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Sometimes the return trip on a hike can be mentally tough. You just came through this section earlier, so you don’t have the same excitement as before. It may be getting dark and you are starting to get hungry. You just can’t wait to get back to your car and hit the local brewery for a beer and a pizza. The good news is that, unless you were hiking down into a canyon, your whole route is now downhill. This is great for your energy levels and ability to speed through the trail. You start flying down the trail. There’s one question you probably didn’t think about, however. “How is this affecting my knees?” The answer starts with talking about your muscles.

Your muscles generate 3 different types of force.

  • Concentric: your muscle shortens as it produces force against another force to move your body or an object. Example – as you go up a step on the trail, your quad activates as you lift your body up against the force of gravity.
  • Isometric: your muscles produce enough force to equal out another force and your joint stays in the same position. Example – let’s say as you go up that step, your back foot comes off the ground, but you stop and let it hang in the air for a moment while you wait for your friend to catch up. That period of time where you are stopped is caused by isometrics.
  • Eccentric: muscles slowly lengthen to gradually let your joints be overcome by another force. Example – as you move down a set of steps on the trail, you are slowly progressing down to the next step. The quad needs to be able to generate enough force to control the movement and prevent gravity from completely overwhelming you.

Eccentric force is the focus of this article and is an often neglected portion of muscle strengthening. Eccentrics place the most stress on the tendons of the muscle, which is what attaches your muscles to bone. Reach down and feel your kneecap. Find the lower-most point of the kneecap and feel the piece of tissue that connects it to the small bump that’s near the top of your shin. That is your patellar tendon, and it is the area most affected by downhill hiking. Every time you take a step down, this tendon takes the load of a lot of stress as your quadriceps work to control your descent down the mountain. If done frequently and with poor mechanics, it can lead to inflammation known as patellar tendinitis, commonly called “jumper’s knee.” Its characteristic sign is pain directly on the patellar tendon, especially when going down stairs.

I’m going to give you an easy step-by-step process to aid in relief of symptoms if you believe you have patellar tendinitis.

  1. Ice directly over the knee focusing as much as possible on the patellar tendon for 10-15 minute
  2. Place your thumb directly on top of the tendon and massage it side-to-side for 5 minutes.
  3. Lay on your stomach and place a strap around your foot on the affected side so that you are able to pull your foot toward your buttocks. Hold that stretch for 30 seconds and repeat for 5 repetitions.
  4. Here is where we work on building that eccentric force. Find a small step stool or go to a bottom step at your house. Keeping your affected leg on the step, bend it enough to slowly and gently tap the unaffected leg on the floor and return to your original position. Repeat this for 30 repetitions and do 3 sets. If your step is too high to do this comfortably, place some books on the floor where you are tapping your foot until it as at an appropriate height.
  5. Repeat ice on the knee again.

Try this program 1-2 times per day for a few days. If you do not notice any improvement after that period of time, it would be wise to consider consulting a physical therapist or other medical or rehab professional to help take care of this. There are other issues, such as foot structure and hip strength, that play a significant role in causing patellar tendinitis that may need to be assessed to fully avoid further problems. If you are unsure about anything you read in this post and want more info, email me at scott@backcountry.physio or reach out on Backcountry Physical Therapy’s social media pages. Be sure to check back on the website for more blog posts and follow us on social media for helpful tips to keep yourself painfree!