Hiking, walking and trekking with healthy knees

Walking in Qatar and trekking abroad

In Doha, walking usually means the Corniche, Aspire Park, neighbourhood parks, malls in summer, or the indoor and shaded tracks around the city. Many residents also plan holidays that involve serious walking: mountain treks in Oman, Nepal or East Africa, long city breaks, or pilgrimage, where many kilometres are covered in a few days.

The problem for many people is the jump from flat, short walks at home to long days with steep climbs and descents. The knee usually copes well with walking itself; it struggles with a sudden increase in load.

Why going downhill hurts more

Going uphill works the muscles hard but is relatively easy on the joint. Going downhill is different: the thigh muscles act as brakes while lengthening, and the force through the kneecap can be several times body weight with each step. This is why the front of the knee often aches on the way down a mountain, on long staircases, or the day after a trek.

Pain on the outer side of the knee during long walks, especially downhill, is often iliotibial band syndrome. Pain along the inner joint line with clicking or catching may be a meniscus problem. Generalised aching and morning stiffness in older walkers is often arthritis.

Preparing for a trek

• Build walking distance over several weeks, adding about one longer walk each week.
• Train on stairs or inclines, including the downhill part, to prepare the thigh muscles. Stair climbing in a tower or a treadmill on an incline works well in summer.
• Strengthen the thighs and hips twice a week with squats, step-downs and bridges.
• Practise with the backpack you will carry, because extra weight adds load to the knees.
• Wear footwear you have already broken in, with good grip.

Walking poles, braces and pacing

Walking poles take some load off the knees, especially on descents, and help with balance on rough ground. Set them a little longer for downhill sections. Shorter steps on the way down reduce the braking force through the kneecap.

A simple neoprene sleeve may make some walkers more comfortable, although it does not fix the cause. Plan rest days on multi-day treks, and do not push through sharp or increasing pain. If the knee swells, rest it, elevate it and use ice in short sessions.

Walking with knee arthritis or after surgery

For many people with knee arthritis, regular walking is part of treatment. It keeps the muscles strong and the joint moving. A useful guide is that mild discomfort which settles within a day is acceptable, while pain or swelling that lasts into the next day suggests the distance or terrain was too much.

After knee replacement, walking is encouraged from the start, and many patients enjoy longer walks and gentle hiking once recovery is complete, often after several months. After ACL or meniscus surgery, the distance and terrain are built up gradually under physiotherapy guidance. Check with your surgeon before a demanding trek.

When to see a knee surgeon in Doha

Book an assessment if your knee swells after walks, locks or catches, gives way on uneven ground, or if pain lasts more than a few weeks despite reducing your distance. If you are planning a demanding trek and already have a knee problem, an assessment a couple of months beforehand leaves time to treat it and build strength.

Seek urgent care if you develop calf pain and swelling after a long trip, or if a fall on a trail leaves you unable to bear weight. At Aman Hospital, Dr. Gelber will examine the knee, and arrange imaging only when it will change the plan.