Common Hiking Injuries: Prevention & Treatment

Content reviewed and contributions made by Brandon Engle, PTA

Whether you are a novice or experienced hiker or backpacker, there are many items to consider when hitting the trails. Backpack weight, proper footwear, food and hydration, weather, routes and more all need to be evaluated before setting out. Further, because hikers are literally on the off-beaten path, they need to ensure that the take the proper precaution against three of the most common hiking injuries: knee pain, ankle sprains and achy feet.

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Complete a Dynamic Warm Up

Just like you would warm up before working out at the gym, you will want to get your body moving before you head out on the trails. Doing so will prep your body for the activity to come, improve your performance and help prevent injury.

Neck and shoulder rotations and torso twists help warm up the upper body, which is especially important if you are carrying a backpack. Completing exercises such as leg swings, walking high knees, butt kicks and lunges are all good ways to get your heart rate up and warm up those lower body muscles.

Taking an extra five minutes or more can lead to better results on your trek. Plus, combining the dynamic warm up and some of the static stretches below before (and after!) your hike can help keep common injuries at bay.

Prevent and Treat Knee Pain

Some backpackers may experience knee pain, especially when walking downhill or after hiking. This pain may be the result of several factors, including previous injury, improper footwear, weak/imbalanced leg muscles or general wear and tear of years spent on the trail.

Even without these factors, hikers can still experience knee pain. Particularly in hilly or mountainous terrains, the body is placed under significantly more stress when moving downhill. As you move downward, your lead leg adjusts to gravitational forces and absorbs the weight of your body and of any items you may be packing. Research suggests that this can amount to as much as 7-8 times your bodyweight.

While using trekking poles can substantially reduce the amount of pressure on your knees, there are several exercises you can do before and after your hike to help alleviate pain. Properly warming up the muscles attached to the IT Band, the hamstrings and the quadriceps can help prepare your legs and knees for the hike ahead.

Standing IT Band Stretch

Use a wall or sturdy surface for support while completing this exercise if necessary.

Instructions

1. While standing, cross the right leg in front of the left and press both feet firmly to the ground.
2. Bring your right-hand overhead to help deepen the stretch.
3. Then, lean to the left until you feel a stretch along your knee and outer hip.
4. Hold stretch for 30 seconds before switching to the opposite side.
5. Complete 3 times per side.

Hamstring Stretch

Instructions

1. Stand with your feet shoulder width. Step your right foot forward and then flex the foot upwards.
2. Bend at the hips, shifting your weight back towards your left foot until you feel the stretch in your right hamstring. Place both hands on your right thigh.
3. Hold for 30 seconds before switching to the left leg.
4. Complete 3 times per side.

Quadricep Stretch

Use a wall or sturdy surface for support while completing this exercise if necessary.

Instructions

1. Stand upright with good posture (i.e. shoulders open, core engaged and body in alignment) with your feet together.
2. Raise your left heel up behind you and then grab your foot with your left hand.
3. With a slight bend in your right leg, pull your left foot upwards towards your buttock until you feel a stretch in your left quadricep.
4. Hold the position for 30 seconds before moving to the opposite leg.
5. Perform the stretch 3 times per side.

NOTE: The quad stretch is very popular but is also performed incorrectly on a regular basis. It is important to maintain good posture throughout the stretch, keep a slight bend in the standing leg (opposed to locking it out) and keep your hips in alignment to maximize its benefits.

Avoiding a Twisted or Sprained Ankle

Part of what differentiates hiking from an everyday walk is changes in landscape. But it is that same ever-changing terrain that may cause a misplaced step and lead to a twisted or sprained ankle.

Like with knee pain, a twisted ankle can be attributed to ill-fitting or improper footwear. Also like with knee pain, a trekking stick can help your balance as you move along the trail. If you experience a sprain while hiking, it is important to evaluate your situation before moving along to avoid any further damage.

But, if you are recovering from an ankle injury (or simply want to maintain strength and flexibility) there are several exercises and stretches you can do to recover your mobility and balance. These stretches are also helpful when combined with a dynamic warm up and then again post-hike to cool down your body.

Calf Stretch

Instructions

1. Stand with your hands placed against a wall or study surface. Bring your right foot slightly in front of you.
2. Place the heel on the ground and point the toes up.
3. Gently lean towards the wall with your body in a straight line until you feel a stretch in the right calf.
4. Hold this position for 30 seconds and then release.
5. Complete the stretch 3 times on each leg.

Achilles Stretch

Instructions

1. Stand with your hands placed against a wall. Place the left foot back with the right foot forward in a slight lunge position.
2. Push towards the wall, keeping your heels against the ground and then slightly bend your left knee.
3. Hold this position for 30 seconds and then release.
4. Complete the stretch 3 times on each leg.

Ankle Circles

This exercise can be performed sitting or lying down as well as standing as long as there is something sturdy nearby for support.

Instructions

Start by turning your right ankle clockwise. Perform 10 repetitions before moving the ankle counterclockwise. Then switch to your left ankle and complete the exercise in a similar manner.

Side-Step Foot Pain

While many foot problems can be mitigated by choosing proper socks and footwear, foot pain (beyond blisters) can creep in while backpacking. Like with your knees and ankles, you can perform exercises and stretches to strengthen your feet to keep them strong.

Toe Raise, Point & Curl

This exercise intends to improve your overall foot flexibility and mobility and includes three stages of movement.

Instructions

1. Sit down with your feet flat on the floor.
2. With your toes on the floor, raise your heels until only the balls of your feet remain on the ground. Hold this position for 5 seconds and then lower the heels.
3. Next, raise your heels a second time. As your heels move upward begin to point your toes. Continue raising your heels until only your big and second toes touch the ground.
4. Hold again for 5 seconds before releasing your toes and lowering your heels.
5. Then curl your toes inward and raise your heels a third time. Once only the tips of your toes are only the ground hold the position for 5 seconds.
6. Complete each stage 10 times.

Toe Extension

After a long day trekking, this exercise can help stretch and relieve pain in an achy foot.

Instructions

1. Sit on a chair with your feet flat on the floor.
2. Bring your right foot up onto the right thigh.
3. With your hand, pull the toes upwards towards the ankle so you can feel the stretch along the bottom of the foot and heel cord.
4. Hold the position for 10 seconds, massaging the arch of the stretched foot if desired.
5. Repeat this exercise 10 times on each foot.

Physical Therapy for Knee, Ankle and Foot Injuries

Performing these exercises and stretches regularly can help prepare you for hiking excursions both big and small. If your aches and pains are keeping you from the trails, our physical therapists are here to help. At ATI, we offer free assessments and treat a number of common injuries and conditions either in clinic or online through our telehealth program, CONNECT.

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