Stay on Trail — Gear for Preventing Injury & Illness During Your Thru-Hike!

Max Kiel
Gear for Preventing Injury and Illness During Your Next Thru-Hike

Months upon months of planning and research have you feeling prepared to begin your upcoming thru-hike or section hike. You have your base weight dialed in; you know the ins-and-outs of the trail you will be hiking; and you have been mentally and physically preparing for life on trail. 

You have all expectations that there is absolutely nothing that can stand in the way of you accomplishing your goals. But what about injury and illness?

The harsh reality is that injury and illness during a thru-hike are common. Walking all day, everyday though rugged mountainous terrain can seriously take its toll on the body. In fact, injuries are the number one reason that hikers pull off trail. 

A study conducted in 2017 by The Trek shows that out of everyone who quit their Appalachian Trail thru-hike, 42% did so because of major injury or illness

Plantar fasciitis, IT band syndrome, torn muscles, knee problems, ankle injuries, giardia and infections are but a few of the common injuries and illnesses that can prevent a hiker from meeting their goals on trail. 

This doesn’t mean that injuries and illness are inevitable. In addition to regularly stretching, as well as listening to your body during your hike, there’s a ton of gear out there that can help. 

In this article, I will highlight some gear that I know can go a long way in helping to prevent or treat an injury or illness during a hike.

First Aid Kit

First Aid Kit Lightweight Backpacking

This is an obvious one, which is why it comes first on the list. There are lots of ultralight first aid kits on the market that feature band-aids, medical tape, tweezers, neosporin, advil, etc. And there's also always the option to make your own kit. 

Falls are common on a thru-hike – I know, I had my fair share of them on the AT. Cleaning out your wound and properly dressing it will prevent infection, which can easily knock you off trail for a while. 

In addition to an ultralight first aid kit, I carried Green Goo’s First Aid Salve with me on my thru-hike to tend to scrapes, bug bites, rashes, and even sunburn. 


Water Filtration System 

Gear for Preventing Injury and Illness During Your Next Thru-Hike

This is another obvious one, but I definitely still feel the need to add this to the list. People love being cocky and choose to drink their water unfiltered. I definitely do NOT recommend this! 

Drinking unfiltered water in the backcountry is highly risky, and can lead to giardia, a nasty stomach bug that can certainly hinder your chances of finishing your journey. There are tons of water filtration methods out there, such as filters like the Sawyer Squeeze and Versa flow, or water purification tablets/ droplets. 


Massage Ball


Gear for Preventing Injury and Illness During Your Next Thru-Hike

This was one of my favorite pieces of gear on my thru-hike. There is no avoiding sore muscles and tight legs early on during your hike, and it is important to stretch and massage these muscles to not only lessen the soreness, but to also prevent muscle strains and tears. 

On the AT, (almost) every morning and every night I rolled out my legs with a massage ball. I truly believe this habit went a long way in preventing any muscle injuries while aiding in muscle recovery. 

Pro tip: use your massage ball on the bottom of your feet too! 


Trekking Poles 

Gear for Preventing Injury and Illness During Your Next Thru-Hike

Using trekking poles takes a ton of stress off your knees, particularly on descents.

Trekking poles also take some of the weight burden off your back, which will go a long way in preventing back soreness and injury. They also help tremendously with balance on uneven and technical terrain, greatly reducing your chance of falling or twisting an ankle.


Cushioned Socks and Proper Footwear 

Gear for Preventing Injury and Illness During Your Next Thru-Hike

Foot injuries are one of the most common injuries thru-hikers experience on trail (surprise, surprise!). But the good news is that many of these injuries, like plantar fasciitis, cracked/ blackened toenails, twisted ankles, hot spots and blisters, can often be prevented. 

Socks designed for long-distance hiking, like Injinji toe socks or Darn Tough, wick moisture, reduce chafing and offer an extra smidge of cushion. These seemingly small things can turn out to be huge as the miles stack up. 

