Hiking Injuries
Hiking Injuries
Richard B. Jones, M.D.
Walking is certainly one of the best forms of exercise. More than 50 million americans incorporate walking into their fitness routines. Walking offers the same benefits as jogging, but avoids the pounding to your body and carries a lower risk of injury. You burn approximately 100 calories per mile during brisk walking, which is similar to jogging. The down side is it requires more time to do so.
Hiking takes walking to a much higher level. You can achieve a higher fitness level due to the increased effort required and time. However, it does introduce a whole new spectrum of injuries. Hiking injuries can be considered in two categories: overuse injuries and traumatic injuries.
Anyone who has participated in any type of long distance physical activity has probably noticed that a small problem if left untreated can quickly turn into a big problem which may inhibit further activity. For example, a small sore area of the foot in a short time can become a large painful blister. Blisters are a frequent overuse injury associated with hiking. One of the more common overuse problems I see as an orthopedist is called patellofemoral syndrome. This is a painful disorder of the joint where the kneecap tracks. Hiking involves prolonged walking on inclines and declines. This puts tremendous force across to kneecap and can lead to disabling pain and may aggravate a preexisting arthritic condition. This can often be relieved with rest and various antiinflammitory medications. As this is often a joint malalignment problem, difficult cases may require further evaluation by a physician or therapist.
Other common overuse injuries involve to foot and ankle and would include achilles tendonitis and plantar fasciitis. The former involves pain along the heel cord near its attachment. It responds well to rest, stretching, and antinflammitory medications. Failure of the symptoms to resolve should prompt evaluation by a physician as rupture of the tendon is a risk. Plantar fasciitis pain involves the heel area also, but it is located on the sole of the foot. Treatment is similar to achilles tendonitis. Heel pads, cups or custom orthotics in the shoes may help this and prevent return of the problem.
Traumatic hiking injuries are usually related to falls on uneven terrain. While staring at the ground takes the fun out of hiking, too much “taking in the scenery” can be hazardous to your health. Common fractures associated with hiking involve the ankle and wrist. These can be difficult to differentiate from sprains in less severe cases. Some fractures will have obvious deformity of the extremity. These often require surgical treatment and immediate medical attention should be sought in these situations. Severe sprains can certainly cause significant pain, swelling, and bruising. Sprains of the wrist and ankle respond well to ice and rest, as well as some form of bracing. Disability is usually short term.
Knee injuries are frequent in hikers as well. Walking on uneven terrain, especially with a heavy pack, can cause balance difficulty leading to falls. Common injuries to the knee include ligament sprains such as the anterior cruciate ligament(ACL) or meniscus(cartilage) tears. These injuries usually cause acute pain and swelling, and may render the knee unstable. They may also have long term consequences in the knee and should be evaluated by a physician.
Overall, hiking is a safe sport and an excellent part of a fitness program. Learning proper technique can reduce risk of injury. Keep your head up and level, and the shoulders relaxed. Keep the shoulders aligned directly over the spine. The arms should swing like a pendulum and the elbows should remain flexed at 90 degrees. You should invest in a good pair of boots, and orthotics should be considered if there is a history of foot or knee problems. Finally, cross training in other activities will compliment an overall fitness program.
Richard B. Jones, M.D.
Southeastern Sports Medicine
828-274-4555