ankle sprain in hikersAn ankle sprain is one of the most common injuries you’ll experience while hiking. While it can happen to anyone there are specific things you can do to decrease the chance of it happening to you. Here’s what you need to do to prevent and treat ankle sprains when you hike.

Causes of Ankle Sprains When Hiking

Many causes of ankle sprains can be avoided. One of the most common causes is hiking with improper hiking boots.

wearing worn out hiking boots can cause ankle sprainsWearing Worn Out Hiking Boots

How do you know if your hiking boots are worn out?

  • Turn them over and check out the treads. If they are worn down or worn unevenly then it’s time to get a new pair of boots. Worn out treads and uneven wear are more likely to cause you to trip and twist your ankle.
  • Worn out ankle support. One of the most important features of hiking boots is the firm ankle support they provide. If the ankle support is worn out it can’t do its job. Check the fabric and cushion around your ankles for wear.
  • Cracked soles. If you have cracks in the soles of your boots, they won’t be supportive.
  • Broken eyelets. If you’re missing some of the boot’s eyelets, you can’t properly cinch your boots.
  • You’ve worn them for 500 miles or more. Boots are only made to last so long. If you’ve worn them for more than 500 miles it’s time to get a new pair.

Wearing the Wrong Size Hiking Bootswearing the wrong size hiking boots

Did you know that many adult’s feet get longer and wider as they age? Some of this has to do with weight gain but some people just develop flatter arches. While your boots may have fit great 5 years ago, don’t assume they still do.

How do you know if they’re the wrong size?

  • You don’t have a least a thumbs width between the tip of your toes and the end of your boots.
  • You can’t wiggle your toes.
  • Your toenails hurt when you wear them.

If any of these things are true for you, go to a hiking store and get your feet measured. If your feet are longer or wider, buy some new boots.

summer hikingWearing the Wrong Type of Boots for Your Hiking Terrain

It’s important to assess the type of terrain you’re planning to hike on before deciding which boots to bring with you. These days they make boots for several different types of hiking:

  • hiking shoes or trail runners (more like a shoe than a boot with little or no ankle support),
  • day hiking boots: for short hiking trips with light loads with some ankle support
  • backpacking boots: the most durable boots with great ankle support for heavy duty backpacking and difficult trails.

It’s particularly important to consider the type of ankle support you’ll need when choosing which boot to take with you. If you choose a boot with poor ankle support for a tougher trail, you’re putting yourself at greater risk for an ankle injury.

Rolling Your Ankle In or Out (pronating or supinating)

hiking on uneven terrain can cause ankle sprainsPoor foot mechanics can cause you to roll your ankle inward or pronate or roll out or supinate. People who tend to roll their feet inward are more likely to have low or flat arches and those who roll their feet outward are more likely to have high arches. Both of these imbalances tend to put you at higher risk for an ankle sprain.

Hiking On Uneven Terrain

Part of the reason hiking is a higher risk activity for ankles is the uneven terrain you often encounter. Stepping into a hole, tripping over a tree root, or coming off a step onto uneven ground are all hiking hazards that lead to ankle sprains.

Increasing Hiking Time and Level of Difficulty Too Quickly

Our bodies need time to build up to more and more difficult hiking situations. If you push yourself either in hiking duration or in elevation gain you place yourself at greater risk for an ankle sprain.

symptoms of an ankle sprainSigns and Symptoms of An Ankle Sprain

If you twist your ankle on the trail, it’s important to learn the signs and symptoms of an ankle sprain so you know what to do to treat it. Unfortunately, you won’t know if it’s broken until you can obtain an X-ray.

Common signs and symptoms include:

  • pain
  • swelling
  • bruising
  • tender when you touch the ankle

resting from hikingTreatment of Ankle Sprains in Hikers on the Trail

Because ankle sprains are so common, every hiker should be prepared to treat one on the trail. Treatment of an ankle sprain on the trail and in the first 24-72 hours should include:


As much as possible, it’s important to stay off the sprained ankle. While complete rest used to be recommended, other experts recommend some movement or relative rest. For example drawing the alphabet with your toes can help your blood circulate to improve healing.

instant cold pack to treat a sprained ankleIce

Icing on an off for 20 minutes several times a day can help reduce pain and inflammation. Instant cold packs are an important staple for your first aid kit.


Applying an ankle wrap on the trail can help provide support. Just make sure it’s not so tight to cut off circulation. Wrap the bandage using a figure of eight, instead of just wrapping in a spiral.


Keeping your foot above your heart will help reduce swelling and inflammation.

c-splint for a sprained ankleSplinting

The American Hiking Society recommends using a C-splint to stabilize the ankle when hiking out with an ankle sprain. An ACE bandage can also be useful if you don’t have a splint.

Contact your podiatrist as soon as possible to obtain an appointment so your ankle injury can be evaluated.

Treating Ankle Sprains At the Office

walking boot to treat a sprained ankleWhen we see you at the office, in addition to the treatments above, we will do one or more of the following:

  • X-ray your ankle to make sure it's not broken.

  • Examine your ankle to determine the extent of tissue damage.

  • Recommend a walking boot to immobilize your ankle if necessary.

  • Prescribe non-steroidal anti-inflammatory medications

  • Refer you to physical therapy

  • Start treat with MLS laser therapy.

For more information visit, our page on Ankle Sprain Injuries.

Make an Appointment


how to buy hiking boots to prevent an ankle sprainPreventing Ankle Sprains

To lessen the likelihood of ankle sprain, do the following:

  • Warm-up and stretch. It’s important to warm-up and stretch to help avoid a sprain. We recommend dynamic stretches and warm-ups for hikers. If you have a tight Achilles or tight calf muscles, you’re more likely to sprain your ankle. Hold calf and Achilles stretches for at least 90 secs or longer. For very tight calf muscles I recommend you use an Achilles splint at home.
  • Build your strength. Keeping your body strong is also key for preventing sprains.
  • Get evaluated and treated by a physical therapist. This is particularly important if you are prone to spraining your ankle.
  • Check your boots for frayed laces. Check your boot laces every time you hike and replace them if needed.
  • Resolve your poor foot mechanics. If you tend to pronate (roll you feet in) or supinate (roll them out), visit your podiatrist for an evaluation. Very likely you’ll need custom orthotics to keep your feet more stable while hiking.
  • Keep your focus on the trail. Because uneven terrain is common when hiking, keeping your eyes on the trail will help you avoid tripping and twisting your ankle.
  • Build up your hiking distance and elevation gain slowly. Your body takes time to adjust to increased exercise. Increase your hiking distance and elevation by no more than 10% per week.

how to buy hiking boots to prevent an ankle sprainIf you're ankle sprain doesn't resolve quickly on it's own or even if it does, it's a good idea to get an evaluation by a podiatrist for several reasons.

  • It could be broken. If it is you'll need to immobilize your ankle and might need other treatment as well.
  • You could have torn the soft tissues. It may take a lot longer to heal depending on what tissues were affected. Your podiatrist will need to determine the best treatment.
  • If left untreated it could become chronic. Chronic ankle instability can occur when a sprain isn't allowed to fully heal.

Need Treatment For Ankle Sprains in Seattle, Washington? Request an Appointment Now

Don't let an ankle sprain go untreated. Complete the contact form on this page or call our office at 206-368-7000 to schedule an appointment with Dr. Berg.

Most new patients are seen within 1-2 week's time. During your initial visit, Dr. Berg will spend up to 30 minutes getting to know you, your podiatry complaints, and your goals so that he can recommend the treatment best meets your needs. Don’t wait—contact us today.

Other Foot Health Topics for Hikers

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Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.
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