You’re hiking along a serene trail. The quiet mist is eerie and captivating. You hear a twig snap: it might be a Bear! No, just Dave being clumsy again.
All of a sudden, you feel a sharp pain in your knee.
You’ve got Hiker’s Knee! What should you do now?
What is Hiker’s Knee?
Hiker’s knee, or “patellofemoral pain syndrome (PFPS)” is a form of pain and inflammation affecting the patella (kneecap). It is a common injury among avid hikers and runners due to the repetitive joint loading.
The pain in Hiker’s knee is around the front of the kneecap, which can make it difficult to walk for even short periods of time.
Relief while out Hiking
Hiking can be tough on your knees. If you feel the dreaded Hiker’s knee pain, you can try these measures:
Knee pain when hiking downhill
When you hike downhill especially, your knees have to absorb a lot of impact. Stop for breaks often and walk at a slower pace. Take an anti-inflammatory e.g Ibuprofen if you have some handy – they can help to reduce swelling and pain.
If equipped, use your hiking poles to take some of the strain off of your knees.
Secondly, you can use a strip of cloth or a long sock for a makeshift knee brace. Wrap the cloth or sock under your kneecap (infra-patellar taping) and secure it in place. Not too tight!
This improvised form of patella taping will reduce strain on your kneecap ligaments and, with a little bit of care, you should be able to hike back to the car, feeling only slightly defeated.
Does Infra-patellar Taping work?
There are a few different ways that you can tape your patellar tendon, such as McConnell taping. Another way is the infra-patellar taping method. This involves placing a strip of tape below the kneecap, at the patellar tendon.
The tension from the tape will help to pull the kneecap up slightly, which can help to reduce pain in hiker’s knee.
Later that day…
Patellofemoral pain syndrome self-care
Now you’re back at home, (or some more basic accommodation like a campground!). If you can, source an icepack to apply around the kneecap for 10 minutes at a time. Rest the legs and relax – you need some recovery time.
If you are on a long hike and must continue the next day, you can make your own foam roller from a towel or clothes rolled up tightly. Massage your quad and hip muscles before setting out again, to reduce tension at the knee joint.
How long should I rest hiker’s knee?
- Within 72 hours, use the RICE (Rest, ice, compression, elevation) protocol liberally.
- Patellofemoral pain syndrome can take 5 weeks or more to resolve, especially if the injury also involved trauma, like a slip or a fall.
For people who experience Patellofemoral pain, exercise is the only evidence-based treatment strategy suggested to improve it, as Dominique C. Leibbrandt and and Quinette A. Louw describe in their 2019 study.
Pain at the back of the knee when straightening your leg? Learn more here
There are many possible contributing factors to hiker’s knee, which can make it tricky for your physiotherapist, chiropractor or osteopath. With that in mind, I want to discuss a protocol we have found very useful for patients who have PFPS.
The Best Hikers Knee (patellofemoral pain) Exercises
Let’s get started building the strength in your quads, glutes, and core, to support your knee joint. Watch below, and see detailed descriptions further down.
The quads are the large muscles at the front of your thigh, and they attach right to your kneecap (patella). Strong quads are essential for healthy patellar tracking.
Stand with your feet shoulder-width apart, a kettlebell held between your hands. Keeping your chest up and core engaged, sit back and down into a squat, until your thighs are parallel to the floor. Press through your heels to return to standing.
1-legged Kb deadlift:
Stand on one leg, holding a kettlebell in the opposite hand. Hinge forward from your hips, until your back is flat and parallel to the floor. Keep your core engaged, and lower the kettlebell towards the floor. Return to standing by pressing through your heel.
Standing Hip abductions:
Stand tall with your feet hip-width apart, core engaged. Raise one leg out to the side, keeping your hips level. Return to start position and repeat.
Lie flat on your back with feet flat on the floor and shoulder-width apart, legs bent to 90 degrees. Drive through your heels, and lift your hips and lower back off the floor, until your thighs and torso are in line with each other.
Extend one leg so it is out in front, in a straight line. Return to meet the other leg. Lower hips back to the mat. Repeat on the other side.
Medicine ball twists:
Sit on the floor with your knees bent, feet just off the floor, a medicine ball held between your hands. Lean back slightly, then twist your torso to the right and reach the medicine ball across your body to the outside of your left knee. Return to the starting position and repeat on the other side.
Lie on your side with your feet stacked and one forearm planted firmly on the floor beneath your shoulder, body straight from head to heels. Brace your core and raise your hips until your body forms a straight line from head to feet – hold for 20-30 seconds each side.
Now on to our:
Trigger point exercises
Foam rolling is a great way to release tension in the muscles around your knee, particularly the quads and ITB (iliotibial band).
Start by lying on your front with the foam roller placed under one upper thigh. Slowly roll your body sideways on the roller, paying attention to hone-in on the tight spots.
Repeat as you move down to lower parts of your quad. For extra pressure, place your other leg on top. Switch sides and repeat.
Trigger point therapy
This can be done with a rubber or lacrosse ball, by lying on your side, ball placed under your outer hip area. From here, slowly roll your body sideways on the ball, paying attention to the tight spots, but avoid bony contact.
As you find them, stop and hold for 30-60 seconds, then continue moving. Switch sides and repeat.
Quad lengthening stretches
Lunge with a twist:
Step forward into a lunge, then twist your torso over your front leg and reach your arms out to the side. Hold for 30 seconds, then switch sides and repeat.
From a low lunge position, bring your back leg forward so that your shin is resting on the floor in front of you. Hold for 30 seconds, then switch sides and repeat.
Quad “couch” stretch:
Bend one knee and place your ankle on the couch behind you, knee on floor. The other leg is out in front, bent knee and foot on floor. Gently clench your butt, until you feel a stretch in the front of your thigh. Hold for 30 seconds, then switch sides and repeat.
If you suffer from patellofemoral pain, these exercises can help to improve your symptoms and prevent further injury. Do what is comfortable – if an exercise aggravates your pain, stop and consult with your doctor.
What is Hiker’s knee? It’s a common injury among those who love getting outdoors! But it can be prevented with the proper stretching and strengthening exercises.
If you already have this issue, the steps above can help relieve pain and prevent further injury.
Have you had Hiker’s knee? What worked for you? Let us know in the comments below!
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