The sport of hiking is no walk in the park. You spend hours climbing and descending hills, which requires strength and endurance. However, even the fittest athletes can suffer swollen knees after hiking. The constant flexing of the knee is often too much for some parts of your body. The most common injuries fall into two categories.
Iliotibial Band Syndrome
The iliotibial band stretches from your hip to your knee. It's a band of thick, fibrous tissue that crosses over your knee cap. The constant flexing of the knee from activity such as hiking can cause friction and irritation of the iliotibial band. The resulting pain and swelling first present after a hike. With increased irritation, it will occur during a hike, especially going up and down hills when you put the most pressure on your knee. Eventually you'll feel the lateral pain even when you're not hiking.
Treating Iliotibial
Treating iliotibial band syndrome is challenging. Your doctor will first order you to stop all flexing of the knee. You'll need to ice the knee for 20 minutes at a time and take anti-inflammatory drugs such as ibuprofen. If that doesn't alleviate the pain and swelling, you may need a cortisone shot. Once the intense pain subsides, you'll have to work with a physical therapist to stretch the iliotibial band and strengthen the gluteus medius muscle that supports it.
If you're like most patients, you'll improve in three to six weeks. This therapy is not effective for everyone, however, and surgery may be necessary to release the iliotibial band where it crosses the knee.
Patellofemoral Pain Syndrome
Another overuse injury from hiking is called patellofemoral pain syndrome. It results when the patella, known as the knee cap, is not tracking properly in its groove in the femur, the bone in your thigh. This pain presents as a feeling behind or around the knee cap. You'll feel it more intensely when you're going up and down hills, again because of the pressure you're placing on it. Resulting fluid in the joint causes swelling and pain.
Treating Patellofemoral Pain
Treatment for patellofemoral pain syndrome is usually accomplished with stretching and strengthening exercises. Initially you'll have to rest the knee and stop flexing it, ice it for 20 minutes at a time and possibly take anti-inflammatory drugs.
Once you can move the knee without intense pain, your doctor will have you work with a physical therapist to strengthen the muscles in your thigh that stabilize the knee cap, the quadriceps. This is usually successful but if it's not you may have to consider surgery to smooth the underside of the knee cap where the femur is rubbing against it.
References
- American Family Physician; Common Problems in Endurance Athletes; David D. Cosca, et al.; July 2007
- American Family Physician; Iliotibial Band Syndrome: A Common Source of Knee Pain; Razib Khaund, et al.; April 2005
- American Family Physician: Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment; Mark S. Juhn; November 1999
