Overuse Hiking Issues

Overuse issues cropping up among hikers and especially those doing long distances. Unfortunately hikers sometimes believe the hike is a competition and they need to keep up with the flock. Or they feel the miles they do is too low and they ought to do more. Thus they end up doing too much for ligaments and tendons unaccustomed to the stress. Because of this, hikers end up with overuse related issues that can jeopardize their hike.

Foot and lower leg tendonitis - Just today I developed an anterior tendonitis in my right lower leg radiating to the right side of my foot from increased exercise and a flexion issue. Pain on the top of the foot may be extensor tendonitis and could be because your laces are too tight. If you have pressure point pain over a bone, a stress fracture may be developing.    

Shin Splints – I have seen many hikers developing this issue, usually after long days of hiking, doing

high miles their limbs are not used to it. Shin splints refers to medial tibia stress syndrome over the shaft of the tibia. It is directly related to doing too much too soon. The pain is felt along the thick bone of the tibia of the lower leg. Sometimes it can be in the calf muscle itself.  There could also be swelling.

Knee issues – this is probably the most common joint that suffers from overuse. The ligaments around the knee become sensitive to the loads we carry, not only of our backpacks but the stresses of uphills,   downhills, and rocky terrain. That plus longer distances puts a good deal of stress on them, leading to pain and sometimes even ligament tears.

Muscle and Body Pain and Fatigue – again, doing too much too soon can lead to weariness in the

body, especially in long distance hikers who are not adequately taking in good nutrition needed for the miles hiked. Or they skimp on drinking water. The body can turn to muscle to burn - a very poor place to find the energy needed to keep things going. Muscle wasting leads to weight drop, fatigue, and health issues once the hike ends.

What to do?

First of all, CUT the miles! If you are developing an issue like tendonitis, shin splints or knee issues, rest is important. RICE – Rest, Ice, Compression, Elevation until symptoms subside.  Take a few days off. Ice the affected extremity. Take Vit I (Advil) or Meloxicam works well too (a prescription). Taking tumeric with pepperine helps with inflammation. I have had very good results with an ointment called Penetrex. Applying an ace wrap or brace to the area sometimes helps (for me, it tends to aggravate things). Search out exercises online to help stretch the affected areas. If you are having foot pain, try relacing your shoes. If there is no relief, get checked out by a good sports medicine doctor.

Check your shoes. I’ve seen hikers that have come 800 miles in trail runners which are only meant to 

do 3-400 miles. Change your shoes ad insoles, and when you do, make sure they are the proper shoes for your foot type. Good insoles and good socks are important. And don’t forget hiking poles.

Make sure you are taking in adequate fluids and nutrition. Eating just ramen or potatoes is not going to provide the protein needed to help your muscles recover. Skimping on good foods means your body may turn to muscle of energy, and that’s not good. Eat a well-balanced meal that also contains dehydrated veggies and protein. Also take a multi vitamin. Water is needed to lubricate joints and prevent that achy feeling.

When you are ready to begin hiking again, ease back into your hiking. Do not be tempted to do too much too soon. Or you will be right back where you started. Be patient and your body will reward with with an awesome hike.

Related blogs:

Hiking and Ankles, the Whole Story

Oh My Aching Knees

When Injury Sidelines You 

Wow, I Hurt from Backpacking! 9 Ways to Prevent It

"Oh, do I hurt!"

You’ve likely heard and said those words many times after a backpacking trip. That unpleasant feeling of soreness. It can come from just carrying a backpack (sometimes with too much weight in it or not properly fitted) to the harsh terrain day after day on foot and leg muscles not used to such rigors.

An overstuffed pack coupled with the terrain can make you sore

The best way to minimize the painful effects of hiking is to try and prevent it as much as possible.

1. Carry the right backpack for you. Gather your gear together first, then check out backpacks at an outfitter. Make sure the backpack is properly fitted. There are also techniques for how to pack a backpack. to minimize the unpleasantness of weight bearing on tender shoulders. But do expect some pain the first few days. After all, you are doing something you have never done before. It will take time for you to adjust. So be patient with yourself and you will be amazed how quickly your body adapts.

