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Knee Pain – A Hiker’s Guide

Chopat Knee Brace

Knee Pain is a common symptom in hikers, runners, skiers, and cyclists.One of the most common types is pain around or behind the kneecaps, which is often diagnosed as Chondromalacia, Patellofemoral Stress Syndrome, or more commonly “runner’s knee.” The symptoms of this type of knee pain worsen when walking up or down stairs, walking uphill, running, jumping or activities that force the knee to bear weight as it is straightened, like rock climbing.

In older hikers, Chondromalacia is often caused by over pronation where the lower leg twists inward when walking or running. This can be caused by worn hiking boots or muscular weakness in the quadriceps and hamstrings. In younger hikers, the pain is often caused by trauma or overuse.

As a hiker, I have suffered from knee pain for the past 10 years and manage mycondition by avoiding activities that require jumping, running, and the breast stroke where my quadriceps rotate in the opposite direction as my lower legs. I use hiking poles now to reduce the impact of my backpack weight going downhill and I make sure that my boot soles are not worn and prone to inward rotation of my foot. I also do a lot of exercise during the week that targets my quadriceps and hamstrings: I ride a stationary bike about 100 miles per week and do a wide variety of weight lifting exercises that target my legs, like lunges, step ups, Bulgarian split squats and hyperextensions. These are all bodyweight exercises and don’t require the use of weights

I discovered these preventative exercises after a very successful round of treatment by a physical therapist. I injured my left knee very badly on a hiking trip in Scotland about 10 years ago to the point where it locked up on me for about 8 weeks. I visited several medical specialists who all wanted to perform surgery but couldn’t tell me for certain what was wrong or whether surgical intervention would work. Instead, I opted for physical therapy and I was lucky to find a therapist who not only cured me but educated me about the functional mechanics of human movement. Be skeptical if you have knee pain and your doctor recommends surgery. Physical therapy can provide you with an alternative cure and help you understand how prevent a recurrence.

If you experience pain on the trail after a hard day of walking, bring along some ibuprofen to reduce the inflammation at night and stretch your quadriceps before sleep You may also find that wearing a knee brace is helpful. Many of my older hiking buddies, like Paul (above), use hiking poles and Cho-Pat knee braces and swear by them.

Disclaimer: I’m not a doctor, so if your knee pain or swelling persist, please seek medical advice.

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  1. Hi! I was surfing and found your blog post… nice! I love your blog. :) Cheers! Sandra. R.

  2. hi. i am suffering from a knee problem on the outer side of my right knee. i am quite a competative athlete and do race walking and middle distance running. thourght it could be related to some of the hikers knee problems sceen as the simptoms seem quite similar. i have just been refered to phisio by my doctor and told to look up some iliotibial band excersis. Do you know if there’s anything else i could do?

    • Try getting yourself a pair of Pacer Poles from the UK, if only to correct your posture. I found that my ITB completely went away when I started using them, my pace increased and I stand much straighter at rests. The owner is a physio. Check them out.

      • I purchased a pair of pacerpoles after reading this post last year. Easily the BEST investment I have made in terms of hiking/backpacking. The benefits are phenomenal: Increased stride, Good posture, Stability, Ease crossing rivers, and even using them to offer assistance to other hiking buddies!

        I got ITB syndrome while backpacking after being super sick and bed ridden for about 4 months. I looked for many solutions and the Pacerpoles are phenomenal. I mixed them with Cho-pat knee straps and hiking is amazing now!

        If you are debating buying either of the items, I recommend it! Invest in yourself; you are worth it! Pain free is the way to be!

      • Tyler, I am so glad to hear about your Pacer Pole experience. They are a fantastic product.

  3. Unlike Becky’s situation, my knee pain was related to being out of shape, unless you consider round to be a desirable shape. My hiking knee pain went away when I dumped half my pack weight and then an equal amount of belt weight. Now, I weigh less wearing my backpack than I did without.

