There are a lot of injuries that us hikers can inflict on ourselves out on the trail, but most of them are avoidable or treatable. In this article we’re going to cover the most common foot injuries that hikers can incur while out on the trail, how medical science deals with them, and how hikers deal with them.
The following foot related injuries we’ll be covering are; Blisters, Blackened or Lost Toenails, Sprained Arches, Tendonitis, Trench Foot, Bone Spurs, and Plantar Fasciitis.
Note: None of the following information should be taken as medical advice! We are backpackers, not licensed doctors or nurses. In each section we will link you to the appropriate professional medical information, so that you can make a more informed decision on how to treat these common ailments.
We’ll be covering ways that we, ill informed hikers on medical issues handle these problems, but you absolutely should consult a medical professional in person, especially for the more extreme ailments.
(This article is a continuation of our Backpacking and Hiking Footwear: Choosing Hiking Boots and Shoes. Check it out by clicking the link. There’s a lot of great information to help you choose the right footwear which can cut down on your chances of injuring your feet.)
What are Hiking Blisters, How Do They Form, and How Do You Deal With Them?
Blisters are the most common foot injury for hikers and backpackers and form for a few different reasons. Poorly sized shoes that are laced either too tightly or loosely, or poor quality socks which don’t wick moisture away very well are the two of the most common reasons.
Blisters can be very painful or even become infected if they aren’t treated well. Home remedies can help ease the pain of blisters in most cases, and allow them to heal faster, but sometimes blisters can become infected and develop into something more serious if not taken care of.
If you’re a masochist without a faint heart, and want to learn the ways that hikers deal with blisters out on the trail in, here we go.
Hikers that are out on the trail all use different methods for treating blisters and there are different ideas about how to treat them among the community. Some people feel you should leave them alone for 24 hours before popping them, others feel you should pop them right away.
It should be noted before you continue reading that popping a blister doesn’t hurt at all, and it’s actually a relief to pop them since it reduces the pressure under the skin. Whether that’s a good idea to pop them is up to medical science though, and you should really read the linked article above.
One method that people use is to heat up a safety pin with a lighter until it’s red hot, then pop the blister with the safety pin, and rub antibiotic ointment on it, or hand sanitizer. Hand sanitizer really shouldn’t be used though, unless you have no other options available, since it contains alcohol which dries out the skin and makes the blistered area susceptible to more damage due to its dryness.
Another method people use is to heat up a sewing needle with a lighter to purge off any bacteria, then they thread the needle with about six inches of thread, and coat the needle and thread in antibiotic ointment. Then they gently poke the needle through one side of the blister and out the other, cut off the needle, and leave an inch or two of some thread dangling on both sides.
Afterwards they lightly place a bandage over top of the blister. The theory behind this method is that the thread will allow the interior to wick away the moisture inside the blister by following the thread and also allow antibiotic ointment into it at the same time. Whether this theory works or not, only medical professionals would know, but this is one method that people use.
Universally, people agree though, that if you start to feel a hot spot while walking on the trail you should stop immediately and place a sticky bandage, leukotape, moleskin or even duct tape, if you don’t have anything else, on the location to reduce the friction in the area. It’s much better to prevent a blister entirely than deal with a fully developed one later on.
If the location of your forming blister is between your toes then you’re going to want to get a pair of toe socks. Toe socks will separate out your toes and force the friction onto the fabric and not your skin.
We also just want to note that toe socks are not just for women. A lot of women or girls wear toe socks and it has become a sort of gendered article of clothing, but they’re really a great invention for hikers, and should be used by hiking men too. You can find our list of the Best Toe Socks for Running and Hiking, which are all designed to wick away moisture and protect your toes from brutal blisters.
Blackened or Lost Toenails
Another common injury out on the trail is blackened or lost toenails. If you read through the sections on Backpacking and Hiking Footwear – The Ultimate Guide to Hiking Boots and Shoes, you’ll know that the primary the result of blackened, or lost toenails, is poorly sized shoes without a large enough toe box, or gap between the tips of your toes, and the front of the shoe.
