Getting Started Tips: Staying Healthy

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Staying Healthy

I would like to thank those of you who have followed me and supported me as I move through this journey of leaving my couch and onto the trails.  Hopefully, I have even inspired a couple of you!  If not no big deal. If you procrastinate it is probably a good thing because I’m going to continue my short series on how you can learn from my mistakes! This week we are going to talk about staying healthy when you start exercising.

Last week, Physical Therapist Cristin McGetrick did a great job of helping with some exercises that will help you get started before you hit the trail. She had some great info and I found her answer’s really helpful. This week I had chance to chat with a different physical therapist about some of the common aches and pains, how to avoid them, and what to worry about.

The Expert

Glenn Wellmann has a Doctorate degree in Physical Therapy, is a certified strength and conditioning specialist, and currently practices in Colorado.  He is an avid hiker throughout the northeast and Colorado.

Disclaimer: This is for general education purposes only.  You should consult with a physician before beginning any exercise program.  Each person is different and opinions given in this article are not to be construed as a diagnosis, personal medical advice, or a treatment plan. Always personally see a medical professional for individual ailments and medical advice.

Aches and Pains of Staying Healthy

Fat Man:  Glenn, thanks for chatting with me.  As you know I am trying to prepare anyone who is trying to change a lifestyle and become more active. I know I was pretty sore after the first few hikes but was wondering what types of aches and pains or sore muscles are typical or expected when starting to hike?

Glenn Wellmann PT, DPT, CSCS:  Aches and pains are very common when beginning your hiking journey, but the most important thing to be aware of are what aches and pains are productive and which ones are warning signs. As a general rule, any time you push yourself beyond what your body is used to sore muscles can be expected. Muscle soreness from hiking typically presents as delayed onset muscle soreness (DOMS) within 24-48 hours after completing your hike (although it can be sooner) and is a sign that your muscle is responding to exercise. Muscle soreness should resolve within a day or two, however soreness lasting more than a few days after it initially presents does not necessarily mean that you have done anything wrong, but should be taken as a sign that you may have pushed yourself a little too far past what your body is used to.

When to Worry

FM: What types of pain or soreness should we be concerned about?  That might be something more serious than just muscle pain.

GW: Again, speaking in generalities here, but soreness that presents along the muscle belly (between two joints), is dull or achey, can be reproduced with palpation (pushing on the muscle) or movement and is typically resolved with rest or light movement is a good sign that your muscles worked hard and need some time to recover.

Pain that is closer to or along the joint line, pain with swelling (particularly at the joint), sharp or stabbing pains, bruising or pain that does not resolve or worsens with rest or light movement are signs that something could be wrong. It is also important to note that general muscle soreness typically presents as a more diffuse, widespread, non-localized ache and is unlikely to be present on one side at a time or specific to one small area.

If you finish a hike and your whole body is a little sore, that is more likely than not muscle soreness, but if you finish a whole hike and only your left ankle is sore, you may have done something to your left ankle. And of course it probably doesn’t need to be stated, but I’ll say it anyway, if you are unsure what you are experiencing or are unfamiliar with the messages your body is sending you, particularly if these symptoms have not resolved within a few days or are getting worse, it is worth seeking a professional opinion.

Common Injuries

FM: What are some common hiking injuries?

GW:  The most common hiking injuries are overuse injuries such as tendonitis/tendonosis (inflammation or irritation of a tendon (muscle attachment)) or patellofemoral pain (catchall term for anterior knee pain at, behind or around the kneecap), but other injuries such as sprains, muscle strains, blisters, skin abrasions or traumatic injuries like fractures or contusions, most commonly from falls, are also possible. Low back pain is also common, though I would argue it does not necessarily constitute an injury in all cases.

The thing to remember with hiking is that overuse injuries build up slowly over time. What may have started as a minor discomfort that was barely noticeable at the start of your first hike may turn into significant pain if you don’t address it. For example, if you’re playing soccer and you plant your foot and twist to go get a ball, feel a sharp pain in your knee, hear an audible pop and notice your knee begin to swell, you are likely to stop what you are doing immediately, ice and go to the doctor to see if you need an MRI.

You know exactly what you did and you know that pushing through it won’t help. With hiking though, because the pains we experience are often not significant enough to cause us to stop what we are doing, we tend to think we can just power through and there won’t be any consequences.

Compensating

In the same way that you can drive a car that is slightly out of alignment short distances without significant repercussion, but when you drive it across the country you start to significantly impact the whole car, when you are hiking and you are compensating or you have muscle weaknesses or imbalances that are not being addressed and you start significantly increasing your distances you may end up with more significant injuries down the road.

When your car is out of alignment it is a lot easier to get the alignment adjusted as soon as you notice it than to have to replace all of your tires and your transmission because you thought you could just drive through it. Hiking is the same thing. It is a lot easier to do some glute, core and/or quad exercises and stretching a few times a week than it is to rehab from a knee or hip replacement.

