How to hike with bad knees: Your guide for pain-free hiking

How to hike with bad knees

Spending time in the great outdoors is one of my favorite things to do. But, having experienced knee pain while hiking in the past, I know how this can ruin your experience on the trail. But thankfully, I’ve managed to survive that dark period in my hiking journey through the use of proper technique, helpful gear, and a few tips to protect and treat my hiker’s knee condition. I had to learn how to hike with bad knees because I wasn’t willing to give up hiking because of this!

In this post, I’ll do my best to share what I’ve learned so you can understand why your knees hurt, and how you can protect and treat them for more enjoyable, pain-free hiking adventures.

What Causes Knee Pain When Hiking Downhill?

The stress that is inflicted on your knees when hiking downhill is what causes knee pain. Other factors also contribute to knee pain when descending on the trail.

  • Increased impact: With every step you take when hiking downhill, your knees absorb more impact than they would walking on a flat surface. This is because you’re putting more weight on your feet and the force of gravity is pulling you downward.
  • Muscle weakness or imbalances: Strong muscles around your knees help to support and protect them. If you have weak muscles surrounding the knee, particularly the quadriceps and hamstrings, this can lead to increased stress on the knee joint during downhill movements.
  • Improper form: Incorrect body mechanics, such as poor posture or improper alignment of the hips, knees, and ankles, can contribute to knee pain during downhill descents. For example, leaning forward too much or locking your knees can make it harder for your muscles to support your weight.
  • Inadequate footwear: Wearing the wrong type of footwear can also increase your risk of knee pain. Shoes with uncomfortable fit, insufficient ankle support, or worn-out soles will certainly have an impact on your knees while hiking.
  • Previous injuries: Previous injuries, such as ligament sprains, meniscus tears, or other knee conditions, may make the joint more susceptible to pain during certain movements. Those injuries might also affect your gait, which in turn will put more pressure on one of your knees causing even more pain.
  • Arthritis or joint conditions: Pre-existing conditions like osteoarthritis or rheumatoid arthritis can cause inflammation and pain in the knee joint, which may be aggravated by downhill hiking.
  • Excessive weight: Carrying a heavy backpack or being overweight can put additional strain on the knee joints when hiking downhill.

How to Hike Downhill Without Hurting Knees?

No matter how experienced you are as a hiker, there will be times when your knees will hurt while going downhill. This is especially true on long strenuous day hikes or multi-day backpacking trips. However, the good news is that there are some tactics and equipment that could help you hike with minimal or even pain-free.

Use trekking poles

I’m not the biggest fan of hiking poles. but when I know I’ll be going on a hike that involves steep descents, I’m certainly taking my poles with me. Trekking poles can help reduce knee pain when hiking downhill in several ways.

  • Distributing the load: when you’re descending, weight is transferred from the front of the foot to the back with each step. Hiking poles help to distribute this load by providing additional support and power through the arms and upper body. Consequently, this reduces the strain on the knees and helps to prevent overuse injury.
  • Improving stability: trekking poles provide a wider base of support which is especially helpful when hiking on uneven or slippery terrain. They help prevent slips and falls which can put a lot of stress on the knees, and thus preventing knee pain.
  • Shock absorption: hiking poles can also help reduce impact forces on the knees by absorbing some of the shock of each step. This is because the poles hit the ground first and can then be used as an anchor before your feet hit the ground.
  • Improving posture: trekking poles encourage an upright posture by engaging the core muscles and taking some of the load off the lower back. This helps keep the knees in a more neutral position and reduces the possibility of falls and injuries.

Wear proper hiking footwear

If you’re still wearing running shoes to a mountainous hike, don’t be too surprised if you struggle with knee pain. Similarly, if your hiking footwear is worn off and is way past its “expiration date”, you will likely feel it in your knees as you walk down a hill. Here are some tips to help guide your selection of proper hiking footwear.

  • The best shoe is the one that fits: this is definitely obvious but often overlooked. Many people gravitate towards the shiny sleek looking shoes at the expense of a good fit. Don’t do that! I’d rather wear ugly looking boots with a perfect fit, than stylish ones that look amazing but are going to be too painful to wear and will most likely give me blisters.
  • Look for shoes with good cushioning: proper footwear with ample cushioning in the soles can absorb much of the impact as you slam down on the ground with each step.
  • Good support is important: you need shoes you can rely on when the terrain is challenging. Hiking boots with supportive features, such as ankle support and a rigid heel counter, can provide excellent stability on the trail.
  • High traction is key: Trail conditions can vary greatly, and downhill sections may be particularly slippery or uneven. Hiking boots with good traction, such as deep lug patterns on the soles, can provide a secure grip on the ground, reducing the risk of slips, trips, and falls that could add insult to injury.

Take smaller but faster steps

It might sound counterintuitive that I’m encouraging you to move faster downhill, but hear me out. Smaller steps will reduce the risk of hyperextension when descending. And, moving at a quicker pace will reduce the pressure on your knees because they won’t need to fully “break”. Shorten your stride and let gravity carry your body weight at a controlled pace.

Also, whatever you do, make sure not to lock your knees when walking downhill as this will put a lot of pressure on the joint. And do your best to avoid walking on the balls of your feet by consciously placing your foot flat on the ground. This will help distribute your weight evenly and minimize the impact off of your knees with every step.

Zig-zag down the trail

This is one of those tricks I learned early on in my hiking journey (over a decade ago), and I’m glad I did. Moving downhill in a straight line will definitely exhaust your knees and exacerbate any pain you might feel. On the other hand, when you move in small zig-zags, your joints are going to thank you for your kindness.