2. Make sure you are not overpacking. Take only what you need. There are ways to cut back on pack weight simply by reducing ounces (which can quickly add up to pounds). While this may not be critical on a weekend venture, over long distances, it can attribute to lots of aches and pains. Look over your gear to see what your need and what you don’t. Have other hikers peruse your list online in trail forums to help you reduce weight. Check out this gear list for backpacking for what you need on a long trip. See the Related Blogs below for other ideas in cut in food, specialty gear, etc. 

3. While hiking, be sure you are drinking plenty of water. Our body is composed mostly of water, and water keeps joints lubricated and less likely to hurt. Carry the means to safely filter your water and bottles to carry it.

4. Eat the right foods like good proteins, veggies, dried fruits, whole grains, and cheese. Avoid useless calories that will do nothing to re-energize or heal achy joints and the micro tears in muscles. A candy bar might give you a temporary sugar boost, but then it makes you drag.

5. Make sure you are wearing the proper footwear for your foot type. Get fitted by a professional. The wrong shoes or worn-out shoes can make your legs feel very achy and sore.

6. Make sure you are getting enough sleep. I tend to crash for at least ten hours because I know during that time, the body is repairing itself. It helps reduce pain. 

7. If your need to, take some pain medicine but don’t overdo it. Advil or other NSAID products can cause wear and tear on your stomach, leading to ulcers. Preventing pain is better than trusting to drugs. If you do need a pain reliever, try the lesser one, like Tylenol. Take turmeric with pepperine also. Do not take narcotics for pain. If you need that much relief, you need to get off the trail and have your affected limb or issue looked at by a professional. 

8. Limit your mileage. Don’t try to be cool and do lots of miles when you're not ready. Take your time to adjust to the rigors of hiking. Stop often to rest, eat a snack, and enjoy a view or a flower. This is about the journey, not the destination.

9. If you feel achy even after limited hiking and it is accompanied by a headache and / or fever, get checked by a doctor. It could be an indicator of Lyme Disease.

Yes, aches and pains can come, but the joy of the trail, the views, the woods, and times with new friends makes it all worthwhile!

Related Blogs:

Lighten that Backpacking Load

Top Three Weight-Loss Challenge for Hikers

Mental Aspect of Long Distance Hiking Explored – Part 2 After the Trail

Congratulations! You’ve finished the trail. You’ve completed the goal. You’ve basked in the glow of it all and the congratulations of others.

Then it hits. You are back in society. Back to the grind of a job, perhaps. Or there with no job and needing to pay bills. Back to society like a busy city. The simple life is gone. It’s so complicated and overwhelming. I yearn for trail life again.

Help!!

I know, I‘ve been there. It’s already coming to light that there can be a certain stress syndrome involved with hikers leaving long distance trail life and returning home.  You can get depressed, anxious, nervous, moody. You can’t think, can’t sleep, can’t do multiple or complicated tasks. You try fitting back in but feel you are only on the outside looking in. You wonder what to do and really, how to live again.

So what can you do?

Realize that you will experience some kind of post trail stress after returning home. I dealt with a letdown – (lots of this is chemically induced that happens when engaged in high activity then suddenly crash when that activity ceases). I dealt with guilt for having been away from home and leaving my husband. I dealt with the guilt of not being able to do certain things, like multi-tasking. I was used to the simple life of a hiker with lots of exercise, plenty of sunshine, and limited decision-making. So give yourself a break and realize there’s going to be some adjustment involved, and it may take time. Have a plan BEFORE you hike is crucial so you aren’t overwhelmed when you return home. Especially if you need to make financial or life changing decisions. Limit those for now until you adapt back into society.

After two AT hikes, I turned to ridgerunning and speaking

Go on a diet post trail. Why should I? I look great. Not for long. Your metabolism will slow down and the pounds will start adding up quick. DO NOT eat what you did on the trail. You are no longer using up 4-6,000 calories and can therefore eat useless carbs. Stop now and eat lots of vegetables, fruits, whole grains, and good types of protein. DO NOT eat a bunch of Snickers candy bars like you did on your hikes. The sugar alone can send you crashing and your mood crashing too. No potato mixes, Ramen, stuffing either. Eating healthy helps you feel better. Drink lots of water too. And skip the sugary drinks and alcohol.

