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Hiking & Knee Pain: A Love/Hate Relationship

Hiking is one of those hobbies that can easily make you feel strong, but also give you a lot of pain. Let’s be real, as avid hikers we have all experienced knee pain. We have accepted that this will be a chronic problem, and to us it’s all worth it. However, there are certain things that can be done to help ease the pain. There are techniques and tools to make life easier on the trail. The trail landscape is composed of a lot of uphill, downhill, sand, mud, snow, pavement, rocks, streams, etc. Having the right gear, including a first aid kit, is important to allow for a fun and safe outdoor experience. To the few lucky ones that don’t have knee pain, it will come- I promise. So read this to stay informed on how hiking can cause knee pain and ways to take preventative measures. I am going to also discuss helpful tips on how to mange knee pain before, during, and after a hike.

Body Movement and Mechanics

Why is walking downhill so tough on the knees? When walking downhill, there’s significantly more pressure on our knees. Our muscles are working extra hard to keep eccentric control. Eccentric contraction means when the muscle is lengthening. This type of control is when the muscle provides a resisting force to slow down or decelerate the lengthening movement. In other words, your muscles are constantly pushing on the breaks while contracting.

For example, imagine driving downhill. It takes a lot more control because the car can roll down without using gas; we need to continuously press on the brakes to keep control. It’s the same with our muscles. We can just let loose and run downhill, but the amount of pressure and muscle power it takes to hold everything together is extremely stressful on our knees. Now add backpack weight and a tough terrain to that, you’ve just added on to the stress.

Tips before Hiking:

1. Shoes: Find the right hiking shoes. This is very important; our feet are the foundation of our body. If you’re uncomfortable in your shoes, you’ll have more than knee problems.

2. Support: If you already have knee problems, then use additional tools for support when hiking. Such tools can be athletic/Kinesio tape, a knee brace, and/or trekking poles. Trekking poles are like your third leg, it’s proven to reduce about 25% compression on ankles and knees.

3. Strengthening: Strengthen your gluteal, quadriceps, and hamstring muscles. Strengthening your glutes alone can help support your ankles, knees, hips, and spine.

Tips while Hiking:

1. Avoid stepping with your toes first and try stepping heel – to – toe. Heel first and eventually your whole foot contacts ground. Digging your heels in can give you better foothold.

2. Don’t allow gravity to control you, control your speed. Making sure to keep your knees pointed out, not in. This does not have to be excessive, just slightly.

3. Take shorter steps to keep center of gravity over your legs. This will help give you control and balance.

4. Take a break and stretch your hamstring and calves.

5. Avoid locking your knees when hiking downhill. No hyperextension!

6. Walk in a zig - zag pattern (if path allows). Almost like you’re creating your own switchbacks.

7. Walk backwards- if it is safe to do so. I usually only do this on a paved fire road.

8. Hiking sideways down the trail can also help with increased control and foothold.

Tips after Hiking:

1. Rest

2. Ice

3. Compression wrap, if necessary

4. Elevate

5. Take an antihistamine for inflammation

6. Continue to use Kinesio tape / muscle relaxant creams