Preventing Knee Pain While Hiking

​Knee is pain is one of the most common issues hikers face on the trail. And, unfortunately, a lot of the information out there on preventing knee pain while hiking is lacklustre (at best).

​To help, this video explores a range of strategies, ideas and exercises a hiker can use to reduce the chance of knee pain and discomfort on their adventures.
​

How To Reduce Knee Pain While Hiking 

Inside this video we cover:

• Why knee pain is SO common for hikers and backpackers 
• Why the ‘typical’ solution for knee pain while hiking often falls short
• 3 very important areas of training which can help with knee pain
• Some of my favourite exercise examples for preventing knee pain 
• A few extra strategies and tips to help hikers with knee pain 

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Video Timestamps:

0:15 
Introduction to Knee Pain in Hiking
6:55 
Understanding Common Causes of Knee Pain For Hikers
13:26 
The Role of Strength Training For Preventing Knee Pain
20:32 
Importance of Mobility Work For Your Knees While Hiking 
28:55 
Conditioning for Hiking
31:55 
Extra Tips for Knee Health For Hikers
36:24 
Managing Footwear Changes For Hiking 
39:11 
Exposure to Pain Triggers
41:02 
Personalized Support and Training Programs

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Want to download our free Hiker's Knee Prevention Guide?

You can get it here: https://www.summitstrength.com.au/hikers-knee.html

Need some personalised help with your training for hiking?

Check out the Online Summit Program here: https://www.summitstrength.com.au/online.html

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Video Transcript:

[0:01] All right, hello, hello, ladies and gentlemen. So today we are getting into a bit of detail around preventing knee pain while hiking, which is probably

[0:10] one of the biggest common issues I hear from hikers on pretty much a daily basis. And unfortunately, when you go out there online and you look at videos and blogs and all of this stuff, the quality information around preventing knee pain while hiking is pretty average it's pretty not amazing and it's often very very very tunnel vision like in the sense it just gets hung up on one or two things but it very very rarely looks rarely looks at a bit more of a broader picture so basically the plan of attack today is we're going to be diving into a few different areas which can make a bit of a difference when regards to preventing knee pain while hiking and hopefully just sort of fill out some of the information which a lot of hikers may have come across in the past.

[0:55] So before we get into it, let's do a quick little overview around what we're actually going to be covering today. So number one, we're going to be covering why knee pain is just so common for hikers and explain that in a little bit of detail. We're going to explain why the typical solution for knee pain while hiking will often fall short and something that I see people fall into all the time. We're going to talk about three important areas of training and physical development which can and make a big difference to your knee pain on the trail. We're gonna talk through some of my favorite exercises which can help with this. And also a few extra tips to round out these ideas and a few other bits and pieces which you may wanna consider or put a bit of attention into. So hopefully you can come out the other end having a pretty good understanding of this topic. Now, before I go any further again, let me introduce myself if you haven't come across my stuff before and make sure you know exactly where I'm coming from.

[1:50] So essentially, my name is Rowan Smith, and I am the founder of Summit Strength, which is an online personal training service which specializes in working with hikers. Now, essentially, through Summit Strength, we help hikers in typically three big situations. Number one is a hiker who has a big trip coming up. So they book something in, they've got something in their calendar, and they're like, you know what, I'm not in the best physical position. And they want to be doing everything they can to give themselves the best chance of success, but also getting out there and properly enjoying themselves. Now, number two, we work with a lot of hikers who do struggle with an ache or pain, and it holds them back on the trail. So knee pain, foot pain, back pain, shin pain, hip pain, all of these are really, really, really, really common in the world of hiking, and we help with a lot of hikers with that. And we also work with a lot of hikers who may not have a big trip in their sights, they may not actually have an ache or pain, but they do realize, look, I like to get on the trail pretty regularly, but I always find my physical condition is holding me back. I get huffed and puffed on hills, my legs burn out, I get really fatigued, or whatever it may be. and they essentially just want to be upgrading that in one way or another. Now, over the years, I've been training hikers for probably over seven years now. I've personally trained and prepared over 400 hikers for pretty much every trip imaginable, from first-time day hikers who are just looking to accomplish their first full-day hike, to people who are doing some of the longest through hikes in the world, to the more hardcore mountaineers going up to 8,000-meter hikers or whatever they may be. And during those years, as this is such a common issue, I have helped hundreds of hikers specifically with their knee pain.

[3:18] Now, when we are talking through the ideas today is I want to be really, really, really clear is I am not a physiotherapist. I am not a physical therapist. I am not talking today about specific diagnoses. I'm not talking about rehab. I'm not talking about coming back from early, coming back from surgery or whatever may be. That is not my role. And if you are in the early stages of after injury, if you're early stages of a flare up or you want a specific diagnosis on your particular knee issue, go and see a physio, go and see a physical therapist and work with someone there. Essentially what I am and where I come into this picture is I'm what we call a return to performance specialist. So essentially to give you a little bit of context here is essentially when it comes down to the typical approach for knee pain while hiking. Someone gets knee pain, they're hiking, hiking, hiking, they get knee pain. They're like, oh my gosh, that sucked. I'm going to go see a physio. They see a physio, the physio sort of says, hey, let's pull back your hiking a little bit for a while and here's some exercises here's some ideas we're going to get on top of this knee pain they go through a little bit of a journey there comes a point where the knees starting to get a little bit better they've been working through the exercises for a while and the physio's like you know you're good you're ready to go back to normal training or you're ready to go back to life or whatever may be and what can often happen is people are like all right cool my knee's feeling good a physio gave me all clear they step out on the trail maybe the first hike goes well but then they ramp things up they ramp things up and all of a sudden the knee's.