Go on an exercise regimen. I started a running program. You need to do something aerobic. Don’t just stop everything. Your body will rebel. So will your mind. Start by some jogging. Or just walking. Walk everywhere. Keep walking and running if you can. If you can take a day hike at times, do it. But do not STOP exercising! Your body and mind need the chemicals exercise generates to help you feel better and sleep better. And you need the sunshine.

If you find you are not in sunshine a lot or its winter take some Vitamin D3. This will help ward off colds (it’s easy to get sick when you are home and around the public) and helps strengthen bones and the immune system.

Reconnect. Set up interviews (like town newspapers) and places to share about your hiking experiences. Write about them on trail journals. Or blog about them. Offer to speak about your journey so others can experience it. Become involved on social media in hiker forums to help others realize their hiking dreams. Concentrating on others rather than yourself helps lift your mood. Find a job having to do with your interests (I turned to ridgerunning and speaking). Be a part of a hiking group in your neighborhood. Or take kids hiking. We started a church youth group and took kids on lots of adventures. Get involved with scouts. Or become involved in trail maintenance. DO something and share about your experience with others! By all means stay in touch on line or by phone with other hikers and join in on an event that brings hikers together. Plan to attend Trail Days or other activities too. I also get involved more in praying and reading the Bible. I felt it helped me a lot by letting God give me the strength when I had none.

Be sure you reconnect with those you left behind. Be a part of their lives. You may have been on the trail for many months. I had get togethers with my friends and showed pictures of my hikes. I went and acted in a play with my husband and son to reconnect our family. Try some new but simple things that maybe

To reconnect in our family post hike, our family performed in a play 

you’ve never done. Avoid multi tasking. and work toward a new goal or dream. Resist the urge though to get out on another long distance hike right after the first. It may be tempting, but honestly, the problems will still be there when you return. Make the adjustment but keep goals for future hikes in mind.

If you find yourself overwhelmed, then by all means seek professional help like a counselor. You may need a little more doctoring afterwards, just like if we suffer a physical injury from too much stress. Stress can lead to mental injury that also needs doctoring. So seek help if things are just not working. Especially seek help if you are feeling like life is not worth living or at all contemplating ending your life – SEEK HELP! Please!    

Most importantly don’t be too hard on yourself. It takes time. Don’t set yourself up with tons of things to accomplish. I found I couldn’t multi-task for a while and told my husband that. Do one thing at a time and do that one thing well. You’ll start getting back into the groove of community living again. But it can take time, so don’t get discouraged. Cherish the great memories you had on the trail and look forward to making new ones.

Related Blog

A Mental Aspect of Long Distance Hiking Explored - Part 1, The Before

Oh, My Aching Knees

 One of a hiker's chief complaints is knee issues that can spring up on the trail. A knee is a rather intricate joint with many ligaments and tendons interspersed through it to make it work as a "hinge" joint. It carries quite a load, and combined with a backpack, on uneven or steep terrain, with long miles, the load on this joint can be incredible. The knee offers a variety of complaints, so much so that is can force a hiker off the trail. 

But there are tricks to keep the knee joint functioning if a hiker treats the joint with the respect it deserves.  

 

Before a backpacking trip, get into a regimen of strengthening this joint. Do knee bends with a pack on your back. Do stretches for your hamstrings and quads. Knee pain often results from these muscle groups that are too tight. Learn the stretch too for ITB (illiotibial band syndrome). Runners World give a nice article on good knee stretches for the athlete.

 

Nutrition is a key element to healthy joints. A balanced diet is best, especially on long backpacking trips. Don't skimp in this area. Up your protein which assists in muscle healing after a hard work-out (and hiking is hard on your muscles). When you stop to rest, don't reach for a candy bar. Eat some cheese or nuts instead. Keep an adequate, consistent intake of water on your hike which helps the body lubricate the joints and brings blood to the area. Consider glucosomine, chondroitin, and msm

supplements. A product I found that is working wonders on my knee is eggstraflex that contains eggshell membrane. I have used this in place of glucsomine with good results. By far the best remedy for inflammation is Tumeric (Circumin). Be sure it contains 95% curcuminoids and Piperine for better absorption. I take it twice a day.

Use good hiking poles. They take the strain off knees, especially on downhills.

