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How to Approach a Sprained Ankle — and Other Minor Injuries — on Your Hike

We must have been cooped up with COVID-19 for too long. Despite scorching summer temperatures, more people than ever are heading to the great outdoors. National parks and public lands are seeing record-breaking visitors. This comes even after a busy 2020, when the nation experienced a boom in hiking.

But with any outdoor activity, there’s the risk for injury. When it comes to hiking, sprains and strains are among the most common sorts of injuries. Each year hundreds of thousands of people are treated for outdoor recreation-related injuries.

Before you venture out this summer and fall, follow our favorite tips on avoiding injuries and what to do if you do sprain an ankle or knee while on a hike.

Prep, Prep, Prep

The most crucial step in preventing a hiking injury is making sure you’re in good shape for physical activity. You should be comfortable with shorter walks before attempting any longer hikes.

Evan Dyer, the Regional Director of Orthopedics for Fast Pace Health, suggests conditioning and training before setting out on a hike, no matter the distance or difficulty.

Starting at 10 or 15 minutes of walking around the neighborhood or on a treadmill each day is an excellent way to begin training. Then increase it from there. If you’re looking to take it a step further, consider starting to carry a backpack with you that resembles what you’d carry on an actual hike (more on that in a bit).

“If you’re going for a very difficult hike and you’re not prepared for it, then the risk of injury is going to be much greater,” Dyer said.

Finding the Right Footwear

You should also make sure you have proper footwear for hiking. “Most likely, that’s going to be some type of mid- or high-top hiking boot,” Dyer says, adding that you should make sure the shoes are correctly laced.

The shoe brand is up to you, but it’s important to look for shoes with deep lugs on the soles. Make sure your toes also have plenty of room when standing on flat ground — they’ll slide forward in the boot more with the weight of your pack while traversing steep downhill trails and terrain.

Purchase your shoes in advance of a hike to make sure you have time to break them in. You might get blisters while breaking them in, so better to do that before setting out on a longer hike away from your vehicle or home. If you’re looking for even more stability, consider using trekking poles.

Pack the Right Pack

Once your training has begun, it’s time to start packing. We strongly recommend that hikers, especially beginners, carrying a backpack with some simple first-aid items.

Dyer recommends carrying an ACE bandage.

“That takes a very small amount of space in your pack and it’s light,” Dyer says.

He also recommends packing a portable ice pack that you break up to activate the cold. They’re usually small/lightweight and can be used with a protective cloth to ice an injured area on and off for 10 minutes, being carful to stop if your skin becomes irritated or uncomfortable. If you don’t have a portable ice pack and end up spraining a knee or ankle, sometimes using your surroundings can be helpful. For example, consider periodically dipping the injured area in a cold creek or river if you’re next to one. Or if there’s snow, using it to help ice the injured area.

It’s also wise to carry some Ibuprofen or acetaminophen (Tylenol®) which, if used as directed, may help reduce swelling, a common issue with sprains. And if there’s extra room, or you’re feeling extra cautious, consider taking some waterproof tape and splints. Dyer recommends a SAM splint because it’s lightweight.

Sometimes you can do all of the prep work, and an injury still happens. Then what? If you suffer an ankle or knee sprain, your goal is to keep it from stiffening while reducing inflammation as much as possible. A sprain usually involves a ligament or tendon, which will swell when injured. While it’s natural to want to rest when a sprain occurs, Dyer says it’s vital to keep moving.

“Because once you rest, that gives your body time to send all of the troops in and start healing it, which leads to swelling, which leads to stiffness, which leads to more pain,” he advises.

Dig out the ACE bandage and wrap the injured area, take some Ibuprofen (use as directed), and try to keep moving to get back to your vehicle. Dyer recommends getting the sprain checked out, even if it doesn’t seem too serious. “Ankle sprains are very under-diagnosed and under-managed conditions,” Dyer says.

Another reason Dyer recommends getting it checked out is what feels like a sprain could be a fracture. “It’s either going to be a sprain or a pretty gnarly fracture,” he says, noting the common myth that if they can move an injured area or can walk on it, then it can’t be fractured. “That’s absolutely not true,” Dyer says.

Bring Friends

Hiking with friends or family is not only more enjoyable, but it’s also safer. And it only helps for some extra support in case of an injury. If you’re striving for solitude, we get it. There’s a unique peace with huffing it alone in the woods. Just be sure someone — or multiple people — knows exactly where you’re going and when to expect you back.

Getting outside can be great for your physical and mental health. And with the proper training and preparation, it can be an enriching and enjoyable hobby. Happy hiking!

This blog was originally published in July 2021