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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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.
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.
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.
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.
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!
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
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.
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.
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.
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.
“You don’t stop hiking because you get old, you get old because you stop hiking.”
I agree with the poster above who said “a body in motion stays in motion.” You need to decide for yourself, Gail, if you want to be immobile or you want to be in pain. With that being said, only YOU can make this decision.
If you need another little pick-me-up… we spent yesterday in the Maine Carrabassett Valley helping thru hikers. We gave husband and wife team JayBird and Towhey a ride (after we fed and coffeed up the group hanging out, lol). They are also flip floppers. Towhey, the wife, fell and broke her collarbone while on trail. They took a couple weeks off… camping away from the trail until she was healed enough to continue. They are also a bit older than the rest of the kids pounding out miles. Gail, neither of them could smile any wider. They were truly enjoying the trail.
To close, I want you to know that it is OKAY if you do not want to continue at this time. You need to take care of you, you need to take care of your soul. If you feel that you would regret quitting for the rest of your life, buy a damn plane ticket. I would pick you both up from the airport and drive you to Franconia Notch. I am absolutely serious. If you accept, shoot me an e-mail.
Oh Gail, I’m so sorry to hear of your knee and hip pain and that you didn’t finish your goal.
You are a vibrant and bright woman who makes things happen…always has, always will.
It seems we boomers are starting to hit the wall in spite of our best concerted efforts. Women have had to be especially tenacious, carrying forth at times for all we’re worth.
You’ll proceed as the rest of us mid-century folk by breaking rules, getting creative, hanging tough, and adopting and compromising as necessary.
I’m sure you, like me, thrill to the sight of young women taking long distance hiking by storm, they make us so proud. Their journals, and those of the men, get us back on the trail, at least virtually.
Thank you, Slackpacker. These past few months have been difficult for me. I’ve suffered a series of physical maladies — some caused by the knee issue, others by sheer bad luck. As I mentioned above, I left the trail in New Hampshire because of my knees. The pain and stiffness altered the way I was walking, which in turn caused excruciating bursitis in both hips. So I went from hiking over mountains to needing a walker, which was quite a humbling experience. For the first time in my life I couldn’t depend on my body, and the simplest tasks, like getting out of a car, were nearly beyond my capacity. Then bad luck hit in the form bronchitis (which had nothing to do with my knees, of course), and I threw out my back from coughing so hard. That hurt so much that I became a complete couch-bound wreck, living on muscle relaxants and unable to even totter across the room. You can imagine how depressed I’ve been.
I guess what this has taught me is to not take good health for granted. It has also forced me to face reality, that I am not 20 anymore, and my body is not immune to the effects of aging. I hope to get back to normal walking again, but even that is uncertain. Yesterday I very cautiously walked one mile at a flat, grassy park, and it took me 45 minutes! Each step was painful and slow. I’m going to physical therapy twice a week, and can’t get by without naproxen patches, ibuprofen, heating pads, and muscle relaxants. Of course, I’ve gained weight which only adds to my bad mood.
Anyhow, it’s alarming how one problem can cause an onslaught of others. After a certain age, it seems that our bodies are held together tenuously, and all it takes is for one injury to cause a domino effect. Someone asked me the other day if the hike was worth all this agony now. I thought about it, and my answer was yes. I wouldn’t trade the experiences I had for anything. Still, I’d really like to get past all this and back to some sort of normal health.
I thought about you and your hike today as I am visiting Tennessee and we were talking about the AT. I was telling my son about your hike and I realized it had been a long time since an update on your knees and hips and if you have plans to return or where you are in your journey. Hoping there has been improvement and the journey is still a go.
Thank you for asking, Mary Ellen! I wish I had a happy answer, but I don’t. The past five months have been very hard and depressing. I have two big problems — my hips and my knees. My knee issue is never going to go away unless they perfect that stem-cell treatment and find a way to repair torn cartilage. (Knee replacements won’t help.) The pain isn’t too bad, just a mild ache in both knees, which I can tolerate. The real problem is that after I’ve walked a few miles they stiffen up, making it very difficult and treacherous to go downhill. (Going up doesn’t bother me as much.) That was what took me off the trail. I was excruciatingly slow on the downhills, and so stiff that I was skirting disaster. I didn’t want to risk a catastrophic fall.
My other problem is my hips: bursitis and IT band issues. That never bothered me on the trail. I think I developed it because my knees caused me to alter my gait. I still have hopes that this will go away, although it is lingering much longer than I ever expected. As long as I hike on flat, soft surfaces (such as a grassy park or dirt trail), I am fine. I can go about ten miles before my hips start to hurt. I also can’t sit for more than a few minutes at a time without needing to get up and move, so that is inconvenient. But, as I said, hopefully that will go away before too much longer.
That still leaves me with the knee issue, though, and right now my chances of hiking the AT again are slim. I don’t think I can ever carry a pack again, so the best I can hope for is to slackpack the rest. Unfortunately, the AT is a very rocky and steep trail — probably the worst terrain possible for my knees. Add to that all the squatting, etc. involved in camping, and you can see the problem. I am exceedingly stubborn, though, and I really hate to abandon a goal once I’ve set it, so I haven’t totally given up. I just need to get my hips back to normal and then figure out what I can do.