8 Common Hiker Injuries and How to Treat Them

Hiking comes with it’s share of injuries. Most are minor if treated promptly.

Consider this. It’s the worst possible time for an injury. Right in the heart of the 100 mile wilderness and another 3 days before the closest town. Murphy’s law says the chances of something going wrong are just about 100 percent. Maybe it’s not something to worry about? Maybe the diligent prep-work before this hike has paid off. Maybe another 60 miles to town is painful, but not impossible.

A little background in medical treatment can go a long way for the bruised and aching hiker. Here’s a list of 8 of the most common hiking injuries, and how to treat them in the absence of medical professional.


The inevitable blisters. As sure on a long distance hike as taxes and bad Marvel movies. Primarily, you should consider how you got this blister. Are your shoes rubbing your heel wrong? Are the ankle cut socks not working for you? Use your best judgment and stop it from happening again. Only THEN, can we treat the wound effectively.

  1. If the blister is big, painful or likely to pop, then pop it. First wash your blister with soap and water. Sterilize your sewing needle by holding the end over a flame until it glows red hot (Or use alcohol if that’s your fuel of choice). Pop it and drain the fluid.
  2. Wash and dry the area, taking care to not let contaminates enter the hole you just made. Place a Bandaid over the open hole in your blister.
  3. Continue to monitor your wound for redness, increasing pain or secretion of pus. If any of these occur, it may be infected. You NEED antibiotics. Go find a witch doctor.
Foot Blister

Photo courtesy of Flickr.com

If the area is just starting to get hot or red, cover it up with duct tape or a Bandaid to prevent any more friction. Then start thinking about prevention, which is important.

Diabetics should take any foot wound more seriously than others. The complications are possibly fatal. Click here for more info. 

When to see a doctor: The pain is increasing, the area is reddening or you can add pus to your gear list. 8

Sprains (Ankles, wrists, faces)

Okay your ankle hurts. Definitely not good. Take a seat. Pop some Vitamin I and grab some lunch. Okay to stand on it? Good. Hurt like hell? End the day.

Walking on a sprained ankle is dangerous. Everything is all bent outta shape and your ankle is suffering it’s own physiological version of PTSD. More importantly, you’ve lost some of your ability to sustain jagged rocks and steep declines/inclines.  Ibuprofen, ice and rest are your definitive treatments. As it starts to heal and feel a little better, shorter mileage days are acceptable. Just forgo the trail-nastics4 for a week or two.

When to see a doctor: When you hear an audible “pop” or you can’t bear any weight on the ankle.

Illiotibial Band Syndrome (ITBS)

This injury is caused by a number of factors, primarily being overusing your legs (damn thru-hikers) and lack of stretching or warming up. Essentially, the ligament that runs down your thigh and to your shin (the illiotibial band) is what secures your knee in place. Hiking makes great use of this band, but without stretching and pacing, it can become inflamed, causing discomfort something tremendous.

  • Take a zero/nero day. This ligament is inflamed because of overwork and it is done with your BS. Rest it. This condition can become very severe very quickly. Again, listen to your body. You don’t want a couple of mandatory weeks off the trail.
  • Ice and Vitamin I! Only temporary fixes, but good for healing.
  • Some specific stretches can help with this condition. I make no claims to have any knowledge of stretching (yet), so I’ve included a video of a few you can try.

When to see a doctor: You overdid it. You pushed through and now you can’t bend you knee. An MRI and some significant time off may be the doc’s first line treatment. 4

Achilles tendonitis

The Achilles tendon is another important hiking muscle. Located on the back of your leg above the heel, this tendon stretches and compresses with movement of the foot. Like ITBS, Achilles tendonitis is caused by overuse and under stretching.

Beyond these stretches you can

  • Treat with Vitamin I, ice, and rest
  • Look at new shoe or insole options
  • Quit hiking

When to see a doctor: The pain isn’t getting any better with rest or you have lost mobility of your ankle(s). Pushing on can cause permanent damage. 1


This is a very VERY real threat for most hikers in all situations. Once you’re overtired, you don’t preform or function as well. You make poor choices and promote injury. You should monitor your body’s reaction to strenuous activity and take steps (not literally) to build up endurance. Should you overdo it, take action.

  1. Find somewhere to REST. If that means a zero/nero day, just do it. If you end your day early or under your goal, don’t beat yourself up about it. You needed it. After a day of rest, you’ll be replenished and have the AT on your mind yet again. Better a zero day than a transition to end earlier than you planned.
  2. Refuel and rehydrate! These are likely a big cause of your condition. Eat a huge meal and make sure your urine is clear as you can make it.
  3. Consider the CAUSE of your fatigue. Are you hiking too fast? Is your pack too heavy? You been fighting bears bare fisted the last 10 miles? (See what I did there?) In any case, make a change. Your hike depends on it.

