Common Injuries while Walking and Hiking.

By Herschel Budlow, P.T.

Exercise devotees in contemporary society encompass everyone from six to sixty and decades beyond.

In my experience as a practicing physical therapist, I have seen the average age of my patient population increase to the point where the phrase "sixty is the new fifty" and "seventy is the new sixty" is applicable. Many of these "young" seniors have been physically active for most of their adult lives and are experiencing the usual aches and pains to be expected. However, continuing all the various activities they enjoy is often prevented by injury which occurs in an unpredictable and sudden manner.

Questions most often asked include:

  • How do I determine if I should stop?
  • What should I do?
  • Should I seek medical attention?
  • Go to ER or wait to see family doctor?
  • Do I self-treat?
  • How long do I avoid exercise?

In order of frequency, the most common significant injuries associated with walking/hiking include:

  • ankle and foot sprains
  • calf muscle strains
  • hip bursitis
  • hamstring strains
  • foot and ankle fractures
  • Achilles tendon tears

Less serious injuries are blisters, bruised toenails, diffuse muscle soreness of the back and legs, and general fatigue. Many of these conditions are associated with changes in an individual's activity level before they are acclimated physically. Sudden increases in distance, time, exertional demand (i.e., unaccustomed hills, rock scrambling, etc.), and speed are factors predisposing one to either acute or repetitive stress injury.

If you are playing a sport, hiking, or working in the yard and suddenly develop sudden pain in the lower leg or twist your ankle, what do you do?

Generally, pain during strenuous activity can be attributed to a specific movement. If you mimic the movement and pain increases with each repetition, obviously you stop the activity. If the area swells immediately, stop. If the pain increases at rest, stop; if available, follow the sports medicine formula of Rest-Ice-Compression-Elevation (RICE).

For most soft tissue injuries, the determination of when to resume activity depends upon the guidelines of pain-free full motion in the affected joint/muscle and the ability to apply force against resistance, such as walking full weight-bearing after a leg/foot injury, or raising the arm full overhead repeatedly after a shoulder strain. The time between injury and resumption of full unrestricted exercise or sports is highly variable depending upon factors such as conditioning, pain-tolerance, age and physical demands.

Most of us who are routinely physically active have learned to "listen to our bodies" and have developed an intuitive sense of when to continue after injury and when to stop and seek advice. However, problems most often occur in making that decision when the symptoms are not sufficiently obvious.

So-called "overuse, repetitive stress, repetitive motion injuries" are the culprit in creating a chronic injury from an acute injury. When does one "soldier on" when hurting, and when does one "shut it down," to use a trainer's comment? It's a tough call. I've often paid the price of an extended lay-off from some of my favorite activities when I ignored obvious injury. If you cannot perform a particular activity, sport, skill, or movement without significantly altering usual coordinated motion due to a specific pain, the solution is obvious: STOP. Seek appropriate medical advice if a few days rest and use of ice and the use of and anti-inflammatory such as ibuprofen do not reduce the discomfort. Of course, there are many symptoms of more significant soft-tissue injuries, such as tendon or ligament tears, major joint sprains, and muscle tears that are not described here. Such trauma is so painful and incapacitating that the need for immediate care is evident.

WebMD is a fine source for those with internet access to look up advice in the sports medicine area. Descriptions are in understandable language without overwhelming jargon. If we use common sense as we participate in our exercise activities, seek competent advice when appropriate, and avoid excessive repetitive activity, especially when uncomfortable, chronic injury symptoms can be avoided.

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