[4:45] Now, essentially, what happens here is essentially typical physiotherapy, typical physical therapy will get people ready for everyday life. They'll get people to the point where they can get through their day to day activities relatively comfortable. But as hikers, we know there's probably a bit of a difference between being ready to just walk around day to day and be comfortable and actually be out on the trail where we have to hike for hours at a time, ups and downs, uneven terrain and all of that. So essentially my role is I fill this gap between when people are cleared for normal life and everyday life to actually getting them ready for the trail and making sure their knees are happy and their other parts of the body are happy for the trail. So that's the context we're talking through today.

[5:26] So with that being said, you know, let's talk about this in a bit more detail. As I said before, knee pain is probably the most common issue I hear from hikers. Now, for some people, they can be really, really clear about where this is coming from. Maybe you've had a history of knee injury. You've had surgery. You could tell us something in the past. Maybe you had a big fall or something. And you're like, you know what? I had this in the past. I know why my knee is sore. That sucks. It's not much fun. But it can be like, you know, nice and clear. For others, sometimes you may not have a bit of a history. You may not know where it's come from. You're just like, you know what? Actually, when I hike, it hurts. It gets uncomfortable. I'm not actually sure what's going on. And for a lot of people, that can be a bit of a mystery. But regardless of where it does come from, whether you know exactly where that knee pain is coming from, or whether it's just a bit of a question mark.

[6:07] It can be an easy way to really ruin our confidence and our enjoyment out on the trail. It's not much fun. And I talk to hikers every single week who just feel really, really restricted with their hiking. And a lot of people who are considering giving up on their hiking, or at the very least, just not doing some of the adventures they really want to be doing, which is a shame. But the good news is, when it comes down to this, is in 98% of different situations, it is almost always possible to see a positive change with your knee pain while hiking if you're doing the right things. Even if you've got this crazy history in regards to knee pain, you may not ever be back to 100% before the injury or whatever happens, but it's almost always possible to make a positive change, to help you feel more comfortable on the trail, to help you feel more confident to get on bigger adventures.

[6:52] Just help that be a little bit better if you do the right things. And that's what we're gonna be exploring today.

[6:58] Now, first thing, let's cover why knee pain is so common for hikers. And ultimately, a lot of people looking from the outside in, if they're not hikers, they're like, well, Why would this be an issue? Hiking is relatively low intensity, relatively low impact. It's just walking. You know, a lot of people don't really consider this an issue. But as hikers, there are a few common things that may do make knee pain such a common thing and a few factors that really, really do bring into it. Number one is descents. You know, most people, descents are a really, really, really big stress on the knee. When we're going downhill, the knees take a lot more force. When we're going down super steep downhills or super steep steps, they take even more force. And on top of that, if we're carrying weight on our back, for every extra kilo or every extra pound we carry on our back, it puts a hugely disproportionate amount of extra force through our knees. So descents, a lot of hikers will face them. That's a big factor. Number two, uneven terrain. You know, most hiking is not on a nice manicured path. There's ups, there's downs, there's, you know, left to right, there's potholes, there's slippery terrain, there's mud, there's, you know, river crossings, there's scree, whatever it may be. And as we're walking along this uneven terrain, the knee often gets put in these weird and wonderful positions, which can sometimes lead to just a little bit of aggravation. Fatigue is another big factor. A lot of people don't realize this and talk about it, but fatigue is a risk factor in regards to discomfort.

[8:19] And essentially, as we get fatigued, we are more likely to experience pain for one reason or another. And a lot of hikers out there, a lot of people can survive hikes, but a lot of hikers are going out there and they're really at the end of the rope. They're really, really tired by the end of the session. They're getting exhausted on hills. They're just getting really, really, really struggling. And they're just fatigued. And that can be a factor. And also a bit of a mismatch in training, both in general training. A lot of people are training and active on hikers and they'll go to the gym or they'll do training sessions. And that's great for day-to-day life but there's a bit of a gap again between what they're actually doing with their training at home and what they actually need for the trail and sometimes the body's just not prepared or in this situation we're saying before with the health professionals maybe we've been going through a rehab process and it's gotten us ready for day-to-day life but then there is a bit of a gap between being ready for day-to-day life and being ready for a three-hour descent or something like that so there's a few reasons why knee pain can be so common and obviously all of these things it's not like you're just dealing with one of these typically descents, uneven terrain, fatigue all come together, pack carrying all comes together and then sometimes a mismatch in terrain and ultimately all of that together ends up being a bit of a recipe for pain.

