5 walking mistakes that are quietly wrecking your knees, according to physical therapists

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Knee pain — especially the kind that hits you like a lightning bolt — is a surefire way to sideline you from your favorite activities. And while many instances of knee pain are short-lived and can be managed with rest and OTC pain killers , who wants to be laid up on the couch nursing a bum leg? If your knees have been giving you trouble lately, and you can't track the pain to a specific injury or underlying condition like osteoarthritis , physical therapists and sports medicine specialists share that it's possible your gait, daily walking habits or even your footwear could be playing a role.

Just keep in mind that not all fixes are quick, especially if you're looking for long-term relief. "Maintaining mobility and strength are two of the best things you can do to support knee health," says James Bruder , a physical therapist at ATI Physical Therapy in Greer, South Carolina. "Loss of range of motion and muscle weakness can contribute to unnecessary stress on the knees." So even if you take steps (so to speak) to address common walking mistakes that could be contributing to pain, it's worth checking with a physical therapist in your area to learn how you can pain-proof your knees.

Look, walking is one of the absolute best exercises you can do — it's an effective, moderate-intensity cardiovascular activity that's accessible for most people and fitness levels, works the major muscles of your legs and supports bone and joint health, but if you're just starting a routine, it's important that you ease your way in. "We often recommend people begin a walking program for general wellness, but so often people will lace up and head out, feel good, then end up over-doing it," says Kim Dallara , a physical therapy assistant at ProRehab Physical Therapy in Louisville, Ky.

To that end, Brian Eckenrode , an associate professor of physical therapy and residential DPT pathway director at Arcadia University in Glenside, Pa., says, "Individuals should consider building up time and distance slowly. Pain and injury can result if the progression is too much, too fast." While he adds that there's "no definitive protocol for progression," he points to a general rule of thumb not to increase mileage by more than 10% per week. "With current technology on our phones and smart watches, tracking steps, mileage and time per week walking is much easier to access, and this information can be helpful to inform when to increase or decrease time on feet," Eckenrode says.

When you pick up your walking pace — whether trying to increase your walk's intensity or because you're running late for a meeting — you may find yourself overstriding. And later, you may find your knees complaining about the effort. "Walking with too large a stride can increase knee pains due to the higher loading forces of your leg being out in front of your center of mass," says Karena Wu , physical therapist, owner and clinical director of ActiveCare Physical Therapy in New York City.

While there's no study that's looked specifically at the effects of overstriding on pain, one large study of about 2,300 older adults found that individuals with longer step length were somewhat more likely to report worsening knee pain two years later. Unfortunately, there's no specific data that indicates shortening your stride will reduce pain, so the best solution is to keep your stride as natural and comfortable as possible, without intentionally lengthening or shortening your steps. "The leg should swing out naturally in front and be placed in a comfortable [position] to accept weight onto the next foot," explains Wu.

There are lots of reasons why someone may walk with an asymmetrical stride, whether front-to-back or side-to-side. All of them, over time, can impact your knees. For instance, Rodante Saballa , a board-certified chiropractic sports physician in Los Angeles, points to individuals who place more pressure on their forefoot than on their heel, walking with more of a shuffle or a tip-toe than an evenly-distributed stride. "There's a lot more load and stress going onto the anterior chain of the leg, which is going to influence the knee," he explains.

Eckenrode points to uneven distribution of weight from side-to-side as another potential problem. "Walking is a highly symmetrical activity, so imbalances in strength and mobility between limbs may lead to compensatory changes in walking gait," he says. This could be due to old injuries, discrepancies in bilateral leg length or your natural tendency to place more weight on one foot or the other. You may not even be aware that you're making these unconscious adjustments, but the soles of your shoes probably tell the tale.

Saballa says to look at the bottom of your shoe and assess whether there's more wear toward the front of the shoe in comparison to the heel, and Eckenrode says to look at differences between your left and right shoes. "Differing wear patterns between the right and left shoe may indicate asymmetry in walking gait mechanics, and likely would benefit from consulting a physical therapist," he says.

There's no substitute for an actual appointment with your healthcare provider, but Bruder offers a simple at-home test to get a sense of your walking pattern. "Walk toward a full-length mirror or have someone record you walking from the front, back and side. Look for noticeable differences such as limping, uneven step lengths, excessive or limited weight shifting, changes in arm swing or one foot appearing to roll inward more than the other," he says. "If something looks noticeably different or causes pain, a physical therapist can provide a more thorough evaluation and determine whether your movement pattern may be contributing to your symptoms."

