Treating tendinitis while walking the Camino de Santiago

Photo de pîed sur Compostelle

Please note that this advice is for informational purposes only. It should not replace medical advice (which is recommended). Links to products on this page are compensated by Amazon, but this does not affect the independence of our recommendations.

This title might make you think you've stumbled upon a miracle page, written by someone who possesses a thousand-year-old secret. That's not the case! If you're not an athlete, or if the sport you practice doesn't put too much strain on your tendons (feet, knees, etc.), you'll probably need to wake up those tendons a bit to avoid problems during the pilgrimage, or at least try to minimize the risks, as there's no miracle cure...

When it comes to tendinitis, it's a condition related to movement. It can affect anyone, including workers who perform the same movement repeatedly, and especially those who think they're immune, like athletes of all kinds. I've met several, despite being used to trekking once a week, or hiking 35 or 40 km weekly (and sometimes more!).

The big difference is that doing the Camino de Santiago doesn't last just one day.

There are exercises to "loosen" the tendons, but it might be more effective to go for a few hikes in your region. At least, you'll be sure to work the right muscles, not to mention the heart and lungs. Plus, sometimes, tendinitis is triggered by a problem with your shoes or a combination of terrain and unsuitable footwear. You can identify this kind of problem by doing training walks of 15 to 18 km with your full gear (backpack and shoes).

By the way, know that tendons don't "muscle up"...

During training, be sure to vary the terrain: asphalt, soft ground, uphill, downhill, flat... For "problems" to start appearing, the minimum distance is often above 18 km. (but it can vary from one person to another). Tendinitis rarely occurs after one or two days of walking. It's usually the result of the accumulation of effort over several days.

It's hard to say who can give you a foolproof recipe to avoid tendinitis. And once again, we don't all have the same tendons, the same type of feet, and the same gait... Plus, some people seem to be predisposed to tendinitis...

Example of a very difficult tendinitis to avoid, as it originates from a morphological problem: tibial periostitis. The pain starts at the top of the ankle and extends into the tibia.

On the other hand, there's no need to pile on the aggravating factors, here are some :

One of the aggravating factors is a lack of proper hydration. Thirst sets in only when dehydration is already well underway (by which point it's too late). It's important to drink frequently. It's recommended to drink small amounts often, rather than large gulps from time to time. In any case, the digestive system can't process a large volume of water at once. The rest simply "passes through".

For tips on how to carry water during your hike, check out our article Carrying your water during the Camino de Santiago?

Make sure to bring a water bottle. Wearing it on your belt is the best way to distribute the weight evenly. Avoid single-use plastic bottles. Water can heat up rapidly in the sun, even during spring.
We recommend using ZEFAL insulated water bottles to keep your drinks cold. Alternatively, any insulated water bottle with similar properties would be suitable. These reliable bottles are made from BPA-free Polypropylene and won't affect the taste of your water. The lightweight, double-walled design keeps your drinks cool for hours.

It's common for hikers to clean the inside of their water bottles, but don't neglect cleaning the mouthpiece to ensure proper hygiene

Gourde à eau Zefal pour Compostelle

Reading various accounts, it appears that pushing oneself beyond their perceived limits, especially when feeling exceptionally fit, and going that extra mile can trigger tendinitis.

This is why some pilgrims who have already walked over 500 km without any issues, also fall victim to it. Some still wonder why...

As you rack up the miles, your body will adapt to the exertion, and you'll feel like you can do more than the day before (or the week before).

In a way, this is true (the body adapts), but too much is too much. The difficulty lies in the fact that everyone has their own limits... someone can do 35 km without a problem, while another will be tired after 25. Avoid chaining together several long stages. Occasionally take rest days with shorter stages (between 15 and 20 km maximum). Also, avoid walking too fast. Your stride length is less important than your own pace (3km/h, 4km/h...).

The worst thing is walking with someone who doesn't have the same pace as you... if the pace is too fast for you, you'll be putting too much strain on your tendons, and one day you might end up with tendinitis that you wouldn't have had if you were alone.

Monotonous terrain, such as long stretches of asphalt or straight paths, can contribute to the development of tendonitis. The repetitive nature of these surfaces, combined with the tendency to increase pace, can overstress the tendons. Additionally, wearing poorly cushioned shoes or improperly laced hiking boots (especially around the instep) can exacerbate these issues.

To date, no significant studies have established a direct correlation between diet and the risk of tendonitis.

Under no circumstances can we offer medical prescriptions. Additionally, given the evolving nature of medical knowledge, information from 2013 regarding specific ointment ingredients may no longer be accurate. It is advisable to seek advice from a qualified medical practitioner.

Due to the evolving nature of pharmaceuticals, we cannot recommend specific medications. Some drugs may have been withdrawn from the market, pose potential hazards, or become obsolete due to newer, more effective options. While doctors may prescribe oral anti-inflammatory medications, healthcare professionals like physical therapists and pharmacists frequently suggest topical treatments, such as patches, which offer sustained relief and minimize gastrointestinal side effects.

It's best to treat tendonitis as soon as you notice the first symptoms. Don't be a tough guy; you risk being immobilized for at least 15 days. You should consult a doctor or physical therapist as soon as possible. If not, a pharmacist can provide advice, especially if you're on the Camino de Santiago, as they've become experts in this kind of problem! Before you leave, ask them for advice (and check any potential allergies to certain medications). There are a number of over-the-counter anti-inflammatories available (including in Spain).

Ointments are limited in their efficacy for tendinitis, as they can only penetrate the superficial layers of the skin, typically 2 to 3 mm. Additionally, in certain instances, the application of anti-inflammatory agents may not be recommended.

These medications are not without risk (they can interact with other medications, even over-the-counter ones). Therefore, it is essential to consult your doctor before your trip to discuss your specific situation. They can advise you on the best course of action in case you develop tendinitis during your pilgrimage..As mentioned earlier, many medications or active ingredients have been banned in the last two years. This is another reason to seek up-to-date advice from your general practitioner...

To sum up

Beyond Achilles tendonitis and issues with the tibialis anterior or knee tendons, other pain sources can be as simple as footwear that's too tight, particularly around the instep. This is often the case with high-top or mid-top hiking boots. The misconception is that a tight fit will secure the foot and prevent blisters. However, excessive tightness can constrict the foot at the joint, leading to both acute and chronic pain. As the upper part of the shoe compresses the instep, limiting the ankle's natural range of motion, the Achilles tendon is frequently affected. Ultimately, it's up to your to find the right fit. We'll provide a detailed guide on proper lacing techniques at the end of this article: What type of hiking footwear is recommended for the Camino de Santiago pilgrimage? Experiment with different footwear options and pay close attention to your body's feedback.

Every hiking resource will emphasize the importance of breaking in your boots. Aim for at least 100 kilometers of wear to ensure they are comfortable and molded to your unique foot shape. Don't let any salesperson convince you otherwise, even if they claim that "modern" boots don't require breaking in.

Experiment with different methods and pay close attention to how your feet feel...

Want to know more about choosing the right hiking boots? check out our article on hiking footwear.