Whether you intend to or not, there may be times during your hiking adventures when you have to spend a good chunk of time hiking downhill. On the outside looking in, it’s easy to think that doing so is going to be a breeze as the hard part is hiking uphill, right?

While hiking uphill has its own set of challenges, we’re here to discuss why downhill hiking can have a very specific issue that can plague even the most avid of hikers out there. The title truly says it all as knee pain when hiking downhill is a very real problem that you can (or might have already) experience.

However, what causes it? There can be a few different reasons why you’ll feel pain in your knees while hiking downhill. It’s possible to develop knee-related injuries such as runner’s knee or iliotibial band friction syndrome (ITBFS). Of course, walking (or hiking) downhill naturally puts more strain on your ankles and knees than walking on level ground or even uphill.

While we want to talk more in-depth about various injuries that could be at fault, we also want to talk about some benefits of downhill hiking (or walking), as well as some strategies you can employ to make it easier and safer overall.

If that sounds like something you’re interested in, then we encourage you to stick around. So, without further ado, let’s get into it.

Injuries that can lead to knee pain when hiking downhill

Photo by Terry Shultz / Unsplash

It’s extremely possible that the following day, after hiking or walking downhill for a significant period of time, you will feel aches and soreness in your muscles. If you aren’t accustomed to hiking downhill, your body may not be used to the additional strain that it places on it.

ITBFS (Iliotibial Band Friction Syndrome)

However, you also may feel flat-out pain in your knees, which could mean that something a bit more serious is at fault. As mentioned, ITBFS could be one of the reasons why. The National Library of Medicine uploaded a medical analysis of the syndrome on their website, in which they mention its association with downhill running.

For starters, the National Library of Medicine defines ITBFS as the following:

“Iliotibial band friction syndrome (ITBFS) involves pain in the region of the lateral femoral condyle or slightly inferior to it, that occurs after repetitive motion of the knee, typically in a runner, cyclist, or other athlete.”

Yes, that sounds like a lot of medical jargon at first, but the last part of the definition is a bit easier to comprehend. What’s more important is what the institution says about the link between ITBFS and downhill running.

“The commonly held association of ITBFS with running downhill may be due to the fact that downhill running results in a higher degree of knee flexion at heel strike, thus increasing the friction of the ITB with the lateral epicondyle or the pressure the ITB places on the underlying soft-tissues.”

The entire analysis gets pretty in-depth, but you can read it in full if you’re interested. Nobody would expect an individual dealing with knee pain when hiking downhill to come to the conclusion that they have ITBFS. However, it could be something a doctor could diagnose.

Runner’s knee

If you’re an avid runner, walker, hiker, or whatever, there’s a decent chance that you’ve heard the term, “runner’s knee.” For starters, it’s not something that’s reserved only for runners. It’s actually somewhat of a broad term and it doesn’t relate to a specific injury.

If we take a look at what WebMD has to say, runner’s knee is:

“Runner’s knee is a broad term used to describe the pain you feel if you have one of several knee problems. You might hear a doctor call it patellofemoral pain syndrome.”

How do you get Runner’s knee in the first place?

Regarding how one would suffer from runner’s knee, there are several ways it can come about, so to speak.

  • Overusing your knees – Performing a lot of high-stress exercises or simply bending your knees over and over and over can cause your knees to be overused. Hiking downhill for extended periods of time could place that type of stress on them.
  • Unbalanced or weak thigh muscles – As WebMD notes, “The quadriceps, those big muscles in the front of your thigh, keep your kneecap in place when you bend or stretch the joint. If they’re weak or tight, your kneecap may not stay in the right spot.”
  • A direct hit to the knee could also cause it, though this would probably only be associated with this problem if you fell while hiking downhill.
  • Foot issues – Certain issues with your feet, such as overpronation or hypermobile feet, can actually cause you to change the way you walk (or hike). This can then also lead to knee pain and possibly even runner’s knee.

How do you know if you have Runner’s knee?

