Can I see Europe without too much walking?
 

Hi everyone,

I had orignially planned to take a trip to Nice, Paris, Venice, Rome and Florence a couple years ago but had to postpone. At this time I am in a position to reschedule, however I am afraid it will not be fun.
Althoug I am young (28), I am having a problem with my knees. Too much walking causes inflammation behing my kneecap which becomes painful. For example, I went to Disney World in January. By the third evening, my knees were a bit sore. By the fourth day I wanted to stay in the room. And this was while taking ibuprofen (I believe it is supposed to help with inflammation) and wearing appropriate shoes!
So my question is, can I see Europe without being in too much pain to enjoy it?
Thanks for any and all advice!

I would investigate city sight-seeing bus tours, make sure you have the funds to make liberal use of taxis, stay in a centrally located hotel with an elevator, allow plenty of time for sitting in cafes, take the afternoon off and kick back in your hotel room, visit just two cities rather than five, etc.

You could of course see Europe but take it easy. You'll just see less, or take more time. If you plan your itinerary carefully, stay at hotels with elevators, always stay very centrally located, and spend a lot of time resting at cafes (the best part anyway!) you'll still have fun.

Here's what I'd recommend though. Can you buy a treadmill or join a gym? If you can get on a treadmill (just walking!) now you will greatly improve your situation. Really, I bet you could you make a huge difference in just a couple of months!

I got on the treadmill about 8 months before we went to Europe because I wantd to lose 10 lbs. I did lose the weight - but most important I have really improved my stamina walking. Also feel much less stiff.

Hi again,

Thanks for the advice!

One thing though - the problem is not that I am out of shape, it is that my knees are not aligned properly. I can workout, I just can't do a lot (as in walking 15 miles a day) because it results in inflammation. Once inflammation occurs, it takes time (one month after DisneyWorld) to heal, so I have to be careful.

The idea of hanging out in cafes sounds fantastic! I'll definitely work this into the schedule.

I assume you have seen a specialists about that? I can get terrible tendonitis in the tendon between my hip and knee. Sometimes my knee is killing me and sometimes my hip. My otho. specialist gave me a shot (cortisone{sp?})in the trouble spot on my hip about a month before our European vacation and we walked like crazy without pain. I have not had to have a shot since and that was over a year ago.

Trains. Rent a car. Buses. Daily tours. Join a tour group.

Break your day, don't walk all day long. Come back to your hotel for a mid-day rest. Use "people-watching" more - a polite term for sitting when a longer rest stop is needed.

Have I missed river cruises? Look into those.

The honest truth is that it really is tricky. I struggle to think of much I'd consider worthwhile that's really easy in your condition.

You probably need to preplan every day with great precision: you can avoid having to climb bridges all the time in Venice, for example, only by using (ruinously expensive) watercabs. And even then: are your knees able to cope with getting in and out of low boats a lot? Never mind changing planes at LHR or CDG.

More importantly, though, your phrase "I believe ibuprofen is supposed to help" sounds dangerously as if you haven't sought professional help.

I have friends who've ignored knee problems till they need complicated (and frequently counter-productive) surgery - repeatedly. I also know people who've had the sense to get physiotherapy early and to follow the exercise regime the physio prescribes meticulously. (Incidentally, this absolutely DOES NOT mean using a treadmill, which can for some people do a lot more harm than good). Their limbs keep on working, however unhealthily I -(oops. Meant "they") - treat my body in every other respect.

Heresy it might be on this board, but you can manage the next 60 years without coming to Europe. You'll have far fewer than 60 years if you don't get those knees seen to now.

Postpone any intercontinental transport till you've bought the best and longest course of physiotherapy (or whatever else your general practitioner suggests) you can dream of affording. And followed to the letter every single exercise, diet, drug and lifestyle recommendation you get.

And avoid surgery as long as you possibly can.

Are you under a doctor's care? I ask because you mention only taking ibuprofen.

Sorry if that is a nosey question, but I recently had minor day surgery that completely cured what had been chronic intense pain in one knee.

Raindrop - The hop on hop off busses in Paris and London are great. It will save you a lot of walking. Batobus in Paris as well.

I had to calibrate the walking in Italy this summer to my mother's walking abilities (which are pretty much nil considering her knees are shot as well). I, of course, am an obsessive walker, and often fancy myself faster than the buses, so it was hard. But. . . here is what I did:

1) used maps of the cities we visited.
This way we could cluster our visits and sightseeing so that minimal walking was needed. We took taxis from the hotel to wherever our first attraction was, did our seeing (with extended coffee breaks), and then taxied it back to the hotel.

