With spring in full bloom and summer quickly approaching, many Albertans are planning their next hiking excursion. Whether you hike for the challenge of scaling the mountainside, to conquer the next summit, for exercise or to simply share in the journey with friends and family, hiking the Rockies can involve risk for injury. Especially vulnerable to injury when navigating the mountain’s uneven and unpredictable terrain are our ankles. However, following the strategies below can help reduce your risk for injury and get you one step closer to safely reaching the mountain tops this season.
At Nose Creek Physiotherapy, we see all types of injuries come through our clinic with one of the most common being ankle sprains. In fact, ankle sprains are the most common injury in the physically active population (McKeon 2008) (Verhagen 2012). Furthermore, approximately one third of people who suffer an ankle sprain will develop Chronic Ankle Instability (CAI) (McKeon 2008). Recurrent sprains and chronic instability can be quite debilitating and lead to a decrease in physical activity in individuals who have symptoms long after their injury (McKeon, 2008). Our ankles serve as the platform that allow us to walk, run and also to hike. These joints must be mobile enough to conform to the ground beneath us, but stable enough so that we remain upright. The ankle joint is particularly vulnerable when hiking on uneven ground and this blog will explain how to minimize the risks so you can continue to conquer the Rockies.
Factors that can predispose a hiker to an ankle sprain
These include a history of ankle sprain(s), increased body weight, strength of the muscles crossing the ankle joint, moving over uneven surfaces and twisting/turning. A previous injury to the ankle has been identified as the most common risk factor for a recurrent sprain (McKeon, 2008) (Verhagen 2012). However, if you have injured your ankle(s) before, worry not! Here are a few simple strategies that can help you strengthen and reduce your risk for an ankle injury while scaling the slopes.
Image from: http://www.drwolgin.com/Pages/footankleanat.aspx
Strategies – What to Do
The optimal strategy to ensure you do not roll your ankle is to condition the joint and surrounding musculature so that it will better tolerate hiking terrain. However, this conditioning does not just mean that the muscles around the ankle must be strong (Verhagen 2012). This is just one component and flexibility, balance/coordination (McKeon, 2008) and endurance also play huge roles in the ability of the ankle to adapt to uneven ground (Van Otchen et al. 2014). Ankle conditioning becomes crucial for those with prior ankle injuries, especially if the past injury was rehabilitated improperly. If you are unsure as to how to properly condition your ankle for hiking, book an appointment today with Nose Creek Sport Physiotherapy. All of our Therapists are trained and excited to teach you how to properly stretch, perform strengthening exercises, complete balance/coordination drills and build your endurance for the mountains.
Taping and Bracing
Another option to protect the ankles may include using external supports such as braces or taping. The scientific research shows that this option has the most consistent evidence for decreasing the risk for an ankle sprain, especially in those who have experienced a prior ankle sprain (McKeon, 2008). However, by relying on external support for our muscles and ligaments, they do not have to work as hard to stabilize the ankle joint and over time this can lead to weakness and instability of the ankle. This can progress to the point where one would be dependent on taping or bracing. This is not to say these are not good options, but they should be employed with caution and only when necessary. Other factors to consider are the cost and comfort of this option. Although it is unclear whether taping or bracing is better at preventing an ankle injury, bracing is decidedly cheaper and some hikers will prefer not to have their ankles covered with tape or a brace when hiking on an extremely warm summer day.
Footwear is another easy way to provide stability to the ankles. Unlike taping or bracing, footwear offers protection but tends to be less restrictive and will still allow the ankle muscles to be engaged for stability. By purchasing higher top, proper fitting hiking boots with considerable boot shaft stiffness, a hiker will reduce their chance for a sprain (Bohm 2010). However, you must be careful because stiffer does not always mean better. Our ankles are designed to conform to the surfaces beneath us and a scientific study comparing boot shaft stiffness amongst several boots showed that a harder boot limits ankle range of motion, causes greater loading of the knee joint, leading to earlier fatigue (Bohm 2010)
Another strategy to reduce the risk of a pesky sprain is to ensure frequent rest breaks are taken. Depending on the hiker and the difficulty of the hike, physical and mental fatigue can be quick to set in. This fatigue can lead to a misstep which could result in a sprain. Another way to give our bodies rest is to distribute weight differently. This can be done with the help of walking poles that have been proven to reduce the forces on our joints, including our ankles.(Bohne 2007). Less force means less muscle fatigue, and with that, a reduced risk for an ankle sprain. Not to mention the benefits that this can offer the knee and the hip joints as well. In addition, walking poles offer us a larger base of support which makes us more stable in an upright position.
To summarize, there are several risk factors that can contribute to a potential ankle sprain. Hiking is an activity that many, including myself, enjoy partaking in but also poses some risk to the ankle due to uneven, rocky terrain. By being aware of the risk factors that apply to us, we can employ a few key strategies to help reduce the risk of injury. These include conditioning the ankle, using external supports such as taping/bracing, proper footwear, taking frequent rests and offloading the ankles with hiking poles. My hope is that you are now more aware of the importance of ankle stability during hiking and that we have equipped you with the tools to rise to the highest heights this hiking season.
Best of luck and I hope to see you out there.
If you have any further questions or would like to schedule an appointment, I can be reached at Nose Creek Sport Physiotherapy (Thorncliffe location) at 403.275.7728.
My current schedule is Monday, Wednesday, Friday 7am – 1pm; Tuesday, Thursday: 1pm – 7pm.
Bohm, H. & Mattias H. (2010). Effect of Boot Shaft Stiffness on Stability Joint Energy and Muscular Co-Contraction During Walking on Uneven Surface. Journal of Biomechanics, 43, 2457 – 2472.
Bohne , M. & Abendroth-Smith, J. (2007). Effects of Hiking Downhill Using Trekking Poles While Carrying External Loads. Medicine & Science in Sports & Exercise, 39 (1), 177 – 183.
McKeon, P. O. & Mattacola, C.G. (2008). Interventions for Prevention of First Time and Recurrent Ankle Sprains. Clinics in Sports Medicine, 27, 371 – 382.
Van Otchen J.M., Van Middelkoop, M., Meuffels, D., & Bierma-Zienstra, S.M.A. (2014). Chronic Complaints After Ankle Sprains: A Systematic Review of Effectiveness of Treatments. Journal of Orthopedic and Sports Physical Therapy, 14 (11), 862 – 871.
Verhagen, E.A.L.M. & Bay, K. (2012). Optimising Ankle Sprain Prevention: A Critical Review and Practical Appraisal of the Literature. British Journal of Sports Medicine, 44, 1082 – 1088.