Back in the Saddle…or Not?

The verdict about my knees came in.  The good news is that I don’t have any stress fractures.  The bad news is…I don’t have any stress fractures. There aren’t any breaks, tears, sprains or strains — or anything else they can repair. What I have, quite simply, are a couple of aging knees.

I’ve got chondromalacia in my kneecaps, which means the cartilage is falling apart.  The symptoms are stiffness when I don’t move and lots of pain when I do. And it seems nothing will cure this type of arthritic degeneration — not surgery, not a knee replacement.  No bracing, taping or drugs will make any difference long-term. I don’t need to lose any weight. My muscles are already strong . I don’t need cortisone shots or anti-inflammatory medication, although icing might help somewhat.

So what can I do?  According to the doctor, anything I want as long as I can stand the pain.  Climbing up and down stairs worsens the symptoms.  So does squatting, rising from a seated position, and walking on an inclined terrain (hiking, in other words).  But hiking didn’t cause the condition.  Decades of living did.

So my knees are old, and the cartilage is wearing out.  And it will never improve — unless I miraculously find the fountain of youth.  But what does this actually mean for my future?  How bad are my knees likely to get?  And most importantly, can I finish my hike?

My doctor cringed when I asked him.  Obviously, spending my days climbing over mountains isn’t the “take it easy on your knees” activity he had in mind.  On the other hand, he didn’t tell me not to do it.  To him, how much activity I could engage in boiled down to my tolerance for pain.  And frankly, sitting around hasn’t helped my knees much.  In fact, three weeks of inactivity has only made my hips hurt worse.

Which leaves me considering my options: (1) Chow down on painkillers and resume hiking.  (2) Stay home and watch TV.  (3) Work out some sort of slackpacking compromise to drastically reduce my pack weight and take more days off to rest my knees.

Right now I’m leaning toward #3.  I’ll spend the next couple of weeks taking day hikes near my  house — first in the grassy park, then on the Maryland section of the AT.  I’ll see how much weight I can carry, gauge my optimal distance, and decide how hard I can push my knees.  I also need to study the terrain down south to see how it compares to the mountains in New Hampshire — because no matter how confusing my prognosis, there’s one thing I know for sure.  I don’t want to put myself in the frightening position of being unable to descend those treacherous rocks again.

So, to decide, I need some input.  Am I insane to consider hiking?  How’s the southern section of the trail? I’ve already hiked from West Virginia to New Hampshire, so how does the Georgia to WV section compare with that?  Does anyone have chondromalacia? If so, do you still hike?  I’d appreciate any advice!


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Comments 10

  • Nadine Symons : Jul 9th

    Hi Gail,
    I also have bad knees, not sure if it is chondromalacia but what you describe is similar. I attempted to thru hike this year but had to stop when I fell into a ravine and broke my ankle. I started in Georgia and made it just south of Bland, Virginia. Before breaking my ankle, I hiked with a sprain ankle for over 400 miles. Sometimes, the pain was bad and other times bearable. I knew I was not making things worse so I decided to continue. I could live with the pain. What I did decide though was to slack pack and I was able to do it for a long time. I also took some zero days and depending if there were a lot of downhills, I would walk less miles.
    The terrain down south is not that bad. There are a few tough downhills but when I did not think I could make it down, I just sat and slid down. I think you will be fine.
    There is a new book out called “How to slackpack the AT”. It details a couple’s thru hike slack packing the whole way except for the Smokies.
    If you decide to get back out there, I have been told and the book confirms it, you would be able to not carry a full pack the whole way (except Smokies). I found that slack packing was easier on my knees and ankle, I could go up and down rocks easier and I was able to do more miles than if I had carried a full pack.
    The only downside is that it’s expensive. There are way to cut down expenses (tent at hostels or campsites), not use shuttles. If you hike with somebody else, you can use 2 cars and that can be your shuttle.
    Good luck and if you want more information about slack packing, simply shoot me an email.

  • Buzzcut : Jul 9th

    Interesting verdict. I have also wondered about the terrain south of Harpers Ferry for the same reason. I will be watching you for your responses and decision. Best wishes.

