TFT2: How To Prevent Knee Pain While Hiking

Knee Pain When Hiking and trekking is one of the most common issues I hear on a daily basis. And it is one way to suck all the enjoyment out of your adventure...

This episode will teach you:

• The reason why knee pain is such a common issue while hiking the trail
• Why the common recommendations for knee pain are 'band-aid' solutions at best
• A short anatomy lesson which can help you understand where your pain is coming from
• The simple 3-Step solution to hiker's knee (which has helped dozens of my clients hike pain free again!)
  
  

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Episode Transcript:

So, welcome to episode number two, of the Training For Trekking Podcast. Now, today I'm going to be talking about the single most common issue that I hear from my trekkers and my hikers, which affects them on the trail, and something that's really, really frustrating for many people, because it can take a lot of the enjoyment, and a lot of the fun, and a lot of the excitement out of an everyday adventure, and just turn it into a real hassle. And, that is the dreaded hikers knee.

Now, in all honesty, probably about three out of four trekkers that come to see me, that I talk to on a daily basis, suffer from some type of knee pain on the trail. And particularly, when you're going down hills. Now, the reason why this is so common is, because when we're hiking and trekking, and when we're walking down Hill, the knees can take a whole bunch of force.

In fact, when we're going downhill, it can take up to six times more force than you would usually, when you're walking on the flat. And, considering this so many of these extended descents, when we're going on these beautiful trails, it's no wonder the knees take a bit of a battering. And then, this is also not even considering the fact that you've got load on your back. So, every extra kilo that you carry, either in body fat, or on load on your back, puts a really highly disproportionate amount of extra force onto your joints, and particularly your knees and your feet.

So, even if you're having 10 kilos, 15 kilos, or up to 20 kilos on your back, this can absolutely grind your knees down, and it is not much fun at all. Now, the reason why we're talking about this today is because it affects so many people, but also because, for me in my past, I've had to deal with this with quite a few of my clients. Now, in particular, a teaching story always use is, my girlfriend Allie.

And so, she's had a real long history of knee pain. So, she grew up as a dancer, she grew up as playing a lot of netball, which is probably the worst thing in the world for many, many people's knees. And, she's dealt with quite a few knee issues and throughout our life. Now, a few years ago, before we got together, she went over to Nepal, and she did part of the Annapurna Circuit. And, she had a really, really good time, absolutely enjoyed herself.

But, I think when she was coming down from Poon Hill, she was starting to get some really bad pain in her knees. So, she was already tired, she was fatigued. And then, just going on this extended descent, she was really, really suffering. And, in her words, as she was going through, it got so bad, that she was literally crying on the way down. And, that whole excitement and beauty of that adventure, over the years, has really been clouded in just that memory of just really, really hating her time going downhill.

And then, when we first got together, and we went on our first hike together, and we're in the beautiful Ku-ring-gai Chase National Park near my home, we did this beautiful trail, which is the Jerusalem Bay Track, which is about 14 kilometers, and it was absolutely lovely. We were a little bit unconditioned, so by the end, we were pretty tired. But unfortunately, the very, very last kilometer of that track is this disgusting access road, which is probably about 30 degrees concrete road, just straight down. And, at this stage, I didn't really know about her history of knee pain, she didn't have any trekking pole, she'd hadn't really done any training, and she was in agony going down that, and we had to basically walk her down backwards, I had to hold her arm, take about half her body weight, and it took us a long, long time to get down.

So, seeing I knew what to do to fix this, and you know, I did it every day, I dealt with hikers and trekkers, and I've been a trainer for many, many years. I sort of made up my own mission. And, I was like, "Hey, Allie, I'm going to fix this for you." And, if you've ever tried to train or do any physical activity with a partner, you know that's a bit of a touchy subject. But, seeing it was such an issue for her, she actually let me help her. And so, today we're going to be talking about the process which I've used for Allie, to help fix her knee pain, but also not only for her, but for dozens and dozens of my other clients, who have gone out on the trail and they've suffered, and this is what we're going to be talking about today.

So, there's a three step process I take my clients through to help them with their knee pain, and we're going to be working through that right now. So, to start with is, the first thing I look at is mobilization. So, a really, really short anatomy lesson, here. In the body, your joints, in general, want to do one of two things. They either want to be stable, or they want to be mobile. Now, your knee joint is a joint that really wants to be stable, so as opposed from the usual flexing and extending that it does day to day, it doesn't really want to be too much more movement through that joint. There will always be a little bit, but we more or less want to minimize that.

