Sicily with a bum knee

I had the same in 2019.
Three weeks before my trip to Italy, the 12 year old partial replacement parts in my knee started breaking down.
I wasn't going to cancel the trip.
I called the ortho surgeon's office, but was told ,,,,"He's in Italy"!
His office partner looked at xrays for me and said off you go.

I got a really good brace, just from the drugstore, and a couple of stretchy supportive knee sleeves.
Also a fold up cane, and a really good supply of Tylenol, Ibuprofen and Voltaren Gel.
Ibuprofen is expensive in Italy, so bring enough with you for your whole trip.

I did fine and walked over 10,000 steps a day with lots of rests.
People in Italy are so caring...one B and B host went out and bought me (unsolicited) a reusable ice pack, and everyone offers you a seat when they see the cane, on transport and in markets, etc.
I was given priority boarding on every one of four flights, and treated royally.
I've since had that knee replaced.

Hiking poles take a tremendous amount of strain off of the knees. Research shows between a 20-40% decrease in ground reaction force. Have you used them before? I bring collapsible poles that pack into my luggage and take up little space. Here is an example
https://www.rei.com/product/162530/black-diamond-distance-carbon-trekking-poles-pair?
They are easy to use and will make a difference on your knees.

Another way to help with knee pain after sitting for a long period of time is to do some stretching in your legs and hips before you start moving too fast or too far. Plan that you will not put anything on the floor under the seat of the airplane while traveling. Leave that entire space free so that you can stretch out your knees periodically and change position.

Thank you, S J, great suggestions and assurance. Carol, my daughter recommended hiking poles when we were in Kauai. I worry about having so much to hold since I love taking pictures. Also, I lose stuff. However, I appreciate the link since these poles are at a price that they may be worth the try.

I can sympathize as I suffered with a bum knee for several years and tried everything (brace, ice, ibuprofen and ultimately cortisone injections). The cortisone injections took care of the pain for two or three months. Eventually even the cortisone didn’t work and I opted for surgery and wished I had done it sooner. You might check with your doctor if a cortisone injection is an option for you. Good luck.

@jules. The poles come with loops that allow you to free up your hands somewhat. I like to take pictures as well. I've struggled with torn meniscus in each knee and I know how hard it can be when your knee hurts. I think you should try the poles. If you find that they are too much, well then put them aside. My guess is that you will notice the difference and the ability to move with less pain will be worth it.

Carol, Purchased! And my husband wanted some as well. What a great deal! (I have a tear in my ACL and I didn't know there were 2 meniscus and both are torn)
Mary, I am a big proponent of cortisone. I had cortisone in November. It worked very well for my "formerly" bad knee. It didn't work that well for the current bum knee, but if its not too soon, I will try another.

I'm hoping most of our accommodations will have ice for an injury. ... For the most part, we are staying at small inns/BnBs.

If they serve breakfast, then they will have a fridge/freezer, which may nor may not have ice.

I could bring a cold pack that could be frozen, but I'd likely forget it somewhere along the line.
Instead of a cold pack, could you bring a stash of really good zip lock bags, perhaps doubled, fill part way with water and ask them to freeze it for you. I'd try this at home first ;-) If it freezes, it will be a block that you'll have to break up. Alternatively, you could get some thin, freezable cold packs at the dollar store, but little bags are easier to carry.

As for asking for ice, you could write something on a card that you can hand to them. Or have a translation on your phone. One of these would do nicely:

Per favore, posso avere del ghiaccio? (ghee-AH-chee-oh) [please, can I have some ice?]
Posso avere un bicchierino di ghiaccio, per favore? [can I have a small glass of ice, please??]

Or just ask them in English. If their hotel caters to Americans, it is very likely they will understand a request for ice!

As another idea to get some flexible cold to put on your knee, bring some suitably sized squares of fabric - maybe cut up an old flannel shirt. Wet a square and put it inside a zip lock bag. Ask the hotel to refrigerate or freeze the makeshift cold compress for you. Even if they're fridge cold, they'll provide some cooling, and they will be more flexible than my previous idea of a frozen baggie of ice water.

You might want to write out that request in Italian. I can just see trying to explain it to someone with limited English ;-)

Disclaimer: I've not tried this, just trying to think of a lightweight solution for some cold!

