How to avoid knee pain while trekking

Knee pain is a very common sight among trekkers. This type of knee pain is referred to as hiker’s knee. It is caused by excessive strain or overuse of your knees, which may result in pain around your knee cap. It usually arises after long hours of trekking and is intensified when trekking downhill. A study found that the compressive forces were 3-4 times greater during downhill trekking.

Photo Courtesy: Tanmay Khandelwal

Arjun Majumdar, founder of Indiahikes shares his observation. “I have noticed that most trekkers get pain in the knee while trekking downhill. One of the reasons is that they trek too carefully, almost like braking, while descending, resisting the natural gravitational pull. This results in stress on the knees. Trekkers must let themselves a little loose, allowing the pull of gravity to be part of the trek. A slightly faster pace than usual can reduce knee pain considerably. Using a trekking pole will further reduce knee pain.”

Here are a few tips to avoid developing a hiker’s knee:

Hiking downhill

Smooth slope:

Hiker’s need to put their body into a rhythmic spring like motion while descending a slope. Do not attempt to hold yourself back more than required, as braking too much during a descent causes the knee to jerk. Take advantage of gravity and hike down at a rhythmic pace. Vivian Sebastian, physiotherapist and trek leader at Indiahikes says, “Trekkers usually are scared and put excessive pressure on the knees while hiking downhill, causing their knees to swell. You need to let gravity carry half your body weight. It is a technique that the body needs to learn.”

Rocky terrain:

Do not hike downhill too quickly if the terrain is rocky. Rapid descents on hard ground intensify compressive forces, thus increasing the negative impact on your knees. “Overpronation of the foot is another cause for knee pain”, says Dr. Shantala. Those who overpronate tend to push off almost completely from the big toe and second toe. As a result, the shock from the foot’s impact doesn’t spread evenly throughout the body leading to increased load on the knee joint.

Do not leap

Do not attempt to leap, especially during descents as landing too hard on your heels transfers’ immense shock to the knees.

Strengthen your leg muscles

Condition your leg muscles by performing weight exercises that work out your quadriceps, hamstrings and calves. This will help reduce the stress endured by your knees while hiking. “Simple and complex squats can help strengthen the quadriceps. One must ensure that the body weight while squatting is on the quadriceps and not the knees. The knee cap must be behind/in line with your toes while squatting. Never in front of it.”, says Vivian.

Use hiking poles

According to a study published in the “Journal of Sport Sciences” hiking poles help reduce compressive forces by 25%. It helps redistribute load-bearing body weight to the arms and shoulders, thus reducing the impact exerted on the knees.

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Knee braces

Wear knee braces

Wearing knee braces can give your knee additional support. These are not essential and must be worn only when you feel your knees may require external support.

Wear quality hiking shoes/boots

What you wear on your feet is probably the most important consideration for any trekker. While choosing a hiking shoe utmost importance must be given to its quality. Hiking boots with shock absorbing soles and ankle support will negate the impact of any shock endured during hikes.

Stretch your muscles before and after hiking

Stretching your muscles before you begin your trek is essential as it allows your body to become more pliable and less prone to injuries. It is particularly important to stretch your lower body and legs as these muscles are going to be worked on more intensely during the trek.

It is also equally, if not more, important to stretch your muscles post the trek. Your muscles are usually contracted after a long day’s trek and it is important to get the muscles back to its normal length. This will also reduce potential soreness.

Dr. Shantala Yogi, renowned sports physiotherapist shares her views on hiker’s knee, “Patellofemoral pains are more common among sports persons. Yes! though surprising, it is true. This is common due to wear and tear in the joint related to high levels of stress that sports exerts on joints.”

However, non-sports persons may also develop knee pain. Dr. Shantala opines, “It is  important to undergo a physical fitness test if one has a history of such pain before going hiking. Getting fit  for a trek is essential. Slight pain can be treated with the right amount of rest and exercise. One must start preparation early to enjoy their hiking experience.”

 

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Nisha Ann Reginald

Nisha Ann Reginald

Nisha Ann Reginald is a national level basketball player and has been playing for the last 18 years. She was associated with Indiahikes as a content manager, bringing out stories from the mountains.

