Having Fort Harrison State Park next door is a pretty sweet deal…for me. I see quite a few hiking injuries. The bad news is there are six problems that show up a lot. The good news is I am one block from the entrance.
Three Common Acute Hiking Injuries
These are sudden hiking injuries that can occur just from you hiking around.
Ankle sprains are on top of the list. There will be little risk if you stay on the paved path around Lake Delaware – the Harrison Trace Trail. If you spend time on the Schoen Creek trail, the Lawrence Creek trail, or the Fall Creek trail, there are roots and rocks waiting to ambush you.
The biggest problem, which will be a theme in this article, is that 98% of this type of injury happens when wearing flip-flops, Keds, or ballet slippers. Basically, wearing shoes that are not very appropriate or protective enough to be out on the trails with.
When the ankle tilts inward the outside ligaments (lateral collateral ligaments) get damaged. A class 1 sprain is a stretched ligament, but classes 2 and 3 involve a partial or complete tear. Early treatment and rehab can make the difference between a 2-4 week recovery and a 6- 8 week recovery.
Another common problem is a painful black nail. This is a result of bleeding under the nail plate. Known as a subungual hematoma. Either a single large impact or multiple minor repetitive collisions on the toenails can cause this.
Kicking a root or rock (single injury) or having a too short hiking boot (repetitive offender) can separate the nail bed and plate. When the bleeding builds up, the pressure can be very intense (or in tents if you are camping). You can create more problems if you play “MacGyver”. The long-term issue with this type of nail damage is that it will allow a fungus to invade the nail. It may take a few years but the nail will become darker and thicker from fungus involvement.
If there is enough bleeding under the nail, the nail will get loose and may fall off. It may take 2- 6 weeks to occur. Potential trouble is that 80% of the nail will be loose but 20% will still be attached- OUCH!
The third common problem is blisters. The superficial skin will separate from the deep layer if enough force is present. Fluid and even blood will fill this void and raise the skin. The discomfort or burning feeling is from the pressure or subdermal damaged skin. This is like a 1st degree burn. I would like to keep the skin intact for 3 days if tolerable. It will take that long for the underlying skin to recover. The overlying skin will act as a biological dressing. If the pain level is significant, the area can be drained or deflated. Supportive care will help the skin recover as fast as the body will allow. The larger or deeper the damage…the longer it will take.
The big question is – what caused the blister? It is usually from flip flops, Keds, or ballet slippers. Bad decisions give bad results. A new hiking boot or shoe may create a “Hot Spot”. A light or mid weight Merino wool sock can prevent this.
A long standing callus can become so thick that it will produce a hot spot/blister. This is from either a biomechanical or anatomy issue. Directing attention at the cause will eliminate or reduce the problem.
Remember, a blister or callus is from pressure or friction. Placing something over the hot spot will cause more pressure and aggravate the problem. Putting moleskin over the pressure area may not be a good idea. Putting moleskin over a blister will tear the overlying skin and damage more tissue. Don’t jump from the fire into the frying pan.
Three Common Chronic Hiking Injuries
These are hiking injuries related to the mechanics of the foot.
Plantar Heel Pain
Pain in the bottom of the heel will be plantar fasciitis. This becomes a pain when you start walking after a 20-30 minute rest or when you take the first steps in the morning.
Pain in the back of the heel is a Haglund’s deformity (Insertional Achilles tendinitis). This may escalate by developing a large bony lump on the heel bone. The other Achilles problem occurs 3-5 inches above the attachment. The Achilles is the largest tendon in the body and it is never a good idea to ignore this problem.
The Other Ankle Sprain
The other common over use problem is Posterior Tibial tendonitis. These symptoms are found from the inside of the arch, ankle to the medial lower leg (opposite side as the inversion ankle sprain). This problem starts off slow and escalates with time. Typically you will see a severely pronated foot (flat foot). Want to know what that looks like? Click HERE. While the tendons slowing deteriorates the rear foot joints are also being damaged.
Hiking is a great way to enjoy the outdoors, stay healthy, and get lost. But there are problems you should be aware of. Watch out and avoid these problems and you will stay away from me.
If you or someone you know is experiencing one of these foot and ankle issues? Contact my office for the best treatment today!