2) broke up the day into 2 parts: morning and afternoon (because I am creative, you see).
Morning was for the stand-up activities (museums, walking around neighborhoods, etc) and afternoon (after lunch and naptime. . . yes, my mother took naps) was the lazy time when we did the tour bus stuff. . . the passive tourism.

3) I picked up the slack.
If we had to wait in any lines, I automatically seated my mother and told her that I would get her when it was time. I carried all of her stuff so that she was dealing with less weight (I am also more aware of pickpockets).

Those were the major modifications I made and it worked out well. If you have someone traveling with you, perhaps they will be into the ideas of picking up the slack. Also, to satisfy myself, I used naptime to get my big walk of the day in, and I went out dancing a few times.

Claire

Also it may help to walk with a can, even if you don't need it - people will be more sympathetic, will let you sit down when you stop, offer help. Just don't forget your cane anywhere like my friend in a phone booth :)

What do you mean your knees are not "aligned?" One leg shorter? Scoliosis? Something's wrong if you're gobbling ibuprofen so be brave and go to the doc. Don't get on a treadmill at this point, although it doesn't sound like you could do much for long anyway.

I would not go on a city vacation until you have this under control -- you will not be happy if all you can do is crawl to the cafe.

Good luck raindrop.

definitely go to the doc. how long have you had this problem? do you have any other joints with any problems at all - even minor ones?

can you wear a knee brace?

No, no, not a treadmill with knee problems! A recumbent exercise bike is the thing, according to both my orthopedist and physical therapist. Any kind of weight-bearing activity puts stress on the knees, which is just what you don't want.

Think about investing in a travel cane (the fold-up kind) and using it when your knee starts to hurt. Also, avoid cobblestones and stairs whenever possible; remember that in the Paris métro there can be quite a lot of stairs up and down, as well as condiderable walking when you need to change lines. I've gradually accepted the fact that having bad knees requires taking cabs.

If you plan your days to minimize backtracking and allow yourself to rest in between lengthy walking, you should be just fine.

This is a great thread. My mom has trouble with her knee - arthritis, under a doctor's care, something she basically just has to deal with. Anyway, I have been considering a trip to Europe with her, but am concerned about her knees and the walking. Most of the time she does great on flat ground going slow and a few stairs here and there. Sounds like if we plan our trip well, then she will do fine. We'd bring my husband and another person as well, so we could easily schlep her luggage, take turns standing in line and sitting with mom, etc.

Sorry to hear of your problem raindrop.

I have an ocassional foot problem that I battle if I walk to much. Last month in Paris, I made sure that ALL my walking had a purpose, therefore I took taxis everywhere (no Metro, no walking between sites).

My sister had knee problems and used a cane on a visit to Paris - she found it very useful.

Regarding preparation, the best excercise machine I have found for my knees is the eliptical.

Consider alternatives to the cities, which generally involve a lot of walking to get the best out of it. What about touring the countryside by car and visiting small towns? Just as enjoyable, but a lot easier on the joints.

Good luck!

I'm not sure if/how it works in Europe but pre-surgery I flew Seattle to San Fran and was forced to use a cane. Without my asking Southwest Air offered me wheelchair service thru the airport. I would have been too embarrassed to ask, but because of the cane (and look of pain on my face?) they insisted and it absolutely SAVED the day.

Drinking wine in sidewalk cafes is my best suggestion... and please cut the number of cities. Five is way to much to try to do in your condition.

There are a lot of other options - but the truth is that one of the major joys of exploring europe is walking the neighborhoods - and yes, that means miles every day.

You can do without it - but you're missing a lot of the flavor and serendipity - and of course, increasing your costs.

I agree with the reco to check out a specialist to see what can be done about the problem on a permanent basis. 28 is way too young to give up on a mjaor part of life. (If there's no one in your area check the nearest major city - or try to get a reference from a world class facility - such as the Hospital for Special Surgery. Medical advances are happening every day - so make sure you have explored every option before giving up. And if I had a problem like that I would consult the best person in the world to treat it before giving up.)

Hi raindrop,
I have a similar situation. I had a bad fall in early August that resulted in my kneecap not tracking and inflammatory pain. I was doing alot better by October and went to Italy as planned with a companion, planning to take it easy and sit around piazzas. I lasted two days - just long enough to get from Rome to Vieste on public transportation. I didn't think that I had walked much at all, but it was way too much. We stayed in Vieste until we could rebook our flight and the whole thing was total misery for me. I have been having intensive physical therapy since August but am recovering very slowly. Like you, if I overdo by even a little bit I am set back. At the time it was almost unthinkable for me to postphone the trip but now I wish I had. But good luck to you and I'd love to hear that everything has worked out for you.

Taping your knee might help.I would agree with the others that a trip to the doc would be a good idea.Some p.t. might be very helpful and he/she can give you some very practical advice for your trip.

