first aid for trail runners

Essential safety and first aid gear for trail runners and ultrarunners

Trail running may not be the most dangerous outdoor sport, it is important to know the risks and how to take care of yourself. Many issues can be mitigated with proper planning and a few items that are easily carried in a running vest. So, let’s discuss first aid for trail runners and how to utilize these items to enhance your safety and comfort. Doing so may place you in a position to help yourself of someone else.

Blister Prevention and Treatment

Even for runners not prone to blisters, carrying a basic blister kit can come in handy, particularly when testing new shoes or running in unfamiliar conditions. Your small, packable blister kit should include: blister tape (I prefer Leukotape P as it adheres incredibly well and offers robust protection), a safety pin or small razor blade to drain a blister, and a lighter which can be used to sanitize the needle or razor blade you’ll use to open the skin on the blister. This article written by Jason Koop is a comprehensive article regarding how to care for blisters. Also, the lighter is useful if you unexpectedly need to spend a night outside and want to start a fire.

Essential trail running first aid kit items

Two additional first aid kit items include latex or nitrile gloves and a non-NSAID over-the-counter pain medication such as acetaminophen. A thin pair of disposable gloves can protect you in a situation in which you may be helping someone address an injury. These gloves can also make a makeshift mouthpiece for mouth-to-mouth resuscitation. They can also be a waterproof layer to help keep your hands warm under a pair of traditional running gloves.

Regarding painkillers, non-steroidal anti-inflammatory medications are not encouraged during ultramarathon training or competition. (Here’s why). However, for acute first aid for trail runners with serious injuries, utilizing a pain medication may limit swelling and keep pain at a manageable level until you reach help.

If you are injured or lost and unable to get to shelter, having a lightweight single-use emergency blanket can be a lifesaver. They should be carried in all weather conditions, but especially if temperatures are expected to dip near or below freezing.

Gloves, emergency pain medication, a safety blanket, and a blister kit stay in my personal running vest year-round.

Long-Run Safety Gear

For longer outings, especially in warm weather, carry either a small water filter or water purification capsules. For multi-hour training runs, carrying all the fluid you will need from the beginning can be very heavy. If you know you’ll be near bodies of water you can filter from, you’ll reduce the weight you must carry. Filtering water takes time, but carrying less mass reduces ground reaction forces for each step you take.

Purification tablets are also effective. Just be sure you know how long the capsule needs to rest in your water before it’s safe to drink. Usually that timeframe is 30-60 minutes, so plan accordingly if you choose purification over filtration. Filtration takes time, but not as long as purification.

Hydration and Sodium Balance

Carrying sodium capsules can provide a way to address the potential onset of hyponatremia. Keep them as a last resort and not your first choice for maintaining sodium balance. It’s important to recognize how hyponatremia develops and the symptoms that are indicators of this serious condition. With a well-constructed nutrition and hydration strategy, you should be able to maintain a safe sodium balance through foods and sports drinks. However, drinking a lot of water and consuming little or no sodium, can put you in a precarious position.

Consuming excessive amounts of sodium can also be dangerous. It’s important to understand the indicators regarding hydration states, electrolyte balance and how to bring imbalances back to normal. Sodium capsules can help mitigate the onset of hyponatremia in a pinch. Ultimately, because purification tablets as well as sodium/electrolyte capsules are small and lightweight, and because staying hydrated is critical for every athlete’s wellbeing, it’s worth considering adding these to your full-time first-aid kit.


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And although not as critical as some of the items mentioned above, my long-run kit include sunscreen and/or lip balm. I prefer this as it serves as sunscreen and protection against windburn and frostbite, a great multi-pronged solution.

Personal safety and injury protection gear

The last few items on my safety and first aid for trail runners list relate to keeping yourself safe – from yourself and others. Superglue is lightweight and can serve a variety of purposes, from temporary gear fixes to closing a skin lacerations. Adding pepper spray to your pack may offer protection from aggressors, in either animal or human form. If you’re in bear country, carry bear spray.

Whether you are running with friends or solo, carry an emergency device such as a Spot or Garmin inReach. These devices can connect you to a rescue crew if you are in a life-threatening situation far from cell service. One word of advice: If you carry an emergency device, plan and act as if you are not carrying it. In other words, don’t take greater risks because you can contact emergency personnel. Be a safe and responsible athlete. Reduce risk whenever possible and use emergency services for true emergencies only.

Summary: Safety is personal

The items above are not a comprehensive list of all the things you could carry. At the same time, carrying everything above could be considered excessive for a relatively short, close-to-town training session. There are times when runners may need and want to add to the above recommendations, and plenty of times it makes sense to carry just a handheld water bottle and a few calories. Use your best judgment, but also make sure you know how to use the safety gear and tools that you choose to carry. Always make the safest decisions to keep yourself and others out of danger, even if it means sacrificing your workout.

By Darcie Murphy,
CTS Ultrarunning Senior Coach


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Comments 7

  1. portable air SAM splint with elastoplast tape to wrap a fracture or sprain..the air ones are lightweight and somewhat compact

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  4. Great article. First time I’ve ever seen anyone write about it. I just finished a Wilderness First Aid class. Something we used in the class that was shown to be incredibly valuable for many types of injuries is a Triangle Bandage. Can be used for Pressure Dressing to stop bleeding, creating Splints, wrapping and supporting something like an ankle, sling for an injured arm, and more. There are different quality Triangle Bandages. Look for a decent one.

  5. What about bandages? I always carry a role of vet wrap (self-adhesive tape) that can be used to wrap a sprained ankle and/or to stop bleeding. I also recommend a small syringe to irrigate a wound.

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