Make sure you are wearing adequate footwear and insoles. It's best to get fitted by a professional shop that knows foot types.

Watch your pack weight. An overweight pack can add more stress load to the knees. Try to cut down on any unnecessary weight.

Watch your daily trail mileage. Forget keeping up with others. Take the hike at your pace, even if that means a 6 mile day. If other hikers run past you down the hill, let 'em.

If you have done bicycling and switch to hiking, it will take time for your muscles to adapt. Give them that consideration.

For pain, an ice pack can help as well as NSAIDS (non steroidal, anti inflammatories such as Aleve or Advil).  I found the cho pat duo knee brace works well. But I try hard to limit its use. Once your knee adapts to it, it's hard to go without it. Prevention is best.  

 
If you find after a hike your knee is quite swollen, or you have crippling pain or the pain persists, be sure to get checked out by a sports MD. There may be other issues involved, such as strained or sprained ligaments or even Lyme Disease (which can affect joint health). 






Related Blogs:

Ankle Injuries
When Injury Sidelines You
First Aid Kit and Wilderenss Medicine
Sore and Achy

That Dreaded Giardia

As a ridgerunner, I've dealt with several cases of hikers unknowingly infected with giardia while on their long distance hike of the Appalachian Trail. You can bet it did not add to their experience to be waylaid by constant "runs". Below is an interesting scientific summary of this illness and its cause and treatment, written by SOLO Wilderness Medicine. SOLO is a terrific resource for all manner of health issues that can affect outdoor enthusiasts. I encourage you to receive their monthly e-mail newsletter and even consider taking a course sponsored by them. Check out also my previous blog on water purification methods when in the wilderness.

Even pristine water sources can still contain harmful microbes that cause illness

GIARDIASIS & DIARRHEA

Double-trouble for the gut

Giardia lamblia (Giardia lamblia) is a flagellated protozoan parasite that infects the small intestine causing diarrhea, bloating, and bad gas. People contract giardia when they consume contaminated food or water.

Giardia has a very simple life cycle. The dormant giardia cyst, ingested along with contaminated food or water, makes its home in the small intestine where the cyst hatches and changes into a trophozoite. (The trophozoites cause the illness-the un-hatched cysts do not.) The trophozoites then reproduce by binary fission (cell division) and the population grows. 

Utilizing a suction disk, the trophozoites anchor themselves onto the wall of the small intestine. They absorb nutrients from within the lumen of the small intestine. Interestingly, they do not feed on, or harm, the cells lining the small intestine. However, as the population increases, the trophozoites spread out across the surface of the small intestine and effectively block the absorption of nutrients out of the intestine. When this occurs, the body tries to rid itself of the parasite by rinsing it out, thus causing the primary symptom of giardiasis-diarrhea.

Giardia is the most common protozoal infection of the human intestine

         It is the most common cause of epidemic and endemic diarrheal illness in the world.

         It is estimated that one out of six people have giardiasis worldwide.

         It is estimated that 50 percent of individuals with giardiasis are asymptomatic.

         The most common symptom of giardiasis is acute, watery diarrhea.

         It is usually a self-limiting disease.

         Death is extremely rare, usually occurring only in malnourished children.

         Consumption of contaminated food or water is the main way that giardiasis is spread.

Etiology (cause) of giardiasis

Giardiasis is caused by consuming food or water that has been contaminated with the giardia cyst. Once the cyst is ingested, it changes into the infectious trophozoite form that begins to reproduce and populate the lumen of the small intestine. This process of reproduction delays the onset of symptoms by 14 - 21 days.

The symptoms of giardiasis are caused by the proliferation and colonization of the lumen of the small intestine by trophozoites. As their population increases, the body's primary protective mechanism to rid itself of the parasite is a mechanical attempt to flush the parasite out via diarrhea. Symptoms include (in order of frequency):

                          Diarrhea

                          Malaise

                          Excessive gas (often a foul-tasting and smelly sulfuric flatulence, or belching)

                          Steatorrhea (pale, foul-smelling, greasy stools)

                          Epigastric pain

                          Bloating

                          Nausea

                          Anorexia (loss of appetite)

                          Nausea

                          Vomiting (rare)

Diagnosis of giardiasis

Diagnosis can by made by taking a patient history, determining potential exposure, and observing the clinical symptoms of acute, watery diarrhea and smelly gas.

