Go with confidence! How to hike downhill and prevent knee pain or deal with knee pain. Be the hiker you want to be!

“Oooh, ouchie, oooh, aggh!” Sound familiar? Anybody who has spent some time on the trails has uttered these oh-so-common sounds. You’re hot, sweaty, and tired and probably more than halfway finished on your journey. You’re heading home when all of a sudden these funny noises start to seep out of you.

Your legs are shaking and your feet are hurting, but most noticeable of all, your knees! The shooting sensation of nasty knee pain while hiking downhill is a common hiking injury any outdoor enthusiast can attest to. Even the strongest trailblazers have run into issues with their tendons, ligaments, or cartilage in one way or another.

Hitting the trails has a lot of benefits, for both your mental and physical well-being. There are so many, it’s nearly impossible to list them all. Breathing in the fresh air, the feeling of accomplishment you get after reaching the top of an epic peak or witnessing a spectacular sunrise, unmatched by any photo to name a few.

Injuries on the trail, however, suck. They will damper any mood and might even deter you from continuing with your adventurous hobby. What can you do about it? Well, let me help.

To be clear, I’m no physical therapist, but I’ve done a lot of backpacking over long distances and up/over harsh terrain so my kneecaps have seen a thing or two. I can safely say I know a bit about hiking knee pain.

I’ll break it down into 3 important areas. 1- understanding the causes, 2 – following some preventive measures, and 3 – adopting proper pre, during, and post-hike practices. Sounds like a lot? Well never fear, for I am here!

In this informal guide, I’ll explore the causes of knee pain, provide essential tips for preparation, and offer suggestions on how to protect your knees while downhill walking. I’ll also detail recovery methods that have helped me and might do the same for you. Ideally, after you’ve read up on some of my practices, pain on the trail will be a thing of the past!

Understanding the Causes of Hiking Knee Pain

Before you fix the problem, you need to know what causes the problem right? There’s not much I can do if you have an old injury from football or dance class when you were a teen, or if you have medical issues that need special attention like those mentioned in this John Hopkins Article.

I can, however, go over some normal reasons you’re getting those sharp little pinches between your leg bones and help determine how to manage and treat the issue. It might not take much change to go from “Ow” to “Wow!

Knee pain from walking downhill can be attributed to several factors

1. Overuse

A simple reason you’re feeling discomfort could be frequency. Improper conditioning or a sudden increase in hiking difficulty may cause overuse injuries among hikers. Patellar tendonitis or IT band syndrome to name a few. Rest and relaxation might solve the problem but If you suspect anything serious please consult a medical professional. 

2. Improper Footwear

Are you wearing incorrect hiking shoes? Wearing a pair without the proper support or cushioning can affect knee alignment and contribute to some discomfort. Find the right pair and your problems might be solved! Here are the best hiking shoes for beginners if you need some suggestions.

3. Muscular Weakness

Have you been sitting on the couch for a few months and then got the sudden bright idea to go on a 3-mile hike out of the blue? I know I have. Even if the walk is low-key, your body might not be ready. You might have lost some muscle strength in your quadriceps, hamstrings, and glutes. These key muscles help support the knees and if they haven’t been used in a while, your knees might pay the price. 

4. Technique

Leaning back or forward too much while descending can be hard on the knees. It often occurs when we’re tired or not paying attention. Landing too heavily or a bit stiff-legged can also cause some aches and pains. All can be remedied with a few adjustments to your form. Keep your back straight and maintain a nice center of gravity for the best results! 

5. Uneven Terrain and Descents

All it takes is one wrong step on a badly angled rock and bam, you’ve pinched a nerve. Try and be mindful as you navigate steep or uneven surfaces, particularly during downhill hiking. You might accidentally twist a part of the knee that isn’t meant to bend that way. Be careful and take your time.