[9:28] So typically when it comes down to the usual solution, well, solution in quotation marks we see, when you go online and someone asks a question in a Facebook group or on a blog, or you sort of see something in Google or whatever it may be, someone's like, how do I get on top of knee pain while hiking? Usually the solution that is always first recommended is use a knee brace or tape up the knee. People always, always, always talk about that. And ultimately, there's nothing wrong with these things. Now, a knee brace and taping up the knee, it will help a lot of people. It will give extra stability. It will give extra support. And for a lot of people, that will help things feel a little bit more comfortable. However, and I want to be really, really, really clear on this. If this is all you are doing and you struggle with knee pain while hiking and you're relying 100% on these things, you're honestly making a big, big, big mistake because this is just a band-aid solution at best.

[10:20] Ultimately, the second you stop using this, if this is all you're using, the knee pain is probably going to come back. So if there's a hike where you forget to bring your knee brace, or if the knee brace just wears out and fails and falls apart, or whatever it may be, or you've just been wearing it for months and you're like, yeah, the knee's feeling good now, I don't need it anymore, you go out on a hike, whatever it may be, more than likely the knee pain will come back if this is all you're relying on. And I see hikers from this all the time. Ultimately, if you are dealing with knee pain, Yes, a brace, yes, taping up, it's absolutely fine. Use it if you want, that's fine. But on top of that, you should be taking steps to help build up and support and develop your knee so you're not fully reliant on the brace. So at some stage, if you forget the brace or if it breaks or whatever it may be, the knee is in a better position. And then ultimately, if you just like the brace and you wanna wear it long-term, building up the knee plus the brace, that's gonna be a great combination. So either way, regardless, you wanna be being proactive about it and not just relying on passive solutions. So today, it's a really long wind of saying, I'm 11 minutes into the video, haven't actually gotten to the crux of it. We are gonna be exploring a few different areas of training which a hike of crew consider to best help their knees.

[11:32] So first area of training, let's get into it, strength training. Now, specific structured strength training is one of the single best things a hike can be doing to help their knees for the trail. And essentially, if we can build up the supporting muscles and structures of the knee, you can do wonders at building up, at reducing pain and discomfort, both on and off the trail and helping those knees feel more comfortable, more resilient and reducing that pain. Plus on top of that is if we can build up strength and support and structure, that can reduce the chance of actually more consequential things happening in the future of like actually really injuring ourself or whatever it may be. Strength is really beneficial for that. So strength training, and if we're doing specific structured strength training, it can go such a long way. Now, ultimately, one of the mistakes I see, a lot of people these days, like strength training isn't a foreign concept. A lot of people these days are pretty kind of happy with the idea that strength can build up an area.

[12:32] But a lot of people really, really fall short in regards to this. And a lot of people, when again, when we're talking about knee pain, you go online, you go into Google, you go on Facebook group and you ask whatever it may be. So many people fall into the trap of saying, you know what?

[12:47] I have knee pain or you have knee pain. You should do step ups or you should work on your glutes or you should work on your quads or you should do this and this and this. And that will cure your knee. You know, that's the old school approach to pain management where you used to go see a physio when they say, you know what, you have knee pain, your glutes aren't strong enough, here's an exercise for your glutes, do that for four weeks, your knees will come back and we'll give you another exercise.

[13:10] In all honesty, that's very, very old school approach. It is very, very, very rare that one muscle is causing a problem. It's very, very, very rare where we can sort of say this muscle isn't strong

[13:22] enough. If you work on this, that will cure your thing. And that's the only thing we're doing. The body's more complicated than that. And ultimately, when it comes to the knees, there's always more than one muscle which is supporting the area. And there's always going to be beneficial and value at building up all the supporting muscles which are supporting those knees or what other problem areas you're having. So instead, when we're looking at a training, we never want to get narrow-minded in this tunnel vision of just saying, I need to strengthen my glutes, or I need to strengthen my quads, or I need to do this one exercise, whatever it may be. We want to make sure we're going with a bit of a broader sense, ensuring all the supporting muscles are getting some attention in our training so to give you an idea around the knees and what we want to be working on here i've got a little visual little picture for you i'm going to talk you through the four major muscles which support the knee and if we want to get technical there are more muscles which goes into supporting the knees and other bits and pieces which do have their role but ultimately these are the four major ones which for a lot of people and most people if you can cover these areas if you can build up each of these areas it's going to make a major difference to your knees.

[14:28] Some people may need some other nitty-gritty things and other specific things depending on their particular issue, but these are four things that cut off most bases. So number one is the quadriceps. So in this picture, you can see quadriceps, front of the thighs, four muscles in there that make the quadriceps. Very, very, very, very important about supporting the knees for uphills, for downhills, for flat hiking, for a bunch of things. Quadriceps play a massive role, very, very, very important. Now, there's lots of exercises out there which can build up the quadriceps, things like step-ups or step-downs, great options, things like squats or wall sits or lunges all of those things can be great options for building up the quadriceps so that's one area now area number two is the hamstrings so the hamstrings are on the flip side on the back of our thighs the muscles running on the back of our thighs again they play a really really significant role about supporting the knees and these often do get neglected when people are looking at helping build up the knees so we want to make sure we're covering these, so again there's lots of options here but some ideas are things like deadlifts or single leg deadlifts, hamstring curls, whatever it may be. By the way, in a moment, I'll show you some video examples of a few of these exercises, but there's some ideas there. Other area you wanna look at, number three is the glutes. So the bum muscles, there's a few different muscles that goes into the glutes, but as a whole, we wanna be working these.

