Hiking and Osteoarthritis:
Painful Hiking Strategies

by Diane Spicer

Meet Hiking For Her's Diane

Are your hikes becoming more about painful knees than the scenery? Hiking For Her shares some tips on hiking with osteoarthritis. #hiking #painwhilehiking #osteoarthritis #backpacking

Hiking and osteoarthritis: not a subject to ignore.

If you're a twenty-something hiker, it might seem like a topic you can safely put off until "later".

  • The reality of a painful hike due to arthritis could appear to be decades away.

But think again about hiking arthritis.

Here's an example of why.

Can knee injuries
lead to osteoarthritis?

A recent review on the topic of hiking and osteoarthritis caught my eye because it connected knee injuries with developing osteoarthritis.

If you want to read it for yourself, it was published in the journal Arthritis Research and Therapy: Prevention of injury-related knee osteoarthritis, 2010, 12:215 edition.

The researchers, Charles R. Ratzlaff and Matthew H. Liang, are employed by the School of Population & Public Health in Vancouver, British Columbia.

The authors declare no competing interests, meaning that they're not taking money from companies related to the diagnosis and treatment of arthritis.

Their research was funded by the Canadian Institutes of Health Research, but also by the Molson Foundation and the Michael Smith Foundation for Health Research.

But I'll recap it for you below.

Hiking and osteoarthritis:
What's the connection?

Hiker wearing a green backpack, working her way up a boulder field using her hands and kneesHiking and osteoarthritis might make you feel like you're climbing uphill through a boulder field.

First, let's define our terms.

Osteoarthritis refers to wear-and-tear inflammation of the synovial (freely movable) joints of the body ("osteo" for bones, "arth" referring to joint, "itis" for inflammation).

Ouch, right?

The older your body gets, the more likely it is that you'll have this type of inflammation.

As a hiker, you bear weight by carrying a pack, plus put your knee cartilage through vigorous usage, on every hike, season after season.

Weigh this carefully

Body weight comes into the equation as well.

Carrying a few extra pounds in your pack, added to a few extra pounds on your skeletal frame (especially after a winter of inactivity), spells more work for your knee joints on the trail.

And if you tackle steep trails, even more work!

This increases the potential for knee damage, which could lead to inflamed knee joints over time.

Trail tip: Carry the lightest pack you can. Be ruthless about your checklist, and toss out anything that does not serve you well on the trail.

One more factor

The article mentioned above brings in one more factor:

In technical terms: "Joint injury will increase a person's risk of developing knee osteoarthritis. For example, research shows that 50% of anterior cruciate ligament (ACL) injuries or meniscal tears will develop knee osteoarthritis."

Ligaments hold bone to bone, and with a complicated and mobile joint like the knee, they seem a bit "under engineered" to me!

What do I mean?

Knees can go out of alignment, just as tires on a car do. This creates areas of "wear" on the cartilage (again, like tire tread fading with usage).

  • If the meniscus is injured, load bearing and shock absorption will decrease while joint stability also decreases.
  • If ligaments and the joint capsule are injured, pressure distribution across the cartilage will change, placing the precious, hard to regenerate cartilage at risk.

Add in one more component: muscular reaction to knee injury.

If your knee hurts, you're going to walk differently, and begin to lose strength in the muscles of that thigh and leg.

You'll also overload the other knee!

If the pain is chronic, the relationship between the nerves and the muscles will change, and put the injured knee joint at risk for increased loads and shear forces when a person is caught off guard -  a lurch forward on a rocky trail, for example.

The authors of this research article counsel prevention of knee injury, especially for young athletes.

So twenty-something hikers,
heads up!

To avoid osteoarthritis from side lining your hiking career, keep your mobile, weight bearing knee joints protected and injury free.

To keep the knee cap (patella) tracking properly on a long hike, hikers of any age might want to try a flexible support like this one.

Hiking with osteoarthritis -
a few tips

If you are hiking with diagnosed osteoarthritis, and/or have already had a few knee injuries, now what?

Avoidance of weight gain will protect the knee from further damage.

So will a conscious effort to insert daily load bearing activities into your daily schedule: moderate exercise such as walking, stationary biking, or swimming to protect your knees.

  • Why bother?
  • Strengthening your quads (quadriceps - the big muscle group on the front of the thigh) will protect your knee joints.

Wear only the best trail footwear.

Eat well to recover quickly from the micro-traumas of hiking.

Keep hydrated on the trail. Your connective tissues need water!

begging for self care as a hiker

And when you receive lovely little postcards from your joints (twinges, pain, limitations on range of motion, for example), don't ignore them!

If you already have diagnosed osteoarthritis with predictable knee pain, functionality of all of the knee ligaments (not just the ACL) might be compromised.

It might be time for a knee brace.

I know, I know: They are ugly.

They are also supportive for all 4 knee ligaments, lightweight, breathable, ventilated, adjustable and washable.

So suck it up and put one on, or hang up your boots.

Your call.

(Tough love. You're welcome.)

Another idea for hiking and osteoarthritis management

Carry reusable gel packs if you know you're going to be hiking with access to cold running water or snow pack.

Alternatively, throw these in the freezer and bag them up just before setting off for the trail head.

  • At lunch time, apply the packs to your knees (and other hot spots) to soothe inflammation and cool things down.

Don't forget to stash one in a cooler in your car, waiting for you when you finish your hike.

These work well.

Another sensible approach to
hiking and osteoarthritis

Another sensible approach to managing the duo of hiking and osteoarthritis is to modify the trails you tackle.

I've already eliminated a few steep hikes from my hiking repertoire, and when I get the itch to re-visit them, I pull out my photos and reminisce!!

To help you find appropriate hikes, use the hiking guide book series entitled "Creaky Knees".

Hiking and osteoarthritis:
keep going!

Joint wear and tear is a fact of life for a hiker's body.

  • Even more so for an active hiker taking thousands of steps with a lot of elevation gain and loss on each hike.

But by taking precautions and avoiding injury, your knees will be able to get you into the back country for a long, long time!

If you already have an annoying level of pain, talk with your health care provider about using over the counter (OTC) arthritis strength pain relief.

Hiking and osteoarthritis can co-exist. I know that for a fact!

And if I spot you on a trail in your knee brace, I'll be sure to stop and say hi.

  • You'll hear me coming - creaky knees will give me away!

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Hiking and Osteoarthritis

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