Ready to Hit the Trails? Don’t Let an Injury Hold You Back.
As the weather improves, it’s the perfect time to get outside and enjoy hiking again.
But with the excitement of getting back out there, it’s easy to overlook one important thing—your body’s readiness for the demands of hiking. Every year, we see a noticeable rise in hiking-related injuries as people ramp up their activity too quickly, or without the right preparation.
And often, the injuries we treat—whether it’s heel pain from plantar fasciitis, a swollen ankle from a sprain, or nagging knee and back pain—could have been prevented.
A little knowledge goes a long way and understanding how and why these common injuries happen means you can take simple steps to avoid them, so you can make the most of the hiking season.
Plantar Fasciitis
Plantar fasciitis is one of the most common foot issues we see in hikers, and it can make every step on the trail uncomfortable. It usually presents as a sharp, stabbing pain under the heel or along the arch of the foot—often worse with the first few steps in the morning, or after you’ve rested during a hike. Left untreated, it can turn a simple walk into a painful experience and make longer hikes difficult to manage.
Why Hiking Triggers Plantar Fasciitis
The plantar fascia is a thick band of tissue that runs along the bottom of your foot, supporting your arch and absorbing shock as you walk. Long hikes, especially on uneven ground or steep inclines, put extra stress on this structure. Combine that with unsupportive footwear, sudden increases in walking distance, or tightness in the calves and hamstrings, and it’s easy to see why plantar fasciitis flares up during hiking season.
How to Prevent It
Footwear is key—and not just any footwear. You need hiking boots or shoes that match your foot type and arch profile. If you have high arches, you may need additional cushioning and flexibility. If you have flat feet, more structured support and stability will reduce stress on the plantar fascia.
Getting properly fitted at a specialist shop, or consulting a physio for advice, can make a big difference. In addition, regular calf and plantar fascia stretching—especially before and after hikes—helps reduce tension on the tissue. Gradually increasing your hiking distances and avoiding sudden spikes in activity allows your feet time to adapt and strengthens the tissues involved.
What to Do If It Starts Hurting Mid-Hike
If you feel heel or arch pain during a hike, take it seriously. Stop, stretch your calves and the bottom of your foot, and if possible, massage the area or roll your foot over a smooth stone or water bottle to ease the tension. If the pain continues, cut the hike short. Continuing to walk through the pain can worsen the condition and lead to more prolonged issues.
Treatment and Recovery Tips for Hikers
If heel pain persists for more than a couple of days after your hike—or if you start noticing that classic morning heel pain—it’s important to see a physiotherapist sooner rather than later. Early treatment can stop plantar fasciitis from turning into a long-term problem. We can help by providing hands-on treatment, guiding you through targeted exercises to strengthen the foot and calf muscles, and advising on footwear or orthotics if needed. The earlier you address it, the quicker you can get back to pain-free hiking.
Achilles Tendon Issues
Your Achilles tendon plays a key role in walking, climbing, and absorbing impact—especially during hiking. When it’s not functioning well, it can quickly become a source of sharp or nagging pain in the back of your ankle or lower calf. Achilles problems are common in hikers, especially if you’re tackling steep climbs, uneven ground, or increasing your distances without giving your body time to adapt.
Why Hiking Triggers Achilles Tendon Pain
The Achilles tendon connects your calf muscles to your heel bone and is responsible for helping you push off with each step. Hiking—especially on uphill terrain—puts repetitive strain on the tendon, often causing irritation, inflammation, or micro-tears.
Tight calf muscles, poor ankle mobility, and inappropriate footwear increase the load on the Achilles, making it more vulnerable. If you’re ramping up your hiking distances or elevation without proper conditioning, the risk of developing Achilles tendinopathy (chronic irritation of the tendon) goes up significantly.
How to Prevent It
Footwear plays a huge part in protecting your Achilles tendon. Make sure your hiking boots or shoes provide the right level of heel support for your foot type. If you have stiff ankles or limited dorsiflexion (the ability to pull your foot upward), a slightly higher heel lift can reduce strain on the Achilles. On the other hand, shoes that are too flat, or ones that don’t provide enough support, can overload the tendon.
In addition to choosing the right footwear, regularly stretching and strengthening your calves is essential. Eccentric calf exercises—where you slowly lower your heel below the level of a step—are especially effective for keeping the tendon strong and resilient. Gradually increasing the intensity and distance of your hikes gives your body time to adapt, reducing the risk of overload.
What to Do If It Starts Hurting Mid-Hike
If you start feeling a dull ache or sharp pain in the back of your ankle during a hike, take a break and stretch your calves. Gentle ankle movements and rolling out the calf muscles can ease tension. If the pain persists or worsens, avoid steep ascents or descents and consider cutting the hike short. Continuing to push through Achilles pain can lead to more serious issues like chronic tendinopathy or even partial tears and ruptures.
Treatment and Recovery Tips for Hikers
If Achilles pain lasts more than a couple of days after your hike—or if you notice stiffness and pain in the tendon first thing in the morning—it’s important to see a physiotherapist sooner rather than later. Early intervention can prevent a minor irritation from becoming a chronic problem.
