View Full Version : Know your enemy
Idealist
02-21-2008, 15:33
We are gathering a list of common hiking injuries. In addition to pre-trail conditioning, we also hope to develop a daily on-trail stretching regime. The hope is: that by knowing about potential physical problems, we will stand a better chance in preventing them.
Here are the biggies we’ve read about:
blisters
Plantar Fascitis (heel pain)
Achilles Tendonitis
Tibial Stress syndrome (skin splints)
Patella Femoral Stress syndrome (knee problems)
stress fractures
Our current prevention regime is being developed from previous WB threads (in the case of blisters) and from http://www.furman.edu/first/sept2526.pdf (http://www.furman.edu/first/sept2526.pdf) (for sports injury).
Questions: Have we overlooked an injury? Do you have suggested treatments/prevention stretches/etc. for the injuries?
Thanks for your help.
I once heard of a napping hiker who was mistaken for carrion and carried off by a vulture. Is that the sort of thing for which you were looking?
Kerosene
02-21-2008, 16:08
Having endured intensive PT for Achilles tendonitis, I can elaborate on the ankle-strengthening exercises and stretches that I use. See this post (http://www.whiteblaze.net/forum/showpost.php?p=170&postcount=6).
Crotch chafing (in hot weather).
Appalachian Tater
02-21-2008, 17:01
Crotch chafing (in hot weather).Which can be severe and involve fungus and which can be prevented to a large degree.
Also falls do happen and you hear about broken bones and such. Not sure they can be prevented.
Besides injuries, you should also look at Lyme and other tick-borne disease as a preventable and potentially hike-ending problem.
envirodiver
02-21-2008, 17:06
I have had a few cases of straining the muscle that starts in the groin and runs along the inside of the thigh to the knee. I think that mostly was due to poor technique of pushing off with the inside of my back foot walking up steep hills. Stretching seemed to help this some.
I've also heard people complaining about lower back pain.
Thanks for that Kerosene - really useful ;)
The Weasel
02-21-2008, 17:15
Severe leg cramps, especially at night, of the "Charley Horse" variety. Potassium supplements/salt helps prevent them.
TW
I've often wondered whether stress-fractures of the foot are more or less common among A.T. long-distance hikers now than years ago and to what extent such injuries are related to footwear, technique or other factors that can be controlled.
Idealist
02-21-2008, 17:39
Thanks to everyone else for sharing. We are acquiring great information here.
Idealist
02-21-2008, 17:41
a napping hiker who was mistaken for carrion and carried off by a vulture
Gosh, maybe I should start another list “animals of concern”: venomous snakes, bees, overly ambitious vultures…
I've often wondered whether stress-fractures… and other factors that can be controlled.
Yeah, us too. Some of the above mentioned injuries have plagued us in the past, but since we’ve taken up regular stretching and conducted more research into our footwear, our problems have not reoccurred. Such is the reason for soliciting everyone’s help in learning about AT injuries.
envirodiver
02-21-2008, 17:44
Idealist, when do you anticipate completing your research and will you post your findings here?
Appalachian Tater
02-21-2008, 17:52
I've often wondered whether stress-fractures of the foot are more or less common among A.T. long-distance hikers now than years ago and to what extent such injuries are related to footwear, technique or other factors that can be controlled.Strengthening your muscles and allowing them to rest will help them better support the bones. Also make sure sure you get enough calcium and vitamin D to allow your bones to repair themselves. But the best way to prevent them is to avoid overuse, especially sudden overuse--it's caused by cumulative trauma.
Heat injuries are probably the most overlooked and the most dangerous.
Idealist
02-21-2008, 17:57
when do you anticipate completing your research and will you post your findings here?
I’d be happy to post up the results. Since injury prevention is the form that my Appalachian Mountain Fever currently is taking, I reckon I’ll have all this information worked up in the next week or two.
I hiked at least to Pearisburg in more than just a little pain much of the time. I took a few days off there, but continued on in spite of it, maybe unwisely.
