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Part 2: The most common hiking injury: Why do overuse injuries happen in the first place?

Backpacking, hiking with dog

Rocky always wants to be line leader....🐶🐾❤️

In this week’s blog, we’re continuing the conversation about the most common hiking injury. If you missed the first one, where we actually reveal what that is, you can catch that blog here (and believe me, you really should read that first, so that the rest of this will make sense. And let’s be honest, if it doesn’t make sense to you, then, you won’t follow through and things won’t improve. So do yourself a favor…if you haven’t read it…go read it NOW…one more time link is here).

Now assuming that we’re all on the same page…we’re talking about the most common hiking injury, OVERUSE injuries, and we’re answering the question “why do overuse injuries happen in the first place?”

If you understand why that happens, then you’re on the path towards fixing the issue or perhaps avoiding one from happening…so that means, this information is for EVERYONE!

The answer to that question, “why do overuse injuries happen in the first place?” is really found in the name. It’s an overuse injury. It happened because you overused it. There. I’m done with the blog! We can all go home. HA!

OF COURSE, I’m not done.

While the answer in some respects really is that simple, that answer does not really help you in preventing this type of issue and also in recovering from an overuse injury. So yet again, let’s dive in a little bit deeper into this issue.

One concept that is imperative to understand to really answer why these injuries happen in the first place is the concept of training errors.

Hiking and backpacking in Arkansas

What are training errors in regard to hiking? And why do I need to know this?

You need to be able to identify training errors in your activity (whether it’s hiking, backpacking, running, or walking (or fill in the blank with your chosen activity) in order to determine where you have exceeded that tissue’s capacity to the withstand the load (remember that’s the definition of an overuse injury).

However, before we dive into what is a training error and what not, I feel the need to step up on my soapbox for a minute and first point out, the first part of that word, TRAINING. You should be training for your activity. If you want to prevent an injury and excel in your hiking, then this is non-negotiable. I’m stepping up on my soapbox because let me tell you the number of people I’ve encountered and also treated where they didn’t think they needed to train. Here’s a classic example. I had an ex-boyfriend (super smart and sweet guy) who truly believed that he did not need to work out his legs in the gym, because he was a runner. He believed that his running and was enough, so he would skip leg day the gym (does this sound familar to anyone?). And yet…he struggled with knee pain. This is an extremely common mistake that I see people making all the time. Whether it’s my post-op hip replacement who believes they can just go on a walk instead of doing their hip strengthening exercises, to the runner or hiker who believes their hike is enough training for their legs, and yet they are puzzled and struggle with ankle pain or knee pain (or pick your issue). If you want to be active and also progress in your hiking (meaning hike longer hikes, hike higher elevations, progress from daily hikes to backpacking), you really must train. And your hikes are not enough. You cannot just hike and think that will strengthen all the necessary muscles. And here’s where I will tell you WHY. First, that's been your MO until now, that's what you’ve done that before…and yet you still struggle with this pain or problem and remain stuck. SO HOW DID THAT WORK FOR YA’?!?!?

Human bodies are amazing machines and can compensate for many different deficits. You can hike with muscle imbalances and certain muscles may be taking the day off (and other muscles having to overwork to compensate for those who just aren’t doing their job (perhaps at all or maybe they’re just not fully up to the task you’re asking them to do) hiking alone will not address your issue and it is not sufficient in order to be a happy healthy hiker. First, you need to determine what those muscle imbalances, mobility issues, and other factors are. And that’s where a physical therapist can help! They can help you even before you are injured and identify the areas you need to address so you prevent an injury from even occuring in the first place! (Did you know you can see a physical therapist for wellness? It’s one of the best times to see them! And it will save you money, time, and heartache in the long run).

A well-rounded training program is what is going to prepare you to reach the summit and also prepare you to be injury-free or pain-free AND to be able to fully enjoy your hike! So for the time being I’m going to step off that soapbox and get back to training errors.

Now that we’ve made clear that yes you need to train for your activity, what does training for your hike entail? Training will include both an actual plan for your hikes, but it will also include a strength training plan. When we consider of all of this, it is a huge amount of information to cover (again I don't want to just throw the information at you. It's vital you actually understand that you follow through). Today's blog focus is on training errors. You should understand that training errors can also occur within your strength training, and that can be a topic for a different day, but today we’re going to focus on your hiking plan and training errors within that. This merely means your schedule of hikes you have coming up or what hikes you intend to do and when. Whether you have an actual plan to your hikes or not (maybe you just wing it and pick different hikes around you and don’t really follow any sort of plan), you can still have training errors. So what is meant by a training error anyway? Well, not to be a smartass but again it’s in the name. It’s an error in your training. HA (cue eyeroll...again).

