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Any Advice about how to strengthen my knees for down hills.

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It would be helpful to know where your pain is when you are walking downhill.

I discovered that I needed to work on stretching and massaging my IT band to relieve pain that I got on the outside of my knee when I walked downhill.

I have zero medical background, but I've learned that the cause of the pain is often not the same place where you feel the pain.
 
On 2 previous caminos I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.

I'd go to see a Physio as a first step.
These things are complicated........ :oops:

I get knee pain on downhills, but it's due to a multitude of reasons.
Arthritis, Bursitus, split meniscus etc etc.

Your causes are likely to be different and require different 'fixes'.
 
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Zig zag down steep hills and use poles correctly. But also get advice from a Physio and/or a Sports medicine Doctor now. I (Anne) have arthritis in my knees and elsewhere, and had quite a bit of discomfort and pain during our Caminos in 2022. I was recommended by my Physio to exercise regularly on an exercise bike or go cycling. I have done the former and hoping that will help for our Camino this year.
Buen Camino.
 
In addition to the constructive suggestions above, I found that walking Caminos with an ample supply of Ibuprofen worked well for me. I use the anti-inflammatory as a preventative measure when on a Camino.

Carrying as little weight as possible helps a great deal. My pack is so light that luggage transfer are just not worth the effort or constraints. :)

Doing research on what is causing your knee pain ( perhaps while waiting for that medical appointment ) may help get an accurate diagnosis more quickly. Bob & Brad might be a good start.

Good luck, and buen camino.
 
On 2 previous caminos I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.
I'd go to see a Physio as a first step.
@Robo said that. Pay attention.
 
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You're possible walking wrong.
That is also a useful comment.

Have people wondered why "athletes" are trained in proper techniques for running?
The same idea of training on good technique for walking for everybody not just athletes can often also be valuable.

I imagine many people don't know what good technique is or possibly haven't even thought about it. It doesn't come naturally to everybody. Whilst meandering around at home it is not a big deal I suppose, but the damage from poor walking can accumulate from 500 or 1,000 kms, over any terrain, amplified by postural change from a packpack.

The holy grail for a Camino: Walk with good form all the time, and with 2 poles most of the time. Be judicious with the Ibuprofen.
 
On 2 previous caminos I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.

Twice in my life I’ve sought medical help for pain in my knees. The second was from a minor injury, the first was when I was training for my camino and was experiencing pain on the outside of my knee, while going downhill.

What I learned from my first visit to the physio all those years ago was the importance of strengthening my knees through lateral movement. It involved resistance exercises using elastic bands. You can check online for knee strengthening exercises, and try these while you wait for your doctor / physio appointment. But do get that expert opinion.
 
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I would only add to the guidance above is that when walking downhill a) go slowly b) gently place your foot down and not "bang" it down as it is so easy walking down rather than up c) when very steep slalom is good but also, as I have big feet, is to go down at an angle using poles if a narrow track i.e. facing at 45 degrees to the descent not straight down.
 
I would only add to the guidance above is that when walking downhill a) go slowly b) gently place your foot down and not "bang" it down as it is so easy walking down rather than up c) when very steep slalom is good but also, as I have big feet, is to go down at an angle using poles if a narrow track i.e. facing at 45 degrees to the descent not straight down.
Hmm. one could sit on one's arse and slither down? :) Have done this quite involuntarily on a few occasions! Saved wearing out the knees but wore out the pride! Have fun and Buen Camino

Samarkand..
 
On 2 previous caminos I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.
Myself, I make good use of my poles to make sure yhe ground is solid and for balance. No matter how " steep", I never walk straight down, I create my own switchbacks, zigzag or slalom, call it what you will, and take my time.
 
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Your feet can affect your knees. Going downhill you may be prone to landing on your heels more than walking on the level and more powerfully because of the height difference. This shock gets transferred up your shins to the knees. Discuss landing on the balls of your feet with your expert.

Also, I had knee problems walking my caminos, not noticeably more downhill though. I discovered it was caused by overpronation of a foot when landing due to an undersupported arch. May as well have this checked out at the same time.
 
