Prevent knee pain with hiking
With the skii and snowboarding season gradually coming to a close, many outdoor athletes in the Pacific Northwest are starting to set their sights on hiking season and all of the bucket list trails and trips that have yet to be crossed off the Alltrails list.
If you consider yourself to be one who likes to push yourself in the steep, treacherous terrain of the Cascades, you may want to consider integrating some preparatory training into your routine before the snow melts and the trails start calling your name.
Not only will getting proactive with your training enable you to do longer hikes earlier in the season; it will also help to reduce the risk of developing the bane of all hikers: knee pain.
Many clients come to us with knee pain from jumping full throttle into hiking without incorporating any kind of hiking-specific training into their routine. Don’t fall into this trap. If you aren’t currently addressing the below factors with your training, there’s no better time than now to start!
Training for the Uphill
When training for the uphill, it is important to have a basic understanding of the ankle, knee, and hip joint angles involved in uphill versus downhill hiking. With uphill hiking, there will be more range of motion, on the ankle and hip for the hiker to be able to clear the ascending terrain without sacrificing on step length, as well as strength demands of those joints to facilitate upward drive and follow-through.
For the ankle specifically, it is important to possess an adequate amount of dorsiflexion (where the top of the foot moves towards the shin) in order to clear obstacles and maximize the amount of propulsion coming from the ankle. The more dorsiflexion, the more forward drive that will come from the calves instead of the knees. To address this, it is recommended to perform single leg heel raises off of a step with 5-10” pauses at the bottom in the stretched position. This technique is preferable to passive stretching as it trains the calf, soleus, and achilles to bear load in a stretched position rather than simply “hang out” there.
Next, to build on this “usable” range of motion of the ankle and further improve your upward propulsion, start adding weight to your single leg heel raises. This could be via a weight vest, dumbbells, safety bar, or barbell. Once range of motion is improving, it is acceptable to reduce the duration of the pause at the bottom of the motion in order to be able to manage heavier weights.
To go above and beyond with your ankle prep, throw in some accessory tibialis anterior (shin) work. A great starting point is to stand with your back against the wall with your feet flat about 3ft away from the wall. Simply raise your feet up in the air using your shin muscles and perform until failure. This will increase shin capacity for ankle clearance, which is an underrated challenge of long, steep ascents.
Lastly for the uphill it is vitally important to train hip extension strength and endurance, particularly of the glutes and hamstrings. This hip drive is where the majority of a hiker’s momentum should come from on the uphill considering the significant amount of pre-loading involved with these muscles during a high step. To train these muscle groups, therefore, it is recommended to incorporate heavy single leg training including weighted step ups, bulgarian split squats, lunges, and single leg hip thrusts. Without getting too into the weeds, rep ranges anywhere between 5 and 20 can be beneficial depending on whether you are targeting muscular strength or endurance.
Training for the Downhill
Preparing for the downhill is arguably more vital in regards to knee injury prevention due to the large demands placed through the quads and anterior knee with each downhill step. Conversely to hiking uphill, downhill hiking asks relatively little of the ankle and hip range of motion and instead asks much more of the knee. With each downhill step, gravity and momentum attempt to collapse our knees into flexion, while we work to use our knees as a suspension system to counteract those downward forces and attenuate the significance of each impact.
The best way to build up the knee to create a more effective suspension system is to build quad strength. This will help with force absorption on the descent and reduce the amount of impact force that is absorbed by the knees themselves.
To build quad strength in a hiking-specific context, some of the best exercises to perform are step downs, ATG split squats, decline squats, and pistol squats. For all of these variations, it is important to keep a vertical torso to ensure the challenge is placed on the quads as opposed to the hips and hamstrings.
Hiking is a high level sport and should be treated as such through focused preparation and training. Pick one or two exercises from the above categories and feel for yourself how much better your knees feel on the trails!
Dr. Brooks Kenderdine
PT, DPT, CSCS, USAW-1
Co-Owner | The PATH Rehab & performance