6. Pre-existing Conditions or Injuries

This is a big one. Prior knee injuries, arthritis, tendinitis, or other underlying conditions can be aggravated by hiking. I’ve had knee injuries lay dormant for years and then rear their ugly heads out of the blue from overdoing it. Make sure you know your body before taking on too much. 

7. Insufficient Warm-up or Cool-down

Some light stretching before you conquer the mountain is highly recommended. Very few of us are in such good shape that we can get out of bed and go straight to the summit. Skipping warm-up exercises before your trek or neglecting to stretch and cool down afterwards can stiffen up your muscles which will lead to knee discomfort. It only takes 10 minutes to get the blood flowing and the muscles flexin’.

8. Bad Load Management

Be sure to only carry what you need. Do you need that 3 Liter Camelbak for a 2-mile walkabout? Are you bringing a rain jacket without a cloud in the sky? Carrying too much or improperly distributing weight can strain your knees, especially during descents.

9. Fatigue and Overexertion

Are you doing too much? Sometimes we overestimate our capabilities out on the trails. Not taking the proper rest or receiving the proper hydration can lead to fatigue. This can compromise form which then can increase the risk of knee pain. Don’t overdo it!

10. Inadequate Recovery and Rest

After you’ve finished you’ll need to give your body a break. If you don’t allow enough time for your muscles to repair themselves then your knees will eventually let you know. Make sure to schedule in downtime, especially on long or multi-day outings. Your body will thank you for it.

Pre-Hike Preparation: Essential Steps to Prevent Knee Pain

There are a few things you can do that will help prevent knee pain before you even step foot out in Mother Nature. Here are some of the most basic ones that could possibly make a huge difference:

11. Strengthening Exercises

If you don’t have a gym membership, don’t worry. There are plenty of strengthening exercises you can do without any equipment that might help you avoid joint pain later on. Squats, lunges, leg presses, and calf raises are standard, but there are many. Do the work now to avoid the soreness later!

12. Proper Footwear Selection

They make all kinds of outdoor footwear, but sometimes newbies pick something that looks “cool” but frankly sucks. Roaming around in Vans may be tempting but simply won’t do! Just invest in a pair of high-quality hiking shoes or boots and you should be fine. For more info check out how to choose the right hiking shoe to make a more informed decision.

13. Stretching and Warm-Up

Every athlete in the world does a pre-game warm up before their games or events, so why not do the same? Dynamic stretching exercises are best. Focus on the lower body muscles to improve flexibility and blood circulation before starting the hike.

14. Check Your Backpack

Pack only the essentials and keep your backpack weight to a minimum. The farther you walk, the heavier that pack is going to get. Not only does it feel heavier over time, the excess weight can strain your joints, including your knees.

15. Use Knee Support

If you have a history of knee joint issues or are prone to pain around the knee, consider using braces or supports. The additional stability during the hike will be immediately felt, but don’t rely on them too much. Make sure they aren’t too tight and you retain good blood circulation.

16. Stay Hydrated

I like to drink a full liter of water before I even get on the trail and always have at least 2 additional L’s on me during. Proper hydration is crucial, especially for joint health. Drink plenty of water before, during, and after your hike to ensure your joints are well-lubricated and good to go!

17. Include Anti-Inflammatory Foods

I bet this one didn’t cross your mind when you thought about how to avoid knee pain from hiking downhill did you? Try to eat foods with anti-inflammatory properties, such as omega-3 fatty acids found in fish, nuts, and seeds and some berries.This can help reduce inflammation in the joints. The more you know!

18. Check Trail/Weather Conditions

Before your hike, research and assess the trail conditions. Did it just finish raining? Has the trail been kept up or are there huge ravines or random boulders all along the path? Knowing the terrain, steepness, and potential obstacles can help you mentally prepare, plan for time and adjust your pace accordingly.

19. Tape or Bandage Support

Some hikers find relief by using athletic tape or bandages to support their knees. This is a step down from the aforementioned knee braces but they can still provide compression and stability during the hike. A simple elastic bandage can work wonders!

