Are you new to hiking and recently found a love for the activity? Have you caught the bug after your first summit that took your breath away? Or maybe you’re a seasoned hiker who is constantly plagued with some different aches and/or pains but you just barrel through (and keep on hobbling up to the top of the mountain...or maybe you don't actually hobble until you're almost done with your hike...but regardless at some point you're struggling). Whichever camp you fall into, this blog post is for you!
So whether you are brand new to hiking or you’re like me, and you’ve been hiking since you were a tiny one, we are all prone to the same hiking injuries. There ARE things that we can do to prevent these from occurring in the first place as well as things we can do to bounce back quickly. This is the first in a 4-part series. So let’s get started! And be sure to stay tuned for more!
So the most common type of hiking injury isn’t really a specific injury itself such as Plantar Fasciitis (though PF does fall in this category) but it’s a classification of injury and that is an OVERUSE injury. So what does that even mean? Well to some degree, it really is as simple as it sounds. You’ve injured a part of yourself (your ankle, your knee, your shoulder, etc) from overdoing an activity or task…in this case, it’s hiking (though it actually could have been from something else and it just affects your hiking). But let’s break it down and be a bit more specific so you REALLY understand.
An overuse injury means that whatever tissue that is injured, whether it’s bone, muscle, tendon, or ligament-you’ve basically exceeded that tissue’s capacity to withstand a certain amount of load. That tissue is just not strong enough to perform the task that you are asking it to do. And the thing to understand is an overuse injury does not always occur with just one instance or moment in time. Actually, when someone is reporting to me their history, they rarely say they had a specific instance where they knew they injured themselves; rather they typically report that it came on gradually or they feel like it came out of nowhere.
So to fully understand this, let’s take an example: Achilles tendonitis. If you don’t know that your Achilles tendon is in the insertion of your calf muscles into the back of your heel. Someone could injure their Achilles with just one instance: they put on a 50-pound backpack for the first time ever and it’s just way too heavy and then they push off on the right foot and pop and have immediate pain. So you’ve just exceeded the load that that tendon is capable of being able to perform. And you’ve possibly ruptured your Achilles tendon. It was not strong enough to complete that task. That is NOT your typical overuse injury…in fact in that scenario, really that’s more of an acute injury (different type but the same principles apply in a way) Most overuse injuries, you cannot identify an exact instance when you know that you did something. It comes on progressively (perhaps starting as a small ache or discomfort and annoying but you may push through because you’ve got places to go and summits to reach) and so it’s more over time and increased load that you exceed that tissue’s (in this case your Achilles tendon) capacity to withstand that load. So in this instance, let’s say you’re new to hiking and you are rearing and ready to go and just start doing it and over the course of a month, you create a list of hikes and just start plugging away at them. And this is your only form of exercise. And within that month you hike 20 miles. (hey, you’ve caught the bug! And you’ve got goals!). But now a month in, you’ve developed heel pain that is limiting your ability to hike; and it doesn’t seem to be improving! What gives!?!?! This is a great example of an overuse injury. By not training that tendon progressively and appropriately to be able to withstand the task you are asking it to do, it is getting irritated and may be sustaining micro-tears in the tendon or at minimum lots of inflammation and irritation.
Not to get in the weeds here, but I’d also argue that even an acute or traumatic injury can still be viewed with these same concepts. You fall and twist your ankle or even break a bone; the mechanism of the fall and the force of that fall override the capacity of that ligament or tendon and then leads to the injury. But hey we'll cover other topics like this in future blog posts...be sure to let me know in the comments below what other topics you want to know. But back to our topic at hand...
The first big takeaway is that you have to understand this simple concept of the tissue being overloaded. Whatever tissue we are talking about (and it’s typically the source of your pain but not always), the injury or pain happens because the load has exceeded the capacity. AND unless you rectify that matter, you will continue to have the same problem.
And so then perhaps you decide to do what comes naturally or is a very normal response, you rest it and then wow, great it feels better. And then you go right back to your activity where you left off. But if it don’t beat all, it comes back and it’s not improved or even possibly feels worse. Why isn’t it going away?!??! Well first of all, you did not fully address the issue by resting it. You just completed the FIRST step, which is by resting it, you are taking away what continues to irritate it. You have decreased the load on the tendon. So yes, that will help it feel better. But if you fully rest it, you also have to realize that with each successive day that you rest, that tissue is weakening bit by bit. (if you don’t use it, you lose it). This doesn’t mean that you shouldn’t rest it (honestly it depends on how severe the pain and injury is; a physical therapist can help you figure this out). Rest may mean different things in different situations and for different individuals. (full rest is not always necessary, but that will help it to feel better, but still doesn’t solve your problem). More importantly, though is if you try to go back to your activity to the same degree you did before you rested it and you do not realize that you are NOT in the same place as when you last did your activity, you are MORE likely to re-injure it or irritate things again. You also didn’t address the real problem which was the lack of strength to that tissue and/or ability of that tissue to withstand a certain load. In fact, you went in the opposite direction by only resting it and thus with rest the strength of that tissue weakened.
So let’s say…instead you took to Google to solve your problem and you found some great stretches that make your heel feel better. Great, you solved your problem. WRONG. You actually did not solve your problem. Stretches are just a temporary fix; they are never a solution to an overuse injury. A stretch by definition is PASSIVE elongation of the muscle. It does not involve strengthening the tissue. So that does not solve the lack of strength or address the inequality of the capacity of the tissue vs. the capacity of the load. If you don’t address the lack of strength in that tissue, then you are prone to repeating the cycle…over and over…and over again.
The other really important thing to understand is the concept of the kinetic chain, which simply means that your body is connected. What happens in your foot, WILL affect things up the chain (look at least at the joint above and below…so if the issue is your knee, then you're looking at minimum your ankle and your hip). So if you just do some calf stretches and it helps your heel pain, (but there is still an underlying weakness present): it’s true and it’s possible that your heel feels better. But since you didn’t actually fully address the issue or the strength deficit, that weakness can later manifest in knee pain. So by not fully addressing the problem, you are prone to other issues in other places. More on this topic of the kinetic chain also coming soon!
Does this make sense to you? Before we proceed further 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 firstname.lastname@example.org or even text me at 214-308-1698 so that this can make sense for you!
Don’t take this to be all doom and gloom though as there is a solution to breaking the cycle! And the first step is knowledge! This is what this blog is all about and the next few in this series. So stay tuned for more information on overuse injuries and what you need to know to address them, to prevent them in the first place, and to break the cycle of repeated injuries that may be affecting your hikes!
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 this sounds like what you need, click here to sign up for a consult call!
Are you a seasoned hiker that’s dealing with a nagging pain or discomfort that’s preventing you from reaching your goals? Scheduled a FREE consult call here to see how I can help you reach the summit and resolve your pain!