As you’re walking down a hill your feet will slide forward a bit and if your shoes are improperly fitted your toenails will smash against the front of the shoe leading to blackened and sometimes lost toenails.
Another reason this can happen is because of untrimmed nails. Make sure you bring a pair of toenail clippers with you and maintain them frequently. Please refer back to the section on How to Size Your Shoes where we describe how to avoid this injury in detail with the wiggle test, the thumb test, and the toe tap test.
Sprained Arches
The result of torn ligaments in the muscles of the foot, a sprain can happen if you twist your ankle by stepping on uneven ground. This is a serious injury and needs to be treated with respect. You can avoid potentially spraining the muscles in your feet by stretching and choosing gradual elevation to continue the hike as opposed to quick shortcuts.
With the choice of either stepping up onto a rock to progress through the trail faster, or walking around the rock and taking a gradual incline, it’s always better to take the gradual incline. Take care of your body and treat it with care out on the trail, especially your feet since they’re taking the most damage.
Taking at least a few zero mile days if you get a sprain is in your best interest, or even calling it quits on your hike if it’s serious enough. Don’t push yourself with a sprain and seek medical attention if the pain is too severe.
Trench Foot
Most people know what trench foot is. It’s caused by consistently wet feet cramped up in a cold boot for a long time. This causes your skin to become saturated with water and it starts to become really painful.
Sometimes blisters can form and eventually, if the condition is left untreated, your flesh can just rot off and fall away causing permanent damage. Trench foot can happen really quickly, in just twelve hours of wet conditions, so you need to take this very seriously out on the trail. Even if the conditions are dry, but your feet are sweating really bad, this can happen, so you need to dry out your feet at least twice or three times per day.
There are very easy ways to prevent this horrible condition such as bringing talcum powder to dry your feet out, or the best way is having plenty of changes of socks or wear two pairs of moisture wicking socks. Follow this link to see our reviews on the Best Synthetic Moisture Wicking Socks for Hiking and Backpacking.
Typically, if you start your hike early in the morning, you’re going to want to take your boots off and switch into a dry pair of socks by lunch time. Then, leave your wet socks hanging off your pack to dry as you walk.
When you go to bed at night make sure you switch into a pair of socks that are dedicated for sleeping only. This will prevent hypothermia and give your feet a chance to recover in a warm and dry environment. If you don’t like wearing socks while you sleep, you need to start. It’s really beneficial to your feet when you’re out hiking.
Bone Spurs
Twenty five percent of all the bones in your body are in your feet, so there’s a lot of room for bones to be damaged. When a section of a bone has grown to extend beyond its normal shape that’s a bone spur. Bones are a hard living tissue, and a bone spur is typically formed by the grinding of bones which causes damage and triggers them to produce more bone in the area in order to protect themselves.
Most of the times bone spurs aren’t an issue, and unless you feel pain in the area, there’s no reason to mess around with them. There are surgical procedures that can remove bone spurs which you can see demonstrated in 3D by following this link, but for the most part bone spurs are not an issue.
Bone spurs typically occur for hikers because of constant trauma to the bones from stomping on the trail, and from poor muscle function due to a lack of stretching or nutrition. Taking breaks, stretching to allow your muscles to operate efficiently, and having quality shoes with comfortable insoles can prevent bone spurs from forming by reducing stressful friction on the foot bones.
Bone spurs can become very painful over time and become a big problem, so you should take your health seriously out on the trail and pay attention to the way your body feels. Don’t push yourself to meet mileage deadlines and allow yourself to relax at least a few times a day out on the trail. It’s not worth it to hurt yourself just to gain a few extra miles per day.
Achilles Tendinitis
Tendinitis in hikers is more of times than not caused by high cut hiking boots rubbing on the Achilles tendon. If you read through the Backpacking and Hiking Footwear: Choosing Hiking Boots and Shoes you’ll see a section which describes how to properly fit your shoes under “How to Break In Hiking Boots and Prepare Them for the Trail.”
In that section it describes how to properly lace your boots by leaving the top two lace hooks undone, tilting your knee forward about ten degrees to allow one finger to slide between the gap at the back of your ankle, between your Achilles tendon and the Achilles notch of the boot, then finishing up your lacing in that position.