[15:42] Ideas here things like glute bridges or hip thrusts or minivan walks and essentially we want to be making sure that's getting developed and on top of that one thing that again often gets overlooked by hikers is the calves so the calves are these low muscles on the lower end of the legs and again they do play a big role in supporting the knees and we can develop this through thing through these things through calf raises so as you can see well hopefully you can see already that the idea around okay i have knee pain and someone says do this exercise it'll sort you out it's very very very short-sighted these four areas we want to be putting work towards and if we can work on these four areas and make sure we are building up them as a whole it's going to be really beneficial for your knees plus as a hiker help you in a bunch of other situations as well so this is what we want to be looking at now let me show you some examples in regards to strength training and just a few of my sort of favorite exercises which fall into this now this particular exercise is called the eccentric pistol squat and this is a really really cool exercise for the quadriceps. So essentially what you're doing here is basically you've got a chair or a couch or a bench behind you and you've got something to give yourself a little bit of support. You can use trekking poles, you can use a broomstick, you can use a chair, whatever it may be.

[16:52] Now essentially what you're doing at the top, you put one foot in the air and essentially we're just slowly lowering down onto that bench and pushing our bum back and slowly slowly lowering down. Then at the bottom we put two feet on the floor and then just stand up with two feet. So we're just going down on one leg, pushing up with two legs. Now, this is a really, really great exercise to help develop the quadriceps, as I said before, specifically developing what's called eccentric quadriceps strength. So strength through the quads as it's lowering down, which in the world of hiking, when we said before, stepping off rocks and stepping off steps can be a bit of a trigger. This is really, really relevant for that.

[17:27] Now, for this particular exercise, if you do find this, if you give this a go and you're like, oh, this is way too difficult, really hurts the knees or something like that, you can basically do this with a bit of a higher box. So you can use a box or a chair, which is a little bit higher. You don't go quite as deep. If you find this super easy, you can use one that's a little bit lower or you could basically take away the supports or you could even have a backpack on your back or something like that. But either way, this is a particular example of a really great exercise which can work the quadriceps in a way that's going to be really specific for your knees while hiking. And it's one of my favorites. Now another example is the single leg glute bridge. So this is a great exercise which can work the glutes, a little bit of hamstrings as well, but the glutes are the bum muscles. This is really common in Pilates, a lot of people have seen this before, but it's really straightforward. You basically lie on the floor, lie on your back, push your hips up to the sky, little pause at the top, and then come down. And really just trying to concentrate on squeezing the glutes, squeezing the bum muscle as you come up and down. Really, really great exercise, but this complements that pistol squat where we're working the quadriceps very, very, very well. Now, with this particular exercise, if you do find this too hard and you're like doing this exercise and you're like, oh, I can't really get to the top or it's just really difficult, you can do like two legs at a time, have both legs on the floor. If you find this really easy, you can put like a weight or a pack across your hips and load it up. They're a really, really cool example.

[18:42] Next one, we want to look at hamstrings. So this is an example of working the hamstrings. It's called the assisted single leg deadlift. So typical deadlifts, a lot of people have seen in the past, can be a great hamstring exercise. I personally like single legged deadlifts for hikers quite a bit, just because they're really, really low risk way of doing this. And a lot of people, you can't really get these things wrong.

[19:03] And a lot of people can do it from home. So essentially, in this example, you're basically on one leg, you've got something for support, like a trekking pole or a broom or hand on a chair. And you're basically keeping one leg relatively straight and just tipping over up and down up and down the idea behind this is working the hamstrings on the leg that's on the floor and a little bit of the glutes as well now for this particular type of exercise if you feel this is a bit too easy you can take the support away or you can just sort of hold on to some weight in one hand and you go with that if you find this a bit too difficult you do it you're like oh this is a bit hard on the knee you can even do this type of movement with two legs and end up doing it with like a normal deadlift with two legs on the floor but this is a nice example here and then for the calves like this is a really simple example for the calves you know most people have been seeing this before calf raises basically one foot just going up and down off a step or off a block or whatever may be essentially just pushing up to the top little pause and then going again really straightforward in this example i'm using barefoot doesn't matter if you use barefoot or shoes or whatever may be now if you find this is a little bit too easy and you're doing this you're like i can do this all day you can load this up with a little bit extra weight with a backpack or a dumbbell or whatever may be if you find this is a little bit hard you can basically use body weight or use two legs at a time or whatever it is there's a really simple example for the carbs there.

[20:15] So essentially they're sort of four examples of those areas, but you know you really can use any exercise as long as they kind of hit those areas. Quadriceps, glutes, hamstrings and calves. And if you can cover those four areas, it'll go a long way.

[20:30] So that's the strength side of things. That is very, very valuable. Second side of things, we want to talk about mobility and how that plays into the role of knee pain while hiking.