Noto day trip (I know there will be stairs)
Yes, a lot of stairs to get up to the cathedrals in Noto and Modica. One of the cathedrals had meandering paths that you could take instead, but I don't recall which town. Each of the cathedrals should be within your 3-5 flights per day limit.

Taormina (for a day, I know it's basically on a cliff, appreciate any "hacks" that will accommodate the knee

There is parking in Taormina from which you can avoid the stairs by taking a shuttle up to the historic center:
https://www.traveltaormina.com/en/how-to-reach-us/parking.html

Once you are in the center, you can largely avoid stairs, except in the Greek Theater and if you veer off the main tourist area down the hill. There may have been stairs down to the Villa with its gardens and fabulous vistas. But those should be within your 3-5 flight limits.

For the climb up to the Santa Rosalia sanctuary, there are a lot of steps. It has been a few years since I was there, but I think there are 4 or 5 sets of stairs, with maybe 15-20 steps in each set.

If you do go there, be sure to drive to the top of Monte Pellegrino and enjoy the beautiful view of Palermo and the water. There is also a scenic overlook about halfway up the mountain where you can park and see the city down below.

When I went to Liguria and Piemonte for several weeks despite hardly being able to walk due to a foot problem, I kept telling myself that limping around Italy was still better than no Italy at all. Yes, to the poles or folding cane, the gel anti-inflammatory, the trying to take it easy and go at a slower pace, and the ice.

I have two suggestions, one of which you will hate as much as I did. Ask for a wheelchair to go through all the airports, even if you don't think you need it --- I toughed it out as long as I could walking with my cane, but it really was a relief (although weirdly embarrassing) to get pushed through the Milan and New York airports by an airport guy while my husband handled the luggage. The second is to take and use a washcloth instead of a piece of fabric to freeze in a ziplock bag --- it will stay cold longer.

Good luck, I hope it all goes well!

Nancy, yes, I would HATE a wheel chair, but may be necessary. When we came home from Kauai, I probably looked more pathetic walking thru MSP than I would have in a wheel chair. The problem there was the long flights and walking thru multiple airports.

A washcloth in a ziplock is an excellent idea!

There are lots of excellent ideas, thanks all.

Has anyone put walking poles in carry on luggage?

And Italy with a crap knee is truly better than Minnesota in April!

On that trip in 2019, after all the great treatment along the way to Rome, we got to Rome and I said to my friend "Well, that's it, no more special treatment."
Next thing as we waited in the Immigration line, a huge Security Guard saw me with the cane, rushed over and manhandled me into a wheelchair.
He shouted at my friend "You run behind with luggage'!
She did and we sped though the line, in front of the airline crew who were there first, and were spat out into the Arrivals Hall in a couple of minutes!
Still laughing.......

Don't refuse a wheelchair if it's offered.....

Regarding walking poles in carryon luggage:
Not TSA approved. Sometimes they go through and sometimes they don't. When they don't, you could be left scrambling. I just check them in my luggage.

Voltarol is a topical ibuprofen gel that cools and relieves joint pain here in the UK. Don't know if you can get it in the US. Because of its size it would be unlikely to be accepted in carry on but would be ok in checked luggage.

My wife and I use it when our knees or elbows give grief.

In Italy it has a similar but different name of Voltaren Emugel - same stuff. Here's the GSK page about it - https://www.ritornainmovimento.it/
I would expect any Italian - even Sicilian - pharmacy to have it. I make no guarantees about the price (cheap here).

Edit - I see that it is Voltaren in the US, https://www.voltarengel.com/

Carol, well that’s a drag. We don’t check luggage. Not that we wouldn’t like to, but outbound, unless we stay in the arrival city for at least 3 days we don’t carry on. We fly MSP to Boston to Rome to Catania. Our luggage has been delayed at least twice. On our honeymoon 38 years ago and about 12 years ago when we flew with 4 kids to Denver and drove to Steamboat. None of our luggage made it. No ski gear or clothes, nothing. 3 days later it got to Steamboat via courier. And in Europe, I’m not sure the carrier would get the luggage to us. It’s rare, but when the luggage is delayed it’s not pleasant.

We’ve never checked, but my husband often carries in a tripod. Now that, could kill someone!

Nigel, so helpful! I’ve never used the stuff but I’m going to look for it. If I can’t find 3 ounce, I will transfer to a smaller bottle and if needed, look for it in Italy

Check Costco. Here in Canada, Costco has Voltaren, 2 x 150g and 1 30g. Way cheaper than the pharmacy. You know you've reached a certain age when you Voltaren in bulk.....

