Whether you are an experienced hiker or backpacker, there are many things to consider when hitting the trails. Weather, foods, hydration, backpack weight, proper footwear, routes and more all need to be evaluated before setting out. Further, because hikers are actually on the off-beaten path, they need to ensure that they take the proper precaution against three common hiking injuries involving knee pain, ankle sprains, and achy feet. 

It is important to complete a dynamic warm up just like a warmup before working out at the gym. You want your body moving before you head out on the trails. Doing so will prep your body for the hike and improve your performance as well as preventing injury. Taking an extra five minutes or so to warm up will lead to better results on your hike. Performing neck and shoulder rotations and torso twists help warm up the upper body which will be used to carry a backpack. Furthermore, performing leg swings, walking high knees, butt kicks, and lunges will warm up your lower body as well as increasing your heart rate. Also, combining a dynamic warm up with a few static stretching before and after your hike can help keep common injuries at bay.

Prevent and Treat Knee Pain

Some backpackers may experience knee pain, especially when walking downhill or after hiking. This pain may be due to several factors such as improper footwear, weak/imbalanced leg muscles, general wear and tear of years spent on the trail, or a previous injury. Even without these factors, hikers can still experience knee pain. Particularly in hilly/ mountainous terrains, the body is placed under significantly more stress when moving downhill. As you move downward, your lead leg adjusts to gravitational forces and absorbs the weight of your body as well as your backpack.

While using hiking poles can substantially reduce the amount of pressure on your knees, there are several exercises you can do before and after hiking to help alleviate pain. Properly warming up the muscles attached to the quadriceps, hamstrings, and IT band can help prepare your legs and knees for the hike ahead. Below are a few stretches to try!

  • Standing IT Band Stretch

Use a wall/sturdy surface for support while completing this exercise if necessary.


  1. While standing, cross the right leg in front of the left and press both feet firmly to the ground.
  2. Bring your right-hand overhead to help deepen the stretch. 
  3. Then, lean to the left until you feel a stretch along your knee and outer hip.
  4. Hold stretch for 30 seconds before switching to the opposite side. 
  5. Complete 3 times per side.
  • Hamstring Stretch


  1. Stand with your feet shoulder width. Step your right foot forward and then flex the foot upwards.
  2. Bend at the hips, shifting your weight back towards your left foot until you feel the stretch in your right hamstring. Place both hands on your right thigh. 
  3. Hold for 30 seconds before switching to the left leg.
  4. Complete 3 times per side. 
  • Quadricep Stretch

Use a wall or sturdy surface for support while completing this exercise if necessary.


  1. Stand upright with good posture (i.e. shoulders open, core engaged and body in alignment) with your feet together.
  2. Raise your left heel up behind you and then grab your foot with your left hand. 
  3. With a slight bend in your right leg, pull your left foot upwards towards your buttock until you feel a stretch in your left quadricep. 
  4. Hold the position for 30 seconds before moving to the opposite leg.
  5. Perform the stretch 3 times per side.

NOTE: The quad stretch is very popular but is also performed incorrectly on a regular basis. It is important to maintain good posture throughout the stretch, keep a slight bend in the standing leg (opposed to locking it out) and keep your hips in alignment to maximize its benefits. 

Avoiding Sprained/Twisted Ankle

Part of what differentiates hiking from an everyday walk is the landscape changes. But it is that same ever-changing terrain that may cause a misplaced step and lead to a twisted or sprained ankle. Like with knee pain, a twisted ankle can be attributed to ill-fitting or improper footwear. Also like with knee pain, a hiking stick can help improve your stability and balance as you move along the trail. If you experience a sprain while hiking, it is important to evaluate your situation before moving along to avoid any further damage. 

However, if you are recovering from an ankle injury or simply want to maintain strength and flexibility, there are several exercises and stretches you can do to recover or maintain your mobility and balance. These stretches below are also helpful when combined with a dynamic warm up and then again post-hike to cool down your body.

  • Calf Stretch


  1. Stand with your hands placed against a wall or study surface. Bring your right foot slightly in front of you. 
  2. Place the heel on the ground and point the toes up. 
  3. Gently lean towards the wall with your body in a straight line until you feel a stretch in the right calf.
  4. Hold this position for 30 seconds and then release. 
  5. Complete the stretch 3 times on each leg.
  • Achilles Stretch


  1. Stand with your hands placed against a wall. Place the left foot back with the right foot forward in a slight lunge position. 
  2. Push towards the wall, keeping your heels against the ground and then slightly bend your left knee. 
  3. Hold this position for 30 seconds and then release. 
  4. Complete the stretch 3 times on each leg.
  • Ankle Circles

This exercise can be performed sitting or lying down as well as standing as long as there is something sturdy nearby for support.


Start by turning your right ankle clockwise. Perform 10 repetitions before moving the ankle counterclockwise. Then switch to your left ankle and complete the exercise in a similar manner. 

Foot Pain

While many foot problems can be mitigated by choosing proper socks and footwear, foot pain can creep in while hiking. Like your knees and ankles, you can perform exercises and stretches to strengthen your feet to keep them strong. 

  • Toe Raise, Point & Curl

This exercise intends to improve your overall foot flexibility and mobility and includes three stages of movement. 


  1. Sit down with your feet flat on the floor.
  2. With your toes on the floor, raise your heels until only the balls of your feet remain on the ground. Hold this position for 5 seconds and then lower the heels.
  3. Next, raise your heels a second time. As your heels move upward begin to point your toes. Continue raising your heels until only your big and second toes touch the ground.
  4. Hold again for 5 seconds before releasing your toes and lowering your heels. 
  5. Then curl your toes inward and raise your heels a third time. Once only the tips of your toes are only the ground hold the position for 5 seconds.
  6. Complete each stage 10 times.
  • Toe Extension

After a long day trekking, this exercise can help stretch and relieve pain in an achy foot.


  1. Sit on a chair with your feet flat on the floor.
  2. Bring your right foot up onto the right thigh.
  3. With your hand, pull the toes upwards towards the ankle so you can feel the stretch along the bottom of the foot and heel cord.
  4. Hold the position for 10 seconds, massaging the arch of the stretched foot if desired.
  5. Repeat this exercise 10 times on each foot.

Performing these exercises and stretches regularly can help prepare you for hiking excursions both big and small. If your aches and pains are keeping you from the trails, our physical therapists are here to help. Come see us to get rid of pesky re-occurring pain so you can continue doing activities you love! Contact us here for more information or to schedule an appointment!