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Part 3: How do I prevent overuse injuries from occurring in the first place?




We’re back with part 3 in our series on the most common hiking injury: in case you missed it (check out part 1 and part 2 so we're all on the same page).


Most hikers have some degree of awareness of the possibility of injury while hiking, and we all definitely have the desire to prevent them. I mean let’s face it, depending on what type of hiking you’re doing, getting an injury could really put a damper on your hike! You might have to cancel your trip altogether, end it early, or heaven forbid, be rescued from the trail. Regardless no one wants to have an injury that sidelines them or takes them off the trail.


The best way to deal with an overuse injury is to prevent it from happening in the first place! So how to actually accomplish this? First, realize that it is multi-faceted, but the most important thing is you do actually need to TRAIN for your hikes (I feel like a bit of a broken record), but this is really non-negotiable. You've got to have a plan. Let’s get a bit more specific about your training plan. What does your training actually need to include?


Many people erroneously believe that they will prevent injuries by stretching or they think this is the answer to their pain problem. How often have I heard, “I keep stretching and stretching and things are not getting better.” Or the flip side of that is I often hear, “I know I don’t stretch enough…” Don’t get me wrong, stretching can have its place in your training and might be a starting point or a single part of your regimen as does other mobility work (stretching is part of mobility but it’s not the only thing). However, more often than not, there is always something else missing in someone’s training (and usually it's related to strength training, although not always). Anywho, without further ado...


Your hiking training plan must include the following:

  • Cardio

  • HIKES!

  • Strength training

  • Mobility work (this might include stretching but is not limited to stretching)

  • REST


So let’s dive into each one a little bit.



Why should I include both cardio and hikes in my training plan?


You may be wondering why I list Cardio and Hikes separately. Isn’t my hike also my cardio? Well yes, it can be so this might be true, BUT (lol there’s usually always a “but” with me). I think it is important to consider them separately as there are factors where it may not be the same thing at times within your plan or there is a need to break them apart, and you want to have them both.


So by Cardio we mean, getting your heart pumping and aerobic activity for a sustained period of time. During this time you are training your cardiovascular system more than your musculoskeletal system (though really you are training both). You may be doing this for a certain amount of time or you may be doing this for a certain distance. Either is fine; if you are a beginner it may be more advantageous to go by time. With this, you also need to have a plan to progressively increase your load. This is a huge area of training errors (see part 2); typically it means you progressed too many variables too quickly, maybe you've tried to increase your distance too quickly and then you also added your pack weight and/or too much elevation gain all at once (or even within too short of a time period. Maybe you started your training late). So if you're having a new pain and you are following a program, you need to look for a training error in your plan.


And then Hikes means just that...your training plan for hiking should of course include...hiking!


Let's talk about why we include them separately though for your training plan.


First and foremost, if your activity is hiking then that’s what you need to be doing! You can’t expect to hike a 14’er in Colorado this summer, by only having worked out at the gym on the elliptical, stair climber, or just gone on runs on your neighborhood sidewalk.


With training for any activity, you must have specificity, which essentially means you are spending time building up your base and training for your hike, by HIKING. While there is overlap with some activities, you don’t use the same muscles when you hike vs walk vs run (or do elliptical or even do stairs at the gym). So you must spend time actually hiking. Your muscles need to get accustomed to the activity you are asking them to do; particularly if you're asking them to do a lot (like hike 250 miles or even 10 miles...that will depend on where you're starting). Your cardiovascular system works in a different manner when you hike versus walk…you’re going to breathe differently when you’re walking up a hill than just on flat land. Also, the starting elevation of your hike and the elevation gain will tax your system (both musculoskeletal and especially cardio-pulmonary) differently. (I’m not even going to delve into that right now as that’s a huge topic for another day). If you walk on the treadmill at an incline or use a stair climber at the gym, that is still VERY different than traversing up a trail where you have to scramble over rocks and boulders. It is not the same thing. So the first point is you really must actually have hikes planned within your training program. Honestly, I feel like most people know this part.


There is another reason to view your cardio and hikes separately and it will depend on several factors. A big factor will be where you live. You may live in a city with no mountains within 200 miles. You may be like me; I currently live in Dallas, TX. We don’t have a huge amount of elevation here! Not like living at 6k in Colorado Springs where I used to live. Big difference! This doesn’t mean I can’t hike here or nearby, but I do have to realize and plan within my training program to get other hikes in that better prepare me for my big hike (depending on what that hike is). In the case of a person living in a flat place, it may mean within your training program, that you plan some trips where you can get more elevation. Or it may mean that you have to incorporate into your cardio training, some stairs or bleachers, or a stair climber at the gym (not my favorite but it'll do if you have to). Along with where you live, you may also not actually live in a place where you can really get outside other than the sidewalk. Maybe you live downtown or in a very urban setting and don't have a way to get outside. In this case, you want to still be addressing cardio regularly, likely in a gym setting. Even there again though, you will still want to have some hikes planned within your training. Your body needs to be prepared for the varied terrain of hiking. Let's just take the example of your ankles. Maybe you live in New York City, and you've planned things out and you're addressing the elevation by using the stair climber and you're evening doing some cardio with your pack on (good thinking). However, no stair climber is going to actually mimic the feats that your ankle must go through to balance and stabilize in going over rocks and boulders. So again you really do need to include actual hikes even if you're limited.


