Dr. Yerrapragada on preventing and treating foot & ankle hiking Injuries

Hiking is a joint friendly exercise that’s fabulous for your entire body — going up and down hills gets your heart pumping and offers a great cardio workout. This helps reduce your risk for heart disease, stroke, high blood pressure, high cholesterol, osteoporosis and even some cancers.

“However, as you can imagine, foot and ankle hiking injuries occur because we are hiking long distances over uneven surfaces,” said fellowship-trained orthopedic surgeon Aditya J. Yerrapragada, MD of Boulder Centre for Orthopedics & Spine during a free online health lecture. “Hiking can result in overuse or traumatic injuries, from tendinitis and plantar fasciitis to stress fractures, fractures, ankle sprains and Achilles ruptures.”

During his presentation, Dr. Yerrapragada described exercises to prevent injury and treatments for pain relief — from nonsurgical approaches to the latest minimally invasive surgical options.

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Watch: “Foot and Ankle Hiking Injuries: How to Prevent and Treat Them"

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Preventive Care

Dr. Yerrapragada had these tips to prevent injury and keep you hiking as log as possible.

• Supportive Shoes - Dr. Yerrapragada emphasized, “Having proper footwear is incredibly important. This is our best defense against the environment. A thicker sole, with more support and cushion and less flexibility, will result in less motion transferred to your foot, decreasing stress across your joints.”
• Orthotics - To supplement your footwear, he recommended orthotics. “Over-the-counter versions will work well for most of us—unless you have a unique foot shape or severe pathology. Orthotics will provide appropriate cushion and support.”
• Ankle Braces and Taping - “Both braces and taping work well for rotational injuries,” said Dr. Yerrapragada. He added, “There are various options for braces. Taping can work, but having someone experienced in wrapping to do this for you is important, especially prior to a hike.”
• Stretching - Targeted stretching both before and after each hike can prevent injury and aid recovery. Stretching increases flexibility and range of motion, improves the strength and stability of the lower extremities and reduces post-hike soreness. Dr. Yerrapragada recommends doing dynamic stretches right before hitting the trailhead to prepare your muscles for managing the uneven trail surfaces.

Pre-hike stretches 

Stretches that work well include calf stretches - which Dr. Yerrapragada recommends doing three sets of these on each side, three times each day (shown below) - forward lunges, standing quad stretches, side leg raises, and wall-lean heel raisers.
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According to the American College of Sports Medicine, muscles are more elastic and ready to be stretched when they are warm, so warm up first and then stretch. For this, Dr. Yerraragada recommends dynamic stretches such as heel-to-toe walks, knee-to-wall stretches and lateral lunges.  For a description of how to perform these and other pre-hike stretches, view this article on hiking tips.

• Tips for stretching success
  • It is important that your muscles are warmed up prior to stretching—walking lunges and leg swings are a good option.
  • A 10-minute pre-stretch warm up or active stretch is recommended.
  • Hold each stretch for 10 to 30 seconds.
  • Don’t bounce while stretching.
  • Take it slow.
  • Keep your routine simple and easy to remember.
  • A 5-to-10 minute post hike cool-down to settle your body back into its normal state, followed by stretching, is as important as your pre-hike routine.

Treatments

• RICE - “The first line of treatment for any kind of condition is “RICE,” which stands for rest, ice, compression and elevation - ideally above the level of your heart - to decrease pain and inflammation,” explained Dr. Yerrapragada.
• Anti-inflammatories – These are over the counter, safe medications that will reduce inflammation. Dr. Yerrapragada recommends non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil), naproxen (Aleve) or diclofenac (Voltaren, a topical NSAID gel) to be used continuously for two to three weeks after an injury.
• Immobilization is helpful in the initial stages, if symptoms are getting worse. “This” said Dr. Yerrapragada, “may be a cast, boot or brace to stabilize the foot and ankle to reduce pain and allow healing to occur.” He added, “Weight bearing is typically allowed.”
• Physical Therapy (PT) - “I typically recommend that my patients begin PT once their inflammation has decreased,” said Dr. Yerrapragada. He added, “Whether you’re using PT for an injury, or preventatively, it’s important to develop a routine that works for you and that you can perform reliably and consistently to help loosen, stretch and strengthen your tendons and muscles."

Most conditions will improve with rest and time. Patience is key. However, when non-surgical approaches don’t provide pain relief, surgery may be recommended to repair a hiking injury.

Schedule an Appointment

Call 303.449.2730 to schedule an appointment with Aditya J. Yerrapragada, MD, at Boulder Centre for Orthopedics & Spine.

Click here to view/download a PDF of slides shown during the lecture.

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