What Causes Knee Pain After Hiking And How To Treat It

Spending time outdoors can reduce stress and keep you healthy. In Arizona, picturesque trails cover every corner of the state, which makes hiking a popular activity year round. Unfortunately, time spent on the trails can result in knee pain, especially for older residents with aging joints. If you’re experiencing knee pain after hiking, you don’t have to suffer. There are plenty of ways to get your discomfort under control. Here’s what you should know.

Why do I have knee pain after hiking?

Our knees endure a significant amount of stress during daily activities, let alone hours spent on rocky and uneven trails. This is why knee pain is very common among avid hikers.

For many people, this pain occurs around or behind the kneecaps and can also cause stiffness. This type of pain typically worsens while walking downhill or up stairs because of the excessive pressure you put on your knees in these situations. Research suggests the force on your knee joint is up to eight times your body weight when going downhill. Furthermore, the force on your knees is two to three times heavier by simply walking up stairs.

Other hikers report inner knee pain in the area closest to your inner legs, which is usually due to a tear or sprain. This may be the result of a specific injury or one of many overuse conditions that cause inflammation.

What causes knee pain after hiking?

In order to begin treating knee pain after hiking, you first have to find the cause of your pain. A diagnosis from your doctor is the first step toward developing a plan for relief.

These are some of the most common causes of knee pain after hiking, along with the symptoms that typically follow. Talk to your doctor if you believe you may be experiencing one of these injuries or conditions.

1. Bursitis

If your knee feels warm, tender, and swollen, you may be experiencing bursitis. This pain typically occurs on the inner side of your knee below the joint.

Knee bursitis is due to inflammation of a small fluid-filled sac called a bursa. These sacs reduce friction and cushion the pressure points between your bones and the tendons, muscles, and skin near your joints. When they become inflamed, they can lead to pain.

While this condition is often caused by frequent kneeling or a blow to the knee, it can also develop after overuse or strenuous activities.

2. Knee tendinitis

Sharp, shooting pain and tenderness above or below your kneecap may be an indication of tendinitis. You may also have swelling and a burning feeling in your kneecap.

This condition is typically brought on by repetitive stress on the knee. Tendons are bands of fibrous tissue that connect muscle to bone. Tiny tears in the tendon can occur, which eventually become weak and inflamed.

3. Tendinosis

In contrast, tendinosis doesn’t involve inflammation. It will be painful, but there is usually no redness or burning feeling as there is with tendinitis. You may also experience stiffness and restricted movement due to the tendons beginning to break down.

Again, this condition is generally caused by overuse and hobbies that put repeated stress on the knees. It is more common in older individuals as the joints become less flexible due to aging. Patients with arthritis are also more prone to tendinosis.

4. Meniscus tear

If you hear or feel a popping sensation in your knee while hiking, it’s likely that you’ve experienced a meniscus tear. This commonly occurs when you forcefully twist your knee, especially while putting your weight on it. Perhaps you were going down a steep hill or kneeling down while carrying a heavy backpack.

Each knee has two menisci, pieces of cartilage that cushion your shin and thigh bone. When torn, you’ll experience swelling and stiffness, along with a sharp pain when twisting or rotating your knee.

5. ACL damage

One of the most commonly injured ligaments in the knee is the anterior cruciate ligament (ACL). An ACL injury tear or sprain can take place because of sudden stops or changes in the direction you’re moving, as well as excessive flexing of the ankle.

Signs and symptoms include:

  • Rapid swelling
  • Severe pain
  • Loss of range of motion
  • A loud “popping” sensation
  • Instability while putting weight on your knee

6. Synovial plica syndrome

The plica is a fold in the tissue surrounding your knee joint. It is surrounded by a fluid-filled capsule called the synovial membrane.

Synovial plica syndrome is a result of your plica becoming inflamed after stressing or overusing it. This usually happens in the middle of your kneecap. You may be able to feel your swollen plica when you press on this area.

Pain related to this condition is usually achy, rather than sharp or shooting. It may also worsen while using stairs or bending down.

7. Iliotibial band syndrome

The iliotibial band is a thick band of tissue that connects muscles to other structures in the lower body. It runs from the hip region all the way down to the back of the knee.

Iliotibial band syndrome, also referred to as IT band syndrome, is a condition in which this tissue becomes inflamed, tight, or swollen. Pain will typically present on the outside of your knee and can spread up the thigh to the hip.

Again, this condition occurs with overuse of the joint. It may result in knee pain that intensifies in response to movement.

8. Patellofemoral pain syndrome

Patellofemoral pain syndrome is a condition in which you feel pain in the kneecap or at the front of the joint. It is often called “runner’s knee” because it’s more common in people who participate in sports that involve running and jumping.