Definitely get a professional opinion here to help diagnose the muscles that are being strained. PT or reputable personal trainer would be my first stops. There are lots of exercises to strengthen the knee generally and they can be targeted to what your particular problem is. I would not rely solely on walking techniques and think it’s important to strengthen the muscles surrounding the knee joint before you start. I have had knee problems on a couple of caminos and thanks to my physical therapy, I now have a couple of quad and hamstring exercises incorporated into my exercise routine. Since then, I haven’t had any problem. Good luck and buen camino!
 
Agree a good PT is in order, and the suggestions offered here are all consistent with the advice I received from mine. I did the Norte/Primitivo last spring, and I think the combo of poles (I think two are best for this purpose), bent knees and smaller steps worked for me. I still had some swelling after some of the longer descents, but with some ibuprofen and an application of Bio Freeze to aid recovery it was manageable.

For what it's worth, I will add that as part of my recovery from an earler knee injury, my PT recommended including backwards walking in my training - the idea being if you're only walking forward, you only develop part of your leg muscles; walking backwards helps develop the whole muscle (and that to prevent knee injuries you also need to strengthen the muscles above and below the knee).

The advice was to alternate 1-2 minutes of backwards with 3-6 minutes of forward throughout the walk. Although the injury healed before I began my Camino, I found that it was so helpful that I continue to try to do it 2-3 times/week - I found it really works leg muscles in ways that forward walking doesn't - I seem to be able to walk for miles going forward feeling almost nothing in my legs, but after a few minutes walking backward, I feel the fatigue in the muscles and particularly on uphills/downhills feel a different stretch in the psoas, which makes me think it's doing something and must be helpful, so I've kept it as part of weekly routine. Your foot also strikes the ground in a different fashion, toe to heel instead of heel to toe.

It's probably safest to do this on a local school track, but I live in a relatively low-traffic area and found a nice 4 mile loop with relatively smooth roads, crossing to the other side of the road for the backwards portions so that while walking backwards I can see cars coming. I know where the smooth parts of the road are, so that's where I turn around to walk backwards, using the side of the road and the middle lane marker to stay centered; I've been doing it long enough now that I barely turn my head to keep on track or avoid bumps/holes. It's slow going at first until you get used to it, and obstructions in the road can be a real hazard. At the time my PT recommended this strategy, I remember reading several articles on it (mostly about backwards running - some claim that you burn more calories backwards, even if it is slower - who knows, that's not why I do it ). It's also an interesting conversation starter! I've had runners, cyclists, even people in cars stop to ask me about it, hahaha!
 
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Agree a good PT is in order, and the suggestions offered here are all consistent with the advice I received from mine. I did the Norte/Primitivo last spring, and I think the combo of poles (I think two are best for this purpose), bent knees and smaller steps worked for me. I still had some swelling after some of the longer descents, but with some ibuprofen and an application of Bio Freeze to aid recovery it was manageable.

For what it's worth, I will add that as part of my recovery from an earler knee injury, my PT recommended including backwards walking in my training - the idea being if you're only walking forward, you only develop part of your leg muscles; walking backwards helps develop the whole muscle (and that to prevent knee injuries you also need to strengthen the muscles above and below the knee).

The advice was to alternate 1-2 minutes of backwards with 3-6 minutes of forward throughout the walk. Although the injury healed before I began my Camino, I found that it was so helpful that I continue to try to do it 2-3 times/week - I found it really works leg muscles in ways that forward walking doesn't - I seem to be able to walk for miles going forward feeling almost nothing in my legs, but after a few minutes walking backward, I feel the fatigue in the muscles and particularly on uphills/downhills feel a different stretch in the psoas, which makes me think it's doing something and must be helpful, so I've kept it as part of weekly routine. Your foot also strikes the ground in a different fashion, toe to heel instead of heel to toe.