And if you just want to talk your way through a step with proper form, Wu offers this: "Are you striking the [ground] with your heel, rolling through the midfoot and pushing off with your first and second toes? You should feel the muscles of your core and legs working to propel you forward."

One other thing to keep in mind: Since most walking is done in the sagittal plane, the muscles that stabilize you side to side don't get much work. Adding simple exercises that engage your abductors (like banded side steps) can help even out imbalances and reduce knee pain . "Hip strength is crucial for knee health … The muscles must be strong enough to absorb the forces that cross through the joint or bone ends," says Wu. Adding a few sets three times a week is a good place to start.

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Hitting the hills and dales is a great way to develop greater leg strength and keep your walks interesting, but walking downhill without adjusting your stride accordingly can place incredible stress on your knees. "Walking downhill increases the eccentric load on the knees and the musculature of the knees," says Saballa. Just think about it — every step you take drops your body further than it would on level ground, and your quads have to absorb that energy as you descend. Walking downhill may feel easier, cardiovascularly, but it's actually much more challenging from a muscles, bones and joints perspective.

If you love trekking on hills, there's no need to stop, especially since there are a few ways you can counteract the added stress. First, take it slow. Walking downhill can i ncrease quadriceps activity by roughly 2.5-3x that of walking on flat ground. Then, shorten your steps — step length affects the drop distance of each step, with larger steps equating to larger, more stress-inducing drops. Finally, while you may be tempted to lean back to maintain balance, resist the urge. A slight forward lean at the hips shortens the lever arm of your quadriceps, reducing the force of each step.

There's one other good way to manage downhill walking — trekking poles. "Hiking or trekking poles may be useful for some individuals, specifically for added balance, as well as reducing the impact loading on the knees, hips and back," says Eckenrode, pointing to a 1999 study that found using poles when going downhill helped reduce the forces to the knees by 12-25%. "Poles will increase an individual's forward trunk lean, reducing the demand on the knee muscles," he explains.

So here's the thing: There's no single best shoe or shoe brand that will prevent knee pain for everyone. But walking in the wrong pair of shoes for you ? Well, that can contribute to knee pain. "You should be looking for 'Goldilocks' here," says Eckenrode. "Footwear should provide a balance between support and cushioning, but an individual's foot anatomy and biomechanics can vary wildly."

For instance, Saballa states that "Someone who has an overly cushioned shoe might be having a lot of stability demands from the ankle that the ankle cannot do, so it's asking the knee to help out, and now the knee is working overtime trying to stabilize what the ankle can't. On the contrary, for some people, having very, very minimalist shoes, there isn't enough force absorption, so now it's traveling up the leg into the knee."

Of course, this complicates things a bit — a shoe that helped nix your best friend's knee pain might have the opposite result for you. This means you have to do the research and seek out the best fit. Bruder points out that the first order of business is to make sure you're matching your shoes to the activity. "A very lightweight shoe may not provide what you need for a trail hike, while a heavier hiking shoe may be unnecessary for walking on a treadmill or around the neighborhood," he says. Beyond that, Eckenrode emphasizes the need to look for shoes you can try on before buying, and Bruder says that the store's return policy is important — you want to know you can return or exchange them if they don't end up working out.

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But, there's one last item that Dallara wants you to keep in mind: "Don't try to out-shoe a problem," she says. See a doctor or physical therapist if your knee pain is consistent, tops a 5 out of 10, doesn't clear up within a week or has you skipping activities you love.

Kim Dallara , PTA, a physical therapy assistant at ProRehab Physical Therapy in Louisville, Ky.

Brian Eckenrode , PT, DPT, PhD, OCS, an associate professor of physical therapy and residential DPT pathway director at Arcadia University in Glenside, Pa.

Karena Wu , PT, DPT, OCS, owner and clinical director of ActiveCare Physical Therapy in New York City

Rodante Saballa , DC, MS, CSCS, CCSP, a board-certified chiropractic sports physician in Los Angeles

James Bruder , PT, MPT, OCS, a physical therapist at ATI Physical Therapy

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