A Physical Therapist's Guide to Enjoying the Mountains of SE Alaska
- medicinebymovement
- Jun 5
- 7 min read
The Month of June is devoted to hiking and mountain racing!
National trails day is June 7th. The perfect day to get out and enjoy our gorgeous trails! A huge shout out to Sitka Trail Works, who maintains and creates some of these treasures. I don’t think Sitkans are aware how lucky we are to have this organization and the ability to step right outside your door and head up a mountain, or wind through the woods without having to bush wack through trees and brush. As a thank you to trail works, I will be offering FREE injury screens through the month of June, and anyone who attends, has the option of donating to Trail Works. And of course, any members of the crew, please come take advantage!
The other motivator for this blog is the Alpine Adventure Run, which is scheduled for July 19th, so if you haven’t been training for this yet, now is the time! We are going to cover some basics with staying safe, and injury-free while hiking, as well as for those who are taking it to the next level, and are running up and down these beasts!
Some basics for hiking:
These aren’t specific to Physical Therapy, or related to injury prevention exercises, but some common issues to think about prior to heading out. As an Emergency Medical Responder, I am always happy to expand on any of these topics-just reach out, but for the sake of this blog, we will just briefly touch on each.
*Blisters: Wear proper fitting shoes, good socks, and always pack at least a band aide or two, and mole skin if you have it!
*Heat exhaustion and heat stroke:
I know, I know…it has barely broke 50 degrees here in Sitka. But, on those rare, 60+ days, this is possible. The sun is a bit more intense here, and these things can sneak up on you. And exertion heat exhaustion can certainly occur. This is when the fluids lost through perspiration is not replaced with other fluids. This results in the body pulling the blood away from the surface areas of the body to protect the vital organs, such as the heart and brain. The most important thing to avoid this is to stay hydrated. If you or someone you are with start to show signs such as dizziness, nausea, cool/clammy skin, muscle cramping, get them out of the sun/heat, and try and apply cool, wet clothes or spray with water. If this progresses to a heat stoke (changes in consciousness, trouble seeing, possible seizures, a throbbing headache, and a temp above 104), call 911 right away, and then try and immerse them in cold water as best you can. This is a rare occurrence around here, but one to be aware of!
*Hypothermia:
This occurs when our body temp drops below 95 degrees. A cold environment can cause this, but more often than not it’s a wet and/or windy environment. We often get hot as we climb a mountain, but when you break through the tree line and stop working your body as hard, the combination of sweat (or your typical SE Alaska precipitation), combined with some winds can drop your temperature pretty quickly. Think of wearing moisture-wicking clothes, pack extras, and get out of the wet clothes whenever possible.
*What’s in my backpack:
Snacks - nuts, fruit, chocolate
Advil
ACE Bandage
Bandaids
Water!
Bear Spray
Bug Spray
Mole Skin
Duct Tape
Trekking poles (can be used as splint if needed)
Some basics for Alpine Run:
Once again, we are so blessed to have folks like Chris and Charles Horan who host these wonderful events. I was lucky enough to participate for a couple years. As always, my participation was more of a way to have fun while still exercising outside in our amazing wilderness. Meaning, I certainly didn’t cross the finish line 1st, but we definitely won for best flare and spirit along the way :). Whether you are running to win, to participate in something that brings you together with others who enjoy the outdoors, or to prove to yourself you can do it…this is not an easy race!
For anyone not familiar, this race is about 7 miles total, but you can expect your race time to be similar to your half marathon time, as you are ascending nearly 2500 feet. The race takes you up Gavin Hill Trail, which is full of stairs, switch backs, more stairs, and some beautiful Sitka scenery. Once you break the tree line, the remainder of the race levels out and takes you across the ridge line to Harbor Mountain. When I say “levels out,” I don't mean it is without some elevation changes, but nothing like the 1st couple miles up Gavin. And if you’re lucky enough to have a clear day, you get some amazing views of Sitka and the surrounding waters. One of my all time favorite hikes, and runs…once I’m done with it!
