Hiking Health: staying fit and safe on the trails

Keeping yourself fit and healthy on your hikes can be hard.

Countless dangers await and, if you’re not prepared, you could end up a casualty or worse!

Don’t worry, this page is for you. Below, you’ll find the most informative resource for every possible environment: from long hikes at sea level to high altitude pursuits. Your health and safety are important to us – we want to meet you on the trail someday!

You’ll find information from a medical and non-medical perspective.

The sections on altitude and the cold contain practical information and advice which could easily save your life on a mountain, and so have been arranged into pragmatic, easily digestible pieces.

We hope that the information we have provided is useful on the trails, in the mountains and forests, or wherever else your journeys take you.

Have a safe, enjoyable trip.

Check out this page for other common injuries hikers experience.

Let’s get this hiking health guide moving…

Hiking at altitude

Altitude is defined as the height above sea level. In essence, there are three altitude categories, namely high altitude (1500 – 3500m), very high altitude (3500- 5500m), and extreme altitude (5500m and above). Illnesses and ailments in high altitudes result from a lack of enough oxygen. Overall, oxygen constitutes 20% of the overall atmospheric gases. In high altitudes, however, the molecules spread more and become less accessible due to decreased pressure. As such, your body must work harder to obtain the little amount available. At the extreme altitude, the available oxygen percentage is less than that of the sea level. In such areas, the body acclimatizes and becomes accustomed to the new conditions and climate, allowing you to survive there for a couple of days.

Here are the common physiological changes resulting from altitude

  • Breathing fast (Hyperventilation)
  • Shortage of breath, especially when exerting
  • Alteration of breathing patterns in sleep
  • Frequent urination
  • Disturbed sleep
  • Abnormal dreams

Your oxygen-depleted body can utilize up to 5000 calories per day at high altitudes. Still, you can’t eat too much since sickness is prevalent, and the food may be typically unappetizing. In order to adjust for the lower oxygen levels available in the air, your body trains to increase the depth and rate of breathing. The kidneys change their way of working to enable the blood to become alkaline.

As a result, the blood absorbs and carries more oxygen throughout the body. To get oxygen to all of the body’s critical organs, the resting heartbeat rate is elevated. Since the blood, notably the red blood cells, must work extra, the body eventually generates more, resulting in a more efficient circulatory system.

Acute Mountain Sickness 

Acute Mountain Sickness (AMS) refers to the reaction of the body to a lack of oxygen, induced by climbing faster than acclimatization. It is still unknown what conditions trigger specific types of AMS. Therefore we can’t forecast who will or will not get it.

Despite its widespread and public awareness, the condition continues to perplex scientists after all these years. From our understanding, AMS is thought to be a result of brain tissue enlargement due to a shortage of oxygen or hypoxic stress.

Since we understand so little about this ailment, it’s typical to treat any symptom as sickness at altitude. Most people believe that having a headache at altitude is normal, whereas, in fact, it is extremely rare. That said, if you have plans of spending time at altitude, it’s a great idea to be aware of the AMS symptoms. It’s been compared to a hangover by some people.

Besides headache, other symptoms of AMS include the following:

  • Weakness or fatigue
  • Nausea or vomiting
  • Loss of appetite
  • Mood swings
  • Interrupted sleep patterns
  • Disorientation and confusion
  • unable to perform motor actions
  • Dizziness, faint and light-headed feeling
  • Apathy
  • A deep inner chill
  • Impaired memory

All the above symptoms can be categorized on a scale of mild to severe, and Lake Louise offers a questionnaire to help determine the phases of AMS. At high or extreme altitudes, a headache generally starts on the second or third day. A throb in the forehead and/or back of the head characterizes the headache, which ranges from mild to severe. It’s usually worse in the morning and at night. Bending over or straining makes it worse.

In case you merely have a headache, it’s advisable to test for AMS using the elimination method. Drink at least one liter of water because dehydration is the leading cause of headaches and if possible, take a low-dose pain reliever like paracetamol. If the pain completely goes away and no other symptoms occur, it’s safe to presume that your headache was not caused by AMS and that climbing can continue.

Severe Acute Mountain Sickness

AMS in its most severe form can affect your lungs, nervous system, heart, and muscles, causing more severe symptoms. For instance, if your brain swells, you may have disorientation. As a result of the fluid in your lungs, you may experience shortness of breath.

Symptoms of severe AMS include:

  • Chest congestion
  • Skin discoloration and pale complexion
  • Social withdrawal

Periodic Breathing

A condition known as “periodic breathing,” which occurs when a person’s typical sleeping pattern is disrupted, is also associated with AMS. The person will have fits of insomnia interspersed with fitful dreams. Their respiratory pattern is disrupted as well, with intervals of deep and rapid breathing followed by times of no breathing. This can last up to 15 seconds. It might improve significantly with acclimatization, though it rarely goes away until the descent.

Periodic breathing can create anxiety in two ways: first, for someone who wakes up and realizes they cannot breathe, or for an individual who wakes up in a stage of hyperventilation and believes they have High Altitude Pulmonary Edema (HAPE). However, an individual who wakes up and discovers their companion has ceased breathing may have a frightening experience. In such a situation, the most advisable thing to do is to be patient until the respiration is self-regulated again since the periodic breathing cycles will certainly continue until the person wakes up.

The best method to deal with AMS is to prevent it in the first place. Ascending should be gradual to allow the body to acclimate. Although each person is unique, the following measures should protect the most individuals against AMS:

  • When you are past 3000m, the altitude should not dramatically change in a day. This implies that you should not ascend more than 300 meters each day.
  • For each 1000m above 3000m, spend two nights around the exact altitude.

