downhill trail running
Staying safe while on a run

As any seasoned trail runner knows, injuries sometimes happen, but the last place you want to find yourself is injured and unprepared. Now a Physician’s Assistant, avid trail runner Alyssa Phillips once found herself in this situation after sustaining a bee sting on a solo run.  “I was on my normal run before work – a couple miles away from my car when I was stung. I didn’t think much of it until I started having trouble breathing. I went from, ‘huh, that’s weird’ to being extremely concerned.” Luckily Phillips was able to make it to her car, and after a scary ride to the hospital, she was treated and released for anaphylactic shock, but the experience changed her habits. Her advice to new runners is simple: “Always, always, always carry your cell phone with you and be sure to tell someone where you’re going, when you’ll be back and which trail you plan on running.”

Know the risks

Dr. Charles A. Mutschler, DPM points out that “The most common injuries seen in trail running are sprains and strains. ‘Twisting an ankle’ is very common due to the uneven terrain where running takes place. Preventing this injury is difficult, but training to strengthen the ankle and wearing the appropriate shoes may help minimize risk.” Exercises that focus on balance and stability, like squats or lunches performed on a BOSU Balance Trainer, are perfect for strengthening the ankle.

Wearing the right shoes is also critical for trail running safety. Go ahead and invest in a quality pair of trail running shoes – they’re sturdier than street shoes and they’re designed to handle the varied terrain. We particularly like the Vasque Mindbenders because they’re lighter weight than many trail shoes, enabling you to “feel” the terrain you’re running on; however, if you live in a very wet or rainy location, you may want to look at water resistant options like the Brooks Cascadia 6 or Mizuno Wave Cabakran.

Other injuries trail runners should be prepared for include cuts, bruises, insect bites and blisters. Carrying a first aid kit designed to treat each of these injuries is an important part of trail running safety.

Put together your pack

For a lightweight and easily transportable first aid kit, stock a runner’s waist pack or armband with the following first aid supplies:

  • Antiseptic towelettes
  • Blister pads
  • Individual packets of Benadryl, acetaminophen and aspirin
  • Gauze pads
  • Small roller bandage
  • Card with emergency contact information

If you have a medical condition, wear your medical alert tags and carry any appropriate medication.

Injury treatment


In most cases, cuts sustained on the trail are minor and won’t need much attention; however, if your cut looks deep or continues to bleed, you’ll want to stop to give it some attention. Wipe down cuts with an antiseptic towelette, then apply a gauze pad, holding it in place with your roller bandage. If you don’t have gauze or a roller bandage, remove your shirt and use it to cover the wound and apply pressure.


According to Dr. Mutschler, trail runners often experience blisters when wet socks or shoes increase the amount of sheer on the skin. Help prevent blisters by wearing moisture-wicking socks made of synthetic materials.

In the event of a blister, simply apply a blister pad. If you don’t have a blister pad, try to minimize sheer on the wound by removing the source of irritation. For instance, take off or adjust your sock if that’s what’s causing the rubbing to occur.


Before hitting the trail, apply bug repellant to help prevent stings and bites.

In the event of a bee or wasp sting, remove the stinger from the site of the injury and clean the site with antiseptic pads. Then, pop a pack of Benadryl to help reduce itching and slow allergic response. If you experience swelling, shortness of breath or other signs of serious allergic reaction, call 911 immediately.


In the event of a twisted ankle, remember the acronym RICE – rest, ice, compression, elevation. If the twisted ankle is painful enough to affect your running gait, cut your run short and head home so you can treat the sprain correctly. Just remember: leave your shoe on until you can get off the trail – it’s acting as a form of compression!

If you find you cannot put pressure on your foot, call for assistance.

Staying safe on longer runs

When it comes to remaining prepared and safe on longer runs, Dr. Guerra, MD, MBA, Chief Medical Officer and Co-Founder of iTriage, emphasizes that “Staying hydrated is one of the most crucial elements of trail running, especially when a short run turns into a longer run. The way to carry water typically comes down to personal preference, but, experimenting with waist packs, fuel belts, camelbacks and simple plastic water bottles can give you feedback in what works for longer runs.”

Dr. Guerra also notes that “Using a smartphone’s built-in GPS capabilities can keep a trail runner from wandering off course. Also, smartphone applications, like iTriage, can be invaluable to trail runners.” These apps answer medical questions and will help you find the closest medical provider in the event of an emergency.

Extra Tip

Not all trails get great phone reception! If you plan on running alone on a quiet trail, don’t rely on your phone’s signal to be good. The ila Sport and ila Dusk are two personal alarms that you can easily carry with you while out on a trail. Both of them emit a 130 decibel signal when activated, so if you find yourself injured and alone, you can attract attention with the help of the alarm. Check out our ila Sport Giveaway and score your own for free!

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