So, it’s summer (at least in some places), and if that isn’t reason enough to get out and go up and down some mountains, either training for the Alpine Adventure Run, or getting out for National Trails Day should motivate you! Here are a few common injuries I see with my clients related to these activities:
Ankle sprains
One of the most common injuries during both hiking and mountain running is an ankle sprain. True, there are some injuries we just can't avoid, but the majority of ankle sprains happen for 2 reasons:
~ The first being your muscles are fatigued and can't respond as well or as quickly when you step on a rock or root that rolls your foot to the side. Strengthening the muscles on both sides, the front and back, as well as the intrinsics of the foot can be helpful for this. It usually doesn't stop at just the ankle either, if your lateral hip is fatigued, that control of side to side motion is going to be translated down the chain to the ankle. This is why I love the side stepping with band exercise. It targets all these muscles at once, and also works the 2nd reason ankle sprains occur:
~ Proprioception. We have all these little receptors in our joints that tell us where we are in space. If you've had an ankle sprain in the past, there is a good chance these are not performing up to par, unless you are specifically addressing it. Anything that challenges your balance, especially with the joints at different angles can be helpful. So, if you've ever had an ankle sprain in the past, or want to avoid them in the future, this is a great exercise to incorporate into your routine!
~For a video and full explanation, check out this link:
Anterior knee pain
I see clients with complaints of pain in the front of the knees probably more often than anything else. More often than not, this is worse with descending the hill, or coming down, but can progress to bothering them at all times. There are multiple issues that can cause pain in the front of the knee, but the most common reasons are either Patellar Tendonosis, or Patella Femoral Syndrome. Both of these have to do with muscle imbalances. The Patellar Tendon attaches your quad muscle (the big one in the front of the leg) to the lower leg. It tends to get irritated when more load is placed on it than it can handle. That can be increasing the load to the tendon too quickly (going from little activity to a lot too quickly). This can happen if your quad muscle is not strong enough, especially in the “eccentric phase,” or the lengthening phase of contraction. This is why it tends to hurt more going down hill or down stairs. And, I tend to see it when we are more quad dominant, meaning we rely on the front of our leg muscles more than the back, and it creates too large of a load for the tendon. Having a skilled PT evaluate you to determine which of these is a larger contributor (amongst many other things in both the ankles and hips) is always a good idea, but one great exercise to help avoid this in the future is an eccentric step down.
~For a video and full explanation, check out this link:
And while you are working on strengthening, consider using some trekking poles. This can help to offload the stress to the knees significantly, and can be a game changer!
Shin splint
There are different injuries that can cause pain to the front of the lower leg, or the shin. The most common is a shin split. But, be aware things like compartment syndrome, or tibial stress fractures are not uncommon with higher level activities such as trail running, and if your pain does not respond well to recommendations below, it is always a good idea to get it checked out and rule out some of these more serious injuries that will require more in depth treatment. But, if you have pain in the front of the shin, it is often because one of your calf muscles attaches there, and is actually pulling on the fascial structure and causing inflammation and/or pain. You have 2 main calf muscles. Your Gastrocnemius attaches up above your knee and then continues down into the Achilles. The 2nd muscle, called your Soleus attaches below the knee, and actually has an attachment to the inside part of your tibia or lower leg. This tends to be the culprit often with shin splints. Just like the Patellar Tendon, we often overload this muscle before it is ready, and it tends to break down at the weakest point, which is the attachment site to the shin. It is important to both stretch this tissue to make sure it has enough mobility, but also strengthen it. For both the stretching and strengthening, in order to take the Gastrocnemius out of the picture, you must bend your knees. This will isolate the soleus. To strengthen it, performing a heel raise, but with the knees bent is great. You can do this standing, but it is much easier to perform seated with a weighted plate on your knees.
~Then see the link here for some stretching of this tissue, and picture above for how to work this tissue: https://youtu.be/9P3kwcG-AKo
Want some more guidance for preventing or treating aches and pains associated with mountain climbing? Or need some advice on proper progressions for training? As always, exercises and improving mechanics are the most important part, but these injuries tend to respond really well to manual techniques such as dry needling, cupping, and joint mobilizations to help speed the process along. Reach out today for more information, or to schedule an appointment!
~Alicia, your PT and Wellness coach
907-623-8708
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