Keep Hiking All Summer With Four Tips for Knee Health

Portland is surrounded by amazing hiking. We have trails that offer views, trails that challenge our strength and trails that meander through quiet meadows. Taking good care of our knee joints today will allow us to comfortably enjoy all of these trails for many years to come. 

First, a bit about knee anatomy. The two largest muscle groups acting on the knee are hamstrings in the back and the quads in the front. The quads straighten the knee and the hamstrings bend the knee. The balance in strength between these muscles is an important component of knee health. The quads are often stronger than the hamstrings; in order to achieve balance we need to strengthen the hamstrings and stretch the quads. 

Strengthen Your Hamstrings

Many of us experience pain in the back of the knees and thighs or buttock while hiking. Pain in these regions is often due to hamstring tension. While our first instinct is to stretch the hamstrings, it is often more important to do strengthening exercises for the hamstrings. Here are two exercises for hamstring strength.

Glute bridges: Lie on your back with knees bent to 90 degrees and feet flat on the ground. Lift the pelvis off the ground and hold for one breath. Return the pelvis to the floor. Try starting with two sets of 10 repetitions. There are many variations of the glute bridge to make the exercise more challenging. 

Dumbbell deadlift: Stand with feet hip-width apart. Have a light dumbbell in each hand. This is your starting position. Hinge forward at the hip while allowing the knees to bend slightly. Keep your back flat and lower the weights along your shins. Then, keeping your core strong, push through your heels and return to the starting position. Try starting with two sets of 10 repetitions. 

Foam Roll Your Quads

The quad muscles, in the front of the thighs, are often the strongest muscles in the lower extremity. In order to balance out all of the forces pulling on the knees, it is essential that we create length in the quads by either foam rolling or stretching. 

Foam rollers for the quads are 10-inch diameter hard foam tubes. They can be found at most exercise equipment stores or online. 

How to foam roll your quads: Start by lying on your front and placing the foam roller under the top of one thigh. Bend the opposite leg away from the roller. Allow your weight to settle in your forearms and shoulders. While using your upper body for support and to control the pressure, slowly move your body weight forward allowing the foam roll to roll towards the knee. If you find sore places, hold over those areas for an extra breath. 

Foam rolling can be very uncomfortable at first; this changes quickly with practice. We recommend starting with 30 seconds to a minute on each quad two times a day.

Manage Downhills Carefully

The knees experience heavy compressive forces while going downhill. Being mindful of your movements will minimize the impact of these forces. Instead of locking your knees when descending steeply, keep your knees slightly flexed and maintain a slow, steady pace. 

Try walking in a zig-zag motion, rotating the pelvis left and right so that the knees don’t always face downhill while descending. Remember to stay controlled and go slowly.

Invest in Your Footwear

Having footwear that is in good condition and well-fitting is important for maintaining healthy knees. Make sure you have enough cushion under the heels to absorb the impact forces; this protects the knees. There are many inserts to help you achieve a tighter fit and increase under foot cushion. 

Your shoes or boots will need to be upgraded regularly. We recommend buying new hiking boots or shoes every 500-1000 miles. Remember it costs more to fix knees and feet than it does to buy new gear.

Many Portland stores have experienced staff that can help you choose footwear that is right for you. We have found the staff at REI particularly helpful. 

We look forward to seeing you on the trails this year! 

Oliver Leonetti L.Ac is a Certified Sports Medicine Acupuncturist and Co-founder of Inner Gate Health & Wellness. Learn more at

Editor’s note: Wellness Word is an informational column which is not meant to replace a healthcare professional’s diagnosis, treatment or medication.

Keep Hiking All Summer With Four Tips for Knee Health

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