It's probably safest to do this on a local school track, but I live in a relatively low-traffic area and found a nice 4 mile loop with relatively smooth roads, crossing to the other side of the road for the backwards portions so that while walking backwards I can see cars coming. I know where the smooth parts of the road are, so that's where I turn around to walk backwards, using the side of the road and the middle lane marker to stay centered; I've been doing it long enough now that I barely turn my head to keep on track or avoid bumps/holes. It's slow going at first until you get used to it, and obstructions in the road can be a real hazard. At the time my PT recommended this strategy, I remember reading several articles on it (mostly about backwards running - some claim that you burn more calories backwards, even if it is slower - who knows, that's not why I do it ). It's also an interesting conversation starter! I've had runners, cyclists, even people in cars stop to ask me about it, hahaha!
Interesting that you should mention backwards walking. I’ve just been reading about that, and have ordered a bicyclist’s rear view mirror which should arrive today. Good for you for trying it.

 
Interesting that you should mention backwards walking. I’ve just been reading about that, and have ordered a bicyclist’s rear view mirror which should arrive today. Good for you for trying it.

Great! Go for it! Eager to hear if you find it helpful!
 
Barring any foot misalignment problems (which many of us have), the most common cause of knee problems is weak hips. The poster who spoke of soreness on outside of knees going downhill described an iliotibial (IT) band problem. The IT band does not stretch, so no amount of stretching will fix it. The fix is a prevention with a series of hip strengthening exercises. An appointment with a physio or exercise physiologist should be your first move. It is what they do. Forget doctors--they do not have anywhere near the training for those issues.
 
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On 2 previous caminos I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.
Hey Billy, Checking with you doctor for starters is good advice. That may lead to referral to physical therapy and/or trainer to work on this area. If you’re cleared to do so, consider training with a dummy load in your pack and poles and include some downhill work. Kind of hard to do downhill here in Florida, so I trained going up and down steep bridges and golf course berms. Good luck!
 
On 2 previous caminos I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.
Practice down hill with your poles to determine the technic that works best for you. Poles are an absolute game changer on down hill hikes. They take a significant amount of stress off of your knees.
 
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On 2 previous caminos I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.
Suggest you get opinion from a physio well in advance. Knee pain can originate from a hip problem, for example, and a professional can diagnose and advise re course of action. I have a dicky right knee and find poles invaluable, particularly going downhil.
 
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Barring any foot misalignment problems (which many of us have), the most common cause of knee problems is weak hips. The poster who spoke of soreness on outside of knees going downhill described an iliotibial (IT) band problem. The IT band does not stretch, so no amount of stretching will fix it. The fix is a prevention with a series of hip strengthening exercises. An appointment with a physio or exercise physiologist should be your first move. It is what they do. Forget doctors--they do not have anywhere near the training for those issues.
Excellent advice.

Progressive ankle, knee, thigh, hip pain, eventually led me to a very experienced Pedorthist.

He provided a detailed diagnosis and prescription to my family doctor and provided a referral, along with detailed notes on foot and leg alignment/injury issues, to an experienced Physiotherapist.

Then there is the most patient and kindest 😇 Dietitian, and a couple of nurses into vigorous strength training to relieve stress - true life savers. Turns out all are life long distance walkers. None have done a Camino - yet. :)

One Nurse just said - gluteus maximus.

Perhaps - accurate diagnosis?
 
All good advice here. Another downhill method I use, with also slight knee bend and using poles, is to step down with the feet a few inches farther apart than usual. This causes your centre of gravity to sway left and right over your feet; in effect, a built-in trail switchback. I learned this via Katy Bowman - she is a biomechanist who has written several books on proper movement and also has lots of information available on the web.
 
There is lots of good advice and suggestions above. I just want to add a word of encouragement and reassurance to all of that. I developed really terrible knee problems on my 2016 Camino. I needed lots of ibuprofen, knee braces, and poles right to the end to see me through. But it can get better. In 2023 I walked the Salvador and the Primitivo, two routes with lots of mountains and steep descents and had no issues. I did take poles right from the start but never had a need for a knee brace, or even a sleeve, or any ibuprofen. So just because your knees were a problem on a previous Camino doesn't mean they have to be on your next.
 