When to see a doctor: You are uncharacteristically exhausted. You may be dangerously malnourished, or the victim of a transmittable disease (lyme disease, West Nile Virus, EEE etc.)



The giardia organism. Photo courtesy Flickr.com

10 miles to go today and your stomach is telling you there’s a problem. Maybe it was one of those 3 microwave burritos you ate yesterday, or maybe it’s something more serious.

Commonly acquired by hikers drinking unfiltered water, the bacteria Giardia intestinalis temporarily causes extreme stomach cramps, vomiting and diarrhea. And while this condition is usually self-limiting, it’s extremely unpleasant. Keep in mind that treatment on the trail isn’t really possible, but a couple of home remedies may alleviate this, and other gastrointestinal upsetting torture a little sooner. 9

Garlic: A remedy dating back to Hippocrates, garlic has been used to treat a multitude of symptoms. Recent research points to garlic as a homeopathic cure for Giardia intestinalis. If you need to, try buying some raw garlic and eating a few cloves a day. Even if it’s not giardia, garlic will “sanitize” your gut and take care of some discomfort. And TP. Bring extra. 3

Grapefruit Seed Extract: Some pharmaceutical companies make this OTC medication to treat parasites in the GI tract. While research into it’s use isn’t as well published as garlic, anecdotal accounts of it’s use are a strong supporter of it’s benefit. At $10 a bottle, it’s worth a shot. Read the directions though. And again, keep the TP within reach. 2 

Water: This is not optional. You’re shitting out your life force. Drink it back in. 

When to see a doctor: The problem isn’t getting better. You should expect an improvement in condition in 2 or 3 days. If not, you may be victim of something more serious.

Skin Problems


John Wayne - Angel and the Badman - 1947 - & Gail Russell

John Wayne – Angel and the Badman – 1947 – & Gail Russell: Photo courtesy of Flickr.com

“John Wayne Syndrome (JWS): A condition in which the victim takes wide ‘cowboy-like’ steps to avoid friction between their thighs, most common cause: chaffing. See also: duck waddle, hopscotch, thunder thighs. “ 6

Like everything else, your best bet is prevention with some Gold Bond or other generic powdered gold. But if you wait too long and you’re walking like a cowboy, baby powder applied to the reddened sensitive areas and some long form fitting boxer briefs should do the trick. If neither are an option for another 3 days, wrap your thighs in a cloth or bandage to prevent any more friction, then wash and treat when you find a town. (or sooner, you crafty son of a gun you.)


Jewelweed: Photo courtesy Flickr.com

Jewelweed: Photo courtesy Flickr.com

We’ve all had a sunburn at some time or another. While aloe vera and time are a sunburns best friend, a thru hiker may have to get creative.

First and foremost, reduce exposure. More sun will only make a sunburn blister and crack. A breathable rain jacket or a hat may be necessary. If the pain is too much, a damp bandana (or the like) can be placed over the affected area. If you’re a skilled agriculturist, look for some Jewelweed in the deep swampy sections of the trail. Slice the stem open and use the goopy insides to sooth your blistering flesh. 7

When to see a doctor: Fatigue is increasing, you are blistered like a pizza and/or you are having trouble staying warm. Large sunburns can become real medical emergencies, resulting in infection and fever.

Poison Ivy (oak, sumac)

Those with a severe allergy already have a war story or 7 about their experiences in Nana’s yard, tearing up those pretty three leaved plants by hand. Walk into any drugstore and an entire aisle will be dedicated to poison ivy remedies. My regular work partner swears by a combination of IVY Superdry and a couple gulps of Pepto. Don’t ask me how the Pepto helps, I don’t know. But I swear, I’ve seen that shit work magic on some insane poison ivy rashes.

A backwoods fix is even easier. If you know you were exposed, wash you exposed skin with as much water as you can spare. That oil on the leaves gets on everything, including clothes. If you miss your window for washing, Jewelweed will sooth the inflammation (see above).

When to see a doctor:  Fever, chills, extreme blistering or pain are all reasons to get off the trail and into a medical office.

