Knee Pain in Summer: Hiking, Gardening, Tennis — Why It Shows Up and What to Do Early

Summer Gardening

Summer is here — and with it comes the urge to get outside, be active, and make the most of the longer days. For many of our patients, that means weekends on the hiking trail, hours spent tending the garden, or getting back on the tennis court after months away.

It's wonderful. And it's also, unfortunately, one of the busiest times of year for knee complaints.

If you've noticed an ache creeping in after a long walk, a soreness that kicks in when you kneel down to plant, or a sharp twinge mid-serve, you're not alone. In this post, we're going to look at why summer activities so often trigger knee pain — and, more importantly, what you can do about it early before it becomes something that sidelines you for weeks.

Why Does Knee Pain Tend to Peak in Summer?

The answer isn't simply "you're doing more." It's that you're doing more, differently, and often too quickly.

During the winter and spring months, many of us are less active — shorter days, colder weather, and busier schedules mean less time outdoors. Then summer arrives and activity levels spike almost overnight. The body, particularly the muscles, tendons, and joints around the knee, haven't had time to adapt.

Add to that the fact that many summer activities involve repetitive loading — the same motion, over and over, for extended periods — and you have a reliable recipe for overuse injury.

The three activities we hear about most? Hiking, gardening, and tennis. Here's why each one creates its own unique challenge for the knee.

Hiking: The Descent Is Where It Usually Starts

Hiking is brilliant for cardiovascular health, mental wellbeing, and building strength. But it's also one of the most common triggers for knee pain we see throughout the summer months.

Why it causes problems:

Going uphill puts demand on the quadriceps and hip extensors. Going downhill, however, is where the knee takes a real pounding. Each step down requires your knee to act as a brake, absorbing the impact and controlling the descent. Multiply that by hours on a trail and thousands of steps, and the structures around the knee — particularly the patellofemoral joint (the kneecap and the groove it sits in) and the IT band — can become irritated and inflamed.

This is often described as an aching pain at the front or outer side of the knee, which tends to worsen on descents and when climbing or descending stairs.

What to do early:

• Don't ignore the first warning signs. Pain on the descent, or stiffness the morning after, is your body asking for attention.

• Use walking poles. They significantly reduce the load through the knee on downhill sections — not just for older walkers, but for everyone.

• Build up gradually. If you're new to hiking or returning after a break, don't start with a 12-mile route. Work up to distance over several weeks.

• Strengthen before you go. Regular squats, lunges, and single-leg exercises help build the quad strength that protects the knee on uneven terrain.

Gardening: A Surprisingly Demanding Activity

Gardening might not feel like sport, but from a musculoskeletal perspective, it's one of the most knee-demanding activities there is. Prolonged kneeling, squatting, twisting, and rising from the ground repeatedly puts significant stress on the knee joint and surrounding soft tissues.

Why it causes problems:

The knee isn't designed to remain in a fully flexed (bent) position for extended periods. When you kneel for a prolonged time, the bursa — small fluid-filled sacs that cushion the knee — can become irritated, leading to a condition called bursitis. You might notice swelling, warmth, or tenderness directly over the kneecap.

Squatting repeatedly to weed, plant, or tend to low borders also compresses the patellofemoral joint, which can become painful particularly if the surrounding muscles are tight or weak.

What to do early:

• Use a kneeling pad. It sounds simple, but redistributing pressure makes a meaningful difference over the course of a long gardening session.

• Change position frequently. Avoid staying in one position for more than 15–20 minutes. Stand up, stretch, and move between tasks.

• Mind how you rise. Use your hands on your thighs or a nearby surface to reduce the load on the knee as you stand.

• Stretch your quads and hip flexors at the end of a session. Tight hip flexors in particular can increase load through the front of the knee.

If you're noticing swelling or heat around the kneecap after gardening, that's worth getting assessed sooner rather than later.

Tennis: Repetitive Impact on a Hard Surface

The return of the British summer almost always brings a return to the tennis court, and with it a predictable uptick in knee complaints — particularly among recreational players who haven't picked up a racquet since last summer.

Why it causes problems:

Tennis involves repeated high-impact movements: sudden stops, lateral changes of direction, jumping, and lunging. On a hard court, shock absorption is minimal, and every landing reverberates through the lower limb. The knee, sitting between the ankle and the hip, takes a significant share of that load.

Common presentations include:

• Patellar tendinopathy — pain at the bottom of the kneecap, often worse when jumping, kneeling, or after sitting for a while. This is a classic tennis complaint.

• Medial knee pain — on the inner side of the knee, often related to the stress of frequent pivoting.

• General patellofemoral pain — diffuse aching around or behind the kneecap, worsened by stairs, squatting, or prolonged sitting.

What to do early:

• Warm up properly. A five-minute dynamic warm-up — leg swings, lunges, lateral steps — prepares the knee for the demands ahead.

• Don't play through sharp or worsening pain. Dull discomfort might settle; sharp, escalating pain during play is telling you to stop.

• Check your footwear. Worn tennis shoes offer significantly less lateral support and shock absorption. If you're playing regularly, it's worth investing in a current pair designed for court use.

• Vary your training. Supplementing tennis with low-impact activities like swimming or cycling helps maintain fitness while giving the knee time to recover between sessions.

What All Three Have in Common — And What to Do About It

Whether it's the trail, the garden, or the court, the pattern is consistent: an increase in activity load, often combined with inadequate preparation or recovery, leads to cumulative stress on the knee.

Here are the principles that apply across all three:

1. Act early, not late. Knee pain rarely resolves faster by ignoring it. Pain that's caught at the niggling stage is far easier to address than pain that's been loaded through for another four weeks.

2. Rest doesn't always mean stop. Complete rest is often counterproductive. What the knee usually needs is modified activity — reducing load and impact while keeping movement going to maintain circulation and tissue health.

3. Address the contributing factors. Knee pain is very rarely just "a knee problem." Weakness in the glutes and quads, tightness in the hip flexors or calves, or poor movement mechanics elsewhere in the body all place excess demand on the knee. A thorough assessment looks at the full picture.

4. Seek professional guidance sooner rather than later. Many patients come to us having tried rest alone for weeks, only to find the problem persists the moment they return to activity. An osteopathic assessment helps identify what's driving the pain — and puts you on the right path to addressing it properly.

When to Book an Appointment

You don't need to be in severe pain to benefit from an assessment. We'd encourage you to get in touch if:

• You have pain during or after your activity that isn't resolving within a few days

• You notice swelling, warmth, or visible changes around the knee

• Pain is affecting your sleep, daily movement, or ability to continue doing what you love

• You've had a previous knee injury and things feel like they're flaring up again

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At Laura Fishlock Osteopathy, we take a whole-body approach to knee pain. We'll assess not just the knee itself, but the hip, ankle, and lower back, to understand why the knee is under strain and what needs to change to resolve it.

Ready to Get Seen?

Don't let knee pain shorten your summer. We offer same-day appointments at our clinics in Newbury and Hungerford, and our team is experienced in helping active people get back to doing what they love — pain-free.

Book online at  laurafishlockosteopathy.co.uk  or call us on 07733 201225.