An Ounce of Prevention…

An ounce of prevention is worth a pound of cure, as they say. My colleague Cristin has written an outstanding piece on some entry level exercises to get the body ready for hiking, I highly recommend checking that out, and if you are dealing with a previous injury or are unsure where to start, again, it never hurts to consult a professional.

So on that note, I will leave you with this as something to consider when it comes to hiking injuries. The human body is an amazing, resilient machine. You can get away with a lot of things and be just fine, until you can’t. 

More than Legs

FM: I assumed my legs would be sore after hikes, even the muscles i didn’t know I had, but how much do core muscles come into play while hiking for stability for instance?

GW: The core is everything because the core is your foundation. To go back to the car analogy that I used above, I don’t care how nice the tires on your car are, if it is way out of alignment you are going to have problems. So to bring that back to hiking, it doesn’t matter how strong your quads, hamstrings, calves or feet are, if you can’t put your foot down in the right position they will never be able to function to their optimal potential.

Imagine trying to ride a bike but instead of a solid metal or carbon frame the bike was made of flexible rubber. You would have to work a lot harder to get where you were going because your legs now have to work to stabilize your trunk, which they are not optimized to do, as well as propel you forward. The same is true of the core in hiking, albeit to a less extreme extent.

Stability Matters in Staying Healthy

This is why walking on the sand or beach is harder than walking on pavement, you have introduced an unstable surface into the equation so your body has to work harder to create stability. Sand and rocks are external sources of instability, you can change surfaces and problem solved, but a weak core is an internal source of instability, you take it with you wherever you go. Don’t make your body work harder than it has to, because your body is incredibly smart, and it doesn’t want to fail you, so if you don’t find stability through your core you will find it somewhere else, but this commonly leads to the overuse injuries described above.

It is also important to note that the core is not just your rectus abdominis (6 pack muscle). What the core is exactly is still being argued over in the literature, but it is generally accepted that the core comprises your rectus abdominis, internal and external obliques, transverse abdominis, glutes, and spinal extensors at a minimum. I won’t get too into it here, but just know that just because you can do a handful of sit ups doesn’t necessarily mean you have a strong core.

Causes of Pain

FM:  What could cause lower back pain, pain in the upper shoulders and neck muscles from hiking?

GW: There are any number of things that can cause these types of aches and pains during or after hiking. A big one is an improperly fitted or overly heavy pack. There are plenty of experts more knowledgeable than myself when it comes to pack fitting, and a quick Google search can give you an idea of what you are looking for, but as a guideline the pack should fit snugly against your back with the weight evenly distributed throughout the pack.

Bad Fit

An overly heavy or loose fitting back will pull your trunk backwards and cause you to overly engage your shoulders and lower back to try to keep your weight even. A pack that has a chest and waist strap can be very helpful for reducing upper shoulder and neck strain as it will more evenly distribute the weight of the pack across your body. It is also common to have back, shoulder and neck pain from being in a constantly tense posture or poorly engaged core. If you are fatigued, fighting a heavy pack, going up or down steep terrain, or are nervous or anxious it would be helpful to take frequent breaks to let your shoulders and neck relax and to do some light stretching to relieve the tension. 

Helpful Gear with Staying Healthy

FM:  What are your thoughts on equipment such as shoes, knee braces, ankle braces or any other gear that could help someone getting started?

GW: I am by no means an equipment expert, so for specifics I would consult someone at your local outdoors store, but I will say having the right gear can make all the difference! Properly fitted shoes are key to having a pleasant experience while hiking. Shoes that are too big or small can cause blisters or bruising and shoes that don’t fit your feet well tend to lead to unnecessary aches and pains.

Braces

As for braces, if you are currently being treated by a healthcare professional who recommends the use of a brace then please follow their advice! If however, you are using the brace to minimize gentle aches and pain then know that in the short term they are a great option to allow for a more enjoyable hiking experience, but they are a band-aid fix for an underlying issue. Or, if you become reliant on the brace to reduce your pain instead of addressing the actual cause of the pain then eventually the brace will stop working and you will be stuck without a solution.

If you wear an ankle brace because you frequently roll your ankles while hiking that is all well and good, and I’m not saying you shouldn’t do that in the short term, but you should also work on improving your ankle stability with the goal of not having to use the brace at some point in the future.

Hiking Poles

Another great piece of equipment that I highly recommend adding to your hiking gear is a set of high quality collapsible hiking poles. They come in very handy when coming down steep terrain or when the inevitable aches and pains creep up halfway into your hike, and they can drastically reduce compensations and limping which will help you avoid creating bad habits which will speed up your recovery between hikes.

Wrapping up Staying Healthy

FM: Glenn, thank you so much. This has been great stuff and I feel I learned a lot. and hopefully the readers have as well. I really appreciate you taking the time.

GW: Hope this has been helpful and informative, and thanks for having me on! Happy Hiking!