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Barring any foot misalignment problems (which many of us have), the most common cause of knee problems is weak hips. The poster who spoke of soreness on outside of knees going downhill described an iliotibial (IT) band problem. The IT band does not stretch, so no amount of stretching will fix it. The fix is a prevention with a series of hip strengthening exercises. An appointment with a physio or exercise physiologist should be your first move. It is what they do. Forget doctors--they do not have anywhere near the training for those issues.
By weak hips do you mean weak glutes?
 
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Billy , I see that you’re in the last half of your 70s and you’re still putting miles behind you in interesting places. We’re both lucky to be able to do that.
I see that you’ve been given lots of advice, so I won’t add to it but here’s a couple of things that are working for me.

I find that the best exercise for walking up and down hills is – walking up and down hills. I live where I can do this almost every day. The month before a Camino, I try to exercise with a pack double my Camino weight and try to stretch everything that bends every couple of days.

On a Camino if anything starts to hurt I take shorter steps both up and down the hill.

I find that zero drop shoes are much easier on my feet and joints. In my early 70s I discovered that I was able to run without knee pain for the first time in my life but I think it would be risky to try a Camino with these shoes without spending several months of daily walking to stretch tendons and see if they might work for you.

Congratulations and best of luck on your next Camino. I will be over 80 on my next and I hope to see you out there.
. Gary
 
I mean glutes (maximus and medius), adductors, hip flexors, psoas, quadriceps, deep core... Strengthening all adds stability that takes pressure off the joints.
According to my PT (I recommend a sports medicine PT, not a regular physical therapist), the glute is the muscle most missing in action in the United States. Ironically, it is our biggest muscle. I had to be taught how to “kick it on” with some exercises. Nothing fancy, just some basic exercises where I could feel the glute tightening.

As walkerooni says, the glutes, the quads, the hamstrings, etc. — all those leg muscles contribute to more stability and strength around your knee and that means less knee pain on the downhills. Having those muscles in shape also contributes to better balance and stability while walking, so it seems like a no-brainer that anyone walking a camino would want to train those muscles.

I am a late learner because I didn’t get the message till after about 15 caminos and a couple with some serious knee pain!
 
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Walking backwards - great exercise, but not so easy to do safely!
I experimented with the motorised treadmill in my gym set at 5% (which they said I could do 'at my own risk'..). Not very satisfactory and I wouldn't recommend it. A bit better is the self-powered curved treadmill on a high resistance setting, but it takes a lot of concentration to maintain a constant rhythm.
Best option is actually the cross-trainer machine, where most models allow you to pedal backwards. Safe and straightforward and you can experiment with the settings to find what suits.
 
I find that the best exercise for walking up and down hills is – walking up and down hills. I live where I can do this almost every day. The month before a Camino, I try to exercise with a pack double my Camino weight and try to stretch everything that bends every couple of days.
I completely agree that the best exercise for walking up and down hills is walking up and down hills. That's been my own approach. My addition and caution is that you probably want to take it slow and easy with this, gradually increasing until you get to a point you are comfortable and confident. I usually start a good few months in advance and gradually increase frequency and duration. You don't want to damage your knees before you leave while you are trying to prepare them so that they won't be damaged on the Camino.
 
I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.
It is often remarked, explicitly or implicitly, on this forum that walking a Camino can have an addictive-like nature, noting that some addictions are pleasurable whilst others can be harmful. (Not an academic discourse on addiction theory.)

Have you given much thought that walking a Camino of more than a 100 km or so (insert any number of your choice) may not be in your long term best interests?

Many people at some stage develop imperfections that limit their ability to do some things in life and may lead to further damage and suffering. (Demanding sports often have most people retire from them in their 30s, more or less.) In which case it could be time to let-go, and retire from that activity (or do the retirement-adjacent version), and pursue other interests involving less physical damage.
 
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It is often remarked, explicitly or implicitly, on this forum that walking a Camino can have an addictive-like nature, noting that some addictions are pleasurable whilst others can be harmful. (Not an academic discourse on addiction theory.)