    I have met people who had knee problems from over training and running on streets. That hasn’t been an issue with me because I only run if there’s a ball, bee, or a bear involved.

    I have to “ditto” the Pacer Poles. I’ve used hiking poles for about seven years and Pacers for the last year or two. Pacers are the nicest ones yet and because of the strength of the dollar when I got them (or was that really the weakness of the pound?) actually cost less even though they were shipped across the pond than my Lekis cost here. Pacer’s website has videos showing the correct way to use them and their printed instructions are informative as well. My biggest pain problem in the arthritis in my wrists and hands and the wonderful hand grip on the Pacers completely eliminates that.

  4. I went long distance hiking for the first time now (west highland way in 7 days). Before this I never been hiking for long, and only ride my bike and go dancing once a week.
    All went fine, but at the end of day 2 I had muscle pain next to both knees on the outside and down my legg. I kept walking on it, next day it was a bit better. But it kept being there my entire journey.
    Didn’t really bother me much, maybe I am just tough XD haha.

    At home I noticed especially my left knee and lower leg very swollen, especially on the knee. Pain wasnt that much, just a little, especially when walking downhill (uphill was a relief).
    So after 3 days now, swelling has gone down but I still have some pain when I walk.
    I think i simply overused it and needs more time to heal.

    I am only 25. I had been hit by a car twice on my bike, which knocked me on the ground falling on the side of my knee, so I think this may make it abit more easy for me to overuse my knees. Although the accidents showed nothing wrong on the x rays and stuff, I still sometimes feel the knee where I hit the ground, but not often.

  5. To get rid of various knee problems, exercise is necessary. Doctors have prescribed a book on patellar tendonitis which consists of certain exercises and stretches that may help one in achieving great flexibility in the muscles that support the knee. These exercises will reduce stress on the sensitive knee joint.

  6. I have read a lot of Blogs and articles about hiking with knee pain and found your article the best. thank you. I will look up the Cho-Pat knee braces, as I have a few different ones but they all seem to help for the short while, may be I am using the wrong ones. I have done a few hikes and am about to do the Everest Base came in 4 months so will try any suggestions to make it easier. The part about exercising to strengthen the legs is definitely good, as I have been doing this and found it helps while hiking though it took some time but saved me around $4000.00 on knee clean up.

    I hope to follow my physio’s and PT’s exercises targeted on the right areas to get better strength on my legs so I can keep hiking till my bucket list is done.

  7. Going to try the poles…can anyone recommend the best walking boots?

  8. I know that you would probably want to avoid any medicinal solution to knee pain, but I do want to mention a solution. I just returned from a 4,000 mile motorcycle ride out west. In the past, while hiking or motorcycling, I have been troubled by a painful right knee. While hiking poles have helped, I found a better, if somewhat temporary solution. My doctor suggested that I try a drug called Volteran. He suggested taking it about 2 days before a beginning a hike or ride, and it was miraculous, like moving from the darkness into the light. No matter riding or hiking, the pain and discomfort disappeared completely. I take it only for the duration of a ride or hike, and it works wonderfully, with no side effects of any kind. For my entire 4,000 mile ride, I was completely pain free. It is by prescription, and it is important to follow your doctor’s instructions, but for those of us of a certain age, it brings back the pleasure of hiking and riding.

  9. Long time hiker and I’ve been doing my annual R2R2R trip at the Grand Canyon for nearly a decade, but the last two trips have left my knees in more pain than ever. Sure, it’s probably age and inflammation, but I’ve been taking supplements to fight the inflammation and doing various knee therapy exercises, especially in the pool. It helps, but I fear the day when I have to accept anything short of the gorgeous R2R2R.

    • @Heather .. I feel your “pain” The R2R is a very addicting& Amazing hike,,, I had a issue with my Left knee 3 weeks after I returned Home..OUCH,,

  10. V helpful! Thank you for sharing this info.

  11. Just experiencing this “hiker’s knee” right now. Good to know it is a common thing. How do you speed up the healing process?

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