Backpacking – Foot First Aid

When you are in the wilderness, you need to be able to address foot problems immediately – if you wait until you’re back in town, a minor issue can turn into a serious injury. Unattended, minor issues can escalate to the point that you have to get off trail for treatment or recovery time. No one wants that.

First Aid Kit

The first thing you need is the supplies to address foot problems properly. The following is what I consider to be a complete foot first aid kit.

Necessary

  • Antibiotic ointment
  • Ibuprofen
  • Bandaids
  • Moleskin or second skin
  • Gauze
  • Leukotape or KT tape
  • Needle and thread
  • Lighter
  • Tweezers
  • Scissors

Optional

  • Anti-fungal cream
  • ACE bandage/tensor wrap/ankle wrap (especially if you are prone to ankle injuries)
  • Muscle cream (such as RUB A5-35 or Voltaren

Don’t Ignore Pain

Be kind to your feet. They are your most important tool when backpacking, so why would you try and ignore the messages they are sending you?

Was the pain sharp or sudden? If yes, you may have caused yourself an injury such as a torn ligament or tendon, a sprain, or a fracture. This needs to be addressed immediately.
Stop hiking and assess the situation.
What do you think happened?
Do you need to take a break?
Do you need to stop for the day?
Do you need to see a doctor?
If the pain is duller or came on gradually, it may be a chronic problem such as a pulled muscle, aggravated tendon, or a blister. The first step for most foot injuries (other than open wounds) is to RICE them.

Steps to Take

Rest
Consider slowing your hiking pace, taking more breaks, or reducing your mileage in order to allow your feet to heal.

Ice
Applying ice helps to reduce pain and inflammation. I realize it’s hard to come by ice in the backcountry, but you can buy instant ice packs to include in your first aid kit. Alternatively, soak your feet in a cold river or lake, or pack some ice/snow into a ziploc bag and use that as a makeshift ice pack.

Compression
Using an ACE bandage or tensor wrap can help limit swelling in an injured foot. Be sure not to tie it too tight, or else you can cut off circulation.

Elevation
Lie down and raise your feet above your head to help blood flow out of your feet and legs. Do this every time you take a break.


What do I do?

visio-feet

Blisters

Blisters are inevitable, you’re going to get them at some point. If you follow all of the tips above, you may be lucky enough to have only a few small blisters. If you care for them properly, they will go away quickly, and you can continue to crush miles without foot pain.

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This was the worst blister I had on trail. Not too bad, all things considered.

If they are filled with fluid, you may wish to drain them. Whether or not that is the best course of action is highly contentious, but if you’re hiking long miles with blisters, then they are going to pop anyways. I figure you should take control of when and how that happens. Sterilize a needle or safety pin (either with an antiseptic wipe or a lighter), then puncture the blister and let it drain.
To keep it drained overnight, puncture the blister with a needle and thread and pull the thread partway through. Leave the thread in the blister overnight and the skin should be firmer and dry in the morning.

Foot Fungus

It is not surprising that when you are hiking often with wet feet and sharing accommodations in towns, the foot fungus makes a go-around. If your feet look patchy and peeling, but not from blisters, you may have the fungus. It’s easy to deal with, just buy some anti-fungal cream and follow the instructions on the bottle. Deal with this sooner rather than later because it isn’t likely to go away on its own and you don’t want to spread it to anyone else.

Plantar Fasciitis

Plantar Fasciitis is not something to be messed around with. It can be excruciatingly painful, and often takes people off trail. I had some early symptoms near the beginning of my hike, but managed to prevent it from turning into the full blown condition.
It is characterized by pain right in the middle or front of your heel. It can be worse first thing in the morning or after exercising. If left unaddressed, it can cause heel spurs.
You treat it by reducing your pack weight and/or mileage. Give yourself foot massages as often as possible to help loosen things up. Take ibuprofen to reduce inflammation. It can be treated with a steroid injection from a doctor if it does not go away on its own, or you may need to take time off-trail to let it heal.

Tendonitis

This is an irritation or inflammation of a tendon from poor gait or overuse. The Achilles tendon is probably the place you’ll get it in the foot. It is characterized by pain or loss of mobility. Apply RICE and take Ibuprofen as needed. This can be very painful and may require medical attention.

Shin Splints

DO NOT IGNORE SHIN SPLINTS.
Let me make myself clear.

DO NOT IGNORE SHIN SPLINTS.
If you ignore shin splints, they can progress into actual fractures. I realize that your shins are not in your feet, but your gait has a significant effect on them. Massage and roll out your shins if they are bothering you. Be sure to warm up in the morning before you start hiking, and do more stretching throughout the day as needed. KT Tape can also help reduce pain and fix shin splints.

Stress Fractures

If you are dealing with excruciating foot pain…you may have given yourself a stress fracture. It is not only possibly, but actually common for people hiking such extreme distance as the PCT or AT to give themselves a stress fracture just by walking. These require immediate medical attention and a lot of rest. It can take you off trail. Do not mess around with this kind of pain or you’ll either be out of commission for longer or you could cause yourself permanent damage.

I had some blisters burst on my first section hike of Bruce Trail (also my first backcountry hike ever), and I was miserable for the rest of the trip. My feet hurt so much. It didn’t help that I was wearing boots that were too small, hadn’t laced them properly (and kept rolling my ankles as a result), and I didn’t know how to care for those injuries. A basic knowledge of foot first aid can save you a world of pain, and can end up saving your hike.


DISCLAIMER: I am not a doctor or a medical professional. This is advice from my experience backpacking; your health is in your own hands. If you are in extreme pain, seek immediate medical advice. Be kind to your body.

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