Tick Bites

Tick types

Photo courtesy of Flickr.com

Some have claimed deer ticks as “the most dangerous element of the Appalachian Trail”. While I don’t refute the danger, you shouldn’t worry about a couple of tick bites, as long as you find them. Lyme disease (a potentially hike-ending condition) can be transmitted by a deer tick to your skin after only 24 hours of contact for 99% of cases. If you’ve found a tick lodged deep into your nether regions, don’t panic!

Classic Bullseye of a deer tick bite. Photo courtesy Flickr.com

Classic Bullseye of a deer tick bite. Photo courtesy Flickr.com

  • Use a pair of tweezers to remove the tick as close to the head as possible. If lacking a good set of tweezers in your super ultralight pack, you may have to get creative with a knife or razor blade. When you get the bastard, destroy God’s creature. It’s okay. I give you permission. Torch ‘em.
  • Wash the area with soap, water and some serious scrubbing. Ticks are gross.
  • Monitor the area for the traditional “bulls-eye” pattern. If you see this you’ve likely contracted lyme disease. Seek medical attention.
  • Even in the absence of a bulls-eye pattern, be wary of extreme fatigue, thirst, muscle aches and fever. Lack of this specific pattern doesn’t mean you haven’t contracted lyme. Know your body, and when it’s hurting.

When to see a doctor: You’ve got the bulls-eye and/or you have body aches/fever/fatigue. Lyme is a true concern. 5

For more info, go check out How You Should Really Handle Injuries and Illness on Trail

What other backwoods fixes do you have for hiking injuries?

Leave a reply below!


These treatments are in no way any replacement for professional medical evaluation and treatment. You should conduct further research before ingesting or applying ANYTHING in the presence of illness/injury. Everyone responds to treatments differently and for this reason, treatment by a medical professional in a controlled setting is the most appropriate option for all ailments. I accept ZERO responsibility for any injury or reaction that occurs as a result of these treatments. You’re grown up and intelligent, you can make your own decisions. This guide is meant purely as a reference material for further personal research.

1.Achilles tendinitis. (2015, August 4). Retrieved September 11, 2015, from https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/basics/definition/con-20024518
2.Bergen, T. (2015, July 26). Grapefruit Seed Extract & Intestinal Parasites. Retrieved September 11, 2015, from https://www.livestrong.com/article/545648-grapefruit-seed-extract-intestinal-parasites/
3.Harris, J. (n.d.). The microaerophilic flagellate Giardia intestinalis: Allium sativum (garlic) is an effective antigiardial. Retrieved September 11, 2015, from https://mic.sgmjournals.org/content/journal/micro/10.1099/00221287-146-12-3119?crawler=true&mimetype=application/pdf
4.ITBS. (n.d.). Retrieved September 11, 2015, from https://www.runnersworld.com/tag/itbs
5.Lyme Disease. (2015, August 14). Retrieved September 11, 2015, from https://www.cdc.gov/lyme/
6.Me. I just said this. Just now
7.Nick, J. (2011, July 13). The Nickel Pincher: 7 Herbal Remedies That Will Save Your Summer. Retrieved September 11, 2015, from https://www.rodalesorganiclife.com/wellbeing/herbal-remedies-and-sunburn-cures
8.The Cure: Beating Blisters. (2005, September 1). Retrieved September 11, 2015, from https://www.backpacker.com/gear/footwear/hiking-boots/the-cure-beating-blisters/
9.The microaerophilic flagellate Giardia intestinalis… (2000). Retrieved September 11, 2015, from https://mic.sgmjournals.org/content/journal/micro/10.1099/00221287-146-12-3119?crawler=true&mimetype=application/pdf

Affiliate Disclosure

This website contains affiliate links, which means The Trek may receive a percentage of any product or service you purchase using the links in the articles or advertisements. The buyer pays the same price as they would otherwise, and your purchase helps to support The Trek's ongoing goal to serve you quality backpacking advice and information. Thanks for your support!

To learn more, please visit the About This Site page.

Comments 5

  • Paulina Louise : Sep 13th

    I gave some powdered activated charcoal mixed in a couple cups o water to a hiker who had a bad case of giardia and he started feeling better almost immediately. Activated charcoal is also good if you get a poisonous snakebite or bit by bees. It adsorbs the toxins out of your body long enough till you can get to a doctor.

    • Jeremy Morris : Oct 16th

      Absolutely, Paulina! Especially if you have it readily available! We used to use it on the ambulance for a number of medication overdoses. Unfortunately, it tends to promote oral expulsion of stomach contents after you drink it. Always look for the cherry flavor!

  • Carol J : Feb 17th

    When you talk about “chaffing” I’m assuming it’s people making fun of you on trail for your spelling?


What Do You Think?