Up hills and down

April/May here on the Left coast means the approach of Spring. Time for the keen hikers to get (even more) outside and start hitting their stride. With that in mind I was asked last week by a client who loves to hike how her aging knees were going to manage this year? And what is harder, going up hills or coming down?

As usual, the devil is in the details. Going up hills you are doing more work so the aerobic system of the heart and lungs (cardiorespiratory system) get more of a workout. The leg muscles are working in a concentric or shortening work pattern, something they are generally used to doing as the knee works in a  bent to straight cycle, carrying you up the hill.

Coming down is less aerobic work which is why you tend to be less out of breath but the thigh muscle pattern is the opposite of going up. The loading is eccentric or lengthening as the knee starts straight and the bends under the load. This is a tough workout on the thigh muscles and puts quite heavy loading on the back of the kneecap or patellofemoral joint.

Not surprisingly going both up and down gives a balanced workout as you get both a concentric and eccentric workout which is one reason that gym machines like the elliptical or stair climber will let you reverse your action from time to time. Likewise it’s even better for your muscles and knees if your early season can start on rolling terrain rather than all up followed by all down. Any moderately experienced hiker will tell you that too much continuous downhill hiking does have a downside, pun intended. It contributes ┬áto delayed onset (as in over the next three days) muscle soreness and is tough on the aforementioned patellofemoral joints which creates frontal knee pain and sometimes even noisy grating swelling from under the kneecaps.

My advice to my client? Start slowly on rolling terrain and use walking poles for the longer downhills to offload the knees. If possible do some snowshoe hiking through the winter to keep the hiking activity familiar. She will be hiking for many years to come.

Matt

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