10/15/2026
If your knees hurt on the descent, the Grouse Grind is trying to tell you something.
The North Shore trail system is genuinely exceptional, and it is also steep, uneven, and remarkably demanding on the knees, particularly on the way down. Pain at the kneecap, stiffness the morning after a long hike, or that familiar ache on the descent are all signs that something in the kinetic chain needs attention. The knee itself is often not the actual problem. It is frequently the thing that suffers when the hip, the foot, or the ankle is not doing its job properly, which is why treating only the knee tends to produce only partial results.
Here are three reasons hikers on the North Shore develop knee pain, and what we typically address when we treat it.