So I think you can see why you'd want to have hikes listed separately on your training plan. But what about cardio? I think it's beneficial to include some different forms of cardio within your training. Cross-training helps to prevent injury and may just be more convenient for some people. I think you can also train your cardiovascular system in some ways better by utilizing different modes of exercise such as walking, running, cycling, or even an elliptical. If you're familiar with things concepts like intervals, which helps to improve your cardiovascular fitness, those are easier to implement in a bit more controlled set-up like these activities, whereas hiking is so varied due to different terrain based on the trail you're on. While you want to spend time in your activity, too much of it can lead to exactly what we're talking about, so cross-training often helps to combat this.


For those people who don't have access to lots of elevation, it's okay! You do still need to seek out some hikes but it may be a bit less frequent than someone who has mountains in their backyard (I really miss living in CO for this very reason…a hike after work or even before was awesome!). Or it may mean you're getting some hikes in but they don't have elevation and so you may have to do stairs. Your body works in a different way both cardiovascularly and from a muscle/strength standpoint, so even if you don't have elevation, you'll want to incorporate or mimic it somehow. This also is a good time to mention that not every training plan will look the same for everyone. These are definitely the basics you need to have covered, but if your goal is to complete your first backpacking trip but it's 40 miles in Texas; your training plan will look very different than someone trying to hike Longs Peak (which is at 14k feet and an elevation gain of 5k ft all within about 14.5 miles). Being well prepared for any hike is great, but I don't have to train to hike as far in distance for Longs but it is much more intense. Your training plan should take into account what your goal hike is.


Related, within your cardio and particularly your hikes, it is necessary to take into account what your actual goal is in other ways. If it is to hike the Appalachian Trail or any sort of section or thru-hiking, remember you must incorporate in your training plan to account for the weight of the pack that you are going to carry. Your pack will look very different if you’re day hiking versus overnight versus section or thru-hiking. So this will vary for everyone (are you an ultralight backpacker or do you carry 50 pounds of stuff). Even this you need to train your body to carry whatever load you are going to be carrying for that actual hike. It most definitely is a factor! If you do not factor these things in, then yes these could contribute to an overuse injury (because you've still exceeded that tissue's capacity to withstand a certain load by training without your pack weight added in).


You have to view both your hikes and your cardio in two different regards. You need to build your aerobic base or more from a cardiovascular standpoint. But then you also need to build both your strength and endurance from a musculoskeletal standpoint. I’m gonna leave it at that for now, and try to keep this simple. Your hikes and cardio must build on each other; they must be PROGRESSIVE. You cannot go from being a couch potato to 5 miles in two weeks. Or hiking 5 miles on flat land (no elevation gain) to 5 miles with an elevation gain of 2000 ft. Or conversely, imagine a 2-mile hike: one has an elevation gain of 500 ft and the other has an elevation gain of 1000 ft; those are not the same. You do have to build up to it. This is the most common training error (which is likely that you're not even following a plan at all or where you are starting is not appropriate for your current fitness level). Following a progressive training plan in this regard is essential. A common general guideline to follow is your total mileage for the week with hikes (as with runs) is not to exceed a 10% increase in distance. As mentioned earlier, elevation gain is harder to control or account for, and I'm not aware of a hard and fast rule regarding your elevation gain. But you do need to pay attention to the elevation gain and also be progressive about this. A 200-400 ft elevation gain per mile would be considered easy, whereas a 1000+ ft elevation per mile would be challenging. This should be kept in mind when selecting hikes to progress appropriately (of course you cannot actually entirely control for this and then when you're backpacking a 30 mile trip, it can be a very different story as there may be a total elevation gain of 2000ft but a 1000 ft of it is within a couple of miles vs 2000ft over the course of 30 miles, again very different). The point with elevation is that you have to keep it in mind within your training plan.


If you’re interested in a FREE 8-week basic training plan that you can follow if you’re a newbie! (or even if you’re not), then click here!




What is often the missing link in any hiking plan? Where do people go wrong with their training plan?


