflamed trochanteric bursitis - my hips were very tender. I could not lift my feet without pain. Finally, the PA consented to give me a cortisone or steroid shot in each hip - complete instant relief. 6 M of annoyance from the hips.

So, do be conscious of your motions - if they are unnatural or favoring one side over the other, this may have a consequence. If you are limping, possibly consult your physician.

The Hyaluronic acid injection is interesting!

FWIW, My doctor has mentioned this stuff, and gave me some literature.
Most insurance plans don't cover it.
Also when asking around I have yet to come across a single person who has a kind word say about this treatment. Most said it made the pain worse.
I did have a couple people tell me that Cold Laser Therapy was very effective. But it's pricey and not covered by insurance.

I just started physical therapy after flaring up both knees (mild meniscal tears) with too much spring gardening. Learned that my hips & ankles have been contributing to the issues. Hoping to be tuned up for the upcoming trip.

My ortho offered either steroid or PRP injections (not a lot of data available yet for PRP). I would like to bring along my tube of diclofenac gel (available over the counter) but the tube is so darn big!

The stronger your leg muscles are, the better for your knee. Wear a knee support, and use a walking stick to help keep balance. Yeah, weight is a big factor.

I have had three rounds of HLA injections in my arthritic left knee. At one point the pain was so bad it hurt to walk down a hill at the San Diego Zoo. Not acceptable for a Colorado hiker, skier and biker.

The regimen of three injections per round. was much more effective than the single shot regimen. In all cases, the pain returned within a few months at best to a few weeks with the single shot. In the first case, the pain relief gave me a cushion to strengthen the leg muscles up enough to support good movement which, in turn, lessened the pain.

What has helped the most is a great physical therapist who was able to note that my left hip and glute were not moving correctly. This was causing muscle tightness and pulling my knee out of ideal alignment. After a few sessions of a dry needle treatment with electrical stimulation, my pain is nearly completely resolved. Only when I overexert does the pain creep back in and then I know how to stretch and roll everything back to normal.

Sounds as if you're doing about all you can do to get stronger before the trip.

I would suggest you get a knee brace for the bad knee--even if it's just an elastic brace to stabilize your kneecap.

Instead of mega walking when traveling to/from/and in mass transit, get a cab when going from place to place within cities.

"I would like to bring along my tube of diclofenac gel (available over the counter) but the tube is so darn big!"

Depending on where you are going, you may be able to get this pretty inexpensively in a European pharmacy. Before it was OTC in the US I got a big tube of Voltaren-branded gel in a pharmacy in Germany. I don't know how much that tube is in the US but 7-8 years ago I paid about $15 for the giant size.

I don't have knee problems but have traveled with my brother who does (currently looking at him lying on the couch with a cold pack on his new knee, lol). Even if you are not having problems when you leave, do take the above mentioned neoprene sleeve in case you have issues. My brother started upping his knee exercises in Dec when scheduled for a total knee and added in some new ones he found on youtube. He was pleasantly surprised that he was able to increase strength in his quads and his knee felt much more stable before the surgery. This might help your knee stability.

I'll add that for my balance I do exercises on a BOSU. This is the half ball on a platform that is a balance trainer. There are some much smaller ones than this one which I've had for years. I can really tell a difference when I use it regularly before I travel. Strengthens my feet, ankles and knees (and probably core) for cobblestone walking.

I have had bouts of plantar fasciitis in the past but switched to zero drop minimalist shoes. I know these are not for everyone but the proprioception benefits of a softer sole are great. Even hiking I like the way I can feel the ground better than what I could with thicker soled shoes.

YMMV.....

Have you been to the doctor for an actual diagnosis? A "tricky" knee can be different things, if it is giving out on you or you have pain you may have arthritis which will can trigger different solutions such as the Hyaluronic Acid Injections, which I have had a had a few times (the treatment is 3 injections once a week) and did not receive any substantial relief so I stopped after about 3 times doing the treatment.
I do have arthritis in both my knees and the only way I can walks is to take Diclofenac orally and topical gel (The Topical gel is also called Voltaran and is sold all over the US no prescription needed) and Tylenol Arthritis.
Also resting once the knee becomes painful (As in it gives out and I can no longer walk) usually a 15 min rest does the trick for the next mile.
If you can now walk 5 miles without pain you will be fine in Europe. I have had Arthritis for about 15 years and have traveled to Europe 3 times and walked 10+ miles every day with some pain but nothing that had me crying or unable to walk. Today is a different story, my time has run out using med's and determination. It is time for a knee replacement if I ever want to see Europe again. These things get worse not better, so go now while you can and walk walk walk all over Europe.

Before my husband had his knee replacement he used to travel with a cane that could fold into a seat. He didn’t really have trouble with the walking, but any prolonged standing caused problems. He doesn’t handle surgery well, so he’s had 2 PRP shot in his “good” knee. They aren’t covered or cheap but they have lasted a long time and he does well with that treatment, but you’d want to know what your issue is.

You mention "lots of e-biking". Do you bike at home? Biking is generally gentle on the knees but depending on your type of pain it can still strain you, and e-biking does not make a huge difference in that respect - it saves leg power, but you still have to turn the pedals.

I do not have a bike, so haven’t done a lot of riding. I have ridden a family member’s e-bike for some short jaunts, and had no problem.
We are planning to e-bike from colmar to a couple towns…not that far, so hopefully won’t be a problem.

My knee problem is not a lot of padding cartilage left, so it gets sore.

I have tried glucosamine and didn’t notice any difference in 90 days.

Also tried the Voltaren gel, and wasn’t more effective than ibuprofen.

KKMINTZ- It may be time to try a prescription anti-inflammatory. I literally cannot walk without my diclofenac oral meds, and if it is a heavy walking day I pair it with Tylenol Arthritis, and it works really well. I am also bone on bone. We recently went to Mexico and I was able to get Voltaren in 2% strength as opposed to the 1% I can get here, and let me tell you that the relief is so much stronger.