20. Listen to Your Body

The sights and sounds of nature might be distracting you from an underlining issue. Try and pay attention to any discomfort or pain during your warm-up or stretching. If you notice any issues, it’s crucial to address them before starting your hike.

During the Hike: Best Ways to Deal with Knee Pain as You Walk Downhill

It’s easy to let your mind wander as you traverse through nature, but in doing so you may get distracted from a few things you should be doing to keep your knees healthy and happy. Consider these:

21. Mindful Trail Selection

This might come with more experience but you need to know your limits. Try and choose trails that are suitable for your fitness level and expertise. You might think you are able to complete a challenging trail, only to second guess yourself halfway through. Work your way up to excessively steep or challenging paths and focus on building your strength and endurance as you go.

22. Proper Technique and Posture

Something of a throwaway in your mind but very important to consider is the way you’re walking. How big are the steps you’re taking? How is your torso is situated? Keep your back straight, shoulders relaxed, and knees slightly bent as you go. If you need to, take shorter steps to reduce impact on the knees. Believe me, these little things add up in the end. Maintain proper posture and you’ll recover much easier.

23. Use Trekking Poles

I highly recommend getting a simple set of hiking poles. They do wonders for those with weak or bad knees. You’ll notice a difference right away I promise you. They distribute weight, help with balance, and provide additional support to all parts of your body. They are pivotal in reducing stress on the knees while navigating varying terrains. One of the best investments you can make! 

24. Monitor Intensity

Enjoy the ride as they say! Don’t be too focused on how fast you’re going and pace yourself. Take breaks when you can and enjoy the wonder that is nature. Your body will tell you when things aren’t 100% so listen to it and adjust speed or intensity accordingly.

Post-Hike Treatment Options: Essential Steps to Alleviate Knee Discomfort

For some of us, the last thing we want to do after a long and grueling hike is more things. It’s one of the harder aspects for me personally, but I feel it’s equally important. How do you “come down” after a long hike? It’s not complicated, but it is necessary.

25. Cool Down and Stretch

Once you have finished for the day but before you take a shower or lie down, you most definitely should try and perform some gentle stretching exercises that target the lower body muscles. This will do wonders in aiding post-hike recovery and prevent stiffness. I won’t get all scientific on you but if you stretch after, you stop the accumulation of lactic acid in your muscles which in turn mitigates stiffness and soreness. Doesn’t take much, 5 – 10 mins, but oh so worth it!

26. Rest and Hydrate

You might be saying to yourself “Yeah, no kidding” but allowing your body to get the sufficient rest it needs is crucial so I had to include it. Also, If you don’t replenish fluids lost during the hike you might develop debilitating cramps that can absolutely stop your hike in its tracks. Drink water and electrolyte-rich beverages so you don’t have to risk a potentially life threatening situation (I almost died hiking in Hawaii due to dehydration and cramps, but that’s another story!).

27. Ice and Elevation

This is true for all muscles and joints, but I think it goes doubly for your knees. Even if you think your knees are feeling fine, prop your legs up on a pillow for a bit and put some ice on them. This will help reduce any inflammation and swelling that you might have received if you didn’t so why not right?

28. Post-Hike Evaluation

After you’ve finished your day in the sun (or rain), try and reflect on the hike and how it went overall. Assess any discomfort or pain you experienced and why you might have felt it. Take note of how you can improve your preparation or technique on the trails and implement these notes next time!

Equipment and Essentials for Hiking: What to Bring

Not all of the following necessarily correlate to knee pain when hiking downhill but they are all important in their rights so I threw them in here anyway!

29. Proper Footwear

Step numero uno is investing in some very high-quality hiking boots with good ankle support and traction. Depending on your intensity and trail selection, the wrong footwear will absolutely ruin a good time on the trails. Also, if needed, grab a pair of properly fitting insoles to elevate your walking experience.

