Health Matters | The first step to safe hiking is proper footwear


BENNINGTON — Summer is a time to be out and exploring the great outdoors. To many in this part of the world, that means hiking. A lot of hiking.

"Hiking is a great way to get out and enjoy the beauty of our region," says Dr. Ivette Guttmann of Southwestern Vermont Medical Center Orthopedics. "But without the proper footwear, it can often lead to injury. Most commonly, a sprained ankle."

According to the American Academy of Family Physicians, ankle injuries are one of the most common sport injuries in the United States (an estimated 2 million annually).

"A sprain most commonly occurs when the ankle is twisted or rolled," Guttmann said, "injuring the ligaments that normally help support your ankle. Depending upon the severity of the injury, a sprain can take weeks or even months to heal." "Without proper treatment and rehabilitation, a severe sprain can actually weaken your ankle and make you more prone to spraining it again," Guttmann added.

In order to avoid being sidelined for the summer season, Guttmann suggests always wearing the proper footwear for a hike. "Especially on loose or wet terrain, you want a shoe or boot that has both a good tread and some support around the ankle. It is also important that it provides firm support through the arch area while allowing flexibility into your forefoot."

Hiking boots should fit snug, but not tight, and should offer some wiggle room for your toes. "With boots that are too tight, it is usually the toes that get the worst of it," Guttmann said. "Blisters, calluses, ingrown toenails, and injury to the nail bed (causing the nail to thicken or bruise) can all be caused by a tight-fitting shoe."

Boots that are too big can cause your foot to slide, producing friction and blood blisters. Guttmann said. "Big boots also fatigue the calf muscle by requiring more work due to the increased contact time of a bigger shoe with the ground. This will also cause you to lose propulsive force."

If you buy new boots for the hiking season, Guttmann suggests wearing them around the home or on errands to break them in gradually before your first hike. "Wear the socks you plan to hike in as well as any insoles you might use," Guttmann said. "Try them out on different surfaces, so you get used to how they feel on your feet and how they react to the different terrain. It will also help break up any stiffness in the material."

While proper hiking footwear is a great first step to avoiding ankle injury, accidents can still happen.

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If you should injure your ankle while hiking, there are a few things you can do to help relieve your pain and reduce the possibility of doing further harm.

Following the PRICE protocol is recommended for acute injuries:

- Protect your ankle from further injury by limiting or avoiding weight-bearing through the use of crutches or an ankle brace, if you have one.

- Rest is important to allow healing while avoiding activities that may stress the injury.

- Ice will help minimize and reduce swelling, which in turn will help alleviate pain.

- Compression can be applied by using an elastic bandage and wrapping from the toes up with a medium amount of tension to provide ample, but not constrictive, compression.

- Elevation above the level of the heart will also help reduce the swelling, decrease pain, and allow for a wider range of motion.

In most instances, a sprained ankle will heal in anywhere from 2 - 12 weeks. "Ignoring a sprain can lead to a number of chronic ankle problems in the future," Guttmann said. "I suggest anyone dealing with a sprain see an orthopedist who can properly evaluate your injury. Until then, be sure to follow the PRICE protocol."

"Health Matters" is a column from Southwestern Vermont Medical Center meant to educate readers about their personal health, public health matters, and public policy as it affects health care.


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