Have you given much thought that walking a Camino of more than a 100 km or so (insert any number of your choice) may not be in your long term best interests?

Many people at some stage develop imperfections that limit their ability to do some things in life and may lead to further damage and suffering. (Demanding sports often have most people retire from them in their 30s, more or less.) In which case it could be time to let-go, and retire from that activity (or do the retirement-adjacent version), and pursue other interests involving less physical damage.
From everything I've read (and selection bias may be at work, I admit), doing a lot of walking is a net positive for our health as we age, rather than something likely to lead to long-term damage and suffering. Certainly that's what I've been hearing from my family doctor.

If this is indeed true, and barring evidence to the contrary (which I don't think the retirement age of competitive athletes provides) then it would seem that the best course of action would be to find out how one can continue the activity without creating physical problems. Clearly people can do so, as the many seniors in our community (and the people we read about completing Caminos well into their 90s) attest. Which is precisely what Billy is doing with this thread.

Personally, I'm not ready to advise that the best thing to do is give up Caminos.
 
I agree to seeing a professional to diagnose the problems. In addition, I recommend gentle whole body stretching and strengthening. Am close to 70 and have been off all pain meds since 2012 due to stage 3 kidney disease (luckily my kidneys are now back to normal functioning after 2 years of herbal treatment). Yes, I still have shoulder, neck, lower back and knee pains but I exercise to reduce their affect.

For knees, legs (front and back) and glutes strengthening, when I brush my teeth, I do 2 minutes of mini-squats from standing to 45 degree knee bend (for the first minute) and then the last minute I do a mini-squat-toe raisers (
), but I try to do the squats and toe raisers quicker than the video as I want to maintain faster reflexes (in case I trip I want to be able to move quickly to not fall, which has happened before and I recovered without falling). Following that I do 25 alternate knee raisers (25 for each leg) and then I go through the basic 5 minute tai chi qi gong stretching before I go for walk with my dog. ~15 minutes in morning and 2 minutes in evening.

My next Camino is in June-July, 2024.
 
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Personally, I'm not ready to advise that the best thing to do is give up Caminos.
I don't think I was giving advice to that effect, but rather for him to question whether it is in his best interest to undertake a lot of walking given he has some form of bodily impairment.

This is different from the normal walking everyone's doctors recommend, and I am not familiar with doctors who recommend walking a Camino. I had a Seniors check-up a few months ago - a question was "Can you walk 100 metres." Answer "Yes".

After the check-up I made a comment that I was a little amused about the 100 metres as I have just returned from walking over 1,000 kms across Spain.

Recovery time from activity is critical, more time is required as we age. People with some form of impairment may do more damage and require even more recovery time, and possibly so much that a Camino might become a slow and well-spaced staccato, and perhaps less pleasurable.
 
I don't think I was giving advice to that effect, but rather for him to question whether it is in his best interest to undertake a lot of walking given he has some form of bodily impairment.

This is different from the normal walking everyone's doctors recommend, and I am not familiar with doctors who recommend walking a Camino. I had a Seniors check-up a few months ago - a question was "Can you walk 100 metres." Answer "Yes".

After the check-up I made a comment that I was a little amused about the 100 metres as I have just returned from walking over 1,000 kms across Spain.

Recovery time from activity is critical, more time is required as we age. People with some form of impairment may do more damage and require even more recovery time, and possibly so much that a Camino might become a slow and well-spaced staccato, and perhaps less pleasurable.
I don't think it is clear he has a bodily impairment and don't know why you would assume that. Suggesting he reconsider undertaking a lot of walking isn't really all that different from suggesting he reconsider walking any future Caminos.

I had terrible knee issues on my 2016 Camino Frances from Roncesvalles. I needed knee braces, lots of ibuprofen, and hiking poles to continue my Camino and, to the end, if I tried to stop with the ibuprofen or knee brace, I found that I couldn't make it and needed to resume them. I don't think that is far off from taking an occasional rest day for my knees. (I also took a couple of rest days in the course of my Camino after the knee problems emerged.)

