They’re assessed. A diagnosis is made. Treatment starts. Training is modified. Rehabilitation begins. Progress is monitored.

There’s a plan.

Now compare that with what many people hear:

“Rest for a few weeks and see how it feels.”

That’s a very different approach.

Athletes do have an advantage

Elite athletes are highly trained. Their bodies have spent years adapting to significant physical demands, and they often start with greater strength and physical capacity than the average person.

But they have another major advantage:

They have an experienced team figuring out what happened and what needs to happen next.

They don’t just rest and hope

When an athlete gets injured, we want to know:

What is the diagnosis?

What needs treatment?

What needs protection?

What can they safely continue doing?

And what needs to happen before they return?

Different injuries require different answers.

A torn hamstring isn’t managed like Achilles pain. A fracture isn’t managed like a gradual-onset running injury.

That’s why getting the diagnosis right matters.

Rest is not treatment

Sometimes rest or protection is absolutely necessary.

But simply stopping an activity until something doesn’t hurt anymore isn’t the same thing as treating the problem.

If running hurts and you stop running, your symptoms may settle because you’ve removed the demand.

But eventually you want to run again.

What’s different when you go back?

That’s where assessment, appropriate treatment and rehabilitation matter.

This is what high-performance sport has taught us

I’ve spent more than 20 years working in high-performance track and field, including with Canada’s National Track & Field Team, after spending 14 years in the sport as an athlete myself.

One thing becomes very clear at that level:

Making an athlete feel better isn’t enough. They have to get back and perform.

That’s the thinking we’ve built Optimal Performance Clinic around.

You may not be trying to make an Olympic team.

Maybe you want to run 10K, lift, ski, play soccer or simply stay active without the same problem getting in your way.

Your goals may be different. The standard of thinking behind your care shouldn’t be.

Book an assessment with our team.

The post Ever Wonder Why Athletes Seem to Recover So Much Faster? appeared first on Optimal.

Then it starts hurting again.

You treat it. It settles down. You go back.

And there it is again.

Sound familiar?

At some point, it’s worth asking:

Why does this keep coming back?

Did you actually injure it?

An acute injury usually has a clear event.

You’re running to catch the bus, feel a sharp pain and tear your hamstring. You roll your ankle. You fall skiing and injure your shoulder.

Something happened, and naturally, much of the initial assessment and treatment focuses on the injured area.

But many problems don’t start that way.

Your hip starts hurting when you run. There was no fall. No twist. No moment when you injured it.

It just started hurting.

That’s when simply treating the painful area may not be enough.

Why is that area struggling?

Your body has to handle the demands you place on it.

Running, lifting, work and sport all create load. Problems can develop when those demands exceed what an area is currently prepared to tolerate.

So yes, we’ll assess your hip.

But we’ll also want to know:

Has your training changed? Do you have the strength and capacity for what you’re asking your body to do? Are your foot, ankle, knee or trunk contributing to the task in a way that’s relevant? Has a previous injury changed what you can tolerate?

We’re not looking for something wrong everywhere.

We’re looking for what actually matters.

Otherwise, it’s easy to chase symptoms

Treating the painful area may make it feel better — and symptom relief can absolutely be valuable.

But if every return to activity leads right back to the same problem, we need to ask why.

Pain → treatment → relief → activity → pain.

At Optimal Performance Clinic, our approach has been shaped by decades of treating active people and working in high-performance sport.

We don’t just want to know where it hurts.

We want to understand the diagnosis, what may be contributing to the problem, what your body can currently handle and what you’re asking it to handle.

Because your hip, knee, shoulder or back doesn’t function in isolation.

And good assessment isn’t about finding more things wrong with you.

It’s about knowing what matters — and what doesn’t.

If you’ve been stuck treating the same problem over and over, maybe it’s time to look at the bigger picture.

Book an assessment with our team.

The post Why Does My Injury Keep Coming Back? appeared first on Optimal.

As summer approaches, thousands of hikers across British Columbia start heading to the trails. And for many this means knee pain. This is one of the most common issues people experience, especially during the first few hikes of the season.

Whether you’re hiking to Garibaldi Lake, Panorama Ridge, Joffre Lakes, or exploring the North Shore mountains, many hikers notice that their legs feel strong on the way up but their knees begin to ache on the way down.

