Knee Pain After Hiking - The Most Common Causes And How To Treat Them

A man wearing a blue jacket

Every hiker knows that nothing comes close to the exhilaration of completing a hiking trail, especially a long-distance one.

They also know that the whole experience is not all roses, and there are many issues you can encounter during hiking.

One of the common problems hikers face is knee pain after hiking.

If you’ve ever experienced this kind of knee pain, or you’re currently going through it, we feel you.

It hurts like hell, doesn’t it?

No matter how severe the knee pain is, it’s important to know what to do if you find yourself in a situation like this.

It’s good to know what helps alleviate the knee pain, at least as a stopgap, until you get medical help.

When talking about knee pain after hiking, it’s essential to know what caused the pain in order to do something about it. This also includes recognizing the symptoms.

In this article, we’ll get down to the nitty-gritty of knee pain after hiking. Stay tuned till the end cause it’s a five-minute read. No need to thank us later; we’re here to help!

What Are the Causes of Knee Pain After Hiking?

after a hike, going downhill will make your knees sore


Before you’re able to treat the issue, you have to know the cause. Going at it blindly can only make matters worse, so it’s vital to know why your knees hurt after hiking.

What Hiking Downhill Does To Your Knees

Imagine you’re going downhill, and your knees start to hurt. Plenty of us have felt this kind of pain in the knees before, and we’re certain you’re no exception. Even the most agile of hikers have been in this situation.

So, what gives? Who’s the culprit?

The main reason your knees hurt when walking downhill is that they’re under much more stress than when climbing or walking on even terrain.

As you go down one step at a time, the leading knee absorbs the impact of your body weight plus the force of going downhill and the weight of your backpack.

There’s one study that explains how the compressive force between your tibia and femur (the knee joints) is between seven and eight times your body weight!

You think your backpack is heavy? Imagine how your knees feel!

Now you understand why we insist you get proper hiking boots - your legs and knees will be forever grateful.

That being said, some hikers are more at risk of getting knee injuries than others.

A lot of factors contribute to the possibility of getting hurt on the track, like previous injuries, weak or imbalanced leg muscles, and so on.

Below, you’ll find the most common symptoms described briefly. If you experience ANY of them, contact your physician to get effective treatment - now is not the time to play doctor (nor is it ever, really).


This is a condition that affects bursae - small fluid-filled sacs that cushion the bones, muscles, and tendons near the joints.

When these little guys (bursae) get inflamed, the pain gets pretty ugly.

If this is what’s troubling you, you’re knees will:

  • Feel stiff, sore or achy
  • Look red and swollen
  • Hurt more when you press on them
A group of people going downhill
A hiker on the downhill


Meniscus tear

This one tends to happen when you kneel down while carrying a heavy pack or when you’re going down a steep hill. If you take just one wrong step and feel or hear a popping sensation in your knee, that might be it.

A torn meniscus is actually one of the most common knee-related injuries in general, not just among hikers.

The main symptoms are:

  • Knee pain
  • Swelling
  • Stiffness


In addition, you may also feel a block to knee motion or trouble extending your knee fully.

ACL damage

An ACL injury is a sprain or a tear of the anterior cruciate ligament, a strong band of tissue that connects your femur (thigh bone) to your shinbone.

It commonly happens due to a sudden stop or change of direction you’re moving in, and the signs include:

  • Severe pain
  • Rapid swelling
  • Popping sensation
  • Loss of range of motion
  • Instability and pain when putting weight on the knee


Synovial plica syndrome

You’re probably thinking - “Now they’re just making up conditions.”

As ridiculous as some of these sound, they’re all real, and some are quite serious.

Let us elaborate on this one:

The plica is a fold in the membrane that surrounds your knee joint. This syndrome happens when plica is inflamed after overuse, and you experience symptoms such as:

  • Achy pain rather than shooting or sharp pain.
  • Pain that gets worse when using stairs, squatting, or bending.
  • Trouble sitting for long periods of time.
  • A feeling that your knee is giving out.
  • A cracking or clicking sound when you bend your knee.


Iliotibial (IT) band syndrome

When the iliotibial band (a thick band of tissue that runs from your hips to the back of the knee) gets inflamed, tight, or swollen after overuse, it's called iliotibial (IT) syndrome.

Most commonly, pain presents on the outside of your knees but can spread all the way to the hip.

Patellofemoral pain syndrome

Often called runner’s knee or hiker’s knee, the patellofemoral pain syndrome is a syndrome that causes you to feel pain at the front of the joint or in the kneecap.

With this condition, the pain increases with movement, be it running, sitting for hours on end, walking up and down the stairs, kneeling, or squatting.

If the pain doesn’t improve within a few days, it’s time to visit your doctor.


The location of the pain is typically the inner side of your knee, just below the joint.

The most common cause of bursitis is frequent kneeling or a blow to the knee. It can also occur after strenuous activities or overuse.

Prevent Knee Pain After Hiking

Knee tendinitis

Knee tendinitis, or patellar tendinitis, is an injury to the tendon that connects your kneecap - patella - to your shinbone.

Tendons connect the muscle to the bone, and when a tear occurs, they eventually get weak and inflamed. Ouch.

The first symptom you’ll have is knee pain. You can always try home remedies before visiting your doctor, but make sure to pay them a visit if the following happens:

  • The pain worsens and doesn’t subside.
  • There is redness and swelling around the joint.
  • The pain interferes with your ability to perform mundane daily tasks.


This condition usually happens due to overuse, i.e. too much stress on your knees.

If you have knee tendinitis, you’ll be no stranger to pain above or below your kneecap.


This is a chronic condition that involves a deterioration of collagen in your tendons (the thing that connects the bones and muscles) as a consequence of overuse.

