You feel euphoric when you reach the summit or traverse the ridge line, but if you suffer from knee pain, anxiety sets in when you think about going down - especially after a multi-day backpacking trip. That's because the downhill seems to aggravate your knees the most. A new study contributes to the growing evidence that muscle weakness contributes to this kind of knee pain. But how can you climb without problem, hike long distances, and still have muscle weakness? Your body is excellent at getting the job done no matter which muscles it uses. So, one possibility is that you're substituting a stronger muscle for a weaker one, and that substitution is placing stress on your knee. Another is that you're strong when doing concentric activities (using shortening contractions) but not when elongating or eccentrically contracting, like what is necessary for descending. Lastly, since most hikes start with climbing, it's likely that the muscles needed to control your knee on the way down are tired and unable to keep the stress off the knee.
So, how do you know which muscles are weak? A new study conjectures that a weak quadriceps muscle changes the biomechanics of walking and places undue stress on the knee, resulting in greater wear and tear. Researchers at the University of California San Fransisco measured thigh muscle volume in 134 subjects, 67 of whom went on to undergo total knee replacement (TKR) and 67 controls who did not. They found that those who did not need a TKR had a higher ratio of quadriceps volume to hamstring volume. Higher overall hamstring volume was also associated with decreased odds of needing a TKR. This study makes a lot of assumptions - including that muscle volume is a reliable indicator of strength - and does not prove any causation between muscle volume, strength, and TKR. However, it contributes to the evidence that strength, specifically quadriceps strength, helps maintain joint health. While unable to say that quad strength will prevent the need for a TKR, many clients report that including strength training in their fitness routine helps decrease knee pain and improves their hiking experience.
Exercises that strengthen your quadriceps include:
Lunges
Squats
Leg lifts
Machine knee extension
Step-ups
And more advanced exercises like:
Jump Squats
Bulgarian Split Squats
Box Jumps
Pistol Squats
Integrating quadriceps strengthening into your off-trail fitness routine is one of the essential components of a pain-free hiking experience!
Are you ready to hike farther with less knee pain and more enjoyment, but struggle with the mentioned exercises? Schedule a consultation with Alicia Filley, PT, MS to find out if The Healthy Hiker's Easing Knee Pain Group Training Program is right for you! This fundamental program begins with exercises that keep your knee comfortable while building strength! Not ready for lunges and squats? No problem!
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