You should do what you can to lengthen them by stretching them gently between now and then. Also, be aware of them and listen to your body when ascending steep pitches.
If it's uncomfortable to ascend with your entire foot on the treadway, you might be able ascend with just the front portion of your sole in contact with the rock. There would also be a message there. Heed it.
How about shoulder injuries?
Strengthening your muscles and allowing them to rest will help them better support the bones. Also make sure sure you get enough calcium and vitamin D to allow your bones to repair themselves. But the best way to prevent them is to avoid overuse, especially sudden overuse--it's caused by cumulative trauma.
Jumping from boulder to boulder on a long descent with a heavy pack I would think's a good way to invite injury. Slowing down and lowering one's feet to the boulder below would be better.
Tater,
What do you think of insoles and do you think they offer any protection from stress-fractures to the foot? Are there any specific recommendations or brands you prefer for your own use?
SOG
Appalachian Tater
02-21-2008, 18:14
Tater,
What do you think of insoles and do you think they offer and protection from stress-fractures to the foot? Are there any specific recommendations or brands you prefer for your own use?
SOG
My feet are almost perfectly flat so I wore blue Superfeet on my thru. I don't use insoles now, and I don't think they really absorbed much stress, being made of hard plastic. If you have insoles that actually absorb stress it would reduce the odds of getting a stress fracture, but I can't recommend any particular type or brand. The key is stress reduction, so they would have to reduce impact.
The easiest way to prevent stress fractures is not to hike too many miles, especially at first. Rest also gives your bones a chance to heal.
Having endured intensive PT for Achilles tendonitis, I can elaborate on the ankle-strengthening exercises and stretches that I use. See this post (http://www.whiteblaze.net/forum/showpost.php?p=170&postcount=6).
I find linking single posts of my own useful and am glad to see others putting this technique to good use. I like it especially to link links I linked earlier, rather than to link them again.
Idealist, I would read up on treating blisters. There seems to be almost as many ideas about how to best treat blisters as there are hikers.
I've used Band-Aids on my heels, oriented vertically. The water-proof, slippery variety. That way I can keep the injury cleaner and change the dressings as needed.
I find if I have a boot or shoe that's shaped like my heel I'm not as apt to experience problems, but such footwear seems hard to find.
You will likely get a lively discussion on this topic. There are possibly some newer remedies that would be worth considering.
Also falls do happen and you hear about broken bones and such. Not sure they can be prevented.
See Another thru hiker fall (http://www.whiteblaze.net/forum/showthread.php?t=26010) for ideas collected last year on how some falls occur and might be prevented.
What about mental problems? :-? ;) :( :confused: :eek:
Sailor (The other one)
02-21-2008, 19:55
I'm a massage therapist and personal trainer working in a chiropractor's office. I've worked with many people with Plantar Fascitis and have suffered it myself.
First, it is not "heel pain." It is a problem with the huge tendon on the bottom of the foot that branches to each toe. Often the pain is in the heel, often elsewhere. In the extreme it can be completly deblitating. I knew a woman bedridden by it.
Simple stretching can be preventative. Extend your leg out and point your toe toward your knee - the same stretch you do for your calves - is a simple one.
The best treatment I have come across is the Graston Technique (http://www.grastontechnique.com/) used by one of our chiropractors. My PS was so bad I couldn't walk 10 yards without limping. One treatment and I'm able to backpack again. The technique is better than anything I have been able to do for my clients, so I refer them.
Generally speaking, a good way to avoid most of these injuries is conditioning, that is, slowly building strength and endurance and flexibility. The body is amazing adaptable if it is stressed within a certain range - not too little, not too much. You don't have to know the range. Simply start with what seems to easy, then increase the intensity slowly. My clients start out complaining "That was too easy" and end up sayong "God, that was tough" but they don't get injured. Easy does it, which means, easy gets it done.
Regarding flexibility, first it is best to stretch a muscle after it has been exercised. There's research that suggests muscles stretched afterwards begin to keep the new length, meaning you're more flexible all the time.