If you’ve experienced pain at the front of the knee during a long descent, you’re not alone.

As both a chiropractor and an avid hiker who has completed many of these trails myself, I’ve experienced firsthand how demanding long descents can be on the knees. At Optimal Performance Clinic, our sports rehab and chiropractic team regularly works with hikers, backpackers, and outdoor athletes dealing with knee pain that develops during long days on the trail. Combining clinical experience with time spent in the mountains gives us a practical understanding of the challenges hikers face.

Why Hiking Often Causes Knee Pain

One of the most common patterns we see is pain developing at the front of the knee, particularly during downhill hiking.

Interestingly, most hikers feel the physical challenge of a climb in their muscles. Your lungs work hard, your heart rate rises, and your legs burn during steep ascents.

However, the descent is often where the knees begin to complain.

There are several things that can contribute to this.

Your Muscles Are Already Fatigued

By the time you begin descending, your legs have already spent hours climbing.

Even if your cardiovascular fitness feels good, the muscles responsible for controlling your movement may be significantly more fatigued than they were at the start of the day.

As fatigue accumulates, the body’s ability to absorb and produce force efficiently can decrease, which can increase stress on the knee.

Downhill Hiking Places High Loads Through The Knee

When walking downhill, the quadriceps must work hard to control your body weight as you lower yourself from step to step.

This type of muscle action, known as eccentric loading, places substantial demand on the muscles and tissues around the knee.

The steeper the trail, the larger the backpack, and the longer the descent, the greater these demands become.

Anyone who has hiked down from Panorama Ridge knows that the descent can sometimes feel harder on the knees than the climb itself.

You May Simply Be Under-trained For The Demands Of The Hike

Many hikers spend the winter skiing, training indoors, or simply spending less time on the trails.

When hiking season returns, it’s common to jump straight into ambitious objectives before rebuilding hiking-specific conditioning.

Often, knee pain is less about damage and more about the body being asked to tolerate more load than it has recently prepared for.

Changes In Movement Can Contribute

As the day progresses and fatigue builds, movement patterns can begin to change.

Some hikers notice their feet turning outward, their stride becoming shorter, or certain areas becoming noticeably tighter.

When carrying a heavy backpack, the hips and gluteal muscles are required to generate and control significant force over many hours.

While these changes do not necessarily cause knee pain, they may contribute to altered loading patterns that increase stress on sensitive tissues.

This is particularly common during backpacking trips where hikers are carrying heavier loads over multiple days.

Strategies That May Help On The Trail

Start With A Good Warm-Up

Many hikers spend considerable time preparing their gear but very little time preparing their bodies.

Before heading onto the trail, it’s generally more beneficial to spend a few minutes performing dynamic movements that gradually prepare the muscles and joints for hiking. Some of my favourites include:

• Walking lunges
• Leg swings
• Body weight squats
• Hip circles

These movements increase blood flow, raise body temperature, and help prepare your body for the demands of climbing and descending.

If you tend to feel particularly stiff before or after hiking, adding a few static stretches can also improve comfort. Some of my favourites include:

• Pigeon stretch
• Figure-four stretch
• Calf stretch
• Quad stretch
• Hamstring stretch

While static stretching is unlikely to prevent knee pain on its own, many hikers find it helps reduce feelings of stiffness and improves comfort before or after long days in the mountains.

Pay Attention To Hip Mobility

Many hikers find that their hips become increasingly stiff during long days on the trail.

Personally, I find that spending a few minutes addressing hip mobility before and after hiking can make a noticeable difference in overall comfort.

Movements such as the figure-four stretch or pigeon stretch may help reduce feelings of stiffness around the hips and improve overall comfort during long hiking days.

Gradually Build Hiking Volume

One of the most effective strategies for reducing hiking-related knee pain is gradually increasing hiking exposure before tackling bigger objectives.

If your first hike of the season is a 30-kilometre day with 1,500 metres of elevation gain, your body may not be adequately prepared for that level of demand.

Consistent exposure to shorter hikes often goes much further than occasional heroic efforts.

Strength Training For Hiking

If you want your knees to tolerate long descents better, strength training can be extremely valuable.

Many of the demands seen during downhill hiking involve the quadriceps controlling your body weight through large ranges of motion. Strengthening these muscles can improve your ability to tolerate long days on the trail.