Next up is strength training. I would say this is probably the most overlooked area for hikers in having a thorough training plan. Some don’t strength train AT ALL….you have to do something, even if it’s very basic. And then on the other end, there are gym goers who hit it multiple days a week, doing squats and lunges, thinking they are training smart, but then they still struggle with their knees bothering them on their hikes. If the latter is you, I highly recommend you work with a physio or physical therapist who will identify underlying causes and can create a tailored plan specific to you. And actually, the people who don’t strength train at all, also really need a physio. Honestly, I really think EVERYONE would benefit from this, regardless of whether you have an issue.


Maybe you do go to the gym regularly, and you struggle with some aches and pain or even just struggle to get up or down the mountain. I can almost guarantee that an area you are falling short with your strength training is HOW you train. Specifically, you’re very likely not focusing on the eccentric aspect of a movement. (Stay tuned, we'll come back to this another time)...and often times this relates to your potential for injury. Another area that's important to your strength training is stabilization training and balance training (think having to do a water crossing and balance on small rocks...most people will just say "Oh I have bad balance. Well you can train to improve your balance!).


Sticking to the general topic right now though…strength training. It MUST be part of your training plan. I have had to say this over and over to people during the course of my career as a PT, but you CANNOT replace your strength training that is specific to certain muscles with your hikes and just think that your hikes can strengthen you and fully prepare you for a bigger hike. The reason for this is our bodies are great at cheating. That’s right. Actually, in a way, this is a good thing. Our bodies are able to compensate for weaknesses in certain muscles, which can end up as a muscle imbalance. There may be certain muscles that are inhibited. And we may never be aware that they exist. To step up a big rock where I have to lift my leg higher than a typical step, there are all different manner of muscles that could be used to accomplish that task. If I’m hiking, I’m not really paying all that much attention to this. I’m just doing it. On a hike, you're just moving and accomplishing your goal. You're not worried about HOW you do it. So there may be weakness in your glutes, for example. And all you're thinking is "ahhh man my quads are burning". Strength training done right is all about not just increasing your strength overall so your muscles and overall system are up for the task you’re about to ask them to do. It’s also about addressing any muscle imbalances that may make you prone to possible injury. So, NO you CANNOT skip the strength training. Do you have a training plan to follow? Let me know how I can help you!






What does it really mean when they say mobility work?


The next area for the components of your training plan, next up is MOBILITY. This is really a huge one too. Yes, this does include some stretching. I do think stretching has its place and can be helpful. But there are so many people who think that this is THE ANSWER for their pain or injury prevention. I see countless people who get hurt and they looked up a few stretches on YouTube and think they are addressing their problem. And then they wonder why they are still struggling. Or in the case of today’s topic, they think that doing some stretches and just having a stretching program will help to prevent the injury. I do think I should back up for just a minute though. As I have worked with people and given them a tailored plan of exercises specific to their issue and some will reply, “These are great stretches.” (uh, they are NOT stretches). So let’s all get on the same page.


What actually is stretching?



Stretching is typically a passive elongation of the muscle. (I say typically because there are two types of stretching but we’ll keep it simple right now). Stretching does nothing to change strength or any muscle imbalances (and by imbalance I mean this: typically to perform any movement, different muscles work together to accomplish that movement. And some people may have some muscles that want to take the day off or not show up and then other muscles have to overwork to account for this). So if you stretch and all you do is stretch, you are not affecting the strength of that muscle. If you are in the midst of an injury, a stretch may be a helpful STARTING point as a way to begin to gently load the tissue. But you definitely cannot stop there. And you need to see the difference between an exercise to gain strength vs a passive stretch. If you don't know why you're doing a certain exercise, you really need to stop and figure out the purpose and where you should be feeling vs where you actually feel it (not always the same and this means you may need to make some changes for your body). Some people will think that their hiking will increase their strength, which to some degree it does. However, if you are hiking and thinking that replaces strength training, that’s a big mistake! Hiking will never replace strength training. The trouble is that when you are hiking, you may likely be moving in a manner that you are compensating and only using certain muscles to help you get up the mountain. You don’t have time to think or focus on the quality of your movement. And so certain muscles may remain weak (and that’s not saying you are weak but yes certain muscles may be or they may be inhibited meaning they just aren’t doing their job). If certain muscles aren’t doing their job, others may take over, and then that just reinforces the abnormal movement pattern and makes you further prone to injury. Stepping off my soapbox about strength and back to mobility work (sorry sometimes I digress).



But there are also other structures aside from your muscles that need to be taken into account that you likely may not think about. A big one that physical therapists often deal with is JOINT MOBILITY, which as it sounds is how the actual joint is moving. Mobility work needs to include these kinds of exercises as well.