Diagnosis is confirmed when microscopic examination of the patient's stool reveals cysts or trophozoites.

Diagnosis is also confirmed when an antigen test of the stool detects giardiasis. 

Treatment of giardiasis

metronidazole (Flagyl) 250mg po tid for 5 days, or

tinidazole (Tindamax) 2g po once with food, or

furazolidone (Furoxone) 100mg po qid for 7 days. (This is typically used for treating children, as it is available in a liquid suspension.) The pediatric dose is 25 - 50mg po qid for 7 days, or

nitazoxanide (Alinia) 500mg po bid for 3 days

This Medical Tidbits article was first published as part of a larger article from the Wilderness Medicine Newsletter Volume 21 Number 5, September/October 2008

10 Things to Do Before You Begin Your Long Distance Hike

You’ve been thinking abut this trip forever, it seems. Your big step onto a long distance trail hike. The nerves are getting to you a bit but so is great expectation. Especially the gnawing sensation if you have everything you really need to do this. Try this checklist to see if you have covered all your bases before you embark on your adventure.

1. Your gear. Have you got everything you need for what may lie ahead? Esp. weather wise? Try this

Gear choices can be overwhelming. Do the best you can.

gear list to see if you may have forgotten something, even the small stuff. Have some money on hand during your hike to replace some gear issues for long distance hiking. Even if your gear choices aren't perfect, it will be ok. Some extra money can help remedy some of that, esp if it is a safety issue. Other times, just let it go.

2. Your means of communication. While we like to get away from the electronics out in the wild, electronics are necessary for planning ahead, calling home, checking on shuttles and hostels, unplanned emergencies, etc. Plan for a cell phone. Some family members may want to follow your progress so consider a SPOT or similar device. Leave an itinerary at home. Though it may change, it gives your loved ones an idea where you will be.

3. Your navigation. Most say just follow the blazes, but lots of time, esp. in surprise weather, that doesn’t always work. Have the means for navigation on you. Maps (or map apps for your cell phone), current guidebook and / or guidebook pages, etc. If using a phone for map apps, be sure you have an extra power pack for it. A compass is an added bonus, but make sure you know how to use it. Same for a GPS for certain hard to follow trails.

 

4. Your health. Have you been to the doctor AND dentist for all necessary checkups? Make sure you will have the medicines you need. How about extra prescriptions, esp. for glasses should they break while on the trail? Do you have a prescription for things like doxycycline for a tick bite on the trail? Also, be up to date on shots like Tetanus. Don’t forget to bring a good first aid kit and consider taking a first aid course before the trip. 

5. Your money. Check your accounts to make sure everything is up to date and you have the money you need should you have to spend a few extra days in town due to bad weather, illness, gear replacement, etc. Carry some cash on you as well as a debit card and credit card on you, along with your driver’s license or other form of ID. Be sure you have an extra debit card at home to mail out just in case the magnetic strip wears out.

6. Your trail mail. Are you expecting mail on the trail? Make sure you have your mail drops ready to go or a person ready to do them for you and a responsible person to mail them. As things can change en route, be sure you give yourself plenty of time for the drops to get there. Use Priority Mailing case you need to forward drops (which can be done for free if you don’t pick up the box at the PO). Use this checklist for maildrops and what to put in them.

7. Your house, bills, pets. Is your place or residence being cared for as well as the bills for it? Things like this can really distract from a hike unless you have prepared for it. Make sure all these things are covered. That also includes any pets left at home – that they are cared for by responsible people and have the food, medicines, vet info, etc they need.

8. Your job. If you have a leave from your job, make sure everything is OK at work for you to return. If you quit your job, have some ideas what you will do when you get back. Maybe make a list or have an idea of a job that interests you.  Be sure there is money to cover several months of bills after you get back as you look for a job or to pay the bills until you start work and get paid.

9. After the trail. Prepare for the after the trail doldrums. See my blog on coping with post-trail issues

which are very real after any major hike. Don’t
let depression and other issues kill the joy of your great adventure.

10. Now…Relax. The bases are covered, so get out there and enjoy it. Take it day by day. And don’t be afraid to change things on your hike if needed. Be flexible. The journey is more mental than physical.