Ankle sprains are one of the most common injuries hikers can experience, and while they can happen to anyone, there are steps you can take to reduce your risk. In this article, we’ll explore the causes of ankle sprains, how to treat them on and off the trail, and the best ways to prevent them from happening in the first place.
What Causes Ankle Sprains While Hiking?
One of the primary culprits is hiking with improper footwear.
Wearing Worn Out Hiking Boots
Old or worn-out hiking boots can increase your risk of ankle injuries. Here’s how to tell if it’s time to replace your boots:
- Turn your boots over and check the treads. If they’re worn down or unevenly worn, it’s time for a new pair. Worn treads can cause you to trip or twist your ankle
- One of the key features of hiking boots is firm ankle support. Check the fabric and cushioning around your ankles. If they’re worn out, they won’t offer proper support.
Cracks in the Sole of Your Boots and Broken Parts
Cracks in the soles of your boots can compromise their support and stability. In addition, if some of the eyelets are broken. you won’t be able to cinch your boots properly which can cause instability.
Boots Have Too Much Mileage
Even if your boots don't look worn out, if you’ve logged over 1000 miles on your hiking boots, it’s likely time for a replacement. If you wear hiking shoes, you’ll need to replace them after 500 miles.
Wearing the Wrong Size Hiking Boots
As we age, our feet can become longer and wider. This is primarily due to weight gain and flattening out of the arches. Even if your boots were perfect a few years ago, they may no longer fit correctly. Here’s how to tell if your boots are the wrong size.
- There should be at least a thumb’s width between your longest toe and the end of your boots. If there isn’t, they’re too short.
- If you can’t wiggle your toes comfortably you likely need a longer or wider boot.
- If your toenails hurt or turn black when wearing your boots, visit a hiking store to get your feet measured and find the right size.
Failing to Match Your Hiking Boot to the Hiking Terrain
Different types of hiking call for different boots. The terrain you’ll be hiking on should determine the type of boot you wear.
Hiking Shoes or Trail Runners: These are more like shoes than boots and offer little to no ankle support.
Day Hiking Boots: Ideal for short hikes with light loads; they provide some ankle support.
Backpacking Boots: This is the most durable option. They provide excellent ankle support for challenging trails and heavy loads. Ankle support provided by your boots is especially important on tougher trails. Wearing the wrong type can increase your risk of a sprain.
Overpronation or Supination
Hikers who excessively roll their feet and ankles in or out are at greater risk of an ankle sprain. Those who pronate or roll their feet in often have low or flat arches, while those who supinate or roll their feet out tend to have high arches.
Hiking on Uneven Terrain
If you wander into uneven terrain, you’re more likely to sprain an ankle. Stepping into holes, tripping over roots, or landing awkwardly on uneven ground are common hazards that can cause a sprain.
Increasing Your HIking Time or Hiking Difficulty Too Quickly
Pushing yourself too quickly, especially with higher elevation gains or longer distances, can make you more susceptible to ankle injuries.
Signs and Symptoms of An Ankle Sprain
If you twist your ankle on the trail, it’s important to recognize the signs of an ankle sprain so you can treat it properly. Remember, you won’t know if the ankle is broken until you get an X-ray. Keep in mind, improper treatment of a sprain can lead to problems in the future, like chronic ankle instability.
Common symptoms include:
- Pain
- Swelling
- Bruising
- Tenderness around the ankle
Every hiker should be prepared to treat an ankle sprain on the trail. During the first 24-72 hours, follow the RICE protocol. Rest, ice, compression, elevation, and splinting.
Rest: Once you get off the trail, try to stay off the injured ankle as much as possible. While complete rest used to be the standard, some experts recommend gentle movement, like drawing the alphabet with your toes, to promote circulation.
Ice: Be sure to carry an instant cold pack with you on the trail. Apply ice for 20 minutes at a time, several times a day, to reduce pain and inflammation.
Compression: Use an ankle wrap to support the joint, but ensure it’s not so tight that it cuts off circulation. Wrap in a figure-eight pattern for optimal support.
Elevation: Once you’re at home, keep your foot elevated above your heart to help reduce swelling.
Splinting: If you need to hike out with a sprain, use a C-splint to stabilize the ankle. An ACE bandage can be used if a splint is unavailable.
After treating the injury on the trail, make an appointment with a podiatrist or urgent care center as soon as possible for a thorough evaluation.
When you visit the office, we’ll take additional steps to ensure you heal properly.
- First we’ll take X-rays to rule out fractures.
- Then we’ll examine your ankle to assess the extent of tissue damage. If the damage appears extensive we’ll send you for an MRI.
- If you need to keep your ankle immobile, we’ll put you in a walking boot.
- I often recommend non-steroidal anti-inflammatory medications to reduce inflammation and pain relief, but you can also start using this medication on the trail if your physician approves it.
- I may refer you for physical therapy to help restore strength and mobility. I’ll also put a link above to a video with guided foot and ankle exercises you can do at home.
- Finally, our office provides MLS laser therapy to promote healing. This laser can help reduce inflammation and pain and heal injuries at the cellular level, getting you back to your activities faster. I’ve put a link above so you can learn more about it.
How To Prevent An Ankle Sprain While Hiking
It's always better to prevent an ankle sprain from occurring in the first place. Here's how.
- Choose supportive boots that fit well and are designed for your type of hiking. Check the eBook located on top of the page called How to Buy Hiking Boots to Prevent Plantar Fasciitis. This information is important for preventing ankle sprains as well.
- Replace boots that are worn out.
- Warm up and stretch before hiking. Dynamic stretching and calf/Achilles stretches of at least 90 seconds can reduce the likelihood of injury.
- If you have flat feet or high arches and roll your feet in or out you should visit a podiatrist for an evaluation. Custom orthotics can help stabilize your feet and keep an ankle sprain from occurring.
- Replace the insert that comes with your hiking shoes. Most shoes don’t have a supportive arch insert. Even if you don’t have poor foot mechanics, an over-the-counter insert can help support your feet. I recommend either Redithotics, Powersteps, or Superfeet.
- Build your strength to support your joints and avoid sprains.
- Consult a physical therapist if you’re prone to ankle injuries.
- When you hike, stay focused on the trail. Watch your step to avoid tripping on uneven terrain.
- Gradually increase your hiking distance and elevation gain. Limit increasing your distance and elevation to no more than 10% per week to help your body acclimate and gain strength slowly.
Finally, don’t put off getting an ankle sprain checked out by a podiatrist. It could be broken and even if it isn’t a soft tissue sprain or torn tissue can take many months to heal. Also, improperly treated sprains can result in chronic ankle instability.
Don’t let an ankle sprain keep you off the trail. Take these steps to prevent injuries and seek timely care if one occurs. Stay safe and enjoy your hikes!