No but really. First, if you’re not actually training, then that's your first training error. It's like going from 0 mph to 100 mph with your training by not even having a plan. A training error basically is that you’re overloading the tissue excessively to the point where that tissue cannot sustain that capacity, particularly if you continue to progress with your load and level of intensity when that tissue has not fully developed the strength to withstand that capacity, time after time. This can look like several different things or even a combination of things. Essentially a training error means you've done too much, too soon, or within too short of a time. Does this make sense?

To be able to identify your training errors, you need to realize there are different training variables (and somewhere in those…lies your training error). So what are training variables?

backpacking and hiking injuries and prevention

What are the training variables of hiking? What do training variables have to do with training errors?

Please understand that this can apply to more than just hiking, but hey that’s what we’re here for, so let’s proceed with that example. (it is possible there are other variables in other activities that we may not cover here). If we think back to elementary school science class and learning how to do an experiment (maybe it was racing a car down an incline and changing the height of the incline...for me I remember making crystal...and using different substances to actually make the crystals), we had different variables that we were changing and then observing in our experiment (there was the independent variable, which is what we were observing and measuring that outcome and the dependent variable that we changed and manipulated to see how these changes affect the independent variable). Not to get into the weeds but then there were also confounding variables that may have been variables we did not consider but may have affected the outcome rather than the dependent variable. Still with me, here? (let me know if you’re not).

In our hiking and our quest for our optimal health…our hikes and our health are the experiment…and there are variables within our hikes that may influence whether we enjoy the hike or end up in pain, limping down the mountain. These variables are different aspects of our hike and also other factors such as when we don’t hike that we can change that MAY affect our outcome (the outcome being, whether you reach the summit, whether you enjoy your hike or are plagued with nagging pains or getting an injury).

So here are the basic training variables of hiking:

  1. Distance: the length of your hike. However, this is not just for one hike, but should also be examined over a period of time as well…what was your distance for the week if you’re doing multiple hikes in a row, or even over multiple weeks or months. The distance of your hike matters, but so does the accumulated distance over a period of time (and the actual duration of time is also important but see below).

  2. Pace: how fast you’re going. This takes into account your distance but is time-dependent…this really does matter as you use different muscles at different speeds. (and also may use different muscles once other muscles fatigue at some point in time or in certain situations…again keep looking below as it comes together).

  3. often do you hike. This is very much related to what follows with #4 because frequency actually somewhat implies rest, but I think it’s still important to keep them separate. So, how often do you go hiking? Look at this both from a week and month standpoint to also year-round. Do you hike year-round? Or maybe you only hike in the summertime. And so within your hiking season, are you going every single day? Realizing that if I go hiking every day and hike 3 miles for 10 days, that’s one thing, but if I go hiking every 5 days but do 6 miles each time….they’re both 30 miles, but you have to realize that those are very different in the amount of strain you place you on your body and within what timeframe. This is very important as the tissue in question may be capable of 3 mile each day consecutively no problem, but 6 miles may actually be where you have a problem, even though it ends up as the same mileage. So frequency is VERY important.

  4. (Rest): as I said above, frequency does imply rest, but I think it’s important to have this as its own factor. Do you hike every single day, maybe you’re a through hiker or section hiker, how many days in a row are you hiking…when do you take a break from hiking? BUT this also could be within your hike. You have to realize that your body will be affected differently if you continuously hike versus taking some rest breaks along the way (to allow for some recovery). At some point your muscle or tendon will essentially be out of gas so to speak and if it isn’t allowed some rest which then refills the tank, then it may not show up at all and then other muscles have to take over and you compensate (which is great that our bodies can do this) but it also makes you prone to injury if those muscles aren’t trained properly either.

  5. Elevation gain: this means are there inclines/declines but on a larger level, what was the elevation gain of the hike total (and also realizing that an elevation gain of 1000 ft over the course of a 5-mile hike, will be very different than an elevation gain of 1000 ft within a mile). This will definitely factor into how you feel, and if you haven’t actually trained for these (and this means more than going on hikes with some elevation, again like pace, you’re using different muscles and also at different angles, so if you don’t strengthen them for this, then elevation gain can often be a problem. Within this factor also is that if you live at sea level and have a hike of an elevation gain of 1000ft, that's really very different than a 1000 ft gain hike that starts at 10,000 ft. (huge difference, and we won't get into this today, but it is NOT because there is less oxygen at 10,000 ft...yet another topic for a different day!)