Hiking knee support

A knee sleeve or a knee brace are excellent options to support your knee on a hike, especially if you’re dealing with a previous injury or struggling with arthritis in your knees. Alternatively you could use tape or a knee strap to avoid compressing your knee joint for an extended period. The added bonus of these options is they are less restrictive and don’t absorb as much sweat as a sleeve would, which makes them ideal for multi-day backpacking trips.

Warm-up before your hike

Before you leave the trailhead, spend some time warming up your muscles with low-impact exercises such as walking around or light jogging. This will help your body prepare for the more strenuous activity of hiking.

Also, consider stretching the muscle groups close to your knees that usually pick up some of the slack off your knees. These are mainly your glutes, quadriceps, hamstrings and calves. Stretching your muscles will help improve their flexibility on the trail which is key to minimize the risk of slipping and falls resulting in painful injuries.

Tips for Hiking With Bad Knees

Tips for Hiking With Bad Knees

There are other things you could do in preparing for your hiking adventure that could help in reducing the chance or the severity of knee pain.

Don’t pack too much

A heavier backpack places more strain on your knees and legs, especially during uphill and downhill sections. Also, carrying a heavy backpack can fatigue your leg and core muscles more quickly. This fatigue can lead to poor form and increased risk of injury, including knee pain. Moreover, a heavy backpack can throw off your balance and posture, leading to awkward gait patterns that strain your knees. By carrying less weight, you can maintain a more upright posture and significantly reduce the impact on your joints. This consequently reduces fatigue and helps minimize knee pain.

If you’re wondering how you could pack lighter for your next hike, consider packing only the hiking essentials and really scrutinise the benefit of any additional item you think of adding to your pack. Also, it’s worth noting that hiking gear have gone a long way over the past decade or two. If you’re still using your old heavy gear, then you might want to consider retiring some of those items in favor of more modern and much lighter (yet durable) gear for the sake of your knees.

Another tip you could consider is buying a water filter rather than carry excessive amounts water when you know there will be water sources along your trail. I’m very happy with my Sawyer Micro Squeeze as it helped me slash 4.5 lb (2kg) off of my typical day hike load. Trust me, that makes a HUGE impact on how your knees are going to feel when walking uphill or downhill.

Choose the right trail

If you know you’re susceptible to knee pain, then it might be wise to think about the type of trails you choose for your treks in the wild.

  • Choose a flat or gently rolling trail. Avoid trails with steep inclines or declines, as these can put too much stress on your knees. Stick with trails that have low elevation gain, ideally 500 feet (150 meters) or less.
  • Choose a trail with a smooth surface. Avoid trails with rocks, roots, or other uneven surfaces, as these can also aggravate knee pain.
  • Start with a short hike and gradually increase the distance as your knees become stronger. Don’t overdo it, as this can lead to pain and injury.

Remember, prevention is key. If you have chronic knee pain, then help it get better by not subjecting it to harsh situations that make things even worse.

Carry pain killers

Painkillers can provide temporary relief from knee pain while hiking, but they should not be considered a long-term solution. They can mask the underlying cause of the pain and prevent you from addressing the issue effectively. However, it’s a good idea to carry pain killers such as ibuprofen in your backpack. If the pain becomes unbearable, they can help relief the pain allowing you to complete your hike.

How to Treat “Hiker’s Knee”?

The treatment for hiker’s knee involves addressing the underlying causes of knee pain and implementing strategies to relieve symptoms.

Strength training

Strength training can be a crucial component in treating knee pain. Strengthening the muscles around the knee and improving overall lower body strength can provide several benefits, including muscle support, joint stability, improved range of motion, and enhanced endurance.

I have experienced first hand, the impact of strength training in reducing knee pain. When I first started hiking over 10 years ago, I used to struggle on the steep and rocky terrain that Lebanon, my home country, is known for. Coincidentally, I started weight lifting at the time, and over the following few months I started noticing I could hike much more comfortably, almost pain-free.

Note that it’s essential to start with appropriate exercises and progress gradually. If you do not have previous weight lifting experience, consider hiring the services of a professional fitness trainer to help in designing a personalized strength training program tailored to your specific needs and fitness level. However, a few examples of strength training exercises that may benefit hiker’s knee include:

  • Glutes: Squats, hip-thrusts, kickbacks.
  • Quadriceps: Leg press, squats, lunges.
  • Hamstring: Hamstring curls, stiff-legged deadlifts.
  • Calves: Calf raises.
  • Hips: Hip abductor and adductor exercises, hip hinges.

Rest, ice, and compress

After your hike, cool down with a few minutes of gentle walking. Apply ice to your knees for 15-20 minutes at a time, several times a day, to reduce inflammation and pain. Additionally, you could use a compression bandage that can help reduce swelling and support the knee.

Also, keep in mind that the most important thing to do for hiker’s knee is to give it enough rest. Take a break from hiking, running or any other activities that exacerbate the knee pain until you feel better.

Consult a doctor

If all the above fails, then it might be best to seek medical help. Consult with a physical therapist or orthopedic specialist to determine the underlying cause of the knee pain and receive personalized advice. In some cases, a healthcare provider may recommend corticosteroid injections to reduce inflammation and alleviate pain. For severe cases or when conservative measures are not effective, surgery may be considered. This could involve procedures such as arthroscopy or, in rare cases, joint replacement.

How to Hike Downhill Without Hurting Knees?

Final thoughts on how to hike with bad knees

Protecting your knees on and off the trail will go a long way toward a more enjoyable hiking experience. Proper (downhill) hiking technique, using the proper gear and equipment, and enough rest and recovery after each trip will help you hike pain free for years to come!

Have you struggled with knee pain in the past? Share your experiences and tips on how to hike with bad knees in the comments!

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