On the other hand, there's your ankles and your hips. They both want to be mobile. Meaning, they want to have a quite a big range of motion, they want to move freely, and just do what they need to do. Now, unfortunately for 90% of the population, both the ankles and the hips tend to get really, really tight. And, unless you have a history of hypermobility, or you had a history of ankle injuries, this is probably going to be you. This is caused from a whole bunch of different things. So, from the hips, it's just from sitting down all day at our desk, on the couch, in the cars. From our ankles, it's from wearing... most people are wearing some type of heeled footwear, like guys and girls these days, from flip flops, from running, from dancing, a whole bunch of different things. But basically, these joints tend to get really, really tight.

And, what happens is, when we're walking or doing any type of movement, if the body can't find movement in these joints, which should be mobile, it'll try and find movement somewhere else. And, what happens, it'll allow more movement through the knee joint, and that is often a really, really, cause of pain. So, in order to help fix this, if you do have, if the clients do show that they have tight ankles, a tight hips, put a big emphasis on loosening this up. So, if this is you, you really need to put a bit of emphasis here.

So, I usually do that through three different ways. So, number one is, through regular foam rolling, or self-myofascial release. So, most people, I'm sure have seen foam rollers at home, or in the gym. They're really, really effective at just helping release the muscles. There's a little bit of debate about how they actually work, but basically, everyone knows they work. But, maybe the science behind it is a little bit confusing. But, we don't need to talk about that today.

But basically, spending a little bit of time each day foam rolling the calves, and also getting into the hips. Sometimes, if it's a bit tough to do that, you can do it with a tennis ball, or lacrosse ball, or if you're out hiking and you know that they're really, really tight, you can literally get your water bottle, and do exactly the same thing, and that can help release it. On top of that is, regular stretching. So, the standard stretching, which I'm sure you've done in the past, which is all pretty old school. Just finding a nice stretch, and holding that, trying to do regular stretching for there. So, most people's idea of stretching is maybe doing 20, 30 seconds after a workout, which you know, it might feel good, but doesn't really do so much. But, trying to do maybe two, three, four times a week of holding these stretches for at least a minute at a time, for a couple of times. So, particularly, as I said, in the calves and the hips, and this can go a long way.

And then, third is, one that's really, really neglected from hikers, trekkers and any type of mountain athletes is, warming up before you exercise. So, most people when they're hitting the trail, they'll just literally start walking, and getting into it. But, if you have a history of knee pain, you really need to be aware that that's not a good thing, and you're going to be putting a lot of pressure into these joints in these first few minutes of you walking. So, spending five minutes before, at the trail, and before you actually start walking, stretching out these muscles is going to go a long way for you. So, that's step number one, and that applies to the majority of people. As I said, unless if you'd had a history of hypermobility, you probably know who you are, and that might not be so relevant for you, but for most people, that's going to be pretty spot on.

Step number two is then, we want to strengthen the supporting muscles. So, this is quite often, again, neglected in a hiker's preparation, strength training as a whole, is usually pretty undersold and under utilized, but it's probably the single most significant thing you can do to help reduce pain on your knees. So, what I mean by this is, the stabilizing muscles, which are the quadriceps, the hamstrings, and the glutes, they all need to be strengthened. If they're not strong enough, and they fatigue too early on the trail, they won't be able to protect the joints, as you go, in the downhill. So, you really need to get serious about this.

So, exercises which I always prescribed to my clients, for the glutes are going to include mini band walks, which involve putting a rubber band around your knees, and doing little crab walks, glute bridges, which involve you lying on the floor, and pushing your hips up to the air, single leg dead lifts, which are glutes and hamstrings, but they're very, very effective for strengthening this up. And then also, things like dead lifts, or Romanian dead lifts, or normal dead lifts. And then, when we're looking at our quadriceps, doing things like squats, lunges, step-ups, step-downs are probably one of the single most effective exercises for this. And yeah, really, really trying to strengthen up these joints.

Now, one thing I will say is, quite often people who don't have so much experience training in the gym, and if they do go to the gym, they might see the leg extension machine, and be like, "Look, this is going to be really, really good for me to strengthen up my quads." I would say that's probably not the best thing to be doing if you do have knee pain. Mainly for the fact that, for a whole bunch of technical reasons, leg extension puts a fair amount of pressure through your knee joint, and if you're already suffering from pain, it might not be the best idea for you. So, just be wary of that.

