The active approach to resolving knee pain hiking downhill.

 

Do you get that general ache throughout the knee hiking downhill?

 

The one that makes you stop frequently. You rest, but then you start again and it just comes back?

 

Are you sick of being at the back of the group, or slowing everyone down?

 

Or, are you avoiding that hike, the one with the magnificent views you long for, but are afraid to do because what goes up must come down?

 

The resolution you’ve been looking for isn’t a secret pack weight or magic knee brace.

 

Unless you’ve got a specific injury that needs to be addressed, this method can and will work for you!

 

 

What does your pre-hike physical preparation look like?

 

Hiking is demanding on the body! You’ve basically just packed on weight (pun intended) and asked all your muscles to carry more than they are used to for much much longer than they are used to.

 

Time and time again I see general advice on social media and forums that all you need to do to prepare for hiking is to go hiking, progressively building the pack weight up.

 

WRONG.

 

Going for a regular day-hike on the weekend with a pack does not compare to several days of pack carrying. Even a few extra short walks after work doesn’t add up to enough!

 

Evidence from multiple studies in military recruits has shown that their pack carrying performance is significantly improved when they do aerobic AND resistance training (Knapik et al., 2012).

 

Additionally, the performance benefit is DOUBLED when their training includes weekly progressively-loaded pack training (Knapik et al., 2012).

 

Active Advice #1:

 

Your pre-hike training should include a combination of aerobic and resistance training in addition to progressively loaded pack carrying walks on various terrain (including downhill!).

 

Bonus Tip: Don’t leave this to the last minute! Strength changes take a minimum of 6-8 weeks. Optimal preparation would be 12-16 weeks of training.

 

 

Are your quadriceps conditioned specifically for hiking downhill?

 

Hiking downhill has completely different muscle demands than hiking uphill and on level ground. In fact, it’s basically the opposite!

 

When hiking downhill your quadriceps are lengthening while producing force, called an eccentric contraction. This is the exact opposite to how they function when hiking uphill!

 

Research has shown that in untrained people just 40 minutes of downhill walking significantly decreases the maximum force production of the quadriceps for up to 72hrs (Maeo et al., 2017).

 

You can’t expect to stabilise and control your knee with sub-optimally performing supportive muscles, can you!?

 

Have a guess what happens when you train specifically for this?

 

In the same research just 5 minutes of downhill walking a week prior to the 40-minute test

HALVED the loss in strength (Maeo et a., 2017).

 

However, strength is specific to how you train it! All the step-ups in the world won’t help you when the track starts to descend.

 

Active Advice #2

 

Your hiking training MUST include some low load (short distance, light pack) downhill hiking.

 

Train in the gym with a specific focus on ECCENTRIC LOADING of the quadriceps. E.g.

  1. Step-downs
  2. Leg Press/Hack Squat: Pressing up with both legs and control down with one.
  3. Bulgarian/split-squat with eccentric overload: Push up with normal tempo, spend 3-5sec controlling down.

 

 

Do you recover on the trails?

 

You should be foam rolling and stretching when you’re active at home, this is no different on the trail!

 

I’ll even go as far as saying it is MORE important on the trail. Why?

 

Research has shown the local muscle fatigue in the ankle and hip muscles from hiking leads to significant postural control impairments (Vieira et al., 2015).

 

This is because the ankle and hips are primarily responsible for controlling the weight of your body. Where the centre of your body’s weight is and how it is moving will determine how the joints are loaded, including your knee!

 

Lack of control = grumpy overloaded knees!

 

Active Advice #3

 

Start your day with a cheeky drink-bottle foam roll of the calves and hips (wrap it in a towel if too intense!) or carry a massage/spikey ball (or golf ball for you ultra-light hikers!)

 

Finish you day with a solid stretching routine of all the muscles in the leg, with extra attention to the calves and glutes!

 

 

Should I be using Hiking Poles?

 

Absolutely!

 

But these should not be your ONLY method of addressing your knee pain.

 

Research has shown that hiking poles reduce the muscle force requirements at the ankles, knees and hips (Bohne et al., 2007). This will contribute to reducing fatigue and therefore improving stability and control.

 

There are various numbers reported in the research, but hiking poles have been shown to reduce knee joint forces by 10-30%

 

Technique Tip: When using hiking poles your elbow should be at approximately 90 degrees for optimal pole positioning and load distribution.

 

 

Final Thoughts

 

Need help with planning your pre-hike training? Seek out the advice of a Personal Trainer, Strength and Conditioning coach or Exercise Physiologist with an interest in hiking!

 

Knee pain stopping you from training for your hike? Come have a chat to one of our Physiotherapists!

 

Mark Walters
Mark Walters
Principal Physiotherapist (APA, DPT) B. Ex. Sci, D. Physio Mark thrives on helping people getting back to the activities they enjoy, and aims to do this with fun and engaging rehabilitation. He also has a passion for injury prevention and performance, as well as helping people age strong.