The name resembles the previous one, but this one is actually more serious than tendinitis.

Tendinitis is an acute condition, meaning it’s short-term. With tendinosis, there’s no actual inflammation, but the tendons are degrading. This condition can occur as a result of untreated tendinitis.

It’s crucial to see a doctor if you feel:

  • Knee pain when you move
  • Stiffness and restricted movement in the affected area
  • The appearance of a tender lump (rare)
A hiker enjoying the view

How to Prevent Knee Pain After Hiking

While reading about the possible causes, you’ve probably noticed how many times we’ve mentioned the word overuse.

We can’t stress it enough - don’t overdo it.

You’re familiar with the old “prevention is better than cure.” Well, we couldn’t agree more with this one.

When it comes to any hiking-related injury, it’s always better to be safe than sorry.

Hiking often puts you in positions where it’s impossible to receive urgent medical care, so getting injured on the trail can be a nightmare.

Here are a few things you can do to stay safe and reduce the risk of hurting your knees on a hike:

Get proper shoes

Wearing the right shoes can make or break your hike.

Not only will they minimize the chances of knee injuries, but your feet will also be forever grateful you’ve provided them with a comfy and supportive home.

The best hiking shoes are those that fit perfectly and provide plenty of cushion to relieve excess pressure on your joints. They should be tight, but not too tight, so your feet could have some room.

They should also be waterproof, able to withstand all weather elements.

Don’t forget to stretch

Before hitting the trail, make sure to do stretches to warm up for the demanding hike.

Long and slow stretches will warm up every muscle, provide elasticity and prevent any possible injuries that occur after spending hours on the trails.

Start every hike with a stretching routine; it only takes a few minutes of your time, and you’ll be thanking yourself later!

Don’t overpack

We get that one can easily be tempted to pack a bunch of stuff while being well aware you probably won’t need most of it on your hike.

Overpacking is not a problem when you’re traveling by car, but having to carry all that weight on your back for miles on end, certainly is.

An overly packed backpack will only put unnecessary weight on your back that your joints won’t be able to support for long.

This type of pressure is what usually causes inflammation in your knees. Your muscles and knees will have to work overtime to support the weight, so don't be surprised to see an inflammatory reaction later on.

Before you pack, make a list of the things you’ll actually need and use, like water, food, sunblock, a first aid kit, fresh socks to keep your feet dry, a waterproof blanket to stay warm, and so on.

Get support garments

Additional knee support, like a brace or kinesiology tape, could really help prevent getting injured on the trail.

It restricts joint movements and provides you with stability.

Get a hiking pole

Trekking poles, or hiking poles, whatever you call them, can make a huge difference in every hike.

Some research shows that these poles are super effective in distributing the pressure away from your knees, so they help reduce the chance of a knee injury.

Take it slowly

There’s absolutely no need to rush! Take your time and conquer trails patiently. Slow and steady wins the race, after all.

Going too fast puts additional stress on your knees, which can lead to serious injuries.


How To Relieve Knee Pain After Hiking?

Here’s what you can try to do to get rid of some of that unbearable pain.

At-home remedies

If your pain is mild, you could treat it with some at-home remedies before moving on to invasive treatment options.

This includes applying ice packs to your knees to reduce the swelling. Repeat it three times a day for about 10-20 minutes for the best results.

You can also try using heat and see how your knee responds to it. If your knee likes it, alternate the application of ice and heated packs.

Last but not least, keep your knee elevated whenever possible. If you’re resting on the bed, put a pillow below the knee. Make sure to keep your entire leg elevated, not just the knee.

Physical therapy

A specific routine of stretching and conditioning can help with knee pain.

This one has to be prescribed by a physical therapist; you should never come up with a routine on your own as you don’t know what can help you the most.

Stretching and similar activities are a great way to relieve the pain, and best of all - they keep your muscles moving!

Your physical therapist can help you learn a full-body stretch routine that involves your glutes, arms and shoulders, knees, and so on. This can serve as an exercise before a challenging hike.


Well, this one is more than obvious. It goes without saying that you should never self-medicate.

In general, no hiker should deal with any pain, inflammation, or injury on their own.

After a hike, pay a visit to your physician and even do a full body checkup. It can't hurt to see how your body is doing after feeling all the pressure of being outdoors on long and demanding trails.

Always consult a doctor, describe what you feel down to the nuts and bolts, and adhere to the prescribed course of treatment.

The treatment options will depend on your condition, but the most commonly prescribed are RICE (rest, ice, compression, and elevation), and anti-inflammatory drugs.

Knee Pain After Hiking - The Bottom Line

Knee pain after hiking - bottom line


Knee pain is a problem you may or may not face after hiking. Whether it’ll happen or not depends on a myriad of things, some of which are out of your control.

If it does happen, the important thing to do is to identify and track the symptoms. Some people keep symptom diaries, where they write down first appearance, duration, pain level, pain-free time, etc.

This could be of great help to your doctor in figuring out the correct diagnosis and treatment, so we suggest you try it.

To treat the pain, you can always try at-home remedies, but if the pain doesn’t subside, visiting your doctor is a must. Going to the doctor is not enough for pain relief, though - you have to actually adhere to their advice.

And if you're all about prevention like us, consider investing in things that'll help reduce the chance of knee injuries. Hiking poles, supportive hiking boots, or a knee brace can be a lifesaver.

Also, don't try to deal with inflammation or injuries on your own; we strongly advise against any extreme pain relief techniques.

Our last piece of advice - make sure to give your body some free time to rest between hikes. While being outdoors on a hiking track is hands down the best feeling ever, make sure you rest your legs before you set out on another, hopefully pain-free, hiking adventure!

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