Common Hiking Injuries: Prevention & Treatment

Sep 2015

A group of hikers on rocks.

Whether you are training for an epic trip or hiking on the weekends, we’ve all felt the effects of sore muscles, blistered feet, or aching joints. These injuries can prevent you from doing what you are passionate about and hamper training efforts when working towards that next big adventure. With a few tips on how to prevent and treat common hiking injuries, you can keep doing what you love and hiking towards your goal. Some hiking injuries are preventable, others are easily treatable on your own. The suggestions here should never take the place of medical treatment or guidance in your training regimen, but they can help you to begin understanding common hiking injuries and how to manage them.




One word, pre-tape. Okay, it’s a hyphenated word. But it means that you can easily prevent blisters if you know where you generally get them. You don’t need to wait for the hot spot to appear. Before your hike, place med tape (cloth tape used mainly for taping hockey sticks, or KT tape works very well) where your blisters will eventually appear. If your blisters are often minor or only get them occasionally, ditch the tape and try a thin layer of NewSkin.

Trekking Pole Blisters

Switch your grip often. Use your wrist loops so you can grip more lightly. You rarely need to white-knuckle those handles to accomplish the goal. And make sure you are using the wrist loops properly: hands should come up into the loop from underneath, not from above.

Knee Pain

Many people think of knee pain as unavoidable as you get older. In cases of past injury or other preexisting conditions it can be difficult to manage, but for most people knee pain can be prevented. Regularly stretching your quadriceps and hamstring muscles can minimize tension on the joint, a common cause of pain. Hiking with trekking poles is very helpful to individuals with a predisposition toward joint pain. Trekking poles allow for a better distribution of weight with each step.

Shoulder Pain

In order to prevent back pain, you should take great care in picking out a pack with the proper fit. Ask for help from a professional at whichever outdoor store you are purchasing from. You will want to test the pack in person before you buy. It is also important that you load your pack properly so that weight is distributed in a way that will not pull on your shoulder muscles. The load of your pack should be riding close to your body and most of the weight should be distributed across your hips.

Low Back Pain

Low back pain is often the result of sitting for extended periods of time, whether at a desk or during your commute.  Sitting for long periods of time can cause our hip flexors and hamstrings to get tight, creating a muscular imbalance that strains the lower back. Stretching out the hips often, and especially before a hike, can help. There are many easy hip-opening stretches to help prevent this.

Foot Arch Pain 

A lot of people switch boots a dozen times and still experience arch pain before finally giving up the sport of hiking altogether. Stretching may be all you need though. Yes, it’s possible to stretch your feet, and you should. Like many of the solutions here, this should be done on a regular basis and just before hiking. Try kneeling with your knees on the ground and your feet under your bum. Your toes should be on the ground as if you were standing on them (pointing forward) so the arches of your feet are exposed fully to anyone standing behind you. If it’s comfortable, try hinging your upper body back a few inches to add more intensity. The most common reason for this sort of pain is plantar fasciitis which can be prevented, but if the pain persists you should see a doctor.


Trail treatment


The important thing to know about treating blisters out on the trail is to take action before the blister actually appears. As soon as the skin turns red and becomes a “hot spot” you want to intervene. Look for spots where your shoe or sock might be rubbing against your skin. If you can eliminate the rub, you can help keep the blister from developing. Placing moleskin around the hot spot or a band-aid over it can protect the area where the friction is creating problems.

Once a blister has formed, it can be a serious concern. Keep the area clean, and avoid draining the fluid or allowing the blister to break open. This can make the skin susceptible to infection. Instead, cover it completely and try to reduce contact points that will create further friction.

Swollen Hands 

Your blood flows really well while hiking, which is a good thing. If it’s causing uncomfortable swelling in your hands though, try looping your thumbs into your backpack straps somewhere. This stops the centrifugal force that is pushing too much blood into your hands. Using trekking poles can also work.


This can be a tricky one, but there are a few common and very treatable reasons hikers get headaches while on the trail.

The most obvious reason for a headache while hiking is dehydration. If it improves when you lie down, this is usually the case. Solution: drink more water. Try doubling whatever you’re drinking now up to 1 liter per hour. Skip any electrolyte additions and instead have a few salty snacks. For snacks, it is sometimes best to avoid peanut butter, peanuts, and chocolate, which can exacerbate a headache in some people.

If your headache does not get better when you lie down, or if it feels better when you’re standing up, you may be suffering from hyponatremia; meaning you’ve drank too much water and need more salts, sugars, and electrolytes in your bloodstream. Take a break and have the saltiest snack you can find (or two). Try to urinate and consider limiting your water for the next few hours if you’ve been drinking more than 1 liter per hour. Add an electrolyte powder to your water for the rest of your hike.

Stomach Ache 

Stomach ache can be related to over-hydration. Try drinking less water or, and having a small snack or two to help process that water through your body. Heat can also cause an upset stomach in some people. The best cure for this reaction is relaxation and shade.

Knee Pain 

Where does it hurt? If it’s on the top of the knee cap, behind the knee cap, or under the kneecap, you should probably see a doctor. While on the trail, try to minimize your movements that cause pain, use trekking poles to better displace your weight. An anti-inflammatory will likely give you temporary relief until you can see a doctor and find a more permanent solution. If your knee pain is on the outside of the knee cap, it is very likely caused by a tight IT band, that long fibrous tissue that runs from your knee to your hip. To loosen it, try foam rolling the outside of your thigh with a foam roller or even a water bottle while sitting around camp at the end of the day. Do this regularly at home and eventually you may get relief.

Shoulder Pain or Low Back Pain

If the bones in your shoulders are aching from your pack, you may need more padding or your pack may need to be looked over by a professional for adjustments to the fit. If your muscles are aching, especially the muscles in the center of your shoulder blades, tighten your sternum strap. Your load is likely riding too far out from your body and torquing your shoulders back. Consult with your doctor if you these adjustments don’t help or if you have an injured your back.


None of these tips for prevention and treatment of common hiking injuries should be used in place of the advice of a medical professional. Please see a doctor should you injure yourself and remember to seek advice from a medical professional before beginning any new training plan.