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Hiking Injuries - How to Distinguish Soreness, Strain, and Sprain

Hikers typically experience musculoskeletal injuries in their legs.

Hikers get injured for many reasons, and there’s a lot of confusion about managing a musculoskeletal injury. This article explains some of the common aches or pains you might feel after a day on the trail. This information is not medical advice; you should always consult your medical practitioner for any suspected injury.


Delayed onset muscle soreness (DOMS) is common after strenuous activity. It’s a function of the healing process that repairs the micro-tears in the muscle. The newly repaired muscle fibers make the muscle bigger and stronger. After a more challenging hike than you’re used to, you might feel sore, tight, or stiff, especially in the calf and quad muscles. Soreness usually peaks the second day after activity, and you should feel significantly less pain and more flexibility by the third day. There’s no need for foam rolling or massaging the area, and doing so could further injure the muscle and result in rhabdomyolysis, a serious syndrome that requires immediate medical attention. Seek emergent care if you notice swelling, redness, or severe pain in the area or if your urine appears brown or reddish. If you feel sore, drink lots of water and eat plenty of protein to give your body the building blocks it needs to repair your muscles. Understand this is a normal physiological process, and the more you train your muscles to handle the hiking load, the less sore you’ll be after a hike.


A muscle that is stressed or stretched beyond its capacity can suffer a strain either in the belly of the muscle or at the tendon. Tendons are the fibrous portion at the ends of the muscle that connect it to the bone. While soreness results from micro-tears, a strain is a more significant tear or disruption in the tissue. You might feel acute pain like you ‘pulled’ a muscle when doing a particular movement. The muscle may hurt and appear red, swollen, or bruised. Mild strains usually improve in a week or so with rest, ice, compression, and elevation (RICE). More significant ones may require medical intervention. See your provider if it doesn’t get better with RICE or if you experience severe pain, numbness, or weakness in the area. Again, conditioning your muscles to handle more stressful experiences like scrambling, hopping across boulders, or climbing steep elevations decreases your chances of straining them.


Sprains occur in ligaments, the strands of cartilaginous tissue that connect bones to bones. Ligaments are typically taught and tough but can become flexible due to repeated stretch, the hormones of pregnancy, or genetic conditions. Some people have more lax ligaments than others and experience hypermobility at the joints, allowing them to hyperextend their elbows and knees and frequently ‘roll’ their ankles.

You might sprain or injure a ligament if it stretches beyond its natural capacity. There are different degrees of severity of sprain, and minor ones have similar symptoms to muscle strain and usually improve with RICE. One way to tell the difference between a strain and a sprain is the location. A sprain will have pain, swelling, and bruising around a joint instead of within a muscle. Sprains are common in the ankle and knee and may make walking painful. They can also occur in the thumb or wrist if you fall with outstretched hands or on your hiking pole. More severe sprains may require medical intervention, especially if the ligament has a partial or complete tear. Seek care if you experience significant swelling or bruising that makes walking difficult or if you heard or felt a pop at the time of injury.

Wearing supportive shoes, using hiking poles, and preventing fatigue with frequent rest and snack breaks help avoid sprains. Ultimately, conditioning your body through strength, flexibility, and aerobic training is the best way to prevent hiking injuries. Schedule your consultation today to learn how The Healthy Hiker Virtual Training Program can help you feel strong, healthy, and fit on the trail!

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