Alright, so if you have knee pain when hiking downhill (or even after the fact), how do you know if it’s runner’s knee? Well, for starters, a doctor is your best bet to diagnose what the actual problem is. Yet, there are some symptoms that you can look out for that may indicate you do indeed have runner’s knee:

  • Just having knee pain, in general, is a good sign that something’s wrong. The pain could be around or behind your kneecap, but it’s probably going to be in the front of your kneecap if you have runner’s knee.
  • You have noticeable pain in your knees when running, kneeling, squatting, walking, or even just getting up while sitting down.
  • Swelling around your knees or even hearing a popping noise.
  • It gets a lot worse when you walk (or hike) downhill (or even downstairs).

How do you treat Runner’s knee?

Now, the good news is there are a number of ways that you can treat your knee or knees if you’re feeling a lot of pain to help with the healing process.

  • Rest – As simple as it sounds, resting your knees is step one if they’re experiencing a lot of pain. Avoid activities that make the pain worse. It’s so simple but so important.
  • Wrap your knees – For additional support, you can wrap your knees with sleeves, patellar straps, or even elastic bandages.
  • Ice your knees – This can help with both pain and swelling (if present). Every three to four hours or so, ice your knees for a good 30 minutes. Continue to do this until the pain (and/or swelling) goes away.
  • Elevate your leg – When you are sitting or lying down, keep your leg/legs elevated on a pillow.
  • Get assistance in your shoes or hiking boots – Orthotics and arch supports for your shoes or hiking boots can help with the positioning of your feet. It can also be a way to make your hiking boots more comfortable.
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If none of the following helps at all, you may need more serious assistance such as orthopedic surgery. Thankfully, it’s pretty rare to need surgery for runner’s knee (the case would have to be very severe).

What are some benefits of hiking downhill?

Adventure in the mountains
Photo by Holly Mandarich / Unsplash

So, even though knee pain when hiking downhill can make the act of doing so miserable (and suffering), there are also some benefits to doing so. However, let’s be clear that what we mean is there are benefits of hiking downhill NOT benefits of doing so with knee pain (as you shouldn’t keep hiking if you have bad knee pain).

It helps to provide balance in the natural environment

This may seem a bit obvious but it’s like when you want to ride your bike down a huge hill. You first need to ride up the hill, and that requires a lot more work. Going down the hill doesn’t require nearly as much exertion (and virtually nothing when riding a bike as you can just ride the hill).

It can be a benefit for people dealing with different conditions

People who suffer from conditions such as chronic obstructive pulmonary disease or cardiac rehab will better tolerate downhill walking or hiking.

It can have metabolic benefits

Research has shown that downhill hiking or walking can have positive metabolic benefits. This can improve insulin resistance and lipid metabolism. It can improve your lean body mass, as well.

What are some strategies for hiking downhill?

We figured this would be a strong way to conclude this post by looking at knee pain when hiking downhill. Proper walking and hiking downhill can help to prevent you from having issues with your knees, in the first place. Just some helpful tips to keep in mind is all.

  • Keep your knees slightly bent on steeper slopes at all times.
  • For enhanced stability, keep your torso in an upright position or lean just slightly forward.
  • Use trekking poles as you hike downhill as they can help take some of the impact off while doing so. Speaking of such, be sure you get the right size hiking poles for the best comfort possible.
  • Try to avoid leaning back while you hike downhill as this can put you off balance.
  • Be wary and take additional care if you’re hiking downhill on loose terrain. Be sure to not go too fast to avoid slipping and falling.
  • It can be better to go faster on stable terrain, as it can result in fewer slips.

Final thoughts

Hiking downhill has its own unique set of challenges, and the reality is that knee pain can be a common problem when doing so. The natural way that downhill hiking places more strain on your knees and ankles can be attributed to that.

Of course, you may be suffering from knee-related injuries or may even develop them while hiking downhill. In other words, knee pain when hiking downhill isn’t uncommon. Thankfully, though, there are ways for you to improve as you shouldn’t avoid hiking downhill altogether.

Unless you’re dealing with knee pain that is, as you should ensure the pain goes away before continuing. Well, that about wraps it up for this topic.

On another topic, have you ever hiked on a blistering hot afternoon? It can be downright brutal. Yet, what if the experience could be improved by following some very important tips? Who knows, it could be as easy as that!