  • Dave Rowell/Carpenter : Jul 9th

    I have had great success using Hyaluronic Acid which I buy as a powder. A friend recently had a shot of it injected into her knee with fantastic, immediate relief to her joint. I had never heard of the injections before. I am 60 and have a thruhike plus a couple of thousand miles.

  • Ralph : Jul 9th

    My sympathies. I am almost 68, have had cancer and suffer from various maladies, but would be lost without regular walking. As long as they are not medically contra-indicated, you might benefit from calcium and glucosamine/chrondroitin supplements. I have seen several cases where these seemed to give a definite benefit. Should not be any great risk, but certainly check with your doctor on this. Good luck with this.

  • John T. : Jul 10th

    I’m 67 and can really empathize with you…I’m way ahead (or behind) you, because I now have two TKR’s (total knee replacements). In earlier years, I hiked about 500 miles each (in sections) on both the AT and the PCT, plus at least several thousand other hiking miles on shorter trails. Plus 40 miles per week of running for quite a few years, soccer, rock climbing and bicycling. I have now had 5 knee surgeries – 3 ‘scope surgeries to buy time before doing a TKR, then the two replacements. The results were excellent, tempered of course by the arduous rehab process (which is critical to full recovery). The good news is that I am still walking around the neighborhood with an 18 pound pack on my back, up to 7 miles so far, trying to see if I’m comfortable doing a short (1 to 3 night) backpacking trip on the PCT (I live in WA state) – my surgeon said go for it if you feel ok. My walking is now essentially pain-free, totally unlike it was before the replacements, but the big worry now is if I wear the replacements out, because a second TKR is often not a good idea or even if it is possible it can be a challenge to do successfully. So although you’re dealing with the pain, at least you still have some cartilage left apparently – at some point you may get to where I was, bone-on-bone, leaving no option but disability with a lot of pain or a TKR. The good news is that as with everything medical, they have gotten knee replacements quite refined and generally very successful (if the patient follows the rehab protocol). Good luck!

  • stealthblew : Jul 10th

    two cents for thought — a body in motion tends to stay in motion, while a body at rest tends to stay at rest –

    – There are plenty of places to explore in America besides the AT… please follow your gut on this one

  • George : Jul 11th

    I’m 66 and just finished a 725 mile section. Let’s face our warranties have expired. You might check out Pilates. Streathening the muscles around the knee will make more stable and Pilates was originally developed as rehab for wounded soldiers. A good teacher will know how to customize your program. I don’t understand why knee replacement surgery isn’t an option. You certainly don’t have to worry about cartilage anymore. I met a guy on the trail who had had both knees replaced. Trail name was Aleve. He posts video on line, you might be able to ask him about the recovery.

  • Jake Wise Owl Bolen : Jul 11th

    I hiked around a guy that was well past the mid-point of the AT in 2001. He had bad knees and was going to need two replacements. When asked why he would put more damage on his knees his reply was simply “I have to get knee replacements so I am wearing out the first set”. He moved quite slowly but was making 8-10 miles a day with lots of breaks.

  • Cato : Jul 11th

    They gave me a similar diagnostic and I’m not 40. It’s not quite about aging knees but wear and tear. If you’re not using a couple knee braces start with that. It will stabilize your knees. If you’re not using orthotics or at least excellent shoe insoles that will also improve your stability. When your knee parts are not rubbing the wrong way, you feel a little bit better. It may or may not be enough to finish the trail, but it should help. When you go home, you should meet with a physical therapist and a chiropractor. I’m feeling better now.

  • ThruHikerWannaBe : Jul 13th

    I’ve been keeping up with you because we are the same age and relative abilities. I have always wanted to hike the AT, however, a year ago I took a tumble and broke my hip and knee. It will be a year or more before I feel that I am fully capable to handle something like a thru-hike. In the mean time, I am looking at several hikes that are longer but less exciting geography-wise (e.g., the Thames path and the El Camino starting in Pamplona). I recognize that I may never be able to hike the AT. But that doesn’t mean I can’t still have an adventure.


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