Should You Go Rucking If Your Knees Hurt?

As discussed in our previous article, knee pain is unlikely to occur during rucking if you practice good biomechanics and build up volume and load progressively. However, knee pain is an unfortunate reality for many people who enjoy rucking. The repetitive impact of walking with a weighted rucksack can take its toll on the knees over time. However, this doesn't necessarily mean you have to give up rucking altogether. The following items, are actions you can take to allow you to keep rucking without exacerbating knee pain.

• Evaluate Your Rucking Gear

• Focus On Form

• Choose Softer Surfaces

• Lighten Your Load

• Strengthen Your Legs

• Take More Breaks

• Use Trekking Poles

• Try Compression Sleeves

• Ice After Rucking

• Use Anti-Inflammatory Medication

• Consider Supplements

• Adjust Your Training

• See a Physical Therapist

• Consider Custom Orthotics

• Explore Knee Braces

• Consider Injections

• Think About Surgery

• Listen To Your Body

Now, let's explore each one of them:

Evaluate Your Rucking Gear

Take a look at your rucksack and its fit. An ill-fitting rucksack that bounces around on your back with each step puts more strain on your knees. Ensure your rucksack sits snugly and doesn't shift around as you walk. The waist belt should bear most of the weight on your hips. Consider trying a rucksack with an internal frame if you don't already use one. This helps transfer weight onto your hips rather than shoulders. Similarly, look for thicker, more cushioned shoulder straps to minimize pressure points. Examine your footwear too. Properly fitted boots with adequate cushioning and arch support help absorb impact rather than letting it travel straight up to your knees. Replace boots once the cushioning wears out.

Focus On Form

Pay attention to your posture, gait, and stride when rucking. Maintaining proper form minimizes stress on your joints. Keep your back straight and core engaged when walking, rather than slouching or arching your back. Lead with your chest slightly. Take shorter, quicker strides rather than overstriding, which can hyperextend your knees. Land gently on your midfoot rather than heel-striking.Avoid carrying all your weight on one side. Distribute it evenly between both shoulders. Swing your arms naturally as you walk.

Choose Softer Surfaces

When possible, opt for softer surfaces rather than concrete sidewalks and roads. Dirt trails, grass, tracks, and even treadmills put less pounding on your knees. If you must ruck on pavement, try to find asphalt rather than concrete when you can. Asphalt has more give. Stay off cambered surfaces that angle your knees unnaturally.

Lighten Your Load

The more weight you carry, the more stress on your knees. Consider reducing your ruck weight, even by just a few pounds. This can make a noticeable difference in knee strain over several miles. Work your way up gradually in ruck weight instead of adding a lot at once. Give your body time to adapt to carrying heavier loads. Vary your ruck weight for different workouts rather than maxing out every time. Do some longer rucks at lighter weights to give your knees a break.

Strengthen Your Legs

Building muscle strength in your hips, glutes, quads, and calves takes pressure off your knees when rucking. Perform targeted exercises like squats, lunges, and calf raises. Do lateral moves like side lunges too. Work both single-leg and double-leg exercises to prevent muscle imbalances. Maintain flexibility through stretching. Strong, balanced leg muscles better stabilize and support your knees.

Take More Breaks

Rucking mile after mile without rest forces your knees to absorb continuous pounding. Taking regular short breaks gives them a chance to recover. Stop and walk slowly without your rucksack for 2-3 minutes every 20-30 minutes during longer rucks. Sit down, stretch your legs, and massage your knees. Drink some water too.

Use Trekking Poles

Trekking poles help distribute your upper body weight across all four limbs instead of just your legs. This takes stress off the knees with each step. Poles also improve stability on uneven terrain, reducing awkward twisting forces on the knees. They provide a little arm workout too. Use poles designed for rucking that can handle the extra weight. Adjust them to the right height – elbows bent at 90 degrees when the tips are on the ground.

Try Compression Sleeves

Compression sleeves worn just below the knee supply gentle, graduated pressure up the lower leg. This may help combat pain and swelling. Look for sleeves sized specifically for your calf and made of breathable material so your legs don't overheat. Ensure a snug but not too tight fit. Rotate between different pairs to prolong the sleeve elasticity. Take them off immediately if they cause tingling or numbness.