I don't think I have a bodily impairment. If I did, I wouldn't have been able to walk the San Salvador and Primitivo last summer without any knee brace or ibuprofen or pain. Two routes much more challenging to the knees than the Frances. I just needed to let my knees heal and support them better on future long walks. Which is apparently what Billy is doing.

While my doctors have never proactively recommended a Camino, they have suggested it is a good thing, as long as I pay attention and listen to my body. They haven't responded that it would wear my body out like a professional athlete's body leading to early retirement.
 
... @Billy Buell ... and learn how to use them.

It is not complicated but I see many people don't get the benefit of poles. For you a good technique is necessary.
Yes poles help and I always use them. Yet there are occasions when the steep downhills still cause pain. At times ( when its safe) I walk downhill backwards to ease my knees. I march up any grade efficiently and then everyone passes me on the downhill as I go slowly zig zagging to the bottom.
I've found a few YouTube exercise videos that might help.
 
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I don't think it is clear he has a bodily impairment and don't know why you would assume that. Suggesting he reconsider undertaking a lot of walking isn't really all that different from suggesting he reconsider walking any future Caminos.

I had terrible knee issues on my 2016 Camino Frances from Roncesvalles. I needed knee braces, lots of ibuprofen, and hiking poles to continue my Camino and, to the end, if I tried to stop with the ibuprofen or knee brace, I found that I couldn't make it and needed to resume them. I don't think that is far off from taking an occasional rest day for my knees. (I also took a couple of rest days in the course of my Camino after the knee problems emerged.)

I don't think I have a bodily impairment. If I did, I wouldn't have been able to walk the San Salvador and Primitivo last summer without any knee brace or ibuprofen or pain. Two routes much more challenging to the knees than the Frances. I just needed to let my knees heal and support them better on future long walks. Which is apparently what Billy is doing.

While my doctors have never proactively recommended a Camino, they have suggested it is a good thing, as long as I pay attention and listen to my body. They haven't responded that it would wear my body out like a professional athlete's body leading to early retirement.
I appreciate your comments. My sore knees were first experienced on the Francigena coming from the Gran Bernardo Pass. Days of downhill.
As I continue I've met and seen numerous casualties from walking sjpdp to Roncesvalles. Just something to be aware of and to take care.
 
Please don't laugh, but research walking backwards. Lots of info on the internet youtube etc. Old Chinese excersize. Strengthens the muscles around the knees. I did 10 to 15 mins walking backwards on a treadmill at the gym a few weeks before I went in July 2022.
I had no knee pain as a result.
I also used poles throughout (Which I hate but they helped).
Going downhill never fully lock your legs straight.
I was carrying about 15kg in my pack, I walked St Jean to Santiago to Finistere to Muxia without any knee issue.
I was 62 yrs and a little overweight.
People laughed at me at the gym but I now notice a year or so later others doing it 😄
 
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On 2 previous caminos I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.
In addition to seeing a PT to determine why you have knee pain and using poles, check out ChiWalking. I used to be a ChiWalking and ChiRunning certified coach and for most people our form and gait is incorrect. You can google it and there are YouTube videos. You may be able to find a coach where you live. Dialing in form and gait will absolutely help on the downhills.
 
On 2 previous caminos I had to take rest days due to my knees becoming very sore from going down steep hills. Is there any exercise or precaution I can practice to avoid this reoccurring. I'd like to do Norte in September but fear the down hills will injur my knees.
Best piece of advice I received was from a sports physical therapist...the trick is to not put blunt pressure on your knees to begin with . We tend to lock our knees in place to brace for a decent, akin to planting a stump on the pavement. This jars the joint. The idea behind reducing knee pain in decent is to pay attention to loose knees, soft landings. Make sure to bend at the knees, lift knees higher than in a usual flat terrain gait. Think 'walking like a stork' or similar tall bird.

Worst knee pain of my life on my first camino (CF) and non issue once I trained myself this way on the next 7.

Worth a shot...it's free!
 
