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Backpacker Magazine – June 2003

A Speedy Recovery

Sidelined by injury? Get back on the trail fast with this easy treatment plan.

by: Buck Tilton

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A twisted ankle. Back pain. A sore shoulder. If you're physically active, you're familiar with sports-related injuries. According to the American College of Sports Medicine, one out of four active adults suffers musculoskeletal injury in a lifetime, mostly to the lower extremities. Many more experience swelling and pain from previous injuries that didn't heal properly, says Robert Duggan, DPM, an ankle surgeon and sports medicine consultant to ABC's Wide World of Sports.

But a little hurt shouldn't force you to the sidelines--not for long. Doctors say fast, aggressive treatment will dramatically shorten your road to recovery. "Athletic injuries should be managed initially and immediately with RICE," says Steve Platz, National Outdoor Leadership School instructor and physician's assistant at Wyoming's Teton Orthopaedics. "If you spend a few days resting, icing, compressing, and elevating the injury, you're going to bounce back quicker," he says, explaining the acronym.

After RICE, you should follow a routine specific to your injury. We asked doctors and physical therapists to help us develop at-home plans for recovering from pains in the ankle, knee, back, and shoulder--the most common injuries to backpackers. They also told us how to spot serious injuries requiring a physician's expertise.


The pain: When you twist your ankle, you're likely to feel some serious hurt and experience a disturbing wobble and lack of balance. That's because the injury has disrupted your proprioception, the intricate system that allows your body to react to exteral stimuli.

The plan: While sitting, trace the alphabet (capitals and lower case) with your toes, flexing at the injured joint; repeat three or four times daily. If that's too painful, rest 2 more days and try again. As soon as you can stand pain-free on the injured foot, try balancing on it. Next, bounce on it gently. When you can hop pain-free from one foot to the other, start hiking.

When to call a doc: "If you can't take more than four steps," says Platz. Most ankle injuries eventually heal without professional care, but disabling pain or instability warrants an X ray.


The pain: Front-of-the-knee discomfort is the number one complaint at sports medicine clinics. It's usually attributed to taking big steps up or down, to running, or to overuse.

The plan: Try the following exercises, which are designed to strengthen the muscles that support your knee.
>>> Leg lifts: Sit on the floor with the bad leg straight in front of you and the good leg bent. Tightening your thigh muscles, lift the injured leg up about 8 inches, keeping it straight, and lower it slowly to the floor. Complete a set of 10, then roll onto your uninjured side, and repeat. Now straighten both legs, roll onto your stomach, and do two more sets of lifts with the injured leg.
>>> Sit-downs: When leg lifts become easy, stand against a wall and slide down until you're in a sitting position. Keep your head and back against the wall. Hold the position for at least 10 seconds, then slide back up. Repeat this 10 times.
>>> Lunges: As your knee improves, try a few lunges. Stand with your feet apart and in line with your hips. Step forward with one foot, letting your knee bend when the foot lands. Push back to a standing position by straightening your knee and stepping back. When you can repeat 10 lunges without pain, you're ready to hike.

When to call a doc: Knees are more likely than ankles to suffer serious ligament or cartilage damage. "If the knee swells quickly or feels unstable when you walk, get a professional evaluation," says knee expert Joe Costello, certified strength and conditioning specialist and founder of the Coreance Rehabilitation Center in Boulder, CO.

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