[20:38] Now, mobility is essentially like range of motion through your joints. So you can kind of, it's pretty much the same as flexibility, not exactly, but pretty much the same. And ultimately this topic, it is often overlooked when we're talking about knee pain while hiking. Beyond the typical things, some people say, hey, just do some stretching or hey, do a yoga class or hey, do this one thing, whatever it may be. And, you know, in all honesty, you know, that advice is not very helpful because a yoga class, it's like, well, go do 60 minutes of a group class. And I love yoga. I'm a big advocate for it. But if someone says, I've got knee pain, and then they say, go do a yoga class, it's not very helpful. It's not very specific. And the same thing with general stretching. A lot of people like, hey, just do some stretching. But it's like, well, where should I be stretching? What am I doing? And what am I actually trying to get out of this? It's a little bit vague. So essentially, what I recommend is putting a little bit of focus into some specific mobility work and actually know what you're trying to do here. It can often go a long way.

[21:31] Now, essentially, what I'm about to explain to you, I'm about to explain a really, really simple system around mobility and sort of understanding how mobility affects pain. To be clear, this isn't a perfect system. It's not 100% correct, but it's close enough for our respects. And it's simple enough that you don't have to be a professional to figure this out for yourself. So it's not perfect, but it's pretty good. So essentially this particular approach, it's what's something that's called the joint by joint approach. And essentially what it does, it classifies joints in our bodies and all the different joints in our bodies into two different categories. There's stable joints and mobile joints. Now, stable joints are basically joints in this system where they kind of don't want a huge amount of range of motion. They relatively want to just be pretty stable. They don't want to be too loose and they just want to be able to do certain movements, but not have a huge amount of sort of variety in their movements or free range of motion. They want to be stable, basically.

[22:31] Now, the mobile joints on the other side of things are joints that they want to have lots of range of motion. In the perfect world, they want to move in all different directions and just be really, really free. So essentially, we want to be in this system. We're classified stable and mobile joints. So when we're looking at the knees through this system and the lens of this system, the knees themselves are what is classified as that stable joint. In the sense of the knees, they're kind of like a hinge joint. They kind of like to flex and extend, if you can see in the camera here, flex and extend, but they don't want to have a huge amount of other movements. Yes, if you want to get technical, there's a little bit of stuff going on there, but in all honesty, majorly, they just want to be flexing and extending, and we don't want them moving in other areas.

[23:10] Now, on the flip side of things, that's the knees, the joints above and below the knees. So the ankles and the hips, they're the mobile joints, meaning in the perfect world, they're going to have lots of movement. They can actually move in lots of different directions. They're not restricted. They're not too tight or anything like that. So knees are stable. Ankles and hips are mobile.

[23:29] Now, essentially, the way this kind of system looks at things is if the ankles and the hips, which are these mobile joints, if they for one reason or another get restricted or tight which is really really really common for a lot of people essentially when we're going through our movements whether we're walking whether we're running when we're stepping up and down stairs or whatever it may be when we're going through things and the ankles and the hips are tight and the body wants movement through these joints but it tries to find movement and it's like yeah these areas are too tight i can't find the movement i want the body's like well if i can't get it through the ankles or the hips i'm gonna have to find it somewhere else because I need to do this movement. I need to go up this step. I need to actually get here. So if the ankles and the hips aren't going to play game, I'm going to find it somewhere else. And in this situation, what can happen is the body can compensate by allowing a little bit more movement through the knee. So essentially in this hiking context, and we can sort of say, okay, let's put ourselves in the visual of going up a steep step and, you know, stepping up on a step in the perfect world with step, we get a foot flat, we push up all happy days. Now, in a situation, if we went up that step and we were like, ah, you know, the ankles are really, really tight, they actually cannot allow enough range of motion. Sometimes for people, they'll step on that step and the knee, instead of being nice and stable, it'll just collapse inwards because the body will be like, I need to find this movement. So the knee is going to move inwards to get this movement. So I can actually get me up the step. Again, this system isn't perfect, but you can kind of get the idea here. So also ultimately, when we're looking at this.

[24:57] Long story short, you know, this type of thing, if there is a little bit of tightness or restriction somewhere and there's movement happening in other areas, you know, it's rarely by itself is a cause for concern, but it can be another factor when it comes into this whole knee pain picture. As I said before, it's very rarely one thing, but it's usually lots of different things coming together. So ultimately, long story short, if the ankles and hips are tight for you personally and you struggle with knee pain and the ankles and hips are tight, doing a bit of targeted mobility work on these areas can be a good idea. Very long way of saying it, but there you go. So to give you a couple of examples here, I want to show you a few exercises I quite like. This is what's called the needle wall stretch, which is a great way about developing ankle dorsiflexion, also known as range of motion through the ankles, and essentially the ability of your knees to comfortably move over your toes, which is really relevant in the world of hiking for a lot of reasons.

