An Overview Of Tendonitis For Hikers

Highlights

• Plantar Fasciitis
• Shin Splints
• Achilles tendonitis
• Common themes

This is more of a quick guide for common tendonitis problems that hikers may encounter. It may help you to determine what issue the problem is, but as a rule, stop hiking and get it looked at by a medical professional.

You should visit a Physical Therapist or other medial provider for a diagnosis and treatment plan tailored to your specific injury.

Plantar Fasciitis

Possible Causes for Plantar Fasciitis

1. High BMI. In this case, it may simply be the added weight of the pack onto your body.
2. Tight calf muscles
3. Stiff plantar fascia
4. Tight Tibialis Anterior (shin muscle) and/or Extensor Digitorum muscle (pulls your toes to your nose)
5. Poor footwear choice leaving a lack of foot support
6. A flat foot and conversely, a high arch

Presentation

1. Painful to touch at the inside edge of the heel where the plantar fascia attaches to the heel bone
2. Pain on the bottom of the foot when first placing weight on it, or after long periods of rest
3. Pain with pushing off during a step
4. Heel spurs may develop as a result. The body adds calcium to the heel as a response to buffer the external stress. This may also lead to heel pain.

Solutions

1. Strengthen the feet muscles
2. Orthotics or taping
3. Stretch the calf, Tibialis Anterior, foot, toes
4. Cross friction massage to the tendon may help alleviate pain and help the healing process.

Shin Splints or Medial Tibial Stress Syndrome

 

Possible Causes for Anterior (front side) MTSS

1. Tight calf muscles
2. Weak Tibialis Anterior muscle
3. Overpronation (overly flat foot when walking)
4. Overuse

Presentation

1. Pain with raising the toes up
2. Pain with certain stretches (like pushing on a gas pedal or pointing toes down)

Possible Causes for Posterior (back side) MTSS

1. Tight calf muscle
2. Weak Posterior Tibialis muscle
3. Overpronation
4. Overuse

Presentation

1. Pain when bringing the foot up and out
2. Muscle fatigue in the feet with long hiking days

Solutions for Both

1. Strengthen the feet muscles
2. Orthotics or taping
3. Stretch the calf, Tibialis Anterior, foot, toes
4. Cross friction massage to the tendon may help alleviate pain and help the healing process.

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Achilles Tendonitis

Possible Causes

1. Increased activity beyond the previous level
2. Switching from higher heeled shoes to lower heeled shoes followed by a lot of walking.
3. Tight calf muscle
4. Missing ankle range of motion in dorsiflexion – think lifting your foot off the gas
5. Overprontation
6. Decreased strength in plantar flexion  – think pressing the gas pedal

Presentation

1. Tenderness in the lower end of the calf muscle
2. Sharp pain in the Achilles
3. Possible heel pain or pain right above the heel
4. Pain with uphill walking

Solutions

1. Wear a thicker heeled hiking shoe
2. Orthotics
3. Starting a training program before your hike
4. Slowly work into a lower heeled shoe or neutral footbed (like Altra’s)
5. Stretch the calf muscle!

Common Themes

A tight calf muscle and a tendency to overpronate show up with all of these problems. This may or may not have been an issue before hitting the trail depending on how active you were before the hike. Once the trail miles start to add up, the problem may start to show.

We all pronate during our normal walking, some just more than others. Overprontation basically means that your arch collapses more than normal. Overpronation can lead to other issues, which we will cover in a future post.

You can also overpronate on one foot, but not the other; these problems are not always symmetrical. Orthotics like Superfeet can be really helpful instead of the standard insoles that come with shoes.

Strengthening your feet can also help. While standing, try to pull your arch up, hold and then relax. Work up to 3 sets of 8 reps, holding for 7 seconds.

 

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Stretches

Focus on gentle stretching, nothing forced. Stay in the stretch for longer periods of time; a single, short 10 second stretch will do nothing for the other 23hrs, 59min and 50 seconds you are not stretching.

You need to rack up minutes throughout the day with stretches. Perform 3 sets of 20 seconds for each stretch 5-6 times a day starts to add up and make an appreciable change.

 

Pain

Pain is also common with all of these issues. This may seem like a no-brainer, but it’s a reminder to listen to your body! It is not “no pain, no gain” or “true to the thru”! If that is your mentality, you will be watching from the sidelines sooner than you’d like.

Pain and discomfort are different, learn to tell which is which!

• Bad pain is sharp, stabbing, electric, throbbing, deep ache, constant
  • What hurts may or may not be the actual source of the injury
  • May or may not occur with activity
  • If you feel that something is not right, it’s probably not! Get it looked at the first chance you have, it may save your hike!
• Discomfort is like doing too many squats and being sore the next day
  • It can be uncomfortable, probably feels like pain, but it’s not the same type as mentioned above.
  • Muscles will probably get sore while on the trail. Massage them, soak them in lakes and streams and stretch them regularly
  • Maybe you feel a little achy, but nothing hurts to the point that it impacts your ability to hike

Do you currently have any of the issues listed above? What is your plan for dealing with them before you start the trail?

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You can reach me info@trailsidefitness.com with any injury issues, past or present that you feel will impact your hike. Training questions are also welcome – I am happy to help!