How to Prepare Your Knees for Long-Distance Backpacking

Knee care from someone with crappy knees

After a psychotic mileage increase during my college running days, I blew out both my knees and ended up in physical therapy, sobbing for the entirety of my  half-mile treadmill sessions because I  just. wanted. to. run. As  runners and hikers are aware, knee problems are among the most common injuries associated with endurance activities, carrying weight, and jarring descents. Luckily, there are precautions you can take to help prevent knee injuries and alleviate  flare-ups.

I’m the one giving the thumbs-up. I’ve always had injury-prone, inward-facing knees.

Before You Go: It’s a little late for current thru-hikers to do pre-hike prep. But for anyone planning a 2015 thru-hike or other long-distance backpacking trip, strengthening the muscles around your knees is imperative for aiding stability. Your knees take the brunt of jarring steps, so the poor guys will appreciate any help they can get.

I like the first three exercises below—I’ve used them to strengthen supporting muscles for my wobbly knees. As a bonus, here’s a computer-generated image of a generic woman doing the exercises. More details on the drills can be found here.

1) Quads: Place a pillow under your thigh. Raise your toes and press down on the pillow with your leg, holding for 10 seconds. 10-15 reps.

2) Hamstrings: Lie on your back with your knees bent and your toes pointed up. Dig with your heels and push back without moving your butt. Hold for a count of 10, 10-15 reps.

3) Leg Raises: Bridge up, with your shoulders and one heel on the ground. Raise one leg straight with your toes flexed, then raise and lower your leg (without bending your knee) 10 times. Keep your hips aligned throughout.

 Aim for 3-4 sets per week, increasing the difficulty as you get stronger.

Descending NH’s White Mountains can be painful. I wrapped my knees wrong, and didn’t help myself at all. Watch the below video from people who know what they’re doing.

On the Trail: The most common source of knee pain comes from  IT band syndrome—aggravation of the tissue along the outside of your knees. IT band syndrome has threatened to end some of my steeper hikes. Massaging the area, or foam rolling if you have access, can help reduce pain. Braces  help as well—I like the Cho-Pat Dual-Action Knee Strap, a popular choice for distance hikers. Elastic bandages provide support, but make sure you wrap it correctly to avoid hindering movement. Here’s a riveting video on how to correctly wrap your knee.

This article from Backpacker Magazine has some soul-crushing ideas about where your knee pain stems from (cartilage disintegration? EEK!), but also includes helpful tips for assessing the pain. You can also preserve your knees by side-stepping down steep grades, using hiking poles to help absorb impact, taking zeros and icing when necessary, and using supportive braces/wraps. Happy hiking!