[25:44] So essentially what we're doing here is basically we've just got one foot on the floor, keeping our heel down, and we're literally just moving through this motion where we're just pushing the knee into the wall, getting a little bit of stretch at the back of the calf, and then coming back. And then as things loosen off we bring the foot a little bit further away from the wall just go a little bit further a little bit further a little bit further really simple exercise but can be great for developing this ankle dorsal flexion which can be really useful now admittedly some people do this particularly with knee pain they'll do it like i fell on the ankles but i also felt a bit in the knees it wasn't 100 uncomfortable 100 comfortable so if it is uncomfortable if you give it a go just do another exercise like another calf stretch or whatever may be whatever whatever works for you and we're looking at improving mobility through the calves now for the hips this is a an exercise i like quite a bit it's called the modified world's greatest stretch um it's a really really great exercise to target the front of the hips and also does a bit of the mid back as well um essentially what we're looking at here we've got one foot up forward one foot on the floor on the floor and essentially we're just sort of rotating our torso up and if you give this a go and give this a whirl you'll notice that oh we get a really really good stretch through the front of the hip here and it can feel really really good now again if you do this you're like that doesn't feel amazing and that's fine there's a million and one ways to stretch the front of the hips and so you can just find any other stretch but basically that's a decent option there.

[27:01] So there's some ideas around strength training and mobility work and some example exercises and how that can relate to your knee pain. But I fully understand they're kind of like a bit more of an overarching ideas around that. And it kind of gives you, you know, the ideas, but sometimes it can be a little bit difficult to kind of put this into action or really figure this, how this kind of comes together. So essentially, if you are going through this and you're like, oh, you know what, that's a little bit confusing, kind of makes sense. But how does it all go into action? I have something cool for you. Basically, I have a free hikers knee prevention program, which essentially will give you some ideas around strength and mobility, specifically what we're talking about before, and how you can use that to reduce knee pain while hiking.

[27:41] So essentially, this guide, it'll give you a bit of extra information around knee pain while hiking. But I also included that it'll give you a free 12-week strength and mobility program to help your knees. So it'll give you 12 weeks of training, so multiple phases where we build up and build up and build up and give you a few ideas to help with this type of thing. Now, if you want to download this free guide, you can go to summitstrength.com.au slash hikers-knee. You can plug in the details, you can get delivered to your inbox, and you can check it out there. Now, to be really, really clear, obviously when we're talking about pain, everyone is unique, everyone is different, everyone has got their own particular circumstances. And this is a pre-made program. It's not customized to you. It's not personalized to your situation. So some of the exercises, whatever it may be, you may not love them or you may do it and you're like, oh, that doesn't quite work. But in that situation, just do what you can, work through what you can. The reason this program is free is because that's what it's worth because it's pre-made. It's one size fits all.

[28:40] That's kind of what it's worth. but it can be really valuable. Just give you a bit of a broader context of what we're talking about today and see how it applies into things. And for a lot of people, and we've had a lot of success with this, have seen some pretty good results from it. So if you want to check it out, go to summerstrength.com.au slash hikers dash knee.

[28:55] So, moving forward, we talked about strength, we talked about mobility, let's talk about conditioning. Now, one risk factor, as we mentioned before, when it comes down to knee pain on the trail is fatigue and exhaustion.

[29:05] Now, basically, when it comes down to if we are on the trail, if we're on our adventures, and we get to that point where we're getting fatigued, we're getting really, really tired, we're like, oh my gosh, you know, I'm losing concentration, my legs are heavy, I'm getting huffed and puffed, whatever it may be. If we are getting to that exhaustion point, you are more likely to experience pain. Now the reason behind this is fatigue is essentially is just a risk factor for pain when we are exhausted when we are tired that can just let change our sensitivity to pain in the body and just lead to feelings of pain on top of that the actual area is probably getting tired and probably getting overworked if you're getting really really really fatigued the actual areas that are supporting you know those pain points are probably getting tired so the quadriceps the hamstrings the glutes the cars we talked about before probably they're getting fatigued and not really doing their job and on top of that is when we are at that fatigue point you are going to have much higher risk of having a bit of a misstep stepping in a pothole not having a you know stepping on a loose rock or just having a bit of an accident a slip stumble or fall which can actually aggravate your knee as well so essentially long story short fatigue and exhaustion something we want to minimize as much as we can now to combat this is we essentially want to be making sure we're doing some regular and consistent conditioning sessions in your week to build up your cardiovascular fitness in a way that's relevant for hiking which is going to minimize the fatigue you experience on the trail and reduce the risk of this pain coming on. On top of that obviously having better fitness is going to help you have more fun on the trail so you know you're going to get a lot of benefits out of this.

[30:32] Now, there's lots and lots and lots and lots of different things you can do here. But essentially, what we want to be looking at, ideally, with this type of cardio, is we want to be looking at cardio which is going to be relevant for hiking. Meaning, you're not doing, like, sessions where you're working crazy different intensities. Like, hiking is a slow, steady sport. You're going for long periods of time at a relatively consistent pace. We want to be doing training, which is going to help with that. So, we want to be doing things that are relatively relevant. There might be stuff like pack walking where you just throw on a pack, walk around the neighborhood for 40 minutes or 60 minutes. It might be stair and hill climbing and finding a local hair stair or hill going up and down that or working on a stair climber or something like that. It may be like hopping on a bike and just doing long periods of cycling, whether it's a stationary bike or a bike around an outdoor bike. You may be doing some longer interval training, going to the gym, hopping on a stationary bike or an elliptical, going quick for like three or four or five minutes, resting for a minute or two and repeating that a bunch of times or whatever it may be. So there's a ton of different ways we can develop this. And I've got loads of other content around hiking-specific conditioning. But general rule of thumb is we basically just want to get yourself, improve your fitness. So on your adventures, yeah, you can get tired. Yeah, it's always going to be strenuous. Yeah, you are going to get a bit of fatigue. But you never reach that exhaustion point. That's what we want to be looking at.