30. Appropriate Clothing

I know this doesn’t have much to do with your knees and how they hold up going down the side of a hill but wearing improper clothing can hinder you in other ways. Overly loose clothing can get caught on branches cause you to change your gait, so pick clothing items that are form fitting, moisture-wicking and contain breathable layers, suitable in all weather conditions. The lighter, the better.

31. Trekking Poles

I know I already suggested these, but I’m doing it again because the the difference they make is so noticeable. The added stability and reduced stress on your knees is pretty much invaluable.

32. Backpack

Now you don’t have to go crazy with this one, but a simple and well-fitted backpack can be a small, yet important difference. Pick a size that carries the essentials, and that’s it. Water, snacks, a map, a first-aid kit, and emergency supplies are a must, but ditch the 3rd GoPro battery if you’re only going to be gone for a few hours.

33. Navigation Tools (Optional)

I know everybody has a phone on them with all types of trail apps but you should think about taking the old reliables with you just in case. A basic map of the area, a compass, or satellite GPS device might save your life one day.

Training for Long Hikes: How to Prepare Your Body and Protect Your Knees

As your hiking experience increases, so does usually the difficulty of the trails you pick. Obviously, the longer and farther you go, the harder it gets on your body, especially your knees. To combat this, I highly recommend that you actively train for hiking. Below are 3 of the general ideas you want to keep in mind.

34. Progressive Training

For some reason I’ve noticed hikers think they can go from hiking 7 miles in a day to 20 without much change in their workout regime. This is a mistake. It’s very important to incrementally increase your hiking distances and inclines week to week to build a nice foundation of endurance and strength.

My ratio is for every 10 miles you want to hike, you’ll need a week of increased training to prepare for it, so if you are getting ready for a 50 mile trek, start training for it about 5 weeks in advance.

35. Cardio Sessions

Now I’ve already given you a link to calisthenic exercises you should do to get into “fighting shape” but I also recommend that you incorporate more general endurance and stamina building exercises like running, swimming or cycling. This will help distribute the stress you put on your body during training and give you more of an overall boost in performance.

36. Hill or Stair Climbing

If you go to a gym or maybe know a buddy that will let you into theirs then I highly recommend doing 15 mins of the stair climber for added strength to your knees. Or, you can always do it the old fashion way and find a set of stairs! Find anything that’s inclined and focus on increasing either the time you do it or the steps you take.

Responding to Unexpected Situations or Injuries

That old adage, “What can go wrong, will go wrong” has a pesky way of revealing its head out in nature and if you frequently get knee pain while hiking downhill, you may be even more susceptible to it. If something goes wrong then you should:

37. Get Immediate Rest

Again, this might be completely obvious but I have to mention it. If you are experiencing a sudden pain or injury, stop and rest. Don’t try and “tough it out”. You might think that you just got a kink in your knee, but there could be some underlining damage and if you continue to hike with your discomfort, you can worsen the condition. Just take a minute and evaluate.

38. Apply First-Aid

I always say you should bring a first aid kit no matter how short or easy of a hike you’re attempting. One bad slip and you could be in a bad way. If you get a deep cut or severely twist your ankle you should administer basic first-aid. You don’t want those minor injuries like cuts, bruises, or blisters to turn into major ones.

39. Contact the Emergency Services

If you are going to be in a place without cell service, especially if you are going solo, you should let somebody know. If you don’t, then bring something that can contact emergency services outside of cell range like a satellite phone. If you need further encouragement, just watch the movie 127 hours!

Final Thoughts

Knee pain while hiking downhill can be mitigated and prevented with proper preparation, technique, and post-hike care. Strengthening exercises, gradual progression, suitable footwear, and attentive trail selection are pivotal for a rewarding hiking experience.

Equip yourself with essential gear, train effectively, and remain vigilant during hikes. Remember, addressing knee discomfort promptly and taking preventive measures significantly contributes to an enjoyable and injury-free hiking adventure. Your knee pain while hiking downhill will melt away!