Here are some of the things you must avoid, as they slow down the rate of breathing:

  • Sleeping pills
  • Alcohol
  • Tobacco
  • Narcotic painkillers

If AMS occurs, however, there are a few simple measures to help avert fatality. Before the ascent, it is critical for all parties to be aware of the risks since ignorance is majorly the cause of disease.

  • Do not leave an AMS patient alone.
  • Avoid climbing any further. This has the potential to be fatal, as the symptoms are just going to become worse.
  • If feasible, descend to the point where you last felt safe. AMS symptoms are likely to fade away much faster.
  • In case symptoms persist, remain at the exact altitude until the body acclimatizes. Only then can the climbing begin again.
  • Rest is vital                                                                
  • Consume plenty of water to stay hydrated.

If you have any serious AMS symptoms, kindly seek emergency medical help right away. Address the problem before it worsens, as it will be much easier to treat. Moreover, in case your doctor concludes that you have fluids in your lungs or brain swelling, you will need to be admitted to the hospital.

Health precautions

A comprehensive examination with a professional GP is essential prior to departure in order to identify and advise on any potential concerns you may have during your travel. This is especially critical for those who have previously experienced blood pressure, heart or lung problems, as well as those who have ongoing medical conditions.

Children

When going with children to high altitudes, you must exercise extreme caution and keep a close eye on them for any aberrant behavior, as small children often have difficulties expressing their emotions. Younger individuals often adapt to the high altitude more slowly, according to research, but no extensive studies on the safest altitude for children have been conducted. As such, doctors propose a maximum height of 3000m for children. However, a lot of children have safely ascended Kala Pattar, which stands at 5560 meters.

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Teenagers

Currently, no evidence proves that teenagers adjust to high altitudes slower than adults, yet they may be at a higher risk than adults due to behavioral tendencies. For instance, teenagers might be highly competitive, refusing to give up throughout the trip. This is more likely to happen on school tours, where peers are involved.

Older travellers

Many elderly people, including those over the retirement age, have climbed some of the most iconic mountains in the world. In essence, older people do not have to be prevented from climbing because of their age; rather, it is an individual’s fitness level that prevents them from participating. Age should just highlight the importance of maintaining a healthy fitness level.

Heart Conditions

There are no studies regarding heart attacks on hikes, or at high altitudes. It seems logical given the altitude’s effects on the body and the fact that the amount of effort required is more compared to that of sea level. If you’re concerned, see a doctor.

High Blood Pressure

High blood pressure ( Hypertension) is highly likely to be a problem at altitude, thus seeing a certified doctor is crucial, particularly one who is familiar with your medical history. They will determine whether it is safe to ascend.

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Epilepsy

At high or extreme altitudes, there is a modest rise in the risk of seizures, but based on the condition’s severity, you may be able to continue. In case of an emergency, your group should be prepared and alert.

Diabetes

Higher exertion while ascending changes the levels of insulin and carbohydrate in the blood; therefore, it’s critical to keep an eye on glucose levels and keep blood sugar levels under control. Make sure everyone in your immediate vicinity is aware of the situation and what to do if an emergency occurs.

Chest Infections in the Past

Individuals who are more vulnerable to chest infections are at a higher risk of becoming unwell since even healthy people might acquire chest problems when they travel to higher altitudes. Any prescription medicine should be brought with you, and based on the severity; you should start taking it as soon as possible. Kindly consult your physician.

Asthma

Most asthmatics discover that their asthma improves when they are at a higher altitude than when they are at sea level. This is due to the fact that there are fewer chemicals in the air that irritate asthma. Nonetheless, it’s a great idea to keep all medication close to reach, such as around your neck or in a zipped pocket. Make those in your group aware of the situation and what they should do if an attack occurs.

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Pregnancy

Because the consequences of low oxygen and altitude on an unborn fetus are yet to be investigated, it’s probably better to avoid ascending if you’re expectant. Furthermore, professional care is frequently required, which may be challenging to obtain at such a high elevation.

High Altitude Cerebral Edema

HACE (High Altitude Cerebral Edema) is a potentially catastrophic variant of AMS in which the brain swells and ceases to function normally. This can take hold for hours once it’s been started, and most individuals aren’t even aware they’re sick. Due to the extreme rapidity with which this occurs, climbers must be aware of the warning indications. They are as follows:

  • Fatigue
  • Confusion
  • Behavioural changes
  • Ataxia, a term for a “drunk stagger.” Have the individual walk in a straight line on a flat surface without wearing heavy boots or carrying a backpack as a test for this condition. Treat them like HACE patients if they miss the line, stumble, or fall down.
  • Strenuous speaking
  • Hallucinations
  • Vomiting
  • Blindness
  • Limb paralysis
  • Unconsciousness
  • Seizure
  • Complete paralysis
  • Coma

Treatment

The treatment is straightforward: quick descending. Even though HACE begins at night, descending must begin quickly because any delay could be catastrophic. This may be challenging since the patient will be disoriented and stagger, necessitating the assistance of others. Descending should be to the point where the individual last felt well after waking up. Because cases of HACE usually only emerge whenever someone with mild AMS progresses upwards, this is most likely where the individual slept the previous two nights. It must be at least 500 meters long. Maximum rest is recommended once a lower position has been reached.

If the individual has descended far enough in a short amount of time, recovery is typically possible. The drunken stagger may, however, last a few days. If the symptoms go away, the climbing can continue at a more moderate speed.

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