[31:47] So now we talked about strength, we talked about mobility, we talked about conditioning.

[31:51] Now I just want to filter in a few little extra tips which can kind of build this out a little bit. Now one thing which is really, really, really, really significant is what's called load management. And this deserves a whole video in itself, but I want to summarize this in a really brief way. Essentially, load management is just managing the amount of stress and the amount of forces that are going through your body, but specifically in our context here, is going through your knees. And essentially, one of the most significant risk factors in regards to your knees getting aggravated is just doing a big jump in load, meaning you're doing something, you're doing something, you're doing something, then one week, all of a sudden, you do way, way, way, way more. That in itself is a major risk factor. And we see hikers struggle with this quite a bit. Now, typically in the hiking context, this sort of falls into when people are just doing big jumps in distance and elevation. So basically people will be like, hey, I'll do a three hour hike one week, then a four hour hike one week, and then all of a sudden I'm doing a seven hour hike or whatever it may be. So essentially, if you do struggle with knee pain, you want to be a bit more intentional about this. If you are the type of person who hikes every single week or most weeks, you can basically make sure there's a slow and steady build in your distances and making sure you're not doing dramatic jumps up.

[33:05] If you're someone who hikes a little bit more inconsistently, so once every three weeks or once a month or once every couple of months, just make sure that you're not just doing massive jumps into distance. And if you are sort of, you know, haven't, it's been a month or two since you've hiked, choose something which is well within your capabilities, but don't push yourself to the limits.

[33:23] Or if you're in a situation where you've been hiking really, really regularly, and then all of a sudden you've been sick for a few weeks, please, when you come back to the trail, don't just go back to where you were before. Give yourself a week or two or a hike or two to ease yourself in. And ultimately if you got out a calendar and you plot i've got out a graph and you plotted all your distances as you went through um or the length of your hikes there's no big jumps in distance but it's nice and smooth up and down whatever you're doing so that's one big thing now another thing that's pretty relevant in the world of hiking um is big changes in footwear so essentially when it comes down to footwear another big recommendation people will often say is like i get knee pain go wear zero drop shoes or wear trail runners or wear this or wear that and everyone is individual everyone will see different results from different footwears. I'm not a big advocate of one type of footwear. People have different preferences and whatever it may be. But one really, really, really, really, really big factor when it comes down to changes in footwear is one big issue is when we change our footwear, whether we go from a full cup boot to a mid boot to a hiking shoe to a trail running shoe to a zero drop shoe, whatever it may be.

[34:27] Each of these changes are going to change the stresses that go through the feet and the legs and the knees slightly because they're different ways of our body striking and moving and there's going to be slightly different stresses going through and what can happen is basically you, If we're hiking, hiking, hiking, one type of footwear, we change that footwear and we keep the same amount of hiking we're doing, all of a sudden some muscles, which haven't really been worked quite as much before, they have a massive jump in load, a massive jump in stress, and that can lead to a little bit of difficulty.

[34:56] So one thing to sort of say is if you are changing your footwear specifically for the knees or not specifically for the knees, make sure you adjust your hiking targets. If you're bringing in your footwear, pull back your hiking for a few weeks and start slow, build up and then get back to normal hiking after that. Just make sure there's not dramatic changes in that because it often gets overlooked. And that's one of the reasons why people are like, oh my gosh, I tried zero drop shoes and I've got all these issues. Um again i'm not a massive advocate for one way or another in regards to drop on no drop but that's probably the main reason why people struggle is they just don't respect that change so keep that in mind um on top of that was also fatigue as we said before respected there's other things we can be doing beyond our train to minimize this so making sure you're on top of your nutrition hydration most hikers out there really do under eat on the trail um most hikers can survive on the trail with barely eating anything but if we want to really optimize our, energy levels and reduce fatigue most hikers probably need to eat a little bit more so nutrition just regularly snacking on the trail making sure we're hydrated if you don't know how to go about things um that's a subject you want to look up on um recovery basically after your hikes just giving yourself giving the body some love um, Do some stretching, do some self-massage, do some calming things, sit in a warm bath, do some meditation.

[36:15] Literally anything that in your mind thinks calming, relaxing, that will be good for recovery.

[36:20] So filtering that in, you know, after your hikes to help with that can go a long way.