The pain is usually dull or aching, but can be aggravated by walking up or down stairs, kneeling, and sitting for extended periods of time.

9. Knee osteoarthritis

Unfortunately, overuse in older individuals can lead to osteoarthritis. This condition is the progressive degeneration, or loss, of cartilage from a joint over time.

While osteoarthritis can be found in any part of the body, it is commonly seen in the knees. Severe and advanced cases of osteoarthritis may lead to direct bone-on-bone contact, which can cause chronic pain.

hiking knee pain

How to prevent knee pain after hiking

As with any medical injury or condition, prevention is your best line of defense. With a few changes and modifications to your hiking routine, you can get back to enjoying the great outdoors without pain.

Try these simple steps for preventing pain:

  • Choose supportive footwear: Hiking involves uneven terrain, rocks, and a lot of other obstacles. Finding supportive and comfortable hiking boots is essential. They should fit properly and offer plenty of cushion to relieve excess pressure on your joints. Be sure to replace them as needed after excessive wear.
  • Stretch before you hit the trails: Start your hike with a stretching routine that warms up your muscles. Focus on letting your legs loosen up with long, slow stretches that promote elasticity.
  • Reduce the weight of your gear: A heavy backpack puts unnecessary strain on your knees. Think about what you really need before each hike. While essentials like sunscreen and water are important, find ways to lighten your load. Instead of water bottles, try a lightweight water pouch.
  • Invest in support garments: Get additional knee support in the form of a brace. This will restrict or stabilize joint movement to give you stability. Some hiking enthusiasts also find relief from kinesiology tape.
  • Get a hiking pole: There is research to suggest that hiking poles are effective in redistributing some of the pressure you feel in your knees. Especially while hiking downhill, hiking poles can allow your arms and shoulders to absorb some of the impact. They also serve as an added layer of protection from falls that could cause serious injury.
  • Take your time: Take trails with a slow and steady approach. Going too fast will only put additional strain and pressure on your knees. Try carefully side-stepping when you’re trying to navigate steep downhill areas. This will help shorten and soften your steps.

Treating knee pain after hiking: 5 approaches

If you’re already suffering from knee pain after hiking, there are several options that could bring you relief. Some are simple at-home remedies, while others will require guidance from your doctor.

1. At-home remedies

You should typically start with simple at-home remedies before moving on to more invasive treatment options, especially if your pain is mild.

At-home care includes:

  • Applying ice or cold packs to your knee. This will help reduce swelling and restore your range of movement. Repeat three times per day for 10-20 minutes.
  • If your knee responds positively to heat and mild activity, alternate the application of heated and cold packs.
  • Trying to keep your affected knee(s) elevated while resting. You can do this with a few pillows, but remember that it’s important to elevate your entire leg all the way down to your ankle.

2. Physical therapy

In some cases, a specific routine of conditioning and stretching is needed to retain or regain flexibility. Physical therapy can help heal the pain you’re currently experiencing, while also conditioning your knees to prevent further injury.

A skilled physical therapist will develop a plan that is specific to your goals and comfort level.

3. Medications

For many patients, conventional over-the-counter medications provide significant relief from pain associated with hiker’s knee, especially during the acute phase of healing after an injury. These include non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, and ibuprofen.

These drugs act by inhibiting the production of inflammatory molecules in the body, thus reducing the associated pain.

However, in serious cases, these medications may not provide adequate relief. If you have stopped participating in rigorous activity, but are still experiencing significant knee pain, your doctor may recommend more advanced treatments.

4. Knee injections

If your knee pain has not improved with conventional therapies, your doctor may suggest interventional pain management.

Steroid knee injections can help reduce pain and inflammation in a specific area. While some patients respond to one injection, others may need several injections over time. Most people experience pain relief and reduced inflammation for approximately six months.

5. Surgery

The last resort in cases of severe knee pain is surgery. However, your doctor will generally only recommend this after trying a range of other options that aren’t invasive.

In general, the need for surgery will be due to serious damage caused by aging, injury, or excessive overuse. Your doctor will either repair and replace torn ligaments or replace the knee as a whole (arthroplasty).

Find help

Hiking is a great way to unplug, get exercise, and enjoy the beauty of the great outdoors in Arizona. Don’t let knee pain stop you from enjoying one of your favorite hobbies.

The team at Arizona Pain can work with you to pinpoint the exact cause of your knee pain after hiking. It could be due to any of the different injuries and overuse conditions discussed in this article. You can rest assured knowing we will find the cause and develop a treatment plan that works for you.

If you’re in Arizona and need more help with your knee pain, contact our pain specialists today at Arizona Pain.