Elderly man experiences swollen and painful knees after hiking
Mr. Wang (pseudonym), in his 60s, is generally in good health. During the Double Ninth Festival, seeing the fine weather, he invited several old friends to hike up Purple Mountain. The fresh mountain air and scenic views lifted everyone’s spirits, and they all agreed to push on to the summit for the breathtaking view. Upon reaching the top, Mr. Wang felt some pain in both knees. Thinking it was just his body adjusting after a long break from exercise, he assumed a bit of rest would fix it. But on the way down, the pain in his knees intensified, and by the time he reached the bottom, both knees were so swollen he could hardly move. He was then taken to Zhongda Hospital for treatment.
Doctors found that Mr. Wang’s joint pain was caused by an episode of osteoarthritis triggered by the climb. Dr. Xu Xiaofei, deputy chief physician of the Rheumatology Department at Zhongda Hospital, explained that when hiking or climbing stairs, the moment you push off to step up, your knees bear a weight equivalent to 7–8 times your body weight. While climbing can strengthen the limbs—especially the thighs—it is not considered a particularly healthy form of exercise.
Dr. Li Yonggang, chief physician of the Orthopedic Surgery Department at Zhongda Hospital affiliated with Southeast University, who has conducted years of research on sports injuries, said that many elderly people in Nanjing especially enjoy hiking in autumn and winter. They believe it strengthens their physique and benefits cardiovascular health, but often overlook the need to protect their knee joints.
Hiking and climbing can exacerbate friction between the cartilage surfaces of the knee joints, increasing pressure on them. Coupled with age-related bone density loss and degeneration, prolonged weight-bearing can accelerate wear and tear, leading to knee joint damage. In severe cases, it may even cause joint deformities requiring surgical intervention.
Descending is more harmful to the knees than ascending
Director Li Yonggang further explained that when descending, the impact on the knees under the load of one's body weight is very significant. The added weight makes the knees more prone to injury. He advised hikers to wear knee pads when going downhill and to learn the technique often recommended by orthopedic doctors: never run or jump while descending, keep a slow pace, reduce stride length as much as possible, lean your center of gravity slightly backward and lower it. Try to minimize the weight you carry, keeping it under one-third of your body weight if possible.
Experts recommend that middle-aged and elderly hiking enthusiasts consider using a trekking pole. With the aid of a pole, the pressure on the knees during hiking is greatly reduced. Additionally, the upper arm that holds the pole can help share the load on the legs. In this way, hiking—a typically lower-body-focused activity—becomes a coordinated full-body workout involving both the upper and lower limbs, resulting in more balanced and comprehensive physical exertion.
Experts suggest that middle-aged and elderly individuals avoid frequent hiking and instead engage in gentle aerobic exercises such as jogging or Tai Chi, practiced consistently over the long term. Moderate aerobic activity not only helps maintain joint health but also relieves stress and promotes mental and physical well-being. However, when practicing Tai Chi, avoid adopting too low a stance or performing overly deep movements; don’t strive for extreme postures but instead adjust according to your own capabilities.
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How to protect your knees and hike scientifically
Warm-up exercises are absolutely essential, especially preparatory movements for the lower body such as leg stretches, knee bends, and ankle rotations. Start at a slow pace, and after some time, you can gradually increase speed or duration—but avoid overly intense activity, keeping the session to around 30 minutes.
Pay attention to your posture when going up and down hills (or stairs). When ascending, lean your body slightly forward. As your leading foot steps onto a stair, push off forcefully with the trailing leg rather than letting it merely support your weight. When descending, to prevent increased pressure on the knees, slightly bend your knees as your leading foot touches the next step. Land on the ball of your foot first, then transition to your entire foot to cushion the impact on the knee joint.