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Care for Your Feet: How to Prevent and Treat Injuries on Trail

Properly fitting shoes or boots are the first place to start, but there’s more to happy feet. Given how hard they work for us, it’s in our best interest to care for our feet, including conditioning them for hiking, and to learn how to prevent the issues we can and to treat the issues we encounter on trail.

By Sandra Saathoff

The foot is an amazingly complex feat of biomechanical engineering. Each foot is composed of 26 bones — nearly one quarter of the bones in our bodies — 33 joints and 20 muscles. Tendons stretch between the bones and more than 100 ligaments connect the whole structure together, along with nerves and skin. With each step, our feet absorb about 2.5 times our body weight. Most of the time, however, we don’t think about our feet until something goes wrong. 

Properly fitting shoes or boots are the first place to start, but there’s more to happy feet. Given how hard they work for us, it’s in our best interest to care for our feet, including conditioning them for hiking, and to learn how to prevent the issues we can and to treat the issues we encounter on trail.

A hiker sits with their feet out in front of them, facing a river.
A hiker letting their feet take a break by a river. Photo by Andrea Laughery.

Conditioning

Just like we benefit from conditioning our bodies to hike, we can condition our feet. Increasing our time hiking by increments prepares the muscles, tendons, ligaments and even our skin for more miles. Increasing mileage or elevation gain and loss too quickly can set us up for injury, so having a plan is helpful. With properly conditioned feet, it’s possible to avoid many of the annoyances of longer hikes, including blisters and foot soreness. 

If planning a longer hike or backpacking trip, start with shorter hikes with a light day pack and, over several weeks, work toward the mileage you’re aiming for as well as full pack weight — and be sure to include uneven surfaces, if that’s what you’ll be hiking on. 

Off trail, we can strengthen our ankles and toes with exercises aimed at the feet. Here are a few simple suggestions to get started:

  • Point and flex your feet. Repeat 25 times. 
  • Move your feet to the inside and outside, to help strengthen the structures that support you.
  • Do stretching — or even look for yoga exercises that target the feet. Stretching can help you avoid the pain of plantar fasciitis, heel pain caused by inflammation of the tissues that connect your heel bone and toes. 
  • Work on your balance. Tools like wobble boards and exercises like tree pose and one-legged forward bends increase our strength and balance, preparing us to deal with on-trail conditions like wobbly rocks and stream crossings.

A hiker sits on a rock to remove their boot and sock, and is smiling at the camera.
A hiker enjoying the great feeling of taking off your shoes and socks on trail. Photo by Mordechai Treiger.

Prevention

If you’re like many people, you may not spend a lot of time hanging out with your feet, so I challenge you to take your shoes and socks off and take a good look. Run your hands up and down your feet, really paying attention to how things feel. A self foot massage from heel to toe feels great and gives you insight into what your feet need. Is the skin smooth and supple? Is it dry and scaly? Are there callouses or cracks? Lumps or bumps? How do the toenails look? Are they trimmed so they don’t bump into the front of your boots, which helps to prevent toenail loss? A soft and hydrated foot is a healthy foot, able to bend and stretch with the rigors of hiking. If you find that you have thick calluses that tend to get blisters underneath, using a pumice stone might help avoid that. And if you have rough or cracked skin, some good foot cream can make a big difference.

Blisters

Knowing our feet helps keep them healthy, but doesn’t prevent all on-trail issues. Blisters are the most common foot injury. For people who routinely get blisters even with happy feet and well-fitting shoes/boots, there are a number of techniques that can help – too many to mention in one article, actually. It takes heat, friction and moisture to make a blister. Preventing them comes down to two main categories: things you apply to the skin and things you wear. 

Applied skin protection: If you know where you normally get blisters, you can help prevent them by applying a protection layer to the skin before you start hiking. This can be athletic tape (ex. Leukotape), which provides a slick surface for the shoe to rub against, saving the skin. If a blister starts during a hike, which you can notice by the feeling of a hot spot or irritation on your foot, immediately stop and deal with it. It’s often frustrating to have to stop and take off your shoes and socks, but it’s worth it in the long term. Apply a bandage, tape or moleskin to take the pressure off and help keep a blister from ending your hike before you’re ready. 

Sock options: A variety of sock options can help you avoid a blister. Some people like to wear two layers of socks: one thin liner and another over that, so that when the shoe begins to rub, it’s rubbing on sock, not skin. Others swear by toe socks, which give each toe its own separate space, keeping them from rubbing against each other. Also look for socks without seams, or those that tout their wicking abilities to help you keep your feet happy. You might have to experiment a bit to find what works best for you. 

Several pairs of hiking socks hang out to dry on a line.
Dry socks are key to blister-free feet. Photo by Heidi Walker.

Treatment

Even with the best planning, life happens. If you do end up with a foot injury on trail, here are some tips to help you deal with it and make it out as comfortably and safely as possible.

Blisters: A blister is an injury and should be treated as such. It’s important to protect the area, keep it clean, and prevent infection while minimizing pain. You’ll always want to hike with a first aid kit with some basic materials for foot care. For a blister that has already formed, you’re going to want moleskin. Cut a hole in the moleskin slightly larger than the blister and press it on the skin so that the blister is visible in the hole, making sure that the application is smooth, so you don’t create a new friction point. Allow enough moleskin around the edges for good adhesion. Next, apply some antibiotic ointment to the blister. Then tape a piece of gauze over the moleskin to help keep dirt out. If the blister has been popped or torn, it’s even more important to keep the area clean and medicated so that infection does not set in. Take good care of your blister until you complete your trip.

Tendon and ligament injuries: Tendons are soft tissue structures that attach muscles to bone, while ligaments attach bones to other bones. Overuse or injury can result in inflammation. Gradual conditioning should prevent a lot of injuries, but again, life happens. It’s important to not ignore tendon or ligament pain. Rest, ice, compression and elevation are the first line of assistance once something feels like it’s brewing. Stabilization as needed and NSAIDs for inflammation reduction can also be important. If you’re out for a day hike, you may get away with taking a break at a stream and doing some gentle stretching, then slowing down the pace back to the car and relying on your hiking poles or some stout sticks for support. If you’re 35 miles out, it’s even more important to deal with the issue immediately, so you have a chance of getting back to the car without undue discomfort. Medical attention may be needed once you’re back in the frontcountry, depending on the severity of the issue.


Next time you head out, do so with a stronger appreciation for your feet and the job they do. Happy hiking!