13 thoughts on “How to avoid knee pain while trekking

  1. I recently completed a trek and suffered from Hiker’s Knee. And 10 days later, I still feel a slight pain and discomfit in my knees while ascending or descending stairs or during other activities. I was wondering if you could tell me, how much time may I expect this condition to last and do I need to take any precautions while it lasts. For example, shall I avoid jogging or engaging in sports?

    1. Hi Rahul, it is not uncommon to have knee pain after your trek. It could any time between a week to a month to go away. Your best option is to go by the standard mantra – RICE. Rest, Ice, Compression and Elevation. Rest your legs for a couple of weeks. As you mentioned, avoid jogging, quick descent or ascent on stairs. Just rest. Also, use an ice pack everyday at least twice. If your knee feels very tender when you walk, use a knee brace. That might help. And when you sleep, keep a pillow or a rolled up yoga mat below your knee to give it a slight elevation.

      Next time, to avoid this pain, before your trek, work specifically on strengthening the ligaments around your knee. There are several exercises for this. This will make sure the ligaments take some pressure off your knee when you descend.

        1. Lunges carrying weight in each hand that when combined equals the pack load that you intend to carry works very well as a hiking exercise.

  2. I did Roopkund and Rupin in successive years. Both from Indiahikes. This is precisely the reason why I have stayed away from treks after that. My left knee has been diagnosed with patella arthritis. I have tried everything. But “Swathi” if you can send across the suggestive exercises specifically for ligament strengthening – I’d be mighty obliged!

  3. Hi Nisha,

    I was recently on a one night, two day backpacking trip which was about 8 miles each way. This was my first overnight backpacking trip, and I chose the Kisatchie national park in Louisiana because it seemed easy with little elevation gain ( about 600 ft each direction ).

    Previously I had only day hiked, so my 35-40 pound backpack was heavier than I was accustomed to. I got an early start and hiked the 8 mile trek to the campsite in about 3.5 hours. During this time I felt some strain on my quads and a little on my right knee, but nothing too serious.

    After setting up camp and gathering firewood for a while, the pain towards the top of my right knee cap began to intensify. At this point I relaxed and began sipping on the half-pint of decent Scotch that I had stowed away. Along with 2 Aleve, the Scotch dulled the pain and I fell asleep quickly.

    The next morning I awoke to the sounds of chirping birds in a rain shower, and increased knee pain. I would be lying if I said that I wasn’t discouraged by the Pain, Rain, and the 8 Miles I had to hike to my car. I managed to pack everything up and start off by 7:30am.

    Besides the pain in my knee, I had the usual soreness in the quads. ( For a person not quite in shape ). Once I got going, the pain in my Quads diminished, as the pain in my knee worsened. After the first mile, the pain in my knee forced me to slow my pace and straighten my leg, especially when going downhill.

    The next 7 miles were terrible. I basically limped and hobbled the entire way. It was cold and raining, and the rolling hills of the Pine Forest made things difficult. Things were much more difficult on the knee during declines. During that 5 hour hike, I worried that I may have torn a ligament. The sharp pain on the top of my knee was not something I had never felt.

    Wet, cold and hurting, I made it to my car around 12:30pm. I drove the 2 hours home, laid in bed, and took 3 Naproxen.

    The knee pain was diminished the next day, and even more the day after that. Now three days removed, I have been researching to quell my worries that I may have seriously injured something. I ran across your article, which seems to describe my injury to a T.

    Thanks for the great article. I hope to read something from you in the future.

    Brian

  4. Hello,
    I am an avid hiker in the southwest region of the U.S. which involves steep and rocky terrain. I recently hyper extended my knee and want to get a knee brace/sleeve. I have noticed that some styles cover the entire knee and some have the kneecap exposed. What is the difference ? Is it better to have exposed kneecap on sleeve as in your picture here?
    Thank You!
    Troy

    1. Hello Troy,
      The open kneecap does not cover the joint and hence is more flexible. It is not too tight and can be used easily for extended periods of time compared to the closed ones.
      The closed ones provide lot more rigid support to the knee than the open one. For most active people, open knee cap is usually suggested.
      However, I would recommend you ask a doctor for what would suit you since you have a specific injury.

  5. Hi nisha

    I am a person who is really interested in hiking and even writes about it.

    However, I am little too heavy and that caused me a lot of knee injuries.

    I am currently using one (knee brace) and I don’t think that is one of the best. I am going to order one today based on what I have read from this.

    Thank you so much.

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