Knee Pain: Causes and Solutions for Hikers

Q: Knee Pain: Causes and Solutions for Hikers

Hello： <br>1. <br>I go hiking and mountaineering every weekend, and I have noticed that after walking down for a while (with intervals like going down stairs), my knee feels like it’s twisted, with a sensation that is almost painful but not quite. <br>After resting for a bit, the

Knee problems

1.
During my weekly outings for hiking and climbing, I have noticed that after walking down a slope (with steps like going down stairs) for a while, I experience a sensation in my knee that feels like it is twisted—it's a dull ache that is close to pain but not quite painful.
After resting for a bit, the sensation returns after walking for some time.
If I go down the stairs too slowly, the sensation becomes more pronounced, so I tend to walk quickly down, which alleviates the discomfort, and sometimes I don't feel it at all.
I do not experience this sensation when going uphill or walking on flat surfaces.
2.
I have bow legs and flat feet.
Is it possible to improve these conditions in adulthood?

A Guo, 30~39 year old female. Ask Date: 2021/11/29

Dr. Chen Bochen reply Orthopedics

Hello:
1.
I go hiking and mountaineering every weekend, and I have noticed that after walking down for a while (with intervals like going down stairs), my knee feels like it’s twisted, with a sensation that is almost painful but not quite.
After resting for a bit, the sensation returns after walking for a while.
If I go down stairs too slowly, the feeling intensifies, so I tend to walk quickly down, which reduces the discomfort, and sometimes I don’t feel anything at all.
I don’t experience this sensation when going uphill or walking on flat surfaces.
>> The symptoms are similar to patellar malalignment, and it could also be indicative of meniscus issues.
I recommend that you visit an orthopedic clinic for evaluation.
2.
I have bow legs and flat feet.
Can these conditions improve in adulthood? >> Bow legs and flat feet do not improve on their own.
Mild cases can be managed with rehabilitation to strengthen the muscles and alleviate symptoms, while severe cases may require surgical correction.

Reply Date: 2021/11/29

More Info

Knee pain, especially for hikers and those who engage in activities like hiking or climbing, can be a common issue. Understanding the underlying causes and potential solutions is crucial for maintaining an active lifestyle.

Causes of Knee Pain in Hikers
1. Biomechanical Factors: Your O-shaped legs (genu varum) and flat feet (pes planus) can significantly affect your knee alignment and function. These conditions can lead to abnormal stress on the knee joint, particularly during activities that involve repetitive motion or weight-bearing, such as hiking. The misalignment can cause uneven wear on the cartilage and lead to pain.

2. Patellar Tracking Issues: When going downhill or descending stairs, the patella (kneecap) may not track properly in its groove, leading to discomfort or a feeling of instability. This can be exacerbated by muscle imbalances around the knee, particularly weakness in the quadriceps or tightness in the hamstrings.

3. Overuse Injuries: Hiking, especially on uneven terrain, can lead to overuse injuries. The repetitive motion of bending and straightening the knee can cause irritation of the tendons or inflammation of the bursae (small fluid-filled sacs that cushion the knee joint).
4. Cartilage Damage: If you have a history of knee injuries or conditions like osteoarthritis, the cartilage in your knee may be damaged. This can lead to pain during activities that put pressure on the knee, such as descending slopes.

5. Tendonitis: Conditions like patellar tendonitis (jumper's knee) can develop from repetitive strain on the knee, particularly if you are engaging in activities that require sudden bursts of speed or jumping.

Solutions for Knee Pain
1. Strengthening Exercises: Focus on strengthening the muscles around the knee, particularly the quadriceps, hamstrings, and calves. Exercises like squats, lunges, and leg presses can help improve muscle support for the knee joint. Additionally, strengthening the hip muscles can help improve overall leg alignment and reduce knee strain.

2. Stretching and Flexibility: Incorporate stretching into your routine to improve flexibility in the hamstrings, quadriceps, and calves. This can help alleviate tightness that may contribute to knee pain.

3. Footwear and Orthotics: Since you have flat feet, consider using supportive footwear or custom orthotics. Proper arch support can help improve your foot alignment and reduce the impact on your knees during hiking.

4. Gradual Increase in Activity: If you are experiencing pain, it may be beneficial to gradually increase your hiking intensity and duration. Allow your body to adapt to the physical demands of hiking, and take rest days as needed.

5. Proper Technique: When hiking downhill, try to maintain a controlled pace. Instead of rushing down, which can increase the impact on your knees, focus on taking smaller, more deliberate steps. This can help reduce the strain on your knees.

6. Rest and Recovery: If you experience pain, it’s essential to rest and allow your body to recover. Ice the knee after hiking to reduce inflammation and consider over-the-counter anti-inflammatory medications if necessary.

7. Consult a Specialist: If your knee pain persists, consider consulting a physical therapist or orthopedic specialist. They can provide a tailored rehabilitation program and assess whether any underlying issues need to be addressed.

Addressing O-Shaped Legs and Flat Feet
While some structural issues like O-shaped legs and flat feet may not be fully correctable in adulthood, there are interventions that can help manage symptoms. Physical therapy can improve muscle strength and flexibility, which may alleviate some discomfort. In some cases, surgical options may be considered, but these are typically reserved for severe cases.

In conclusion, understanding the causes of your knee pain and implementing appropriate strategies can help you continue to enjoy hiking and other activities. Always listen to your body, and don’t hesitate to seek professional advice if the pain persists or worsens.

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