Sore Knees:
What's A Hiker To Do?

Sore knees are a plague upon the house of hikers.

Prevention of knee injury is the very best approach.

Already have sore knees on or off the hiking trail of life?

Blame part of it on human anatomy: a hinge joint that bears weight isn't the best design for a hiker's knees, but it's what we've got to work with.

Blame part of it on bad habits: running, lunging, squatting without proper form.

And the rest? Blame it on any or all of these:

  • genetics,
  • youthful injuries that flare up from time to time,
  • inattention to precious knee cartilage,
  • excess body weight,
  • heavy packs coupled with the wrong footwear,
  • or the phase of the moon (not too sure about that one).

Regardless of where you place the blame, the question is:

What are you going to do about it?


Sore knees: figure out what
you can control or change

Every step you take along the trail shouldn't be painful.

But sometimes hiking pain is the reality.

If your knee pain is a consequence of a recent injury, stop reading. Go get it checked out before you do more damage.


But if your knee pain is chronic (lasting more than a few weeks and interfering with your hiking time), keep reading.

There are two choices for you:

You can mask the pain.

  • That's in the category of control.
  • But at what cost? Further knee damage?

Or you can use your hiking aches and pains as clues to figure out what might be done differently in your hiking routine to decrease the pain level of your sore knees.

I'm assuming that you already know how to swallow over-the-counter pain relief, so let's move on to how to decode the messages hidden in your sore knees.

Begin your quest to change your knee pain by paying close attention to the pain while NOT hiking (i.e. your "off the trail" movements and habits):

  • exact location of the pain;
  • if not pinpoint, area of the knee pain (inside of knee, top, etc.);
  • quality of pain: sharp, bright, dull, achy, pounding, etc.
  • quantity of pain: 1 to 10 scale, 10 being unbearable;
  • constancy of pain: always there beginning with first step in the morning, etc.;
  • what brings you pain relief other than medications: ice, rest, elevation, ace bandage, stretching, etc.;
  • associated noises and sensations in your knees: click, pop, grinding or pins and needles, for example;
  • the types of movements that you can't, or don't want to, do.

Now that you've completed your inventory of knee pain unrelated to hiking, do the same thing on your next hike.

Then compare your notes.

Is the knee pain you experience at home or work the same knee pain that you experience while hiking?

Go even further if you wish:

Are your sore knees exactly the same during and after a short easy hike compared with a longer, tougher hike?

Given all of this data, you now have a baseline from which to make changes and note whether or not your knee pain improves.

Ready to give it a go? Here are some ideas.


Medical diagnosis of knee pain

You could skip the rest of this page and head straight to your medical care provider.

Knee pain could be due to any of the following conditions:

  • osteoarthritis (wear and tear) of the knee;
  • rheumatoid (inflammatory) arthritis;
  • bursitis;
  • cartilage damage interfering with joint movement;
  • meniscal tear in the knee joint;
  • or lots of other things that you need a medical team to figure out.

Aggressive treatments such as injections and surgery can be discussed with your health care team.

Note: No medical advice is being given here.

Just common sense advice to pay attention to the pain and to get to the root cause of it.

If you already have a diagnosis, it's time to see what you can do to manage your aching knees and still keep hiking.


Change your habits
and hiking routine

Self awareness can be painful if you approach it as a burden. Let's approach it as a key to unlocking your knee pain.

You're used to doing things a certain way, right?

  • getting in and out of bed;
  • entering and exiting your car;
  • crossing your legs during a movie or a long meeting;
  • carrying a heavy bag on one side or the other;
  • and lots more examples I'm sure you can provide.

Here's why all of that matters.

Your knees support the weight of your upper body, transferring it through your ankles and feet for distribution to the floor or the ground.

Knees are built to withstand heavy loads, but experience wear and tear over decades of usage.

A dedicated hiker will probably experience some knee issues along the Hiking Trail of Life.

So to help your knees in their important work, try these ideas.