...when you buy Voltaren in bulk....

Why not get a few of the ice packs that you activate by twisting them. No refridgeration needed.

Also, if you use your trekking poles in the airport with rubber tips will they let you through...like canes. Perhaps a doctor's note will help as well? And if you ask for assistance flying out with a wheelchair you will certainly seem more in need of them as an aide.

Jules, your comment about cortisone shots made me laugh. Back in the day, before my sister and I traveled together, our mom and her sister would take trips together. They always coordinated on timing of their cortisone shots in whatever area they needed it before they'd depart. Sometimes, it was a hip. Sometimes, it was knees. They were doing this into their 80's!

Re: HIKING POLES.

I have always put them in my carry-on baggage and I’ve never had a problem. I love my poles!
It is worth spending the money to get a lightweight foldable pair that is high-quality. You are spending tons of money to go on vacation, why worry about an extra hundred dollars for what I think is the most important part of my luggage
(many days of my trips are spent hiking).
I went to REI and they not only help you pick out a good pair of poles but show you how to use them correctly.

Walmart has equivalent to Voltaren in 3.53 oz (100g) tube for less $ than brand name.

We just completed the RSE tour of Sicily and had a fantastic time until Covid interfered at the very end. (That’a whole other story.)

You’ve gotten some good suggestions above and I won’t comment on them.
Realistically, you may need to amend or sit out some activities and move around more slowly and deliberately than usual. Some of us creaky-kneed travelers, though devoted runners and walkers, found the going a bit more daunting than we expected. There were many many steps to climb (e.g., Monreale is a long climb and Castlemola even more so) and steps were not necessarily even or evenly spaced. Footpaths up among the temples and ruins were often rocky, rutted, and steep, without handrails or anything to grab for balance other than prickly pears, The Mt. Etna crater more so, with hail and rain for fun. The Taormina funicular was not operating when we were there - perhaps it will be open by the time you are.

In other words, physically moving around may take more time and attention than you’d think. It was a wonderful trip worth every twinge and Tylenol. I hope it is for you too!

Thanks for the additional suggestions. I looked at Voltaren today at Costco and plan to check out generics at Walgreens and Walmart. I've never heard of topical NSAIDS. It could be awesome for me. The Costco bundle did have a smaller, travel appropriate size. Anyone know if Voltaren has the same possible stomach impact as oral NSAIDS? I read the package warnings, I have to think it'd be easier to handle than oral advil. My regular dr. is less than thrilled with the amount of Advil I take, yet he doesn't have a messed up knee.

I thought about the ice packs that are activated by twisting, but I'd need about 30 for the trip, and I don't have the room. That said, I think they'd be a good option for the flight. Love the idea for freezing a washcloth. I should have thought of that. I used to freeze them to cool the kids for tennis/soccer matches.

We don't plan anything in the Mt Etna area other than sightseeing along the roads surrounding the mountain, wine tasting (should help the knee) and walking around Randazzo. We've climbed to the top of Volcanoes at other places.

I ordered REI poles and will go to my local store for lessons. I think I'm going to get a dr.'s note and then try to get them thru TSA with someone waiting outside the airport to give them to if I can't. We can put them in checked luggage for the flights home.

Any additional recommendations are very welcome. I feel like I have a lot of good ideas so far, and I'm very appreciative.

If you do decide to visit Zingaro we preferred the Scopello entrance. You don't have to hike very far for beautiful views and going through the tunnel is fun. I also don't remember it as being very demanding. It is definitely different than Kauai.

I know I'm stating the obvious here, but if you plan to pack the poles in even one direction, be sure the ones you buy are collapsible. I'm pretty sure the ones in Carol's link are not. I was tempted until I realized that.

I had a trip like that. I brought several gallon size ziplocks and my husband would scrounge ice everywhere we went. Even on the airplane.
Everyone was helpful & understanding.

Something that really helped me was strength tape — those strips of tape you see on athletes’ shoulders or backs or whatever. My physical therapist showed me how to position it on my knee to give support, and it was amazingly helpful. Plus it looks way cooler than an ace bandage! You might ask your doctor or PT about this.

