【Deep Dive Essays】Knee Pain on the Descent: Why Your Knees Give Out Hiking Downhill and How to Prevent It

Article Info

• Difficulty: Beginner
• Intended readers: Hikers with less than a year of experience who suffer from knee pain, or who want to prevent it
• Article type: Integrated analysis (technique × equipment)
• Keywords: hiking knee pain, knee pain downhill, trekking poles and knees

Introduction

Most people who take up hiking experience knee pain on a descent at some point. You climb strongly all the way to the summit, and then, on the walk back down, a sharp pain suddenly shoots through the inside or outside of your knee. It is easy to dismiss this as “just a lack of fitness,” but fitness is not the only cause.

I have run a full marathon in under three hours, yet I have injured my knees many times. That experience taught me how baseless the assumption is that “if you are fit, your knees will be fine.” Running ability and knee resilience do not necessarily go hand in hand.

Both how you walk (technique) and what you carry and wear (equipment) shape the load on your knees. In this article, we first look at why knee pain occurs, then examine practical techniques and gear choices that beginners can put to work.

1. Why Do Knees Hurt on the Descent?

Most hiking-related knee pain strikes on the way down. The reason lies in how much load the knee joint carries.

On level ground, the load on the knee is estimated at roughly one to two times your body weight. Going uphill it rises to around three to four times. Descending is more severe still: the knee is thought to absorb impacts of four to eight times your body weight, repeatedly, and this load accumulates over several hours.

Two conditions are typical of knee pain on descents. The first is iliotibial band syndrome (Chōkei-jintai-en), known in Japan as “runner’s knee.” It causes pain on the outside of the knee. Repeated downhill movement makes the iliotibial band, a strap-like ligament running down the outer thigh, rub against the bony prominence on the outside of the femur, and this friction triggers the condition. The second is pes anserine syndrome (Gasoku-en), which is a likely culprit if the pain is on the inside of the knee. It is an inflammation of the area where the tendons of three muscles involved in bending and straightening the knee converge.

ℹ️ Glossary

• Iliotibial band syndrome (runner’s knee): Inflammation caused when the iliotibial band, a strap-like ligament running along the outer thigh, repeatedly rubs against the bone on the outside of the knee. It is characterized by sharp pain on the outer knee when going down slopes or stairs.
• Pes anserine syndrome: Inflammation of the pes anserine (“goose’s foot”), the point just below and inside the knee where the tendons of three muscles attach. It appears as pain or stiffness on the inner knee and tends to worsen after long walks.

⚠️ Caution: If the pain is severe, or accompanied by swelling or heat, do not keep walking. See an orthopedic doctor as soon as possible. The measures introduced in this article are intended only for prevention and for coping with mild discomfort.

2. The Technical Side: How You Walk Changes the Load

Basic Posture for Descending

The core of knee-friendly walking is to spread the impact out. A common habit among beginners, often unconscious, is to land hard on the heel with the knee fully extended. This sends the shock straight into the knee joint.

The recommended posture is as follows:

1. Keep your knees slightly bent. Do not lock them out, even at the moment of landing. Consciously use the knee as a cushion.
2. Lean your center of mass slightly forward. If you descend with your weight shifted backward, you tend to land harder on the heel. Tilting your upper body slightly forward makes it easier to land on the middle of your foot.
3. Shorten your stride. Long steps down increase the impact of each step. Aim for short, quick steps to spread the load.

Think About Where You Place Your Feet

On trails with rocks and big steps, where you put your foot matters too. Land on flat, stable ground whenever possible, and avoid putting your full weight on a tilted rock or an unstable surface. This reduces the risk of your knee twisting sideways.

Be More Careful When You Are Tired

Knee pain tends to get worse in the later part of a descent, once fatigue has built up. When the leg muscles tire, their ability to absorb shock declines, and the knee joint takes on the difference. The urge to “get down quickly because I’m tired” is understandable, but the more tired you are, the more carefully you should place each step.

ℹ️ A Step Further: Change the Angle of Your Feet from Time to Time

On a long descent, the same muscles and joints take the same directional load again and again, and fatigue builds up. By deliberately changing the angle of your feet, you can distribute the load across different areas. For example, you can point your toes slightly outward (a bit like a duck walk). On steep slopes, another option is to turn your body sideways and descend diagonally, or to zigzag down. What these methods share is the idea of not using your body the same way for too long.

3. The Equipment Side: Choosing Gear That Protects Your Knees

Trekking Poles: The Most Effective Piece of Gear

When it comes to knee pain, trekking poles deserve special mention. Used correctly, they are thought to reduce the load on your knees during a descent by roughly 20–30%. The principle is simple: planting the poles on the ground lets your arms and core help absorb the impact, so less of it is concentrated on the knees.

What to look for when choosing:

• Material: Aluminum poles are relatively inexpensive (about ¥5,000–12,000, roughly US$35–80) and durable. Carbon poles are lighter but cost more (about ¥15,000–30,000, roughly US$100–200). For beginners, aluminum is enough.
• Length adjustment: Choose poles whose length you can adjust to your height. As a baseline, the grip should be at the height of your hand when your elbow is bent at 90 degrees. Set them a little longer for descents and a little shorter for ascents.
• Folding vs. telescoping: Folding poles pack down small and are easy to store. Telescoping poles make fine length adjustments easier. Each has its advantages and drawbacks.

