If you’re a hiker, you may love the way hiking lets you explore the outdoors as you stay active and support your physical and mental health. Whether your hikes are casual walks along gentle paths or miles-long climbs to mountain summits, aches and injuries can happen, even on trails you’ve hiked many times.
Here’s what you need to know about the most common hiking injuries, so you can spot early warning signs and know when to get medical care.
Why hiking injuries happen
Uneven ground, hills and changing conditions put demands on your body. They can stress muscles and joints in ways that your daily activities don’t.
When you’re hiking, you may face:
- Rocky or slippery terrain
- Fatigue on longer hikes
- Shoes that don’t fit properly or provide enough support
- Hot, cold or rapidly changing weather
- Elevation changes
- Challenges to your fitness level
Muscle strains and sprains
Strains (pulled muscles) and sprains are among the most common hiking injuries, especially in the ankles and knees.
“Ankle sprains are the most common acute injury during hiking,” said Amy Jo Overlin, MD, a sports medicine specialist with Banner - University Medicine. They often happen when you step on uneven ground and your foot slips or twists, so you roll your ankle.
Symptoms of a muscle strain or sprain include pain, swelling, stiffness or difficulty bearing weight. You’re more likely to get a strain or sprain if your muscles are tired, because fatigue makes them less able to respond to stressors.
Overuse injuries from long or repeated hikes
Not all hiking injuries happen suddenly. Repetitive stress can lead to gradual pain that gets worse over time.
You may notice:
- Knee pain after a lot of downhill hiking
- Foot or heel soreness
- Discomfort in your hip or lower back
Overuse injuries often get worse if you maintain or increase your activity level. Getting them evaluated and treating them early can help you recover more quickly and keep you on the trails.
Cuts, scrapes and minor wounds
Falls, loose gravel, sharp rocks and brush can lead to small cuts or scrapes, often on your hands, knees and shins. These types of injuries usually aren’t serious but they can get infected if you don’t clean them properly.
Blisters and foot irritation
Blisters form from friction, moisture and pressure from shoes that don’t fit properly. Even small blisters can affect how you walk, which may lead to strain in other areas. “Blisters are the most common non-traumatic condition caused by hiking,” Dr. Overlin said.
Early signs of blisters include:
- Hot spots
- Redness
- Tingling or burning sensations
Addressing these symptoms early by protecting the area or adjusting your footwear can help you prevent more serious problems.
Heat-related issues
Warm weather hiking and sun exposure increase your risk of dehydration, heat exhaustion and heat stroke.
Warning signs of heat issues include:
- Headache
- Dizziness
- Nausea
- Unusual fatigue
If you notice these signs, find shade so you can cool down, rest and drink fluids. Don’t ignore the signs, since heat problems can get worse quickly. End your hike early if you feel even mild symptoms of heat illness.
Sunburn is also a risk, so be sure to wear sunscreen and bring it along with you so you can reapply as needed.
Cold-related injuries
Cold, windy or wet conditions can make you stiff, numb or uncoordinated, especially in your fingers and toes. You’re at higher risk if the weather changes or you’re hiking at higher elevations. “Be aware of the environment you will be hiking in and layer clothes if needed,” Dr. Overlin said.
When a hiking injury needs medical care
Get medical care for a hiking injury if:
- Pain or swelling keeps getting worse.
- You can’t bear weight or move your joint normally.
- A wound is red, warm or draining, which could be signs that it’s infected.
- You have heat-related symptoms that don’t get better with rest and fluids or you have signs of heat stroke. This is an emergency and you should call 911.
Listening to your body can help keep minor injuries from becoming major problems.
Simple ways to reduce your injury risk
Dr. Overlin shared these steps that can lower your chances of getting hurt on the trail:
- Break in shoes over time before you go on longer hikes to help prevent blisters.
- Pick trails that match your ability and conditioning.
- Wear supportive shoes. Consider high-top hiking boots, which may help reduce ankle sprains (though more research is needed).
- Use good quality, padded, moisture-wicking socks. Bring extra socks in case your feet get wet.
- Take breaks and don’t rush.
- Drink water regularly. If you are hiking for over an hour, consider an electrolyte solution. Carry enough water to prevent dehydration in both cold and hot weather.
- Check weather and trail conditions before you go.
- Always hike with a friend and listen to local officials. If the trails are closed for any reason, don’t risk it.
To prevent falls when hiking, build strength in your legs, hips and glutes. “This helps prevent muscle fatigue during hikes,” Dr. Overlin said. Strengthening your ankles can help prevent sprains.
She also recommends a training program that increases FITT (frequency, intensity, time and type of exercise). “You should increase your activity slowly, adjusting one of the variables by no more than 10% each session,” she says.
Balance training can also reduce your risk of falls. “You can start by holding onto a chair if you’re a beginner. Advanced balance training can involve an unstable surface such as a balance board or a foam surface,” Dr. Overlin said.
Hiking poles can also help. Dr. Overlin said to make sure you train with them consistently so you’re accustomed to using them and you don’t strain your arms.
The bottom line
Hiking injuries are common but you can often prevent them by being prepared and staying aware of conditions and risks. Paying attention to early signs of injury and knowing when to rest or get care can help you stay active and safely enjoy the trails.
If an injury keeps you from moving comfortably or managing your daily activities, reach out to a Banner Health provider who can review your symptoms and help you start down a path toward recovery.
