Knee Pain In The Peak District

May 16, 2020

I had a phone call recently from one of our regular patients – Linda from Swanwick who wanted some advice about some new knee pain that she was suffering.
She said ….” I went out into the Peak District at the weekend and Dave (her husband) persuaded me to do the Ridge Walk from Hope to MamTor and back. I was OK to start with, but as we descended back into Hope, both knees started to really hurt and a couple of times almost gave way. I thought they would be ok after a sit down at the tea-shop, but when I tried to get out the chair, I could hardly move. Dave almost had to carry me back to the car and by the time we got home, both knees were red and puffy. What do you think, I’ve done?”

If you’re a keen hillwalker you may have also felt this pain aswell. So what’s going on?

Walking is one of the best ways to enjoy life and one of my own favourite ways to keep fit – it’s awesome exercise, allows your mind to unplug, the local scenery is unbeatable and, most of all, it gets you outside into the fresh air.
Whilst nothing beats the views and the sense of achievement when you reach the top of a particularly difficult hill /fell /mountain many walkers may find the downhill stretch to be less than pleasant.
So what’s going on? What makes even the most agile and capable walkers experience knee pain while going downhill?

The Culprit

The primary reason your knees hurt when walking downhill is because they’re under significantly more stress than when heading uphill or on flat ground. As you descend one leg at a time, the leading knee is obliged to absorb the impact of not only your bodyweight but also the added forces of going downhill and the weight of any rucksack you’re carrying.
Theres been considerable research into this issue and various papers have found that the compressive force between the tibia and femur (your knee joint) is between 5 and 8 times your bodyweight when going downhill!
So even if you weigh in at a reasonable 12 stone, when you’re heading down the hills, your knees are absorbing the weight of 60 -96 stone!!!!! – it’s no wonder they get a little sore.

Of course, not everyone suffers from knee pain whilst walking downhill, and it seems that some walkers are more at risk
For example, if your knee caps don’t align correctly, you have weak or tight leg muscles, you have a previous injury or your feet/shoes give you problems you may be more at risk of suffering from knee pain.

This is exactly what we found with Linda, when she came in for an appointment last week for me to look into her knee pain. Both knees were still sore and slightly swollen, but the main issues I found were that her quadriceps muscles (on the front of her thigh) were much weaker and tighter than expected, and she also had some weakness in her hip muscles (glut medius) which was also a potential cause of her pain. Her right kneecap also didn’t have as much freedom of movement as the ideal.

The Solution

In Linda’s case, we’ve developed an action plan to reduce her immediate levels of pain and soreness and then start working on her muscle strength deficits, kneecap mobility and muscle lengthening.

If you’re suffering from knee pain whilst walking and its affecting your enjoyment of the great outdoors, we would always recommend a thorough assessment from one of our very experienced Chartered Physiotherapists, to establish a diagnosis, the cause and develop a plan to sort the issue out, just like we’ve done with Linda.

 Tim's Top Tip

You may want to consider using walking poles whilst your exercises start to work. Poles help lessen the forces on your lower body, especially when you’re going downhill

Rather than your knees and ankles taking the brunt, poles allow for some of the load to be redistributed to your arms and shoulders.

Strapping and supports can also offer some temporary relief, but should not be relied upon in the long term, as they are doing nothing to address the actual cause of your pain.

You can also look at your descending technique. Slow down and take your time. You may have to take some steep sections sideways.

Hopefully the above tips will help, but ultimately you need to find out the true cause of your problems and then address them. We’ve helped many people over the years get back to walking pain free. If you would like to book an assessment to see how we could help you, please call 0800 246 5817 or book online at CLICK HERE