Take a Hike!

by Rachel Levy, PT, DPT, CIMT

As a big fan of our national parks, I can fully attest that hiking has some great payoffs. I mean HELLO VIEWS for days. And as we look for ways to escape the summer heat (and still get outdoor exercise) many of us head up to north Georgia and hit the trails.

Hiking gives us both mental and physical challenges as we problem solve the best way to climb over a fallen tree trunk or scramble up a slippery rock. Going for a walk in a natural environment can decrease repetitive negative thought and neural activity in an area of the brain linked to mental illness (1) and outdoor exercise is associated with decreased tension, anger and depression (2).

Hiking is a great lower body workout and fires up your core as you work to keep your balance while ascending and descending uneven terrain. Depending on the length and difficulty of the trail, your overall endurance and cardiovascular conditioning can also be put to the test. But with those challenges comes the risk of injury.  A survey of more than a thousand people attempting to hike the entire Appalachian Trail found some of the more common injuries forcing an early exit include Achilles pain, ankle pain, iliotibial band syndrome, and knee pain (3).

So what can you do to make sure your trails are happy ones?

One tip is to consider the weight of your backpack. Any time you head into the wilderness you need to ensure you have enough water, food, appropriate layers, and an emergency first aid kit. For overnight trips the supplies can really add up with each liter of water weighing in at a little over 2 pounds. To limit fatigue in your legs try to keep your pack around 15% of your body weight (22.5 pounds for a 150 pound  person) and consider 30% of body weight as the upper limit (45 pounds for a 150 pound person) (4). Using hiking sticks or trekking poles can also have several benefits. Trekking poles have been proven effective in decreasing stress on the major joints of the legs (hips, knees, and ankles) (5), improving balance (6), and decreasing the overall feeling of difficulty during a hike (7).

If you’re planning a longer hike, or several days of hiking, it’s also important to think about how you move on the trail. Unlike a paved road or a staircase there’s no rule limiting the degree of the incline or decline on a trail and ankle mobility, balance and muscle power can play a big role in how you navigate this terrain. Here are 3 easy ways to test this at home…

1. KNEE TO WALL test for ankle mobility. Start off standing, facing the wall and keep your foot flat on the ground as you bend one knee to touch the wall. Slowly back up until you find the maximum distance from the wall you can stand and complete this test.  Compare this distance to the other leg.  They should be the same.
2. SINGLE LEG STANCE to test balance. Time yourself for 30 seconds standing on each leg, does it feel about the same or does one side feel markedly easier?
3. SINGLE LEG SIT TO STAND to test the power of your legs. Sit towards the front edge of a sturdy chair and keep one foot off the ground as you stand up while keeping your knee pointing forward (not collapsing in towards the middle of your body). Compare how it feels on each leg, does one side hurt or feel unsteady?

These simple tests may highlight any areas of restriction, weakness, or pain that may require a customized exercise plan to get you up, down, and around whichever trails you want to tackle.

1. Nature reduces rumination and sgPFC activation. Gregory N. Bratman, J. Paul Hamilton, Kevin S. Hahn, Gretchen C. Daily, James J. Gross. Proceedings of the National Academy of Sciences Jun 2015, 201510459; DOI: 10.1073/pnas.1510459112
2. Does Participating in Physical Activity in Outdoor Natural Environments Have a Greater Effect on Physical and Mental Wellbeing than Physical Activity Indoors? A Systematic Review. J. Thompson Coon, K. Boddy, K. Stein, R. Whear, J. Barton, and M. H. Depledge. Environmental Science & Technology 2011 45 (5), 1761-1772
   DOI: 10.1021/es102947t
3. Chrusch, Adam, and Michelle Kavin. “Survey of Musculoskeletal Injuries, Prehike Conditioning, AND ON-TRAIL Injury Prevention Strategies Self-Reported by Long-Distance Hikers on the Appalachian Trail.” Wilderness & Environmental Medicine, vol. 32, no. 3, Sept. 2021, pp. 322–331., doi:10.1016/j.wem.2021.04.004.
4. Quesada, P. M., Mengelkoch, L. J., Hale, R. C., & Simon, S. R. (2000). Biomechanical and metabolic effects of varying backpack loading on simulated marching. Ergonomics, 43(3), 293–309. https://doi.org/10.1080/001401300184413
5. BOHNE, Michael, & ABENDROTH-SMITH, Julianne. (2007). Effects of hiking Downhill Using TREKKING poles while carrying external loads. Medicine & Science in Sports & Exercise, 39(1), 177–183. https://doi.org/10.1249/01.mss.0000240328.31276.fc
6. Jacobson, B. H., Caldwell, B., & Kulling, F. A. (1997). Comparison of hiking stick use on lateral stability while balancing with and without a load. Perceptual and Motor Skills, 85(1), 347–350. https://doi.org/10.2466/pms.1997.85.1.347
7. Jacobson BH, Wright T. A field test comparison of hiking stick use on heartrate and rating of perceived exertion. Percept Mot Skills. 1998 Oct;87(2):435-8. doi: 10.2466/pms.1998.87.2.435. PMID: 9842582.