Knee pain while hiking or running is quite common. It can be difficult to bear and, in all cases, is fairly debilitating in the long term. It most often occurs during descents (gonalgia on ascents is genuinely rare). There are, however, ways to guard against it and still enjoy your time in the mountains. Our advice is here to help and guide you, but it is no substitute for a consultation with a general practitioner or specialist.
Why do knees hurt while hiking?
The weight-bearing joints of the lower limbs (hips, knees, ankles) are required to work much harder depending on walking or running speed — particularly during descents. These joints must "absorb" one, two or even three times the body weight with every step or stride, due to the dynamic effect of walking downhill, depending on the gradient. For example, for a person weighing 75 kg, the joints must bear an additional 75, 150 or 225 kg with every step.
It is therefore clear that there is a logical biomechanical reason why a joint problem that is not necessarily felt on flat ground can become apparent in the mountains. In most cases, this manifests as gonalgia affecting the weight-bearing knee joint: the femur on the tibia.
Furthermore, the muscles of the lower limbs act as a braking mechanism to prevent falls and control body balance during descents. This very high tension acts on the second joint of the knee, namely the knee extensor mechanism (quadriceps muscle, patella, patellar tendon). This can trigger patellar pain — the type of gonalgia most commonly found in hikers.
How to avoid knee pain while hiking?
Travelling light
As discussed above, weight has a significant impact on the joints. It is therefore important to travel light. If you have sensitive knees, opt for day hikes with a light pack, or choose guided tours with luggage transfer, which still offer a very comfortable experience.
Your weight also matters: very often, knee pain while hiking affects people who are carrying a few extra kilos. If you walk regularly, you are already on the right track to losing them. Keep an eye on your weight with a balanced diet to take the pressure off your knees.
Warming up properly
Warming up is essential — especially on routes that start with a climb or a steep descent. Check out our warm-up advice and do not overlook this essential work for tackling your daily walks in the best possible conditions.
Stretching after hiking
Like warming up, stretching is important and will help relieve your muscles. Remember to do gentle extensions without putting too much strain on your painful joint. However, after a long walk, if you are suffering from knee pain, avoid sitting for extended periods, especially in a car with your knee bent at 90°. There is nothing quite like that for causing serious pain afterwards, or even the next day.
Avoid very rough terrain and scree fields
If you experience knee pain while hiking, it is wiser to avoid very rough terrain. You can still head into the mountains, but you should avoid the steepest slopes (stepped inclines, for example) and anything on very loose ground or scree fields. Unstable terrain forces you to compensate heavily through your muscles and tendons, resulting in greater pain.
Walking with hiking poles
The ideal solution is to choose good hiking poles. They are essential for walking in a balanced way and will take the strain off your joints. They significantly reduce the load on your knees and provide vital support for your stability. Good hiking poles will also reduce your effort, whether going uphill, downhill, or even on flat ground. It is a low-cost investment given the benefits they provide!
What are the solutions for knee pain?
In cases of gonalgia affecting the weight-bearing joint, orthoses (knee braces) are not necessarily useful. A trekking pole would be more advisable.
In cases of gonalgia originating from the patella (the knee extensor mechanism), a patellar knee brace will be recommended. It helps to centre and control the tracking of the patella, thereby preventing pain caused by misalignment. It is important, however, to choose a patellar knee brace rather than a ligament one.
In any case, it is entirely possible to walk with a patellar knee brace while also using hiking poles. The two are not mutually exclusive.
A medical consultation, and in particular with a sports doctor, is nevertheless strongly recommended. This will allow for a precise diagnosis of the origin of your pain and guide you with advice on your practice. Knee pain while hiking is not inevitable. It can be prevented and reduced, whatever the cause. It should not stop you from enjoying this wonderful sport and discovering breathtaking landscapes.
