If you're experiencing lower leg and knee stiffness while hiking downhill, you're not alone. The condition results from overuse of the knee and is a common complaint among hikers. The exact cause is likely one of the three most common overuse syndromes. See your doctor for an exact diagnosis and for treatment so that you can get back on the trail.
Patellar Tendinopathy
Patellar tendinopathy is a common hiking overuse injury of the knee. The patellar tendon is at the bottom of your knee and connects your patella, or knee cap, to your tibia, or shin bone. The tendon enables your thigh muscles to extend your lower leg. The constant extension of the knee required for hiking downhill can cause tiny tears in the patellar tendon that your body is unable to heal fast enough before you cause new tears. The anterior pain and stiffness that result gradually becomes a constant ache.
Patellofemoral Pain Syndrome
Patellofemoral pain syndrome is another common knee overuse condition that results from hiking. It happens when the patella, or knee cap, is no longer tracking properly on the femur, the bone in your leg. The misalignment can cause the underside of your knee cap to wear down. The pain and stiffness start out feeling like they are coming from around or behind your knee. The pain and stiffness are especially intense when you hike downhill. The knee eventually hurts all the time.
Iliotibial Band Syndrome
Iliotibial band syndrome is the third common overuse injury that hikers experience. The iliotibial band is a thick fibrous tendon that starts at your hip, travels down your leg and crosses over your knee cap to your tibia or shin bone. The frequent flexing of your knee joint during hiking can cause too much friction between the tendon and the knee cap. This causes the iliotibial band to become irritated and inflamed. The anterior pain and stiffness become worse when you hike downhill.
Treatment
Treatment for all three conditions starts with resting and elevating the knee, icing it for 20 minutes at a time and possibly taking anti-inflammatory medications or getting cortisone shots. You may also have to wear a knee brace. When the pain subsides, you will have to undergo physical therapy to strengthen the muscles that support the knee and stretch the iliotibial and patellar tendons involved. In cases where the knee does not respond to physical therapy, surgery may be needed.
References
- "American Family Physician"; Common Overuse Tendon Problems: A Review and Recommendations for Treatment; Dr. John J. Wilson, et al.; September 2005
- "American Family Physician"; Management of Patellofemoral Pain Syndrome; Dr. Sameer Dixit, et al.; January 2007
- "American Family Physician"; Iliotibial Band Syndrome: A Common Source of Knee Pain; Dr. Razib Khaund, et al.; April 2005