[36:24] On top of that, if you struggle with knee pain while hiking and you're not using hiking poles, please use them. They can make such a big difference and they take such a big proportion of stress out of the knees on the downhills, make such a big difference and that's a really, really easy way. And the final thing also talk about is getting exposure to triggers which again it could probably deserve this whole video but something i'll briefly touch on one issues a lot of hikers face with their hiking as we said before there's certain things that can often lead to the knees to get uncomfortable and particularly with hiking it can be things like downhills uneven terrain and pack carrying stuff like that and one situation a lot of hikers will fall into is they'll hike and hike and hike they'll go out on a hike which has lots of elevation a lot of up and down and they'll be like oh my gosh my knees were really really really sore with all those downhills so they're like all right my knees don't like downhills so what i'm going to do in my future hiking i'm going to intentionally avoid this stuff and i'm intentionally going to avoid a certain amount of elevation and i'm going to make sure my knees are happy and that's all well and good for a while while you can avoid these things but at some stage or another you'll probably get exposed to these triggers and hiking is a little bit unpredictable maybe you'll go out and you'll just forget to sort of plan things. Maybe you'll be like, oh, you know what? My friend was going on a hike, they planned something and I jump in and all of a sudden I'm doing a bunch of elevation again. And because the body hasn't dealt with this in a long, long time.

[37:48] That can lead to a flare-up and it ends up being this recurring thing. So long story short, if there are certain things that you're like, hey, this is a trigger for my knee, instead of completely avoiding it, we want to introduce and get some exposure to this in a controlled way. So in this downhill example, okay, downhill hiking hurts my knees. I'm going to avoid downhill hiking for a while because I don't enjoy that. But while I am avoiding that downhill hiking, during my week, I'm actually going to do some hill or stair training to practice those downhills. I'm going to find a hill locally and I'm going to practice this so my body and my knees get some exposure to this so when I see it on the trail it's not so much of a surprise and then you know there is a bit of an art when it comes to this and you know a lot of people are like all right it's a trigger and I practice it I'm like oh my gosh it's uncomfortable so essentially we need to find the amount of this type of stuff which you can do comfortably and build from there so for example on these downhills someone might go out and say I'm going to try and train a stair session, I did 10 minutes of stairs and my knees got sore. Then you're like, okay, let the knees recover. Next week, I'm going to do it again. But this week, I'm just going to do seven minutes.

[38:52] Did the knees get sore? If they didn't get sore, cool. We'll do seven minutes and each week we'll add a minute. We'll do seven minutes, eight minutes, nine minutes, 10 minutes and slowly build up. Or if you do seven minutes, you're like, oh my gosh, that got sore again. Go down to four minutes. And you're like, all right, did four minutes go? Or whatever it may be. But again, this could do, I could speak for 40 minutes on this subject. I was just trying to I cram a lot, a lot, a lot into that.

[39:12] But ultimately, if there are things that trigger the needs, you're aware of it that you may get exposed to on the trail, we wanna get some exposure to that in your training.

[39:21] So, a bit of information to digest there, but hopefully that just gives you a little bit of an overview around how to go about your training to best support your needs with your hiking. Because this is such a common issue with hikers out there, so many people struggle with it, and I know the quality information out there is really, really, really sucks. So hopefully this just fills in a few gaps, gives you a little bit of a broader understanding and a few different ideas to explore with your training. However, I fully, fully understand this can be a little bit of a big subject, like the ideas about, okay, how can I put these ideas into my own workouts? How can I plan out a training program? How can I get that exposure to things? How can I make sure I'm coming on my bases or whatever it may be? It can be a little bit confusing. So ultimately, if you do need a little bit of help putting this all together, I would love to chat with you. As I said at the start of this video, through Summit Strength, we offer personalized training program for hikers to help them get fit, strong, resilient for their adventures.

[40:11] Essentially, what our packages typically include is we will create a custom and personalized workout program to get you ready for anything the trail may throw at you, including strength, cardio, recovery, mobility work, even your hiking as well. We'll give you direction and programming, which is a bit around you, your life, your situation. So you know exactly what you need to be doing and can get the best sort of results through that training for you and your hiking and your knees. Now, on top of that, we also do put a big emphasis into educating you on all the peripheral factors which can affect your knee pain. Things like nutrition, recovery, self-care, things like how mindset works, some different pain prevention strategies, and a bunch of other things that kind of build out the broader context of this type of stuff. And also we'll give you the coaching, accountability, and support to keep you on track because pain prevention journeys and training journeys in general, they're never a linear process. There's always ups and downs. There's things that get in the way,

[41:00] life gets up or whatever it may be. And essentially we make sure we have someone in your corner to help you through things that are going on, keep you moving forward, and keep you accountable. Now, if you did want to find out a little bit more about this type of thing, what you can do is go to summitstrength.com.au slash online. Now, on that page, we have a nice long video which talks about...

[41:19] How we go about our training, how our programs come together, and what it all looks. And if that does sound like something you want to explore a little bit more, on that page, there's a link where you can book a call with our team. We can have a really thorough chat and just learn a little bit about your situation, your preferences, your needs, your knees, your hiking, and just really, really get the full context of you and what you've got going on. And once we've got that context, we've got a good understanding. If it does sound like, look, we're pretty confident we can help you, then we can talk you through one of the packages which we offer, which may fit into your situation. And you can make a decision or we can make a decision together if and how it may be right for you. So with that being said, I really do hope you've enjoyed today's video. I hope you got a bit out of it. I hope you sort of said, you know, this helps a lot of people out there. I know it's a bit long-winded, but hopefully it covers a few bases that a few people haven't explored before. So thank you so much for watching and we'll talk to you soon. Bye.

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