Absolutely go to the doctor. I've had arthritis for a number of years and for a couple of years I had cortisone shots and synvisc injections, both of which helped for a time. (The synvisc replaces the synoval fluid in my knee joint.) I finally have had both knees replaced, which is simply wonderful. I am completely without pain when I walk.

I second the suggestions that others have made: know where you're going, take lots of sidewalk cafe breaks, maybe take a break in the middle of the day, and use cabs, etc., whenever you can. I have also used the hop-on, hop-off busses in lots of places, and have liked their convenience.

I think the cane is a great idea. I took one after having had arthroscopic surgery and a couple of times was offered rooms on lower floors when hotels didn't have elevators. It also gave me a good reason to get wheelchairs at airports so that my operated knee could rest on those long journeys from one terminal or gate to another.

After you see your doctor for good guidelines (and I'll be very surprised if he or she warns you off of walking) I wouldn't rule out a treadmill. I figure, if your goal is to walk, and if you're cleared to do so, then you better start walking! If she or he warns you off walking then you better stay home.

Good luck and keep the faith!

I'm begging you, please don't take medical advice from a travel forum!! Except for the part about seeing a doctor or specialist.

Depending on the type of knee problem compression (the taping recommended above) is not what you are supposed to do! Weight bearing exercise (get on a treadmill or walking) is different from non (use a recumbent bike).

My situation was similar to Linawood above, I traveled with a torn miniscus which had not been diagnosed. It was extremely painful and scary and looking back I should have cancelled the flight/trip and stayed home until after surgery and healing.

Hi Raindrop: I have a similar issue, in that I played girl's basketball in highschool and taught tennis, and it ruined my knees. I've had the creaky knees and on again/off again pain since I literally was 17. So now, at 48, I went to the doctor and asked what I could do. He said I have crepitis, and what happens is that when the thigh muscles weaken they don't adequately support the knee and knee cap. He sent me to physical therapy to build up the strength in my things - with leg lifts and squats - and it definitely helped. Regarding Ibuprofen, he also said take 3 before going on long walks or hikes or climbing over pyramids and such. I also had my SCUBA instructor tell me the same thing when I had serious leg cramping issues during one of my open water dives in cozumel. He said to take two advil BEFORE I dive and I wouldn't get leg cramps. That was 12 years ago, and four additional SCUBA certifications after that, I have never had another leg cramp. But I would check all this out with your doctor. I just go when I am in Europe and climb all over the ruins and hike everywhere and deal with the pain, because I want to see all this stuff before I get too much older that I won't enjoy anything. In November of last year we went to Jordan and Egypt for 3 1/2 weeks and we had a blast. This year, it's Ireland in May, Italy in June and Bhutan and India for the month of November. Bravo to you for going forward and don't hurt yourself, but don't stay at home and not experience Europe. You won't be sorry and you may have to elevate your legs for a few minutes each evening when you get back to your hotel, but the adventure will be worth it!
Buon viaggio!

Hello again!

Thanks for all the wonderful wishes and advice. My knees "click" and have since I was about 12. I have told my family doctor about this (and the pain) many times over the years, and at one point had x-rays done which showed no abnormalities. The last time I saw her she suggested we look at them with a scope (as in surgery)! I declined this as for the most part they are pain-free, it is only with a LOT of activity that there is a problem. Also, my father's knees "click" just like mine (but louder!). He is almost 70 and doesn't ever complain about them, so I kind of figured it won't get too bad.

At one point my doctor suggested I may have a certain syndrome (I can't recall the name), in which the knee is misaligned, causing friction when the joint is flexed. There is no diagnostic test for this, it is just based on patient-described symptoms.

Anyways, you have all convinced me to take better care of myself. I will schedule an appointment with a specialist right away.

Thanks again!

Does the term chondromalacia patella ring a bell? I am a massage therapist(hence my handle) and we learned a taping protocol for this syndrome. It seems to work pretty well.

This is by no means a diagnosis nor a prescription,just something to look into with your doctor/pt/massage therapist

From a nursing standpoint, and I'm sure you've probably already heard this if this is a chronic problem, I recommend taking an anti-inflammatory, like Ibuprofen BEFORE the activity that agitates your knee. Also, some patients often under-medicate themselves...So if you are only taking 400 mg (i.e. 2 pills), you might try 600-800 per dose, keeping in mind the daily maximum dose. If the Ibuprofen is not helping the pain alone, it is okay to also take Tylenol, for example, since it is acetaminophen (in a different drug class) concurrently with the anti-inflammatory.
Also, coming from an immensely involved health-professions family, my step-father (a physical therapist) would recommend doing stretch-band exercises, or even using a towel as resistance to strengthen up your knee.