The Grind, The Chief and Perhaps Some Good Old Knee Pain – Lina Englund, Physiotherapist

Hiking season is in full bloom and many of us love hiking the gorgeous mountains of Vancouver and its surroundings. Unfortunately, many hikers experience knee pain while hiking, especially on the descent.

Knee pain while descending can have a number of different causes, and it is always advisable to see a physiotherapist or physician to make sure that you take care of yourself the best way possible. In this post I will give you some general advice regarding knee pain during downhill hiking and how to avoid it, because it is most often avoidable!

Why Does it Hurt?

  • During the descent the body weight is shifted from the thighs and butt to the knees and calves. If you are not strong enough in one or the other, it will cause an imbalance and greater strain on the knee joint and patellofemoral joint.

  • The pressure between your kneecap and femur (thigh bone) increases when bending your knee during high force, which increases stress on the patellofemoral joint.

  • We are often fatigued on the descent and tend to throw one foot in front of the other instead of performing the proper one-legged squat move.

  • When it comes down to it you are likely either too weak or plain unlucky with previous injuries or genetics causing you trouble

  • If you have a genetically irregular surface of your patella, this may cause excessive pain.

  • Previous injuries such as ACL, MCL, meniscus and cartilage tears will most likely cause you grief.

How To Avoid It

  • As always, warm up. After the ascent we tend to take a break at the top to capture the beautiful view, all the while our muscles stiffen up. Take a stroll on the flat, do some squats and get a bit of stretching done before you descend.

  • Land on the ball of your foot. There is a greater force through the knee joint when landing on the heel, so make sure to land softly on the balls of your feet.

  • Make your butt work!  Try thinking of the descent as a series of one-legged squats where you are giving your butt a workout. You will most definitely use your thighs as well, but the butt is easy to forget. The more force that is taken up by your larger muscles, the less will travel through your joints.

  • Think about the alignment. The proper alignment of your leg goes from your hip (middle of your thigh), through the middle of your knee to the 2-3 toe (big toe being number 1). Altered alignment has a tendency to mess up most muscles and joints.

  • Do not push through the pain. I cannot stress this enough. Most of us think it is a good thing to be tough and rough it out. It is not. It can potentially cause a much bigger problem than the initial pain. Listen to your body and do not put yourself through the pain unless it is unavoidable. Sore muscles and some discomfort is normal, but give yourself a break when it comes to actual pain (catching the gondola down does not make you a bad person).

  • Use orthotics or insoles if you need them. What happens in your feet and ankles is directly linked to your knees.

  • Strengthen what is weak. In this case we are most likely looking at the muscles around the knee and hip. A health professional can assess your strength and stability and recommend a training program to make sure that you get the pain under control.


So no need to throw the hiking boots onto the top shelf just yet, most episodes of hiking related knee pain are temporary and can be successfully treated with proper care!


Take home message: Be prepared for your challenge, strengthen what is weak, use proper technique, be aware of preexisting conditions and be smart about it.


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