Once you've strengthened the joints. So, I usually recommend doing, for all hikers and trekkers, trying to do two strength sessions through the week, and that doesn't have to be in the gym, I might add. Like, a lot of these exercises you can do at home, it's very, very achievable. But, once you have put all that into action, then the third step is to get your equipment right. So, I'm not huge into talking about equipment, and I'm not going to be talking about a huge amount on this podcast, but the two things that we do need to be aware of when it comes to knee pain.

Number one, trekking poles are an absolute must. Now, trekking poles are good for whole bunch of different reasons, but specifically for your knee pain. They've been shown to take up to 30% of the pressure off your knees, when you're walking down Hill, which is absolutely huge. And, that in itself is complete justification why should be using them. Also, they've been shown to improving movement efficiency when you're going uphill. So, what that means is, it's going to reduce the fatigue on your muscles. So, it's going to allow them to stabilize a little bit longer, and it also is going to improve your balance. So, the slips, falls, stumbles, sometimes they can put a bit of extra pressure through your knee. So, minimizing that in any way possible is always going to be a good thing.

And then, secondly is, if you are wearing boots, you want to be getting them fitted by an expert. So, these days, internet shopping is so easy and you can just get things at a click of a button. Really, really not a good idea when it comes to your boots. The same as if you're just helping yourself in a shop, and you might be feeling shy, and not wanting help from the attendant, 100% speak to someone, because even the slightest misfit of your boot can really, really put on big repercussion through your body. So, 100% get on that.

So, that's the three step process I usually go through, my clients. Obviously, that type of stuff isn't a magic bullet, it's not going to happen straight away. Mobility and strength in particular, does take consistency and time to develop. The equipment stuff, you can put into place pretty quickly, and it can make a really big difference. One extra bonus tip, which I tend to get my clients to do, is a hiking technique that's something called the heel push, and this is really, really effective when you're going up hills, when sometimes you can take a fair bit of pressure in your knees, and a lot of fatigue in your legs.

So, when you're in the gym environment, when you're doing squats or step ups or launches, a particular cue, most people will tell, when you're trying to teach it, is to try and push through the heels, and not through the toes. And, the idea behind that is, that gets the hamstrings and the glutes doing a little bit more work when you're pushing through the heels. But, if you're pushing through the toes, that's just going to put a lot of pressure in your knees. And, this is exactly the same thing as when you're going up hills, and stairs on the trail. So, if you're going up a stair on a trail, try to plant your heel, as opposed to walking up on your toes, and if you're going up hills, try to plant your heel, again, as opposed to just being up on your toes all the time. Even that one simple change can make a huge, huge, huge difference on the trail. And I really, really recommend you trying it out. Particularly if you're doing stair sessions and you're training, and you're doing lots and lots of stairs, this is really, really important to do.

So, all of those things ,in my eyes, are very, very, very effective for preventing knee pain on the trail, and it's not just in my opinion, but it has been proven time, and time, and time again, with my clients, so I highly, highly recommend you give it a go. Now, obviously that is a lot of information to take in, and if you don't have so much of experience with the strength training side of things, or the mobility side of things, you might really not know how to apply this, and put this into action, but I've got you there, so do not worry.

A little while ago, when I first realized this is such a problem, and I realized there's solutions out there weren't really so great, I developed this ebook, which is called the Hiker's Knee Prevention Guide, which I give out to my people on the internet for free. Basically, it talks about all the stuff we talked about today. But then, at the end, it has a 12 week training program, which focuses on the mobility and the stability side of things. So, that not only gives you structure, not only gives you direction in your training, but also gives you progression. So, over 12 weeks, you're not just doing the same things over and over and over again, and the body's not really getting better, but it improves over the weeks, and makes it tougher, and helps your body develop. And, from all the feedback I've gotten from this program, so far, since I've released it, everyone's said, who's actually gone through the program, they've said it really, really helps. So, I very much recommend that to you, and it'll be available down in the show notes, to download completely for free, so help yourself to it there.

But, I think that's about it for today. So, I really hope you've gotten a bit of information around there. If you do have knee pain, I hope that's going to help you, and if you'd know anyone who suffers from that on the trail, I highly recommend you pass this on to them, because these adventures, and these hikes, these treks and everything, they're such an amazing time, but you don't want it to be clouded in pain. So, I really hope this can help you, and I hope you can take away from it. So, that's enough for me today. Thanks for stopping by, and we'll talk to you soon. Bye.

You've been listening to the Training For Trekking Podcast. So, if you've enjoyed this episode, please remember to subscribe, rate, and review us in iTunes. So, thanks for getting involved, and we'll see you on the next one.