The Center for Podiatric Care and Sports Medicine

Saving Lives Despite Achilles Tendonitis: Heroic Wilderness Guides in Pain

Posted by on Tuesday, January 1st, 2013


If you’ve ever been on a guided hike through miles of rugged wilderness, you’ve had a taste of the challenges guides face every day. Not only are they hiking the trails themselves—navigating hills and crevices, rocks and fallen trees—they’re responsible for keeping groups of city slickers safe. They chase down stragglers, scout ahead for wild animals, and embark on long search and rescue missions on a regular basis. From 1992 to 2007 there were 78,488 people involved in 65,439 SAR incidents. These included 2,659 fatalities, 24,288 injured or sick people, and 13,212 “saves,” or saved lives. According to a study published in Wilderness and Environmental Medicine, without search and rescue operations, 1 in 5 requests for help would result in a fatality. Of course, being obsessed with feet I immediately wonder: what foot injury are these rangers suffering from the most?


It turns out, Achilles tendonitis is one of the most common injuries in serious outdoorsmen. This is just what it sounds like: an inflammation of the Achilles tendon at the back of the heel. This is also a common running injury, often the result of a ramped up training schedule, vigorous hill running, or interval training. Anything that jars the heel repeatedly (like racing down a steep incline to an injured climber) can cause or aggravate this chronic injury.  Carrying excess weight can significantly contribute to this problem, since the weight puts added strain on all of the tendons and ligaments in the feet.



“I’m not only on my feet all day, I’m also carrying 50 pounds,” says Steve Silberberg of Massachusetts, a wilderness backpacking guide for Fitpacking. “I find that the amazing scenery makes it all much more bearable.”


Symptoms of Achilles tendonitis include swelling, pain along the back of the heel that worsens with exercise, severe pain the day after exercising, thickening of the tendon, and heel spurs where the tendon attaches to the heel bone. Of course, any pain can be deadly in the back woods. A ranger or guide suffering from Achilles tendonitis may need to call in a search and rescue team for himself.

Guides and rangers can prevent Achilles tendonitis by:

  • Training outside of the job. Daily hikes aren’t enough to protect your body from the occasional extreme stress of search and rescue. If you slowly work up to interval training including sprints and hill running, you’ll build muscle around your tendons that will protect them from jarring movements.
  • Doing regular calf stretching. Tight calves put pressure on the Achilles tendon and may contribute to injury.
  • Doing regular heel drops on a stair (see illustration below). These exercises strengthen calves, stretch calves and tendons, and increase flexibility in the back of the leg.



If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.