Hiking is great exercise, but crossing uneven terrain poses a risk of injury, most commonly to the joints of the legs. Walking downhill can be hard on the knees and ankles, especially if you walk too fast or land too hard on your feet.
Hitting the ground too hard repeatedly can wear away articular cartilage, which lines the ends of the bones in your joints. This can lead to osteoarthritis. Improper downhill walking technique can also cause bursitis, which is inflammation of the fluid-filled sacs that cushion the joints. Going downhill too fast increases your risk of falls and ankle sprains.
The following steps can reduce the risk of hiking injuries:
It’s best to go downhill slowly, even if it feels more natural to go quickly.
Taking small steps can prevent the knees from flexing excessively.
A hiking stick allows your arm muscles to support some of your weight, taking pressure off your knees, and some people use ski poles for this purpose. Support is especially helpful if you’re carrying something heavy, such as a backpack. Studies have shown that one stick is sufficient when not carrying anything, but two sticks make it easier to keep your balance when carrying a load.
If the trail is wide enough, walking from side to side across the trail as you go down can reduce the effect of the slope on your knees.
Supportive hiking boots can reduce the risk of ankle sprains.
Consult a physical therapist to learn exercises that stretch and strengthen the muscles that support the hips, knees and ankles.
If a hiker experiences moderate to severe pain and swelling in the knee or ankle, it’s best to rest the leg, even if it’s necessary to cancel the rest of the hike. Ideally, ice should also be applied, but if none is available on the trail, it can be helpful to soak a cloth in cold water from a stream and wrap it around the injured joint. Hikers should carry an elastic bandage to wrap an injured area; compression can reduce swelling. Elevating the injury above the heart will help drain fluid and reduce swelling. These steps can be easily remembered by using the acronym RICE, which stands for rest, ice, compression and elevation.
Bursitis sometimes goes away after one to two weeks of rest, but treatment may involve draining the fluid, cortisone injections, or physical therapy to learn appropriate exercises and stretches. Treatment of arthritis can include medication, physical therapy and surgery.