Second, most people don't hold a stretch long enough. A muscle's first reaction to a stretch is to tighten. You must give it time to relax then get into the strecth. My clients stretch 30 seconds minimum. One of the reasons yoga is so effective is the length of time stretches are held.
Last, don't bounce when you stretch. You'll tear something. Hold the stretch steady and keep breathing while you hold it.
Hope that's helpful.
Blissful
02-21-2008, 20:16
How about ITB - Illiotibial band syndrome. That could be lumped in with the knee, but can affect the thigh. I had that a lot on the beginning of the hike. There are stretches for this. I also wore a knee wrap at times on the affected extremity.
Blissful
02-21-2008, 20:18
See Another thru hiker fall (http://www.whiteblaze.net/forum/showthread.php?t=26010) for ideas collected last year on how some falls occur and might be prevented.
You WOULD have to bring that up. :(
(Just kidding)
Idealist: Gosh, maybe I should start another list “animals of concern”: venomous snakes, bees, overly ambitious vultures…Be extremely careful not to accidently follow one of the numerous Sidehill Gouger Trails that crisscross the AT. If you happen to follow one of these trails, it is said to encourage one leg to grow longer than the other causing problems later in life.
Sidehill Gouger
Kingdom: Animalia
Location found: North America (with related species found in parts of Europe)
http://www.museumofhoaxes.com/EE/images/uploads/sidehill.jpg Sidehill gougers are herbivores highly adapted to living on steep hillsides. The legs on one side of their body are longer than the legs on the other, allowing them to stand comfortably on sloped terrain. These creatures come in two varieties: left-handed and right-handed (also known as counter-clockwise and clockwise gougers). The legs of a left-handed gouger are shorter on the left. As a result, it can only travel around a hill counter-clockwise. Right-handed gougers are just the opposite, with legs shorter on the right. They always move clockwise. This business of always moving in the same direction is the source of the gouger's name, because they gouge a path in the side of a hill as they endlessly circle it. If gougers do try to reverse direction, they inevitably topple over.
Right-handed and left-handed gougers, it should be noted, are simply different forms of the same species and can breed together. However, their offspring often end up with mismatched legs (a long leg on their front left and a second long leg on their back right, for instance) making it almost impossible for them to move. Such hybrids usually don't survive long.
Beyond the unusual length of the gouger's legs, little is known about the appearance of this creature. Some say it's badger-like. Some say it's goat-like. One observer, a Harry S. Knight of Camp Wood, Arizona, has been quoted as saying: "A Sidehill Gouger is jest a burrowin' buffalo, sized down and growed crooked."
There have been reports of a Gouger sub-species found in the Appalachians that has fur only on the downward-sloping side of its body. The fur on its other side has been worn away by constant rubbing against the side of the hill. The skin of these creatures, being so highly polished and smooth, is sought after by handbag makers.
Almost There
02-22-2008, 10:17
Illiotibial Band Syndrome or ITBS, the thick band that runs from your upper hip along the outside of your thigh down to the outside of the knee. When it is overused it tightens and feels like it is catching on a bony knob on the outside of the knee. Doesn't cause permanent damage, but hurts like no tomorrow. Stretching is key for this one. Lunges as part of your training program can eliminate this one.
I had a nasty case of ITBS from running just before starting a long section a couple of years ago. It was bad enough that I thought I might have to postpone the hike. This exercise (http://www.sportsinjurybulletin.com/archive/runners-knee.html) completely cured my ITBS, and I swear by it. If the description is confusing, someone put up some pictures here (http://mis_nomer.blogspot.com/2006/10/walt-reynolds-itb-special.html) (though I think you need to bend your knee quite a bit more than the pictures show).
take-a-knee
02-22-2008, 11:45
I would add a tight illiotibial band to that list, it can cause knee pain. Learn to stretch it.
Also, most injuries on your list are overuse injuries, they won't heal without adequate protein intake, your bones are 25% protein (collagen). A diet of pop tarts is a recipe for failure.