Doing this allows free range of motion while walking and keeps your Achilles tendon from constantly rubbing on the liner and heel cap of the boot. This will also reduce your chance of having blisters form on your heels.
Achilles tendinitis can also turn into plantar fasciitis since the tendon starts in the calf muscle and warps down around the heel into the bottom of the foot. So, stretching your leg muscles is very beneficial because it makes your muscles more elastic and reduces the chances of them being torn or damaged from constant use. Follow the link to this article to learn about leg stretches that can help you keep your body in good shape for hiking.
Plantar Fasciitis, Posterior Tibial Tendonitis, and Peroneal Tendonitis
When you’re out on the trail, you’re an athlete. If you’re carrying a backpack that weighs anywhere from 20-40 pounds you can look forward to burning about 500-800 calories per hour depending on your age, gender, weight, and height.
Since the average thru-hiker walks anywhere between 10-25 miles in a day on a trail that means calorie requirements, including the standard 2,000 per day, are anywhere from 7,000 to 22,000 calories to maintain normal weight.
Plus, since you’re sweating, you’re losing even more nutrients. So, maintaining proper nutrition is difficult, and requires almost constant consumption of food and water. If you’re not keeping up on your nutritional requirements your body will start to feel the effects and everything spirals out of balance.
In general, there are four reasons for foot pain, or any other leg pain out on the trail. Improper nutrition, inflammation, muscle tightness, or improper footwear.
With poor nutrition your muscles lack the proteins to repair and heal the tiny tears caused by the vigorous physical activity. The cells lack the carbohydrates needed to energize them, they lack the fats which carry vitamins throughout the body, they lack the vitamins to help fight against infection and carry oxygen, and they lack the iron to help that oxygen be carried and keep your muscles growing in a healthy way.
All of these nutritional deficiencies together cause your muscles to fatigue more easily which reduces their ability to stretch and causes tightness, which can then lead to inflammation.
Maintaining proper nutrition, and drinking a ton of water, is really the cornerstone to keeping your muscles healthy. Finding a really high quality nutritional tracker app on your phone can help you follow your nutritional needs more closely.
There are a few really popular phone apps such as Cronometer, and MyFitnessPal which will allow you to type in the food you’ve eaten and see what nutrients you’re lacking. We highly suggest you check them out.
You can also check out this link here to see your daily nutritional needs in percentages.
Beyond nutrition there’s stretching. Foot pain often starts well above the foot in the calf and thigh muscles. Stretching your feet, ankles, calves, and thighs before, during and after a hike will help them be more elastic and reduce the chances of them tearing.
Please follow this link to see foot stretching exercises, and click on this link to see stretches for your legs and upper body. Stretching your upper body is also important for back which is carrying your backpack. You should really view stretching holistically and stretch your entire body since everything is connected in one way or another.
Next there is footwear. We suggest you go find a Dr. Scholls insole machine, or visit a podiatrist, and get insoles properly fit to the shape of your foot. This is really one of the best investments you can make for yourself and it makes a world of difference. Please do this for your feet, you won’t regret it.
So, in summary, if you have proper nutrition, you’re stretching three times a day and drinking plenty of water, and you have good shoes with proper insoles for the shape of your feet, and you’re still feeling foot pain, you need to go see a medical professional. There really is no substitute for having a doctor examine you. Don’t mistake a search engine for a medical degree.
Conclusion
There are numerous ways to injure your feet out on the trail, but most of them are completely avoidable through proper nutrition, stretching, quality footwear, and keeping your feet dry. We really can’t stress enough how important it is to constantly be thinking about your feet while out on the trail and how to keep them safe and healthy.
As you noticed throughout each section we referred you to websites with better information than what we provided here because as we explained we are not medical professionals. If you can think of any other foot problems that can arise while hiking please let us know down in the comments section below. We always love hearing your questions, comments, concerns, or suggestions since it makes this website a better place.
As always, thanks so much for being here, may the trails be kind to you, and have a wonderful day!
ParagonTrails 
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