Injury

Symptoms

Prevention

Treatment

Plantar Fasciitis

Pain in sole of foot just in front of heel; stiffness in sole with first steps of the morning.

Stretch Achilles and foot after runs, hikes; massage sole of foot: firm shoes; 1/4" heel lift; arch supports.

Stretch the Achilles tendon and foot on incline board; tape sole instep; massage, ice sore spot; place 1/4" heel lift in shoes.

Metatarsal Stress Fracture

Pain in long bones of foot, especially 2nd or 3rd, worse with weight bearing; aches at night.

Avoid training too much too fast, too soon; take care when transitioning to new training surfaces (grass to asphalt); different footwear (old shoes, new boots).

Decrease amount of running or hiking: avoid full-weight bearing, use crutch or cane: seek medical evaluation.

Muscle Cramps

Sudden severe pain in muscle belly, causing stiffness and loss of motion.

Maintain Hydration/ acclimatization protocols; stretch at first hint of muscle tightness.

Grasp and tightly compress muscle belly with both hands; stretch muscle to maximum tolerable length until cramp resolves.

Achilles Tendonitis

Pain at the back of the heel along the heel cord; worse with running and climbing.

Incline board stretch of achilles over the counter arch supports; stretch after all runs.

Ice for 15-20 minutes every hour when possible; incline board stretch; cross friction massage.

Shin Splints

Pain at lower third inner tibia, usually after long or hard runs or hikes. Pain worse with the first steps of running or hiking.

Good shoe /boot wear; stretch before and after runs/hikes; pronators (flat feet) should use arch supports.

Ice to painful area before and after run, hike; ankle strengthening exercises, calf stretches, arch supports; medical evaluation for pain longer than 12 days.

Iliotibial Band Rub (ITB)

Pain at outside portion of hip or knee; gets worse several minutes into a run.

ITB stretches; discard broken down shoes; use running shoes with wide heel base; check leg length differences.

Ice to painful sites. ITB stretches, hamstring and quad stretches. Heel lift for leg length difference.

Injury

Symptoms

Prevention

Treatment

Patellofemoral Syndrome

Knee pain localized under or around the kneecap; worse with going up or down hills or after prolonged sitting.

Quadriceps stretching/strengthening exercises; hamstring and ITB flexibility exercises; check foot for biomechanical abnormalities (over pronation).

Ice and range of motion to acute injury; NSAIDs for 5-7 days; stretching/strengthening program arch supports or inserts for over pronators.

Rucksack Palsy

Weakness, pain, and/or numbness of upper extremities or shoulders.

Correct load distribution; adjustment of straps as needed. Correct padding.

Avoid heavy load-bearing for 2-3 weeks; NSAIDs for 5 -7 days

Foot Blisters

Localized pain and redness: "hot spots" caused by friction rub; clear fluid in blister.

Shoe insoles (Spenco) Adaptive training to toughen skin; change out of wet socks immediately; moleskin to blister prone areas.

Cover blister with clean bandage and/or moleskin; apply antiseptic to open blisters, and keep clean with a dressing.

Ankle Sprain

Pain, swelling, loss of function after turning twisting injury.

Ankle stretching and flexibility exercises, ankle braces.

Ice the area for 20 minutes every hour. Compression wrap from toes to lower leg; leaving no gaps. Keep foot elevated. NSAIDs for pain; Partial weight bearing using cane or crutch.

Medial Epicondylitis

Pain at inner bony aspect of elbow; worse with wrist extension.

Caution with aggravating factors: narrow-based hand placement for push-ups or wrist extensions under resistance; needs wrist strengthening program.

Ice to bony prominence; wrist stretching/strengthening exercises; cross friction massage; avoid aggravating factors.

Heat Stroke

Hot, dry, flushed skin, high body temperature. altered level of consciousness, weakness, incoordination.

Hydration, stepwise acclimation to environmental conditions.

This is a life-threatening emergency. Replace fluids; if possible cool water immersion in the field; ice packs to the armpits, groin, temple.

Heat Exhaustion

Cool, damp skin; nausea, weakness, fatigue, poor concentration.

Maintain hydration, during exercise in all weather. Avoid black flag conditions.

Remove excess clothing; replace fluids, cool body with water immersion, ice packs, and transportation to medical facility.