RE: Blisters - If you cut a patch out of duct tape a little larger than the blister and stick it to another, larger piece, then stick the larger piece to your blistered area, the inner piece will not stick to the blister (of course I meant sticking the two pieces together with the adhesive surfaces facing each other).
Prepping the area around the blister with an alcohol pad will also keep the duct tape from slipping. Do NOT use stove alcohol. It has poisonous additives.
I had a nasty case of ITBS from running just before starting a long section a couple of years ago. It was bad enough that I thought I might have to postpone the hike. This exercise (http://www.sportsinjurybulletin.com/archive/runners-knee.html) completely cured my ITBS, and I swear by it. If the description is confusing, someone put up some pictures here (http://mis_nomer.blogspot.com/2006/10/walt-reynolds-itb-special.html) (though I think you need to bend your knee quite a bit more than the pictures show).
Bookmark. I can confirm that crowned roads, gravel, too! will do this.
A good homemade stretch. Like dropping down for a pushup. Inverted V. Bend one knee a little and sway the butt out, gentle! Left hip hurts, bend right knee, sway to the left.
Thanks for the link!
envirodiver
02-22-2008, 18:09
.
The best treatment I have come across is the Graston Technique (http://www.grastontechnique.com/) used by one of our chiropractors. My PS was so bad I couldn't walk 10 yards without limping. One treatment and I'm able to backpack again. The technique is better than anything I have been able to do for my clients, so I refer them.
My daughter is a very competetive soccer player. For a couple of years she suffered with very painful shin splints. Our chiropractor gave her a Graston treatment and she was so much better, after 1 treatment, that it was amazing. It was close to magic. After 3 or 4 treatments she was cured. She said that the treatments hurt like he**, but it was worth it to be able to play and not hurt so bad when she ran.
Now if she ever feels a twinge she goes and gets a treatment.
What about bear bites, dog bites,etc?
take-a-knee
02-22-2008, 22:58
My daughter is a very competetive soccer player. For a couple of years she suffered with very painful shin splints. Our chiropractor gave her a Graston treatment and she was so much better, after 1 treatment, that it was amazing. It was close to magic. After 3 or 4 treatments she was cured. She said that the treatments hurt like he**, but it was worth it to be able to play and not hurt so bad when she ran.
Now if she ever feels a twinge she goes and gets a treatment.
No, Diver, there's no way a chiropractor actually helped your daughter! It couldn't be true!:rolleyes:
Since Tater or the other WB quack police haven't posted some AMA sponsored link yet intended to scare people away from effective chiropractic care I couldn't resist...sorry. Millions of people see chiropractors and feel better after doing so, how many MD's can say that?
Idealist
02-23-2008, 05:24
...Sidehill Gouger...
He, he, he… I haven’t thought about these guys for sometime. I might add them to my AT mammals list!
R U French!!! Nope, American. Currently living in France.
Idealist
02-23-2008, 05:25
Thank you everyone for your help. We are gathering great information here (as is the norm on WB).
We did not know of the Graston Techinque. Thanks for the tip, RBrownkatz.
plyometrics are what i find to be the best exersizes to prevent injuries. stretching is great but it really doesn't prepare your joints and ligaments for the pounding of real activity. stretching is slow and controlled. when you jump or run or plant your foot hard that does not mimic what you do when stretching - the plyos mimic the hard impact encountered in the real world of sports and activities
http://www.sport-fitness-advisor.com/plyometricexercises.html
tina.anderson
03-05-2008, 15:24
Heat injuries are probably the most overlooked and the most dangerous.
I agree. I have had sun poisoning before and it is not fun.
Neurosis
03-05-2008, 15:30
The only real big problem Ive ever had with hiking it leg cramping, which can easily be avoided by eating some peanuts or raisins. But onetime it got so bad I was completely immoblized on the south face of Mount Washington (not good) thank god this women cam rolling through the wind in fog and saw me. She then gave me a banana of hers and sat with me for a few minutes. I eventually was able to move, slowly but got myself to the summit and back fine. You've got to love hikers in New Hampshire there absolutly amazing, Ive never meet a bad one.