One thing I never anticipated when I, a 17 year-old boy, first arrived at Tufts was just how academically rigorous the school was going to be. Class sizes were always small, the curriculum focused, and the bar was set high. I would walk up the hill to class dreading the possibility of being late. One could never really anticipate how long the walk would take. If I was alert and active, I'd give myself five minutes, maybe ten, to reach my target building. Of course, that required me to be aware of weather conditions and my own energy level when on most days I kept the blinds shut and stayed in bed until 15 minutes before my first class. 

After a few months at the school, I could really notice positive physical changes. The hill was doing me good, all of that walking seemed to be helping to develop muscle and improve my conditioning. I was getting used to classes and assignments. But, unfortunately, stories like this always seem to have a little falling action (no pun intended).
I had been playing basketball a lot by the end of my sophomore year. It was a regular activity, something I enjoyed, and while I never developed a good-looking shot, I felt like I was improving to a non-embarrassing level. But as the summer came around, and the dog days promoted laziness and the simple comfort of the couch, I achieved an astronaut-like level of muscle atrophy. By junior year, I still appeared to be in good physical shape, but I quickly discovered that I was, once again, no match for the hill. 

I tried playing basketball, but my knees often ached afterwards. I tried my hand in running, but they couldn't stand up to the stress. It wasn't the hill's fault. At least, I don't think it was. But hey, I have to have someone to blame. Therefore, this blog post is dedicated to the potential knee problems associated with hills. If you find it too subjectively negative, I apologize (and let me preface it by saying that these are only injuries associated with hill exercise and that by taking adequate preventive measures, understanding your pre-existing conditions, and slowly increasing difficulty, you can tackle any hill you want). 

Knee Problems Aggravated by Hills: 

Runner's Knee (Patellofemoral Syndrome): 

This injury is common in runners and frequently manifests painfully when running downhill. However, it is often caused by weak quadricep and gluteal muscles. It can also be caused by prolonged sitting (definitely a possibility in my case) and poor form during exercise (looks like I'm 0 for 3). 

Check out Knee1's clinical overview here and jump to the 'Take Action' tab to find interesting ways to avoid re-aggravation. 

Iliotibial Band Syndrome

Iliotibial Band Syndrome (no simple nickname for this one) is an injury that causes lateral knee pain in runners. Basically, the Iliotibial Band is tissue that is helpful for stabilizing the knee during running. Running on hills too much or on banked surfaces (in which one leg is slightly lower than the other due to the slope) can cause this injury to manifest. This can also occur when inflammation of the tissue causes it to rub against the thigh bone that runs along the knee joint.

If you feel pain along the outside of one of your knees, see a doctor. If the doctor determines that you're suffering from an ITB injury, recovery can take as long as six weeks. When you reintroduce hill running into your exercise regimen, do it slowly. If you don't, you risk re-injuring your ITB and starting the whole process over again. And who wants to miss 12 weeks of good exercise? (Check out this article on Livestrong)

That's all for now. Feel free to read up on more injuries associated with runninghere. And try not to blame the hill, as tempting as it is. With the right tools and a healthy approach, no hill is worth avoiding.