While walking downhill is usually tolerated well by healthy people, overuse or deformity may cause damage to the cartilage under the kneecap, called the patella. Because the exact cause of knee pain can be difficult to pinpoint, you should seek a proper diagnosis before you start any kind of treatment regimen.
Knee Anatomy
Your knee is comprised of tendons and ligaments that attach your three leg bones to your patella. The patella glides smoothly over the bones cushioned by a thin cushion of cartilage. The cartilage helps prevent your kneecap from rubbing against the ends of the bones.
Patellofemoral Pain Syndrome
Patellofemoral pain syndrome accounts for the majority of knee pain felt when walking downhill, up or down stairs, or when wearing high heels. The syndrome often occurs when the patella comes into contact with the femur due to a breakdown of the collagen in the cartilage. The syndrome often occurs with overuse of the knee but can occur in people with deformities of the feet or knees, or weak leg muscles, especially quadriceps. While actual damage rarely occurs, patellofemoral pain can progress to chondromalacia.
Patellofemoral pain is usually treated by avoiding any painful activities, icing the joint, taking anti-inflammatory medication and stretching and strengthening the muscles that surround the knee. If caused by a deformity, treat the underlying condition to help prevent pain from recurring.
Chondromalacia Patella
Sometimes confused with patellofemoral pain syndrome, chondromalacia involves actual damage and fraying of the cartilage under the kneecap and usually occurs in adolescents and young adults. In older adults, chondromalacia can indicate arthritis of the knees.
While walking downhill does not cause chondromalacia, trauma and overuse can contribute to the condition.
Treatment for chondromalacia is similar to the treatment for patellofemoral syndrome. You may require shoe inserts for deformities and surgery is sometimes indicated when pain does not resolve or if signs of arthritis develop.
Prevention
While knee pain can occur without warning, you can help prevent damage to your knees when descending hills.
Maintain a healthy weight. Extra pounds can increase the stress you place on your knees and can cause joints to wear out faster.
Strengthen the muscles that support your knee. Your quadriceps on the front of your thighs and the hamstrings on the back of your thigh help keep your knee aligned, which can help prevent injury. Warm up and stretch your muscles and joints to get the blood flowing. Supple, limber joints absorb shock better and protect your knee cartilage. Increase intensity gradually and don't run downhill.
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