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Your Questions, Answered: Hiking


Hiking is a popular outdoor activity, especially during the warm summer months. Whether you’re new to hiking or a seasoned pro, these tips from a physical therapist and experienced backpacker can help answer some common questions about hiking. Gain a unique perspective on how to make the most of your hiking adventures!

How can hiking help improve my health?

Hiking truly has multiple health benefits. Trails that include hills or mountains include a significant strength component which can improve your entire leg strength. With more modest terrain there are still cardiovascular benefits, which can aid in maintaining your current weight simply by moving around and burning calories. One of the most significant benefits though in today’s culture is certainly the mental health benefits. The act of pulling yourself out of the usual daily or weekly schedule to spend time in the woods allows the chance to think clearly and reflect on the week. The value of the chance to decompress cannot be overstated with the act of hiking.

What are the most common injuries you see in hikers?

One very common injury would certainly be knee pain, particularly at the front of the knee and just below your kneecap. One of the common contributing factors to this pain is tightness and stiffness of the quadriceps, or front thigh muscles. This can contribute to excessive forces and stress at the front of the knee, which is why a balanced exercise routine that includes activities which strengthen all of the knee muscles is very beneficial.

Low back pain is another common injury. For someone who is regularly carrying a heavy pack (shout out to all my fellow backpackers!) low back pain can be a result of poor posture while hiking, or excessive use of the low back muscles. Many of these injuries greatly benefit from a supervised and individualized set of core exercise progressions which restore balance to all of the musculature at your low back, abdominals, and hips.

I tend to roll my ankles. How can I avoid ankle injuries while hiking?

Hiking bootsI have two major suggestions for this. The first is to consider wearing a mid or high-ankle hiking boot. Though I am not always in favor of footwear that covers above the ankle, this is a case where it is a good idea. For someone who has a history of frequently turning their ankle this higher footwear provides a greater support to the ankle. This is especially beneficial with the nature of varied terrain while hiking. And if you have a history of rolling your ankles and are going backpacking for the first time (or even if you don’t have a history of ankle issues) I would definitely recommend wearing a hiking boot with coverage at least up to the ankle bones on either side, if not higher.

hiking - trekking polesMy second major suggestion is to consider use of trekking, or hiking poles. When I began backpacking in my early 20s I saw trekking poles as an unnecessary piece of gear that only benefited folks who might have been in poor physical fitness. I was very wrong about how beneficial they are. From a movement, therapy, and fitness perspective trekking poles get 5 stars in all three categories for me now. Not only do they take greater than 10% of the workload off of your legs while hiking, they also provide another great source of stability while hiking over varied terrain. One of the more common times when ankle sprains occur during hikes is on the way down the mountain. This is the time when the legs are already tired, and when hikers generally start to loosen their focus on the trail’s features. When hiking down heavily rooted paths or rocky terrain the trekking poles provide two additional points of contact with the ground. I personally have been able to avoid ankle sprains in large part due to my trekking poles.

Pro tip on technical use of trekking poles: instead of keeping the poles by your sides while hiking down the mountain, try placing them out in front of you as you step further down the mountain. I have found that this allows you to position the poles so that they prevent too much forward momentum. It also enhances your stability by providing a wider base of support (as if you were walking on all fours).

How can PT help me get in shape before a big hike?

I can’t stress enough that doing a long day hike or a prolonged backpacking trip places a big demand on both your low back and the knees/ankles. The benefit of physical therapy is that it allows the chance to determine what postural deficits, muscle imbalances, or movement deficits that you may have. These are deficits which often can be exacerbated by hiking for many miles, and certainly when wearing an average size backpacking pack (20-30lbs). Physical therapy will provide the chance to identify these deficits and create an exercise program that restores good movement quality and good posture.

A good example of this is for any one of our knee patients. In a number of cases we observe that the patient has difficulty maintaining good alignment of their knee, ankle, and hip while stepping down off of a 6-8 inch step. During their treatment program we address this deficit with targeted exercises that improve use of their gluteal muscles and core muscles. In this way we can restore good alignment during stepping down, which then will provide them the chance to hike down a mountain without placing excessive stress on the front of their knee and on their ankle with every step.

Can you recommend any specific exercises to help me avoid injury?

One particular exercise that can provide great benefits to low back pain, knee pain, and the prevention of these is a bridge. If you have never done bridges before, or have yet to begin a consistent exercise routine, a separate exercise I would recommend first is glute sets. For this activity you can lie on your back with both knees bent and feet flat on the floor. Squeeze the buttock muscles together and hold for several seconds, then relax. The trick to this exercise is to practice it so that you can tighten the glute muscles without simultaneously tightening the low back muscles.

Upon mastering this exercise, or if you have already been exercising regularly, try bridges. Lie on your back with both knees bent and feet flat on the floor. Tighten the buttock and brace your abdominal muscles (think tensing them as if someone was about to poke you in the stomach) before then lifting your hips off the floor until your entire upper body and thighs are in a straight line (from your shoulders to your knees). Throughout the exercise you should mainly feel that the activity is challenging your abdominal muscles and your glute muscles, not your low back.

Do you have any tips for hiking safely?

hiking trail mapsOne of my biggest tips is to make sure that you have a trail map with you, or that you are hiking with someone who is already familiar with the trails you will be on. And if you are planning to try out a new trail, regardless of your experience level, please make sure to reference a trail map in advance or have the map with you. I can’t tell you how often I speak with friends or other hikers I meet who decided they would try out a new trail in their favorite area…only to become lost. They realized too late that they should have looked at the trail map to understand where the trail leads to, and landmarks along the trail. It becomes especially dangerous when people try out these new trails around dusk. Please, if you plan to try out a new trail unfamiliar to you do it earlier in the day well before dusk.

My second tip is to dress in layers, especially if you are planning on hiking in one of the big mountain ranges in the Northeast or in the Southeast. It is common for a change in 1000 feet in elevation to be accompanied by a 5-7 degree difference in temperature. So if you are hiking a larger mountain, even in the summer sometimes, bring that extra fleece layer. And if you are hiking in the summer and the area is very sunny consider wearing a sunshirt or a sun hoodie. These very lightweight pieces of clothing provide excellent moisture wicking, while also providing a cooling effect on the body by blocking the direct sunlight from shining on your skin. Plus many of these lightweight shirts also have a UPF sun rating, meaning that they provide extra protection against the sun.

Do you have a favorite place to hike? If so, what makes it great?

My favorite place to hike is definitely the Adirondack Mountains in New York. There is an area of this state park called the High Peaks region where there is something adventurous to do at all times of the year. You can do mountaineering or ice climbing in the winter, backpacking at any time of the year, and big day hikes or shorter hikes through the summer. One of my favorite parts about it is how remote the trails are and feel. There are many other big mountains to hike in other state and national parks, but for the Northeast the Adirondacks are special – in part because there are a number of peaks that require 5-10 miles of hiking into the wilderness to even reach them. I always leave the Adirondacks fulfilled, both by the adventurous terrain and by the remoteness of some of the hikes.