  1. Why not strengthen your knees with physical therapy? You could work with a licensed physical therapist on stretches and strengthening work, along with some of the coping strategies mentioned below.
  2. You can also build stronger knees through applied exercises and weight machine work outs focused on your legs. Strong thighs keep knees in good alignment, and make you ready to tackle any type of trail.
  3. Use trekking poles appropriately on every hike.
  4. Use both of your knees to get up from a sitting or lying down position, to bear your weight, and to move through your daily activities.
  5. Your daily diet might need some tweaking to support your joints and bones.
  • There is evidence that omega-3 fatty acids might help with stiff, sore joints. Find these in salmon, tuna, sardines and other fatty fish. Capsules of fish oil are also an option.
  • Work some high quality olive oil into your diet via salad dressings. A daily dose of  a compound called oleocanthal is what you're going for here.
  • Collagen and connective tissue is supported with adequate amounts of vitamin C and antioxidants. The good news? Yummy fresh fruits and vegetables are an easy way to get enough of them. Or bring supplements along on a backpacking trip.


Ten coping strategies for sore knees

In no particular order, here are a few things you can do to deal with the pain of sore knees.

  1. Pain on the outside of your knee could be related to your iliotibial band (IT for short). Use these stretches to see if it brings you any relief.
  2. Use these anti inflammatory strategies during and after every hike.
  3. If your knees are sore on the top and front, it might be a patella (kneecap) problem that should be diagnosed before any further damage is done. Meanwhile, ice and rest!
  4. Keep your knees limber with these fast, easy stretches. Please make time for them, or you will have to make more time for achy knees :(
  5. Take some time off from hiking. I can barely bring myself to type that sentence, because I know that you want to get out there and hike. But a good long term strategy to achieve your goal is to stop hiking now and figure out what's wrong. But don't stop moving altogether: keep using your knee joints on moderate daily walks on soft surfaces.
  6. Support your knees on the trail with well designed and lightweight knee braces. Inexpensive elastic knee sleeves are another, less supportive option.
  7. Use a cane or crutch when a sore knee becomes overwhelming. This won't work if both knees are sore, because you need to use the non-sore knee for weight-bearing as you swing or bend the sore knee.
  8. Reduce your body weight, even by a little bit. You might be pleasantly surprised by a reduction in knee pain.
  9. Pay close attention to what you wear on your feet. Cushioned insoles or orthotics in your daily shoes and trail footwear could make an impressive difference in your pain levels. Get rid of nonsupportive, worn out footwear, too.
  10. Don't make things worse for your knees with high impact activities: running, kick boxing, jumping, squats. Instead, substitute non-weight bearing activity like swimming or stationary biking as you cross-train for hiking.


Six hiking strategies for sore knees

If you're taking steps (small knee pun) to keep pain levels manageable at home, and have decided to take a hike, here's what you can do on the trail to help your knees.

  1. Bring anti-inflammatory strategies with you, including crushable on-demand ice packs that you can apply at regular intervals. Or use Mother Nature's ice, snow or cold streams for an impromptu ice pack.
  2. I'll say it again because it's so important: use trekking poles to distribute your weight more evenly.
  3. Use the feedback from your knees to take more frequent rest breaks. Use part of your break for stretches to relieve pressure on your knees.
  4. Elevate your leg(s) at every opportunity, allowing blood to return to the heart and bring fresh nutrients and oxygen molecules to your sore knees.
  5. Be keenly aware that your balance will be a bit off. Don't put yourself into situations that demand excellent balance, such as steep rocky slopes or narrow exposed trails.
  6. Wear a brace or elastic knee sleeve (see above for suggestions) to support your sore joint. Just be sure you have adequate circulation to your tissues: remove the supportive device at rest breaks, and don't wear it while sitting as you are transported to and from the trail head.

What will you do next?

If you're in "information mode", you just finished looking at some ideas to cope with your sore knees as you keep hiking.

If you're in "get it done mode", you now have some strategies to apply as you take action to manage, and cope with, your knee pain both at home and on the trail.

If you're in denial, you'll probably keep hiking on your sore knees.

  • Not doing something to change is actually doing something.
  • In this case, something that might cause further damage.

So as you choose an approach to deal with your sore knees, you have my very best wishes for pain free hiking in the beautiful places of the world, like Mount Rainier in Washington State, USA.

Mt. Rainier in all of her glaciated glory

Just trying to sneak in a little motivation to do the right thing ;)


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