Common Injuries on the Trail

If you thru-hike the John Muir Trail you are going to probably hurt yourself. Chances are that the injury will not be enough to stop you, or even slow you down much, but almost no one walks 210 miles without some sort of minor injury or affliction. In John Ladd’s 2014 John Muir Trail survey, he reported that the top three complaints (in regards to injuries) were blisters, knee or ankle problems, and back or hip problems. It should be noted that all were well behind the number 1 complaint: mosquitos.

Here is a list of the most common ailments and a little information on how to handle them. Keep in mind that my expertise (and that might even be too strong a word) is in the area of Sierra Nevada backpacking, not in medicine. I’m not a doctor and the closest thing I’ve received that could be called medical training was a Combat Lifesaver Course, which was a long time ago. (Besides, I’ve found that sucking chest wounds are infrequently encountered on the JMT.)

This is hiking advice, not medical advice.

Altitude Sickness. Almost everyone suffers from a bit of altitude sickness. The symptoms can be as benign as a loss of appetite and trouble sleeping, to a nasty headache, to something potentially fatal. I’ve written a little about this here and here, but – if you want the best thing out there on the topic – the Unofficial Acclimatization Guideline for JMT Hikers is where you need to go.

Skin Problems. (I’m not talking about acne.) I would guess that the vast majority of hikers will suffer a blister, a burn, an abrasion, or cut.

Regardless of what kind of skin problem it is, keeping the wound clean is important. The best way to clean a wound is with sterilized water specifically prepared for a medical setting. Since no one has that on the trail, the next best choice is purified water – which you should be able to produce in abundance. (This is an area where some water-purification approaches are superior, since a few eliminate the threat from bacteria AND viruses, and others just bacteria.)

Blisters are NOT inevitable. Good footwear, proper preparation, and a light load can virtually eliminate the friction that causes foot blisters. If you get one and you are able to avoid draining it, don’t drain it. Just clean it as well as you can and apply a blister bandage to keep it clean and to avoid further damage. If the blister is so large or is in a place where you feel it must be drained, puncture it at the edge with a sterilized needle or knife just enough to allow the fluid to run out. Remember, though, that you have now provided germs with an entry point into the wound. From now on you need to take extra care to keep it clean. You might want to carry some sort of antibiotic cream with you for these types of situations, though I would recommend you consult your doctor before you do so. Allergic reactions to these ointments are possible; what might be a great idea for me could be catastrophic for you.

If you are cooking in the field and you manage to get to the end of the trail without at least a minor burn, you are far less clumsy than I am. (In fact, I would guess that 99 people of every 100 that are reading this blog are less clumsy than I am. Sad, but true.) The two things you need to evaluate when it comes to burns is how bad (first, second, or third degree) and how big (i.e., how much skin is affected). Severe burns or burns that cover more than a few square inches on the body are beyond the scope of this article, and are pretty rare on the trail. What is more likely is that you will spill boiling water on yourself or inadvertently grab a hot pot or stove. The best advice, here, is similar to blisters: try to avoid the problem entirely! When you are heating up water in the evening for that beef stroganoff, remember that you are tired and that you are trying to “cook” on uneven surfaces. Slow down and be careful.

If you do burn yourself, if possible, immediately submerge the affected skin into cold water (which is in abundance on the trail, and is often near your campsite). Cooling the area quickly can help reduce the severity of the burn. Afterwards, proceed as if it were a blister (which, in a sense, is just another type of burn). Keep it clean and covered as much as possible.

Cuts and abrasions are less common, but the remedy is the same: clean the wound with purified water, keep it clean, and keep it covered.

Twists & Sprains. Nature may have afflicted me with a propensity to trip and stumble, but it tried its best to make up for it with flexible joints. I have suffered some horrific ankle twists on the trail – so bad that I could not walk a single step for several minutes – and have completely recovered in less than an hour. If you twist an ankle on the trail, even if the pain is pretty severe, don’t necessarily conclude that the injury will be catastrophic.

The classic prescription for the sprain is R.I.C.E. That stands for rest, ice, compression, and elevation. On the trail you will need to improvise, so stay off the affected foot while soaking it in a cold stream or lake. Your boot, or an ace bandage you carry with you, will provide the compression, and you can elevate your leg onto your backpack while you sit against a tree or rock. Obviously, some sprains could be severe enough to cause you to abandon the trail. Give your body a chance, though, and you might be surprised on how quickly it recovers.

There are lots of other ways to hurt yourself in the woods, but when it comes to injuries that are not severe enough to make you leave the trail, these are the most likely. My last suggestion would be to carry some sort of small first aid guide with you; knowledge is always the most effective solution to any predicament!

Good hiking, Ray