  6. Pack weight: basically this means added weight that you are not accustomed to carrying around with you on a daily basis. This factor affects backpackers the most, but could possibly affect a new day hiker (who isn’t used to any sort of pack, but brought all the essentials for hiking and may have added 10 pounds of weight). Another perhaps unpopular thing to point out would also be your own weight. Let’s say you’re a hiker who mainly hikes a few times a year, but let’s say for whatever reasons (pregnancy, thyroid issue, whatever) you’ve gained 25 pounds since you last really hiked at any given elevation. That’s the same as the pack weight. The added weight makes the muscle, tendon, ligament or whatever tissue we’re having problems with, it’s got to work that much harder with added weight. It can also create strain in areas not previously strained before, meaning how the weight is distributed can be a factor as well.

  7. Terrain: basically what is the composition of what your feet are moving over? rock scrambling anyone? Or a trail that is very sandy and you feel like you’re walking on the beach…and having trouble making any headway. Or maybe you have a gazillion water crossings. This isn’t really a variable that you can change but if you’re wondering why you’re hurting, this most definitely could play a role, particularly if you’ve isolated all other factors!

I’d say the first four are the main ones, but the last three are also factors that are important to consider and be mindful of…and also where your training error could lie (and so helps you to figure out where your plan is leading you to pain or why you’re having trouble recovering from an overuse injury).

Hiking and backpacking injuries and prevention
Rest and recovery is important

Just a bit of a tangent...but it is possible there may even be more variables….was it windy that day? Was it raining? Your equipment could be a training error...think shoes, poles, etc...(but those are topics for a different day). Don’t have to go overboard with it least not until you dial in these first things. Really start with these basic ones first.

So now what do training variables have to do with training errors? Training errors are why you’re dealing with an overuse injury. But for a moment, let’s go back to what is an overuse injury…it’s when you’ve exceeded the capacity of that tissue to withstand a certain load and this typically happens with training errors. A training error involves the different training variables and somewhere within one of those (or it could be with more than one), you have exceeded the capacity of that tissue.

Let’s take an example to hammer this home. Sally is a seasoned hiker and has been hiking all her life. But she got sick with Covid and so hasn’t been active in over 3 months. She’s got a trip planned to hike one of the 14’ers of Colorado, Pikes Peak to check another one off her bucket list; it’s in two months. She’s started back to hiking 3 miles 3 times a week and then plans to do bigger hikes on the weekends. She also lives in Dallas so she doesn’t really have a whole lot of opportunity for some serious elevation. She feels she is starting small and building up to bigger hikes and so feels like she’s taking all the appropriate steps. However, she has developed this nagging pain in her knee just below her kneecap when she’s gone on her longer hikes lately; however, it’s not enough to stop her and she continues with her prep for her trip. The weekend comes and she’s in agonizing pain when she tries to a warm-up hike in Colorado to prep for the big hike to the top of Pikes Peak in 3 days. What could be some of her training errors that have led to her overuse injury?

  1. First and foremost not realizing that you are not where you were before you had Covid…factors here may be how long has it really been since you’ve hiked 3 miles…if it’s a few weeks, is different than if it’s been 3 years. So you have to acknowledge that you’re not at the same fitness level you were. I’m not saying don’t push yourself, but it’s about PROGRESSIVE overload.

  2. She had somewhat of a plan but quite frankly it is rather vague. If you don’t know Pikes Peak is 13.5 miles…ONE WAY. (with an elevation gain of over 7400 ft). So at least in this example, she is extremely under-prepared for this hike. First and foremost, she’s doing her 3 miles in Dallas, TX…there is minimal elevation gain here. And not enough to even come close to this.

Can you find any more errors in her "plan"?

To recap, an overuse injury occurs when you've exceeded that tissue's capacity to withstand a certain load. In hiking and really all activities, overuse injuries are related to training errors (and perhaps having too many training errors to tip you over the edge into injury). Training errors are basically found within the different training variables we mentioned above. You also have to realize that all of these things add up. And we'll get into this more in the next blog where we dive deep into how to prevent an overuse injury.

Does this all make sense? Do you feel like I left out a variable that you normally consider? Which variable for you is what you struggle with? Are you struggling with an overuse injury? Let me know in the comments below!

hiker backpacker physical therapy injury prevention

If it doesn’t make sense to you, and before we continue further down the road in our discussion, it really is important to grasp this knowledge, so if for some reason, this doesn’t make sense, please feel free to comment below as I really want you to understand these and break the overuse injury cycle! You can also always e-mail me at or even text me at 214-308-1698 so I can help you to make sense of this and apply it to you!

Are you new to hiking? Do you want to avoid an overuse injury? Click here to learn more about Hit the Trail: A Hiking Program for Beginners. If you’d like to sign up to be contacted about the program, you can click here!

Are you a seasoned hiker that’s dealing with a nagging pain or discomfort that’s preventing you from reaching your goals? Or may you want to prevent an injury from happening for your upcoming trip! Scheduled a FREE consult call here to see how I can help you reach the summit and resolve your pain!

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