Hikers in a vast wilderness landscape symbolizing common skin injuries.

Wilderness Wounds: A Guide to Skin and Soft Tissue Injuries on Outdoor Adventures

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"Learn about the common skin and soft tissue injuries that occur during wilderness expeditions and how to prevent them."

For millions, the great outdoors is an irresistible call, offering adventure and escape. Hiking, camping, kayaking, and climbing provide unique challenges and rewards. But with these activities comes the inherent risk of injuries, particularly those affecting the skin and soft tissues. Understanding these risks and how to mitigate them is crucial for a safe and enjoyable experience.

The National Outdoor Leadership School (NOLS), a leader in wilderness education, has been tracking illnesses and injuries among its expedition participants since 1984. This vast database, encompassing millions of participant days, offers invaluable insights into the patterns and trends of wilderness-related health issues.

A recent analysis of NOLS data from 1984 to 2012 focuses specifically on skin and soft tissue injuries, the second most common type of injury in their records. By examining this data, we can learn about the activities and factors that contribute to these injuries and identify strategies to minimize risk, ensuring safer adventures for all.

What are the Most Common Skin and Soft Tissue Injuries in the Wilderness?

Hikers in a vast wilderness landscape symbolizing common skin injuries.

The NOLS study revealed that soft tissue injuries accounted for 22% of all reported incidents, with a significant portion requiring evacuation. These injuries range from minor cuts and bruises to more serious infections and burns. While athletic injuries like sprains and fractures were the most frequent overall incidents, soft tissue injuries remain a substantial concern.

Here’s a breakdown of the most common types of soft tissue injuries encountered during NOLS expeditions:

Infections and Rashes: These were the most frequently reported issues, accounting for 33% of soft tissue incidents. This category includes cellulitis, fungal infections, insect bites, and plant-related rashes.
Lacerations, Punctures, and Contusions: These injuries made up 25% of the soft tissue incidents, often resulting from falls, trips, and contact with rocks or branches during hiking.
Burns: Burns accounted for 9% of incidents, most commonly from scalding with boiling water during cooking.
Insect Bites: Insect bites also represented 9% of incidents, highlighting the importance of insect protection in the wilderness.
Blisters: Blisters comprised 8% of the incidents, a common nuisance for hikers and backpackers.

The study also identified the activities most frequently associated with these injuries: hiking, camping, and cooking. While hiking injuries often involved slips, falls, and contact with the environment, cooking injuries were primarily burns. Interestingly, a significant portion of soft tissue injuries occurred independent of specific activities, suggesting the ever-present nature of risks in the wilderness environment.

The Path to Safer Wilderness Adventures

By understanding the patterns and trends of skin and soft tissue injuries in the wilderness, outdoor enthusiasts and organizations can take proactive steps to minimize risks. Emphasizing education, proper gear, and pre-trip fitness can significantly reduce the likelihood of these injuries, ensuring safer and more enjoyable adventures for all.

About this Article -

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Everything You Need To Know

What are the main types of soft tissue injuries commonly experienced during outdoor expeditions, according to the NOLS study?

The NOLS study, based on data from 1984 to 2012, identified several common types of soft tissue injuries. These include Infections and Rashes, which were the most frequent at 33% of incidents. The category covers issues like cellulitis, fungal infections, insect bites, and plant-related rashes. Lacerations, Punctures, and Contusions made up 25% of incidents, often from falls or contact with the environment. Burns accounted for 9% of incidents, commonly from cooking. Insect Bites and Blisters each represented 9% and 8% of incidents respectively. These findings highlight the diverse range of risks faced by outdoor adventurers, emphasizing the importance of understanding these injury types for effective prevention and treatment strategies.

Which activities are most frequently linked to soft tissue injuries, and how do these injuries typically occur?

The NOLS study found that hiking, camping, and cooking were the activities most frequently associated with soft tissue injuries. Hiking-related injuries often involved slips, falls, and contact with rocks or branches, leading to lacerations, punctures, and contusions. Camping, in general, contributed to various injuries due to the nature of the environment. Cooking injuries were primarily burns, often caused by scalding with boiling water. It's worth noting that a significant portion of these injuries occurred independent of specific activities, indicating a constant risk in the wilderness.

How significant are soft tissue injuries compared to other injuries reported by NOLS, and what does this suggest about outdoor safety?

Soft tissue injuries, according to the NOLS data, were the second most common type of injury, accounting for 22% of all reported incidents, with a substantial portion requiring evacuation. Athletic injuries such as sprains and fractures were the most frequent overall incidents. This suggests that while other types of injuries occur more often, soft tissue injuries remain a significant concern. Their prevalence highlights the need for thorough risk assessments, preventive measures, and proper first-aid training. The data underlines the importance of preparation and awareness in mitigating these risks and promoting safer outdoor experiences.

What are the preventative measures recommended to reduce the likelihood of experiencing soft tissue injuries during outdoor adventures?

To minimize the risk of soft tissue injuries in the wilderness, several preventative measures are recommended. Emphasizing education about common injuries and their causes is crucial. Proper gear, such as appropriate footwear and protective clothing, can prevent injuries. Pre-trip fitness helps to prepare the body for the physical demands of activities like hiking, thereby reducing the risk of falls and other trauma. Additionally, awareness of environmental hazards and the implementation of safety protocols during activities such as cooking can significantly lower the chances of burns. These combined efforts can greatly enhance the safety and enjoyment of outdoor expeditions.

Besides injury types, what other insights did the NOLS study provide regarding wilderness health and safety?

Beyond identifying specific injury types, the NOLS study provided valuable insights into the broader landscape of wilderness health and safety. It highlighted the significance of long-term data collection, which allowed for the identification of patterns and trends over time. The study underscored the importance of preparedness, proper training, and risk assessment as key components of safe outdoor adventures. The fact that a significant number of injuries occurred independent of specific activities emphasized the constant nature of risks in the wilderness environment. The findings emphasized the need for ongoing education and preventative strategies to minimize risks and enhance the overall experience for outdoor enthusiasts.