Basic technique:

On a descent, move the pole opposite to your stepping foot forward at the same time (if you step with your right foot, move the left pole). Plant the poles slightly ahead of you and lean some of your weight on them as you descend, so that the impact is shared with your arms.

Hiking Footwear: Check the Sole and the Fit

Impact on the knee begins at the foot. Footwear that balances cushioning with stability forms the foundation of knee protection.

What beginners should check:

• Sole stiffness: A sole that is too soft feels unstable, and your foot wobbles easily. For day hikes, the standard choice is a hiking shoe or trekking shoe with a reasonable degree of stiffness.
• Ankle support: Mid-cut shoes limit sideways ankle movement better than low-cut ones, which in turn helps limit twisting at the knee.
• Fit: If your foot slides forward on descents, your toes jam into the front of the shoe and the balance of your whole foot is disrupted. When trying on shoes, always walk down a slope to check the fit.

💬 TOM’s tip: Visit a proper shoe store such as ASICS and have them measure whether you overpronate or supinate.

Knee Supporters and Other Support Gear

Knee supporters and taping are worth considering as supplementary options. However, they are not a fundamental solution. Masking the pain with a supporter and then pushing on can even make symptoms worse.

Bandage-style wrap supporters are available at retail from about ¥1,500–3,000 (roughly US$10–20). Types that support both sides of the knee are considered effective at limiting the sideways wobble that occurs on descents.

4. Integrated Analysis: Technique and Gear Work Only in Combination

Technique and equipment have limited effect when used alone. Even if you focus on how you walk, your footing stays unstable without suitable boots. Conversely, even with excellent gear, your knees take the same load if you keep walking with fully extended legs.

Combinations by situation:

Case study:

M, a woman in her 40s with six months of hiking experience, developed pain on the outside of her right knee in the latter half of every descent on her day hikes. Watching her walk, it became clear that taking long steps and landing with a fully extended knee had become a habit, and she did not carry trekking poles.

Two changes were made: (1) consciously shifting to short steps with a bent-knee landing, and (2) adopting trekking poles (aluminum, telescoping). From her next hike on, the pain eased, and from about the third hike she was able to descend with almost no trouble.

As this example shows, correcting technique and adding equipment together tends to produce the best results.

5. Summary

✅ Key points:

• Knee pain on descents tends to occur because impacts of four to eight times your body weight are repeated again and again
• The three basics of walking are a bent-knee landing, short steps, and a forward lean
• Trekking poles are the most effective piece of gear, thought to reduce the load on the knees by roughly 20–30%
• Check the stiffness and fit of your boots; mid-cut models are easier for beginners to handle
• Technique and gear are two wheels of the same cart; either one alone has limited effect

Knee pain is a challenge that many hikers face at least once. But by understanding the cause and addressing both your technique and your equipment, you can prevent it to a considerable degree.

Don’t rely on gear alone, and don’t try to tough out the pain either. Combining how you move your body with the right tools is the mindset that should underpin a long relationship with the mountains.

Next Step: Train Your Knees on Days You Are Not in the Mountains

Alongside improving your technique and gear, strengthening the muscles around your knees through everyday training is another effective long-term approach to preventing knee pain.

Squats and single-leg squats

The most important muscles for protecting your knees are the quadriceps (front of the thigh) and the hamstrings (back of the thigh). When the two are well balanced, shock absorption on descents tends to improve markedly. For squats, bend to around 90 degrees without letting your knees travel past your toes. A good starting point is 10–15 repetitions a day, about three days a week. Once you are comfortable, move on to the Bulgarian split squat (a single-leg squat with your rear foot raised on a bench), which trains the single-leg loading that hiking demands.

Use stairs on the way down

Getting your knees used to downhill movement in daily life is another option. Taking the stairs down instead of the elevator is structurally close to descending a mountain trail, and it can be expected to help muscles, tendons, and joints adapt gradually. The ground rule is that you should stop if it causes pain.

Combining with running

Running trains your cardiovascular fitness and leg strength at the same time, so it is worth considering as supplementary training for hiking. On the other hand, running with poor form can itself trigger iliotibial band syndrome. If you have had knee pain while hiking, start with walking on level ground, confirm that it does not hurt, and then move to jogging gradually. Light running for about 30 minutes, two to three times a week, is a reasonable baseline for building the legs for hiking.

ℹ️ Note: If you have an existing knee condition, or feel pain during training, consult an orthopedic or sports medicine specialist before continuing.

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北村智明

登山ガイド

日本山岳ガイド協会認定登山ガイドステージ2。ガイド歴10年。東北マウンテンガイドネットワーク及び社会人山岳会に所属し、東北を拠点に全国の山域でガイド活動を展開。沢登り、アルパインクライミング、山岳スキー、アイスクライミング、フリークライミングと幅広い山行スタイルに対応。「稜線ディープダイブ」では、山行の記憶を物語として紡ぎ、技術と装備の選択を語る。