Ice After Rucking

Icing your knees for 15-20 minutes after rucking reduces inflammation and swelling that can lead to knee pain. It also helps flush out metabolic waste products. Use an ice pack wrapped in a thin towel or try a specialized knee ice wrap that stays in place hands-free. Don't ice directly on bare skin. Elevate your legs while icing to further minimize swelling. Follow icing with some light knee stretching.

Use Anti-Inflammatory Medication

Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen help control knee pain and inflammation related to rucking. Always follow dosage directions.NSAIDs work best when taken preemptively before rucking. Time your dosage to peak when you’ll be on your ruck march. Avoid excessive NSAID use which can cause side effects. Don’t use them to mask the pain from a serious injury.

Consider Supplements

Some supplements may support joint health and help reduce knee discomfort from rucking. These include glucosamine, chondroitin, turmeric, omega-3s, and collagen. Research shows mixed results on supplement efficacy. Glucosamine and chondroitin have the most evidence behind them. Talk to your doctor before starting supplements. Expect to take supplements consistently for 1-2 months to notice benefits. Ensure you use high-quality products from reputable companies.

Adjust Your Training

If simple measures don't alleviate your knee pain, you may need to modify your rucking training more significantly. But don't panic - you don't necessarily have to stop rucking altogether. Cut back on rucking volume by reducing the number of sessions per week or total weekly mileage. This allows more recovery time for your knees between rucks. Substitute some rucking workouts with lower-impact cardio like cycling, swimming, or rowing to give your knees a break. Focus on strength training rather than long ruck marches for a period of time. Build your leg muscles to better support your knees.

See a Physical Therapist

A physical therapist can assess your specific knee pain and limitations. They will identify any muscle weaknesses or movement compensations contributing to knee strain. The therapist can design a customized rehabilitation program including stretching, strengthening, and gait retraining exercises tailored to your needs. If certain rucking activities consistently aggravate your knee pain, a therapist will help determine if and how you can modify the technique to reduce knee load.

Consider Custom Orthotics

Custom shoe inserts prescribed by a podiatrist can optimize alignment and weight distribution through your knees when rucking. Orthotics help correct overpronation or supination caused by high arches or flat feet which can lead to knee pain. They provide arch support tailored to your feet. Add orthotics to the boots you wear for rucking. Give them at least 1-2 weeks to get used to them before longer rucks.

Explore Knee Braces

Wearing a knee brace applies compression and helps stabilize and support joint structures. This may enable you to ruck with less pain. Look for lightweight, breathable braces that won't restrict movement. Hinged braces allow fuller knee bending. Proper fit is vital for a brace to be effective. Consult a doctor or brace specialist to ensure you get the right style and size.

Consider Injections

Corticosteroid injections deliver anti-inflammatory medication directly into the knee joint. Hyaluronic acid injections supplement the fluid that lubricates the knee. These injections can provide several months of knee pain relief, enabling you to keep rucking. However, results are mixed and repeat injections may be needed. Potential side effects include cartilage breakdown, infection, and nerve damage. Discuss thoroughly with your doctor before pursuing injections.

Think About Surgery

If conservative treatment fails to resolve persistent knee pain, surgery may be an option in some cases. This could involve cartilage repair, ligament reconstruction, or knee replacement. Surgery aims to repair damaged structures and restore normal knee function. It requires extensive rehab but can allow you to eventually return to rucking. Surgical procedures vary greatly in invasiveness, recovery timelines, and outcomes. Thoroughly discuss risks and expectations with your orthopedic surgeon.

Listen To Your Body

The most important thing is tuning in to the signals from your knees. Stop any activity that causes sharp pain or swelling. While some knee discomfort is expected when rucking, severe or worsening pain indicates a need to back off and reassess your training. Persisting through pain repeatedly can worsen existing knee damage. Let pain be your guide to finding the rucking frequency, distance, and weight your knees can handle. Rucking should invigorate you and support your health goals, not bring you to your knees. Pay attention to what your knees are telling you. With some patience and experimentation, you can find the sweet spot that allows you to keep rucking without knee grief. Don't give up hope.