Even more important than socks are properly fitting shoes. Make sure you wear hiking shoes that tailor to your needs, whether that be trail running shoes or high top hiking boots. 

If you find your feet riddled with blisters and hot spots, or notice a slight limp in your step, it might be time to invest in a new pair of socks and shoes. Foot health is vital for a successful backpacking expedition. Also, don’t hesitate to soak your feet in an epsom salt bath when in town! 



Gear for Preventing Injury and Illness During Your Next Thru-Hike

Sorry, but more foot talk. Again, chances are that blisters and hot spots will occur at least once during your thru-hike; and the way you treat these blisters will determine your overall foot health. 

One popular item many hikers carry with them is Leukotape. Putting a layer of Leukotape on a popped blister or hot spot will lessen the pain you experience, and will greatly decrease the chance of an infection. 

I will say this one more time: Foot health is vital for a successful backpacking expedition. 



Gear for Preventing Injury and Illness During Your Next Thru-Hike

Some people swear by night hiking; it is a great way to cover miles in cooler temps and is a new way to experience nature. But even if you never plan to hike at night, bring a headlamp, because you never know when you might find yourself still looking for a campsite as darkness begins to fall. 

Having a reliable, bright headlamp makes moving about in the dark safer because it reduces your chances of tripping over a root, encountering wildlife, getting lost, etc.



Bonus Tip  — Lower Your Base Weight 

Gear for Preventing Injury and Illness During Your Next Thru-Hike

I can’t stress enough the importance of trying to be as light as possible during your hike. I remember one hiker who started their Appalachian Trail journey with a 50-pound pack. My shoulders hurt just thinking about carrying that much weight. 

Remember, everything you bring with you has to be carried for hundreds to thousands of miles, depending on the thru-hike. Too much weight adds a ton of stress on your whole body, greatly increasing the chance of injury. 

I’m not saying that you have to be a sub-8 pound gram weenie (in fact, I don’t really recommend that either — according to the same Trek survey referenced above, the typical pack baseweight for people who completed the AT was 20 lbs.); but think twice about bringing that heavy solar charger that you probably won’t even end up using, or that giant cooking pot that isn’t necessary. 

A light, comfortable pack equals a happy, healthy hiker. 

Do you have any other gear items that you know of that can prevent/ treat injury and illness? Let us know in the comments!


Continue Hiking with Max >>> @max_kiel_trail
Trail talk




My current base weight is nearly 9 kg. I have some really lightweight things, and I’ve switched to cold-soaking & carry an alcohol stove with a few ounces of fuel as a back up. But the one thing I can’t seem to make lighter? My first aid kit. I believe it’s a very common side effect of having attended NOLS’ wilderness first aid class. Some gram weenies would cringe, but I can’t imagine how I’d feel if I encountered someone who needed help and all I could offer them is some leukotape.



Thank you for discussing first aid. As a back-country EMT, I’ve felt this is a topic that is barely touched on by well known YouTube through hikers, yet 42% of hikers are quitting due to injury. Some of those may have been able to stay on trail if they knew how to treat their medical issues or recognized symptoms before they became trip-ending injuries. People will spend hours researching a tent but not spend 10 minutes on knowing what to do if they or a fellow hiker get sick or injured. Unlike an urban or suburban environment, that cell phone you carry will not get you help very quickly, especially if weather conditions are bad or there’s no reception.

If you’re going to do a months long hike, you need:
1. A backcountry/backpacker first aid kit. It isn’t heavy but it will probably have more than what most hikers are currently carrying. Leukotape and “vitamin I” is not a first aid kit and won’t work for anybody.
2. Take a back-country first aid course. Being able to identify symptoms early and know how to use the items in the first aid kit is essential.

In addition, before I did my hike of the AT, I got a tetanus booster and went to the dentist to make sure there weren’t any issues that needed immmediate attention.

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