Preventative Rehabilitation for Hiking

Prehab for hiking
It's getting warmer, the snow is melting, and the days are getting longer. Winter is coming to an end (hopefully) and spring and summer are upon us. For some Coloradans, that means heading to the mountains to hike and explore the endless miles of beautiful trails this state has to offer. Some may be enjoying a easy day hike with friends and family, others may be attempting to bag a few 14er's this year.

Whatever you choose, are you ready to tackle those trails all summer without those pesky knees, hips and ankles acting up? What about that back? Are you going to suffer through those aches and pains that pop up after your first few tough hikes? What if there were a few exercises that you could start doing now to get your body ready?

Hiking can be a lot more strenuous than your day to day walking, especially in Colorado. You will have to deal with uneven terrain, elevation gains, and possibly carrying a heavy pack. All of these things can wreck havoc on your joints and can potentially end in injury. Good ankle stability can be the difference between recovering from stepping awkwardly on that root and a nasty ankle sprain. Strong hips can make all the difference in the forces your knees have to put up with while descending that mountain you just conquered. And good core stability can allow you to rest pain-free after a long day in the mountains and be ready to do it all over again the next day.

By focusing on specific strength exercises and addressing any movement dysfunctions, a physical therapist can help you put your best foot forward this summer. I want to share with you a few of my favorite prehab exercises that focus on what hikers need most. These exercises are also great for those trail runners out there.

Calf Raises

We will start at the bottom and work our way up. Balance starts at your feet. If you don't have good foot and ankle strength, flexibility and stability, you may have trouble adjusting to uneven terrain. My favorite exercise for foot and ankle strength is single leg balance. The twist is, you lift your heel off the ground so you are balance on the ball of your foot. In this position all the muscles in your foot and ankle have to work together to keep you stable. First try this while holding onto two hiking or ski poles. This will give you a little more stability at first. Try to balance for up to 2 minutes at a time. To progress, make small circles or a marching motion with your non-stance leg. You can also get rid of the poles to challenge yourself more.

Hip Flexor Stretch

Next, lets move up to the hips and knees. The biggest complaint I hear about hiking is knee pain. More often than not, it really has to do with hip strength. Your hip abductor muscles help to keep your knees in proper alignment, this can significantly reduce the risk of anterior knee pain. Hip abductors, the muscles on the lateral side of your pelvis, are often ignored in exercise routines. There are a few exercises you can do in your home to improve the strength of your hips. Half kneel balance is my favorite stability exercise. Line your front foot up with your knee as if you were on a balance beam and attempt to hold this position for 2 minutes. If this is easy, close your eyes. Keep your front knee bent to 90 degrees and focus on keeping good posture throughout.

Doorway Squat

Doorway squats are another great way to improve hip strength and stability. Being in a doorway limits your ability to 'cheat'. Focus on keeping the knee of your front leg in good alignment with the door, but do not let it touch the door frame. You want to keep your weight through the heel of your front leg and try to sit straight down. Only use the door frame for balance, do not pull on it. Do 10-20 repetitions each leg.


And last but not least, core stability. Core stability is the building block of all movement. If our arms and legs have a solid foundation, they are able to move correctly and efficiently. There are hundreds of different exercises you can do to maintain good core strength and stability. If you are lost in a sea of YouTube videos about which one is the best, fear not; just plank. There are a few plank variations I like more than others. As always, start on elbows and knees, focus on maintaining alignment of shoulders, hips and knees throughout, and do not perform any exercise that causes you pain. Side planks with a leg lift are a great two for one exercise. Core stability and hip stability in one! Shoot for 10-20 repetitions on each side. Front planks with alternating leg extensions are great too. They focus on keeping your trunk still with alternating leg movement, mimicking the demands of walking with a heavy pack. Do 10-20 repetitions at a time.

All of these exercises can be completed in your home without any special equipment in about 15 minutes. Everyone can make time for 15 minutes of stability and strength training. The standing balance exercise can even be done while waiting in line at Cost-co, just don't try the other ones there…people may question your sanity!

This is not a comprehensive list and by no means will address every impairment that you may have or guarantee an injury free hiking season. The only way to address your specific deficits is to see your PT and let them customize a program for you. Currently our healthcare system is pushing for more preventative health care. Let's translate this to physical therapy. PT's are movement experts and we love nothing more than to help people move better. If we can keep you moving well, hopefully, we can keep you pain and injury free. Wouldn't you rather see your PT a time or two now so you can avoid having to see them down the road after an injury or surgery? Prehab is typically not covered by insurance, however, if you compare the cost and benefit of a personal training session or two versus a couple sessions of PT, there is more value in seeing a PT. Physical therapists are highly trained individuals who typically have a clinical doctorate degree. You will gain insight into how and why your body moves and functions the way it does and what you can do to reduce your risk of injury. Our goal is to not have to see you again unless it is to enjoy a hike together. So call a physical therapist today and ask about a prehab program customized to your needs.

Agility Physical Therapy and Sports Medicine

(303) 773-0771