For people with low back pain, hiking can be a great way to exercise core muscles, improve balance and stability, and get blood flow moving in the lower back muscles. If you're a hiker with low back pain, you're not alone in your love of adventure.
In 2018, there were approximately 47.86 million participants in hiking in the U.S., according to data gathered by reporting agency Statista
. Since 2006, hiking has seen a significant bump in interest, when nearly 30 million people hit the trailheads to enjoy the great outdoors.
While hiking can be as simple as hitting your favorite hiking trail and spending the day in the rough, if you don't plan, you can be met face-to-face with injuries, particularly to your lower back. One way to prepare is to begin a moderate exercise and stretching routine a few weeks prior to your hike.
" [You] definitely want to strengthen your core muscles—this means trunk and hips. A well-rounded program here would target all sides of your torso and including the major muscle groups," says Dr. Theresa Marko
, PT, DPT, MS, a board-certified Clinical Specialist in Orthopaedic Physical Therapy. "Exercises that would be good to include would be bridges, plank, side plank, squats, abdominal series such as tummy tight with alternating heel tap, side walks with a band."
Marko adds that abs, glutes, quads are targeted areas for strength training. To improve those areas, she says to try standing hip flexor lunge stretches, hamstring stretches, and backward bends for some spinal stretching.
One that can go overlooked is the relationship between the feet and the lower back. Improperly outfitted, pain generated in the feet can travel up the leg and knees straight to the lower back. If you already have back pain, this could spell trouble when on a trail.
"You want a hiking shoe/sneaker that comes up to your ankle to give your ankle stability, so it doesn't move around too much while hiking. This will then also stabilize the knee, hip, and torso as the stability would move up the chain," says Marko.
Another important piece of equipment for a successful hike is having a properly fitting backpack. Marko says a good backpack should not weigh over 20% of your body weight for a short hike and over 10% for a longer hike. One that's too heavy can add injury to an already ailing lower back, or if the weight is improperly distributed, can strain muscles in your neck and shoulders.
"You want a good backpack that is not too large for your body and is sturdy, has pockets on the outside for things like your water so you can easily pull it out without having to stop, take it off, bend over, and open and re-close it every time," says Marko.
"One other thing that is very important is that it must have a belly strap and chest strap. Many people do not like these because of cosmetics. However, the straps help to unweight the backpack off of your neck, making the weight evenly distributed to your body, as if your body is carrying the weight and not just your neck and shoulders. This will help you avoid a neck and back strain."
Hikers with moderate back pain will want to be more considerate of the terrain they chose. Many parks have graded hikes based on difficulty and fitness levels.
" Generally, hills are a bit harder on the knees, hips, and spine as it just takes more effort to go up them and it takes a lot of control to come down them, so you don't come tumbling down," she says.
Marko says your choice of terrain could add unpleasant pain and stress to your back and spine.
The other thing to consider is the evenness or unevenness of the terrain. If it rocky, holes, puddles, etc., you are going to have to be more skillful at navigating and will take more demand on your legs, which will put demand on the spine also.
No matter which terrain you choose when hiking, you'll want to be sure to rest your back as you go.
"Take a break every hour for about 10 minutes or so. That is a great time to throw in some stretching standing up, drink water, eat a few almonds or other snacks," Marko adds.
It's important to know the terrain and the layout of any park you plan to spend your day hiking. Prior to arrival, know where any potential rough paths may be, where restrooms are, and where ranger stations are positioned. It's also wise to know where wild animals and poisonous plants may be. Downloading a hiking app
—and getting physical copies of the park's layout if you lose cellular coverage—is advisable.
"It would be great to carry some emergency ice packs, the kind you can twist, and they activate. You would want to give the person a longer rest period. Also, if the person can take an anti-inflammatory (they should have cleared this with their M.D. first), that would be advised. If it is severe, you might have to rest for quite a bit and return home or call someone to come pick you up,” she says.
Hiking is fun, and when the adrenaline kicks in, you may be tempted to push yourself past the limitations of what your back can endure for the day. When hiking with back pain, be sure to know when to slow down, when to take breaks, and clearly map out your hike's starting and ending points.
"Stick to flat terrain, keep your backpack light, keep it short distance, stay somewhere that you will have cell phone reception in case of emergency, stretch every hour. Most importantly, do some pre-hike training and exercise to get stronger before," concludes Marko.
Updated: June 5, 2021