Hiking certainly isn’t something that is free from the the risk of injury. The unpredictable terrain, together the repetitive movement over vast distances, presents hikers with a large number of challenges when it comes to preventing injury. As such, we’ve put together the following guide to help Sheffield hikers spend more time on the trail than on the physiotherapy table – something that is especially relevant considering the huge number of amazing walks that are accessible from this great city.
Impact Injuries From Hiking
Lower limb injuries are very common when hiking, particularly due to the unpredictable terrain. Whether it is getting your foot stuck in a rabbit hole or tripping over a rock, it is important to know what to do to aid a speedy, safe recovery.
More often than not, with most injuries you sustain in this way, you should follow the P.O.L.I.C.E (Protect, Optimum Loading, Compression, Elevation) principles for the swelling management and early mobilisation of your injured area.
Knee and ankle injuries can vary quite significantly, from a mild ligament sprain to a complete rupture or break. The mechanism of injury often gives you a good idea as to what is damaged and the level of impact can also give you a good idea as to how sever the injury is (however not always the case).
If you suspect it is a mild knee/ankle injury:
- Follow the P.O.L.I.C.E (Protect, Optimum Loading, Compression, Elevation) principles.
- Maintain your range of movement and strength.
- Give yourself time to recover- allow swelling to settle before returning to hiking.
- Ensure you have good stability around your knee/ ankle and ensure it feels strong before you do go on a hike.
- Gradually build up the distance that you’re walking.
- Improving your balance and proprioception after injury is very important due to the unpredictable surfaces and terrain.
- Once the swelling has settled, and your range of movement has improved, you will need to start strengthening your entire leg, paying specific attention to your injured area.
Repetitive Strain Injuries For Hikers
Plantarfasciitis (heel pain)
Plantar Fasciitis is a very common and painful foot condition experienced by walkers and hikers. It is repetitive injury and often presents itself as long-standing heel pain. The pain is caused by the inflammation of the ligament that connects your heel bone to the ball of your foot.
If you suspect you have this injury:
- Reduce the amount of time you spend hiking – you may have to stop for a period of time while the inflammation reduces.
- Ensure your footwear provides good heel and arch support.
- Freeze a water bottle, and roll under your foot to reduce any swelling and provide temporary pain relief.
- Stretch and release your feet using a spikey massage ball. Stretch out your plantar fascia ligament in sitting by crossing one leg over the other, grab your big toe and pull it towards you – hold for 40-60 seconds.
- Stretch your calves within a comfortable range / use a foam roller / book in for some soft tissue massage to release this area off as tight calves can pull at the ligament further, causing more pain.
Achilles tendinitis is a common condition that occurs when the large tendon that runs down the back of your lower leg becomes irritated and inflamed due to repetitive use. Your achilles tendon is the largest tendon in the body and connects your calf muscles to your heel bone. Although the Achilles tendon can withstand great stresses from running and jumping, it is also prone to tendinitis. Pain can occur within the tendon itself or at the point where it attaches to the heel bone.
Common symptoms are pain and stiffness along the achilles tendon (especially in the morning or that worsens with activity), severe pain the day after a hike, thickening and swelling around the tendon. It is more likely to occur if you have suddenly increased the distance / time / gradient that you are walking before the body has had time to readjust.
If you have experienced a sudden “pop” in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.
If you suspect achilles tendinitis:
- Follow POLICE protocol listed above.
- Stretch out your calves – tight calves can put extra stress on the achilles tendon. It may also be worth considering soft tissue release from a massage therapist or using a foam roller.
- Seek the guidance of a physio who can help you with an eccentric strengthening protocol, which involves strengthening muscles as they lengthen. These need to be supervised initially to ensure correct technique then can be progressed to a home exercise programme.
Stretches for Hikers
Back Pain & Hiking
Back pain is a common complaint within the general population, and due to uneven terrain and gradient when hiking, it can creep into your walks too. The main thing to remember is to keep moving a healthy back is one that moves, not one that stays in one position for long periods! Secondly, knowing how to deal with the back pain when it hits and how to prevent it is your first line of defence.
One of the most important parts of preventing back pain is preparing your body for a hike, ensuring your muscles are warm and mobile before heading out. Towards this, dynamic stretches are perfect for a pre-hike warm up, then more static, gentle stretches are recommended post-hike (normally alongside a nice cup of tea). See our video below for some quick-fire ideas on how to warm up and cool down the whole body effectively.
It is important to take your whole body through these stretches, as if one part of you feels stiff, this can have an impact on how the rest of your body is moving. Regular stretching will keep the ligaments and muscles loose and can reduce stress on joints while improving the flow of blood.
In terms of other actionable tips on how to manage hiking with back pain…
Start With Your Backpack
Your backpack is the first place to address if you are suffering from back pain on the trail. Your backpack is going to be the source of the load on your back and the best way to eliminate useless weight.
Get one that fits: You should be able to maintain good posture with your backpack on – no overarching of the bag or you leaning forward to compensate. It is important to remember that your backpack may feel great in Mile 1, but as you progress, it becomes a literal pain in the back or glutes. Only carry what you need and make it as lightweight and form-fitting as possible.
Spread load evenly on your back: Load your pack so the weight is evenly dispersed throughout to avoid an unbalanced load. Have the heaviest items closest to your back and lighter ones to the outside. This lessens the load on your back and makes your bag more stable.
Wear Good Shoes
You always want to have a good pair of shoes or boots for hiking. If you are getting low back pain when hiking it may well be due to worn-out footwear that is no longer supportive. Your feet are the beginning of the kinetic chain and if you don’t have a good foundation here then this can lead to problems up and beyond. Always wear a good pair of shoes that support your ankles and feet in uneven terrain, whilst giving you adequate arch support.
Always Think Core
Hiking requires a good foundational level of core strength and stability in order to support the back, maintaining good posture and ensuring you are moving efficiently. It is always a good idea to start with some pilates-based exercises in order to build up this foundational control to help keep your strong, injury free and able to walk faster and for longer. Why not try one of our pilates taster sessions to see if pilates can help you!
Top Tips For Staying Injury-Free Whilst Hiking
As well as the above recommendations for ensuring an optimal backpack, correct footwear, excellent core strength and the inclusion of stretching, certain lower limb strengthening exercises are especially important for staying injury free whilst hiking.
Improve Lower Limb Strength
Ankle stability is very important when hiking to the types of terrain that you will be walking along. Ways to build on your ankle stability include:
- Jumping drills/ hopping drills
- Single leg balance work (as simple as standing on a cushion)
- Proximal control (knee and hip control)
- Taping may also provide short term benefit.
When hiking it is important to have good eccentric quadricep control (muscles ability to lengthen while contracting), this is because as you walk downhill your quads work eccentrically. If you have poor eccentric quad control then you’re at greater risk of injury as you’re not able to control the movement as effectively. Ways to improve this include:
- Single leg squat, ensuring you keep your knee straight
- Step down
- Leg press
Hip strength is also really important when it comes to lower limb control as your hip is responsible for control laterally (sideways) and if your hip is weak then it has a knock-on effect on the rest of your leg, again predisposing you to injury. Was to improve your hip strength:
- Crab walks with a resistance band
- High step ups
For more information, or to discuss your own pain or discomfort whilst hiking, please get in touch to book an appointment with one of our physiotherapists.