Some of my favourite exercises for hikers include:

• Step-ups
• Step-downs
• Walking lunges
• Leg extensions
• Squats

These exercises help develop lower-body strength and improve your ability to tolerate the loading demands commonly encountered during hiking and backpacking.

For hikers preparing for bigger objectives, strength training is often one of the most overlooked pieces of injury prevention.

Consider Using Trekking Poles

If you’re planning longer hikes or carrying a heavy backpack, trekking poles can make a noticeable difference, especially during long descents.

Rather than relying entirely on your legs to absorb each step downhill, trekking poles allow you to share some of that workload with your upper body. This can reduce the amount of force your knees need to manage on steep or prolonged descents while also improving balance and stability on uneven terrain.

For many hikers, poles are the difference between finishing a hike with tired legs versus sore knees.

If you’re new to using trekking poles, spend some time practicing before a longer hike. Keeping the poles slightly in front of you during descents and using them to help control your speed is generally more effective than simply carrying them for balance.

Recovery Matters

For backpackers and multi-day hikers, recovery between hiking days becomes especially important.

Simple strategies such as adequate food intake, hydration, sleep, and managing overall daily mileage can help improve recovery.

Many hikers also find that cooling off in a cold alpine lake after a long day provides temporary symptom relief and helps them feel more refreshed for the following day.

Personally, if I’m on a multi-day backpacking trip and have access to a cold lake, I’ll often spend five to ten minutes in the water at the end of the day. While this isn’t a magic fix, many hikers find it helps reduce soreness and improve comfort heading into the next day.

When Should You Be Concerned?

The type of knee pain discussed in this article is typically gradual in onset.

Many hikers notice mild discomfort early in the day that slowly increases as mileage accumulates.

This is different from a sudden twisting injury, fall, or traumatic event.

Consider seeking assessment if:

• Pain persists after the hike
• Symptoms continue to worsen over multiple outings
• Swelling develops
• The knee feels unstable
• ain begins limiting your ability to enjoy hiking

How We Approach Hiking-Related Knee Pain

At Optimal Performance Clinic, our sports rehab teams in Vancouver and Burnaby work with hikers, backpackers, trail runners, climbers, and outdoor athletes throughout the Lower Mainland.

One thing we see every day is that two people can hike the exact same trail, carrying the same backpack, at the same pace, and have completely different experiences. One finishes feeling great, while the other develops significant knee pain. That’s because hiking-related pain is rarely caused by a single factor.

Rather than taking a one-size-fits-all approach, our assessment is designed to identify the specific factors contributing to your symptoms. Depending on the individual, these may include strength, mobility, training volume, hiking exposure, movement patterns, recovery strategies, previous injuries, or how your body tolerates load.

Treatment may include:

• Manual therapy
• Mobility work
• Strengthening exercises
• Load management strategies
• Hiking-specific rehabilitation
• Return-to-hiking planning

The goal isn’t simply to reduce pain, it’s to understand why it’s occurring and build an individualized plan that helps you continue exploring the mountains with confidence.

Final Thoughts

Knee pain while hiking is extremely common, particularly early in the hiking season or during long descents.

In many cases, it is not a sign of serious injury but rather an indication that the demands of the hike exceeded what the body was prepared to tolerate.

By gradually building hiking fitness, improving strength and mobility, and managing recovery appropriately, many hikers can significantly reduce the likelihood of knee pain limiting their adventures.

If knee pain is preventing you from enjoying the trails, our sports chiropractic and sports rehab team in Vancouver can help identify the factors contributing to your symptoms and create an individualized treatment and rehabilitation plan so you can get back to exploring the mountains with confidence.

See you in the mountains,

Dr. Jake Hanna

The post Why Your Knees Hurt While Hiking appeared first on Optimal.

We focus on restoring the body’s natural, intended movement patterns so you regain full function and prevent recurrence.

Not a professional athlete? That’s not a barrier — it’s an invitation. Whether you’re active recreationally, working at a desk, or performing physically demanding work, you get the same accurate diagnosis, effective treatment, and preventative rehab trusted at the top levels of sport and performance.

We’ve helped thousands of people recover from sports injuries, workplace injuries, motor vehicle accidents, and the aches and pains of daily life.

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