We did Zingaro, but from Scopello it was mainly uphill, and rocky, and I didn’t get too far. I personally don’t think you’ll miss much if you skip it. I’m glad you’re seeing Lipari. It’s a little hilly but, after Ortygia, was our favorite place in Sicily. Have a great time!

The gel anti-inflammatory should not bother your stomach at all, but you do need to be careful to use the right amount --- a little measuring thingie comes with the tube. I knew I would lose it (and I did) but because I knew my future self so well, I made some copies of it. The cool thing about the gel is that you rub it in right where it hurts, so it acts fast.

I can imagine places and situations in which a folding cane will send a better message about your knee, and you might therefore get the consideration a bum knee should bring you. Like in a restaurant. Think about taking both. My cane (from CVS) is lightweight and has flowers on it and, I think, signals "injury" rather than "exercise fanatic." Fits in my husband's purse.

This all reminds me of when my mother, aged 91 at the time, broke a bone in her foot and couldn't use a cane --- she had to use a walker and she seriously wanted to put a sign on it saying she'd broken her foot and NOT that she was old. Funny, the things that embarrass us.

Ask your orthopedic surgeon about a Synvisc knee injection. It provides cushioning in the joint and relieves knee pain from arthritic conditions longer and more completely than just a steroid injection. But you need to have it done at least 3-4 weeks before your trip as it takes that long for a full effect. Also it will not help if you are already “bone on bone”. You could also get a steroid injection a couple days before the trip even if you had the Synvisc.

Bring a knee brace/Support and a cane or hiking poles as well as Naproxen or Ibuprofen if you are not allergic and don’t have kidney problems or blood pressure problems.
Good luck. Enjoy your trip. I have knee, hip and back problems and just had cancer surgery but I am going to Sicily in 5 weeks. Life is short and meant to be enjoyed.

@bobbo22, I looked at pictures on BING supposedly of Zingaro and I was seeing beautiful pics of coves with beaches. Are you able to describe what its like or give me a link to something that looks like what you saw? We are very outdoorsy and I am torn about Zingaro because it was a place I wanted to go.

@tead102, thanks for the suggestions. We are likely in Sicily at the same time. Do you follow Sarah Murdoch former RS guide and now "Adventures with Sarah"? She is in Sicily right now and posting pictures and short videos. They have been helpful for me.

@Nancy, thanks for the additional info!

For all, Re. Zingaro. I'm reading about a road from San Vito into Zingaro called Calampiso. I read that the views were lovely. It also sounded like there were resorts on this road. Anyone do this road?

Debating cane vs. walking sticks. I have used a single walking stick on various hikes (a branch picked up from the ground) It helps a lot. I feel like a cane is used differently from a single walking stick, yes? Canes are cheaper (in case of confiscation). What works better on steps, such as church steps, with or with out a railing? I'm trying to envision going up stairs with a pair of walking sticks. Not sure how one does it. I think my problem will be going down lots of stairs (its the weight when I step down that is painful) or downhill on gravel or uneven paths. Beyond those concerns, I feel like a cane/walking stick just provides stability reducing the possibility of further pain/injury.

For my fellow traveling and hurting forum friends. I scouted out voltaren and generic equivalent. At regular price, per ounce, Costco had the best price, but it comes in a bundle, of which one tube is travel size. Walmart per ounce price of its generic did not beat Costco.

And the winner was Walgreens. Their generic is , at least this week, buy one get one free. So I got 2 travel size for $10.

Maybe this helps someone.

@jules m, Zingaro in early May was beautiful blue water, coves, beaches, wildflowers and beautiful rock formations. You hike up above the beaches and make your way down to them on established trails from the main trail, some may be difficult with a bum knee. We are from the Northern California Coast and avid hikers and thought Zingaro was beautiful. We will go back. We only hiked from the Scopello end but did drive to the other entrance from San Vito on the road you mentioned. The views are nice on that drive and the resorts are below you on the coast. My favorite view while driving the area was of Spiaggia Di Macari while driving into and out of San Vito Lo Capo.

Jules ...good job on price shopping...I'm going to go to Walgreens tomorrow and see if I can find the same deal. Thanks for sharing.

I want to sincerely thank you all for the great suggestions. I’ve been finding relief from the frozen wet wash cloths and Voltaren. A couple days I made good use of a cane kindly shared by a forum member that lives near me. Today we did Valley of the Temples, I forgot the cane and ended up not needing it, anyway.

I appreciate all the thoughtful responses