Hiking and Knee Pain: Common Treatments

Knee pain during or after hiking can be caused by:



• Overuse and strain: Prolonged hiking can lead to overuse of the knee joints, causing strain and discomfort.
• Improper footwear: Wearing shoes that don't provide adequate support or cushioning can put extra stress on the knees.
• Poor hiking technique: Incorrect walking or hiking techniques, such as not bending the knees properly, can contribute to knee pain.
• Previous injuries: Existing knee injuries or conditions like tendonitis, bursitis, or meniscus tears can be aggravated by hiking.
• Muscle imbalances: Weakness or imbalances in the muscles supporting the knee, such as the quadriceps, hamstrings, or calves, can lead to knee pain.
• Excessive weight: Carrying a heavy backpack or being overweight can increase the load on the knees, leading to pain.
• Uneven terrain: Hiking on uneven or steep terrain can put additional stress on the knees, causing pain.
• Lack of warm-up: Not properly warming up before hiking can result in muscle stiffness and increased risk of knee pain.
• Arthritis: Conditions like osteoarthritis can cause knee pain, especially with the repetitive motion and impact of hiking.
• Dehydration and electrolyte imbalance: Dehydration or imbalance in electrolytes can lead to muscle cramps and discomfort, affecting the knees.

At Back in the Game Physical Therapy, our team is here to help you with knee issues that stop you from fully enjoying your time outdoors.

Not all knee pain is the same, and understanding the root cause of your knee pain can help you take steps that keep your symptoms at bay.

Different types of knee pain caused by hiking include:



• Patellofemoral pain syndrome (PFPS): This condition causes pain around the kneecap, and is especially noticeable when you're going down the stairs or walking down a hill. PFPS can be caused by overuse, muscle imbalances, and misalignment.
• Iliotibial band syndrome (ITBS): Symptoms of ITBS include pain on the outer edge of the knee that may radiate up the thigh. Repetitive bending or extending of the knee can cause or exacerbate ITBS.
• Osteoarthritis: Characterized by pain, stiffness, and swelling that typically worsens after activity, osteoarthritis is the degeneration of the cartilage in the knee joint.
• Tendinitis: Overuse and/or repetitive stress on the knee can cause pain in the tendons around the knee, known as tendinitis.
• Bursitis: Swelling, warmth, and pain at the front of the knee can be a sign of bursitis, an inflammation of the small, fluid-filled sac that cushions the knee joint. Bursitis often occurs due to overuse or repeated pressure.
• Ligament injuries: Ligament injuries can include damage to the ACL, MCL, LCL, or PCL. Symptoms can include knee instability, swelling, and severe pain.

At Back in the Game Physical Therapy, our team offers many treatment techniques that can support joint health. If you're experiencing hikers knee or other knee injuries due to hiking, we'll work with you to create a personalized treatment plan to heal your current injury and prevent future problems.

Treatments for hiker's knee and other knee injuries related to hiking include:

• Dry needling: This technique uses thin, solid needles to stimulate myofascial trigger points, creating a twitch response that may provide pain relief, an increased range of motion, decreased inflammation, and enhanced healing.
• Functional drills and balance training: Activities that mimic hiking movements, as well as movements that enhance proprioception (like single-leg stands, exercises on a balance board, or exercises that use a stability ball) can help to build your strength on unstable surfaces, helping you heal while decreasing the likelihood of future injury.
• Strengthening exercises: Your rehabilitative plan may include exercises like clamshells, side-lying leg lifts, hip abductions, straight leg raises, leg presses, and more.
• Patellar mobilizations: Your physical therapist may recommend these gentle movements of the kneecap to promote alignment and support joint mobility.

If you're getting ready to ramp up your hiking routine, it's important to gradually increase the intensity and duration of your time on the trails, as doing so can lessen the likelihood of injury. Staying consistent with your routine can help you maintain the strength necessary to prevent knee problems. If you're concerned about your knee health while hiking, it's smart to make an appointment with a physical therapist to learn more about exercises and techniques that can support you on and off the trails.

Sometimes, knee pain is more than just an annoyance—it can be a medical emergency.

Signs that you need to seek medical attention right away include:



• Severe pain
• Visible deformity
• Significant swelling
• Inability to move the knee
• Injury with a popping sound
• Redness and warmth
• Locking or catching
• Instability