Patellar Tendon Problems and Ruptures
The patellar tendon is a key player in knee stability and strength, especially during hiking. It connects the kneecap (patella) to the shinbone (tibia) and helps you straighten your knee, absorb impact, and control movement—particularly when walking downhill.
When this tendon becomes irritated or overloaded, it can lead to patellar tendinopathy, causing pain just below the kneecap. If left unchecked, it can progress to more serious issues, including partial or complete tendon rupture.
Why Hiking Triggers Patellar Tendon Problems
Hiking puts repetitive and often heavy loads on the patellar tendon. Long descents are particularly demanding—each step requires the quadriceps to work hard to control your pace, which increases strain on the patellar tendon. If your quads aren’t strong enough or you’ve suddenly increased the distance or elevation of your hikes, this stress can cause irritation, inflammation, and micro-tears in the tendon.
Unfortunately, we see a couple of cases each year where the patellar tendon ruptures completely—and without fail, it’s always happened on a steep descent. The combination of fatigue, poor control, and the heavy forces involved make the descent a risky time if the tendon is already under strain.
How to Prevent It
Preventing patellar tendon problems starts with conditioning and support. Strengthening your quadriceps, glutes, and hamstrings is essential to reducing the load on the tendon. Exercises that focus on slow, controlled movements—like eccentric squats or step-downs—help build tendon resilience.
Footwear also matters. Choose hiking boots or shoes that suit your foot alignment and biomechanics. If you tend to overpronate or have flat feet, you may need more structured support to prevent excess strain traveling up to the knee.
Trekking poles are highly recommended, especially on descents. They help take the pressure off your knees by distributing some of the load through your upper body. And as with any activity, pacing yourself and gradually building up hiking distances and elevations gives your tendons time to adapt.
What to Do If It Starts Hurting Mid-Hike
Pain just below the kneecap is often the first sign of an overloaded patellar tendon. If you notice discomfort—particularly when descending—it’s time to ease off. Take regular breaks, stretch your quadriceps, and if you’re using poles, rely on them more heavily for support on the way down.
If the pain becomes sharp or persistent, it’s best to cut your hike short and avoid steep downhill sections. Continuing can push an irritated tendon closer to rupture.
Treatment and Recovery Tips for Hikers
If your knee pain lasts more than a couple of days after a hike—or you’re experiencing morning stiffness, swelling, or weakness—book an assessment with a physiotherapist sooner rather than later. Early intervention can prevent a minor problem from escalating into something more serious.
In the case of a rupture—typically marked by a sudden, sharp pain, swelling, and an inability to straighten your knee—immediate medical attention is required. Surgery is often necessary, followed by a structured rehabilitation plan to restore strength and function.
The key is to take knee pain seriously early on. With the right prevention and management, you can protect your knees and enjoy hiking without fear of injury.
Back Pain from Hiking
Back pain is one of the most common complaints we hear from hikers—whether it’s a dull ache in the lower back after a long day or sharp discomfort that sets in partway through a hike. Hiking might seem low-impact, but the combination of carrying a backpack, walking on uneven ground, and climbing inclines can put a lot of strain on your back if you’re not properly prepared.
Why Hiking Triggers Back Pain
There are a few key reasons why hikers experience back pain. Carrying a backpack, especially if it’s heavy or poorly packed, can throw off your posture and increase stress on your spine and surrounding muscles. Add to that the constant adjustments your body has to make to navigate uneven terrain, and it’s no surprise that your back can get overworked.
Steep ascents and descents often force you into awkward positions—leaning forward when climbing or bracing hard when going downhill—which can overload your lower back muscles.
Another common but often overlooked factor is your footwear. Shoes or boots without adequate shock absorption transfer more impact forces up through your legs and into your lower back. Supportive footwear with good cushioning and shock-absorbing soles can make a big difference, reducing the impact with each step and easing the load on your back—especially on hard, uneven surfaces.
How to Prevent It
Start with your backpack. It should be well-fitted, with the majority of the weight resting on your hips rather than your shoulders. A poorly adjusted or overly heavy pack can quickly lead to fatigue and back pain. Pack only what you need and distribute the weight evenly.
Footwear matters just as much. Choose hiking boots or shoes with proper shock absorption to help cushion each step and reduce the force transmitted up to your spine. Look for soles designed to absorb impact and provide support over long distances and varied terrain.
Next, work on your core strength. A strong core stabilises your spine and supports your lower back, especially on uneven ground. Exercises like planks, bridges, and bird-dogs are great for building endurance and control in your deep core muscles.
Flexibility is important too—tight hip flexors and hamstrings can pull on your pelvis and place extra strain on your lower back. Regular stretching, particularly after a hike, helps maintain mobility.
Trekking poles can also make a difference, helping distribute the load and reducing the strain on your back, especially on long hikes or steep descents.
Hiking is one of the best ways to enjoy the outdoors and stay active, but it’s important to prepare your body to avoid injury. By understanding the common issues like plantar fasciitis, Achilles tendon problems, patellar tendon pain, back strain, and ankle sprains—and taking steps to prevent them—you’ll be able to hike further and feel better.
If you’re dealing with any of these injuries or want advice on how to stay injury-free, we’re here to help. Get in touch to find out how physiotherapy can keep you moving comfortably this hiking season.
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