Agree a good PT is in order, and the suggestions offered here are all consistent with the advice I received from mine. I did the Norte/Primitivo last spring, and I think the combo of poles (I think two are best for this purpose), bent knees and smaller steps worked for me. I still had some swelling after some of the longer descents, but with some ibuprofen and an application of Bio Freeze to aid recovery it was manageable.

For what it's worth, I will add that as part of my recovery from an earler knee injury, my PT recommended including backwards walking in my training - the idea being if you're only walking forward, you only develop part of your leg muscles; walking backwards helps develop the whole muscle (and that to prevent knee injuries you also need to strengthen the muscles above and below the knee).

The advice was to alternate 1-2 minutes of backwards with 3-6 minutes of forward throughout the walk. Although the injury healed before I began my Camino, I found that it was so helpful that I continue to try to do it 2-3 times/week - I found it really works leg muscles in ways that forward walking doesn't - I seem to be able to walk for miles going forward feeling almost nothing in my legs, but after a few minutes walking backward, I feel the fatigue in the muscles and particularly on uphills/downhills feel a different stretch in the psoas, which makes me think it's doing something and must be helpful, so I've kept it as part of weekly routine. Your foot also strikes the ground in a different fashion, toe to heel instead of heel to toe.

It's probably safest to do this on a local school track, but I live in a relatively low-traffic area and found a nice 4 mile loop with relatively smooth roads, crossing to the other side of the road for the backwards portions so that while walking backwards I can see cars coming. I know where the smooth parts of the road are, so that's where I turn around to walk backwards, using the side of the road and the middle lane marker to stay centered; I've been doing it long enough now that I barely turn my head to keep on track or avoid bumps/holes. It's slow going at first until you get used to it, and obstructions in the road can be a real hazard. At the time my PT recommended this strategy, I remember reading several articles on it (mostly about backwards running - some claim that you burn more calories backwards, even if it is slower - who knows, that's not why I do it ). It's also an interesting conversation starter! I've had runners, cyclists, even people in cars stop to ask me about it, hahaha!
I had horrible knee pain when walking downhill from arthritis. I used poles and did a switch back strategy. Worked a little at first. A wonderful woman came to my rescue on the long down hill approach to Ribadiso coaching me to walk backwards. I used this the rest of my journey and it made it possible for me to complete my way. It does get some odd looks, but it works! Buen Camino.
 
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I had horrible knee pain when walking downhill from arthritis. I used poles and did a switch back strategy. Worked a little at first. A wonderful woman came to my rescue on the long down hill approach to Ribadiso coaching me to walk backwards. I used this the rest of my journey and it made it possible for me to complete my way. It does get some odd looks, but it works! Buen Camino.
Works for me too. This is how I got down all 268 stone steps from the chapel of Saint Michel d’Aiguilhe in Le Puy.
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This is all so interesting. Thanks to everyone sharing your experiences. I’m wondering how I will do on the descent to Roncevalles next week and will keep these tips in mind.
 
This is all so interesting. Thanks to everyone sharing your experiences. I’m wondering how I will do on the descent to Roncevalles next week and will keep these tips in mind.
I highly recommend not taking the official Camino trail down to Roncesvalles. There is a gentler way to the right. It is on the Buen Camino app, and shown here on the Gronze website.

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You can ask about it at the Pilgrims Office in SJPdP
 
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My hiker friend who has very bad knees (doctor told her she will end up in a wheelchair soon) went to a gym with a personal trainer who guided her into specific exercises. He told her to get an mri first to see what the problem was exactly and then he knew how to help her.
One of the exercises that she did was “wall sits”
I think Youtube can also be a big help.
 
I can only tell what has helped me for several years following the guidance of medical personnel.

STRENGTH - thighs (all types of squats and f.eks wall-sits as mentioned), calves and hips. All muscles in the legs relieve the knees downhills.
BALANCE - squatting on one leg, standing barefoot on a sockball... and thousand other variations.
STRETCHING - before, during, after... + passive warming up and holding the positions for a long time as often as time (and motivation, which is my week point ;-)
 

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