Outdoor First Aid

The Cure: Treating Knee Pain

Show your knees a little TLC

Your knees work hard when you play hard. So show them a little TLC at the first sign of pain and you’ll extend your hiking years, says Belinda Brownell, a Colorado-based physical therapist who’s been treating hikers for more than 20 years. Below she explains the probable causes and best treatments for common hiker complaints.

If you feel…

…a persistent ache under the kneecap, your knee may not be tracking properly or the cartilage might be worn down. Hiking downhill or sitting for long periods in a kayak can exacerbate such injuries. Relief could be as simple as getting shoe insoles and strengthening and stretching the muscles around the knee, but it’s best to let a doctor decide which approach is best for you. If pain sets in midtrip, apply a cold pack or snow and take ibuprofen.

…a sharp, shooting pain above or below the knee while hiking, it’s most likely tendinitis, an inflamed tendon caused by overuse. A sudden increase in hiking mileage is the most common cause, says Brownell, followed by tight hamstrings and weak quadriceps. At the first sign of pain, ice the area and rest. If the pain isn’t gone after a few days off, see your doctor. On the trail, take an anti-inflammatory, dunk your knee in a cold stream during breaks, and lighten your load by asking your hiking partner to carry the tent.

…pain around the entire knee area after a fall, you may have torn the anterior cruciate ligament (ACL), the knee’s main stabilizer. This injury is more common in hoops and tennis than hiking, but a fall that twists or hyperextends the knee can cause it. A telltale sign is the knee buckling when you try to stand. Walk out using trekking poles as crutches, keeping the knee bent, and placing weight on your toes. Don’t wrap the knee as it could increase the swelling, says Brownell. Head to the doctor’s office from the trailhead.