Let’s take the analogy of a door in your home that does not move. You can’t get it to close (or open…doesn’t matter which one). So you try pushing on it, and pushing on it and pushing on it…and it doesn’t budge. What do you often have to do? You have to look a bit more closely at the hinge; the hinges have to move in order for the whole door to move. So maybe they need some WD40. Same thing with a joint (well not the WD40 part). Let’s take your knee. Let’s say you have trouble bending your knee or maybe you hiked 20 miles and you have trouble straightening your knee (again doesn’t matter which). Could it be that your hamstrings are tight, yes quite possibly that may play into it. But it also could be that the actual knee joint known as your tibiofemoral joint (really there are more joints than just the typical hinge joint you think that influence your knee's ability to bend and straighten). The point is, there are certain exercises for mobility work and ones that are tailored towards your joint mobility. Many times also you may need some hands-on work to affect your joint mobility. Once you know what areas need to be affected, then you may learn self mobilizations.




There are also other things that encompass mobility work. You do have other structures besides joints and muscles that could be affected. You could have a nerve mobility issue that is getting aggravated, so yes there are actually nerve glides that we do.


Also in the area of mobility work can be things that address the tone of a muscle. Neuro-dampening a muscle that is overactive (but can also be weak)...foam rolling might be an example of this. Yes, foam rolling does have its place in mobility work, but please do not think that you are actually changing your scar tissue or breaking down adhesions by foam rolling. There is absolutely no evidence to support that. And really, if all it takes is a foam roller to do that sort of thing, we would be having all sorts of issues anytime we took a tumble or bumped into things. The better theory as to why foam rolling is beneficial is the concept of neuro dampening. You have various receptors in your skin, fascia, and muscle tissues that are connected to your brain and nervous system. By using the foam roll in certain spots, you are giving a signal to your nervous to reset or to tone things down and it’s your nervous system that adjusts the settings and that’s why you feel better. Your body is an amazing machine and it’s going to take way more than a styrofoam foam roller to actually break things apart.


So, all of these types of things encompass mobility work. And they are all very important. While you might learn some of these things from a YouTube video, it really does matter that you understand the intention of why you are doing them. If your intention when you lay on your back to use a foam roll is to stretch your chest, that is really going to look very different than if you are trying to use the foam roll as a tool to mobilize your thoracic spine. Your purpose with the exercise will most definitely affect HOW you do it. And then there may be certain people who should do some exercises and then there are others who should avoid those exercises. It is not a cookie-cutter recipe. A great example would be someone who has an underlying instability in a joint. They need to focus on stabilizing the joint and not mobilizing the joint. Mobilizing too much could make the problem worse. So knowing why you are doing something and really whether it’s appropriate for you is really important.

I could go on about each of these topics all day…but we’ll save anything further for another blog post.



How important is REST in my training plan?


Last on the list is REST. For some people, this is no problem. For others, it is the reason why they stay injured (or as soon as they heal, they go hard and heavy! HEY, I”m feeling great, I can get back at it). Rest is so incredibly important to your training. And actually when I say rest I don’t just mean taking the day off from your activity or the gym. An active rest day is okay but it really should be easy. Your muscles need time to recover from the microtrauma that you put them through with your hike or your strength training. Microtrauma is actually a good thing as that is what makes you stronger. But if you don’t allow time to heal, then it doesn’t have time to recover and then you’re asking for injury. Because if something is injured or not as strong as it could be, and then you go right back at it, it’s very likely going to be even worse off, especially over time. (HELLO, overuse injury). However, by rest, I also mean SLEEP! Your body does so many amazing things when you get quality sleep. Including muscle recovery. But also with quality sleep, your performance will improve, in large part because your BRAIN has recovered and is also able to work optimally. Sleep demands for people can vary based on age and other factors, but the general guideline for sleep adults is around 7-9 hours.



So those are the components of your Hiking training plan. To prevent overuse injuries, you really must include all of these. If you are missing any of them, it’s important that you stop and start to incorporate them right now. Do any of these surprise you? Do you have all of the components? Which one was missing? Let me know!


Stay tuned for the last part in this 4 part series on overuse injuries....you're plagued by an overuse injury that just won't go away...now what do I do?!?!


Are you a new hiker that is wanting to hike for the first time and are concerned about injury or maybe you’re not confident about being out on the trail? Or maybe you have hiked in a long time due to a previous injury and are anxious about re-injury. Click the link to sign up for my online coaching program Hit the Trail: A hiking program for beginner hikers. It will incorporate all these training aspects and will be tailored to you and your body’s needs!


If you’d like some FREE resources and tips regarding improving your hikes and also preventing injury, join my Happy Healthy Hikers Facebook Group! We'll also talk about other things related to hiking and backpacking, gear talk, nutrition, and more! I'd love for you to join us.


Also be sure to check our store for recommendations for your training, recovery, and hiking/backpacking needs!

If you have some specific questions as to what is appropriate for you, feel free to text me at 214-308-1698 or via e-mail at jill.mitchell@thrivephysioandwellness.com I want you to get back on the trail, reach the summit and enjoy the hike both up and down!

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