Training for the Trail: PT for the AT

The Physical Therapist as the Patient

Using my skills as a PT, I am preparing to thru-hike the AT in 2020.  I have  the benefit of being both the therapist and the patient.  I have suffered severe injuries from being hit by a car while running, and then later again after a head-on car collision. Two years ago, I underwent a right hip replacement due to a combination of factors. My husband reminds me that “nothing like that ever happens to me on the couch.”  I am happy to say, I continue to be able to run 30+ miles a week without pain.  OK, so I love being active, despite the risks.  However, as a physical therapist, it is nicer to prevent injuries than treat them.

Taking a History

Preparing for  thru-hiking the AT, I want to prevent injuries.  I want not only to complete my hike but to enjoy it.  Looking at my history reveals what factors may make me more prone to certain injuries or pain during my journey.  I will be turning 50. Although I hate to admit it, I can’t just go out and run a half marathon without training anymore.  Recovery times increase with age.  My body is less resilient and more prone to injury.   Previous injuries have left me with multiple implants: I have plates and screws in my left arm, a metal coil that remains in my spleen, and a hip replacement. Although none of these things limit my current activities, a fall could result in a fracture around these implants, which would most certainly end my trip. Medication and symptoms of hypothyroidism and anxiety/depression is also a consideration.

What Am I Worried About?

This crazy, wonderful, life-changing activity does come with risks. Blisters and plantar fasciitis can occur when a person walks more than his or her usual distance, carries excess weight, or wears improper footwear. Scrambling up and down steep inclines, rocky trails, and wet, slippery terrain challenges even a good athlete’s balance and endurance, increasing risk for a fall resulting in injury.Weather changes and a limit in what one can carry can result in heat exhaustion, hypothermia, or dehydration. Pain, exhaustion, and poor nutrition or hydration can lead to poor mental function and increase risk of getting lost, or making poor decisions, not to mention result in a less than enjoyable experience.

Program for Prevention

Weighted Vest
Training equipment

Twenty-pound weighted vest.

So, what am I doing to minimize my risk of getting out there only to end my trip prematurely?  I don’t have a lot of time to go on practice backpacking trips.  Working six days a week (I have to save up for those six months off,) it is a struggle to get my weekly running miles in.  I bought a weighted vest (20 pounds) that I wear several hours a day while working, cleaning, doing yard work, etc.  I have been increasing the amount of time per day I wear it.  This is helping me not only build my endurance and tolerance for carrying extra weight, but strengthening my feet, ankles, legs, and core without taking time out of my day.  This will help prevent plantar fasciitis, fatigue, and help build my core and muscles that support my joints.


Tightness causes pain.  Restriction of  normal movement of our joints and muscles can result in nagging aching pain.  Although, it seems simple, it is of utmost importance to keep joints moving through full range of motion.  I am as guilty as the next person in neglecting this.  Yes, even me, the PT who knows better.  The point is, I do know better.  Now, I need to get back into the habit of daily stretching for my feet, ankles, back, neck, arms, hands, wrists, fingers. Everything!  Sleeping on the ground and hauling 30 pounds for 14+ miles of rocky terrain a day is going to create stiffness!  Heck, sitting in a chair for more than 30 minutes these days creates stiffness.  So I need to start now and give myself and efficient stretching routine that I do morning and evening.


On a run with Mika, my border collie.

Running above the fog.

I wear a Fitbit.  I don’t live and die by it, but it does make me a bit more conscientious of the distance I cover on a daily basis. Fourteen to 20 miles a day is what I want to be comfortable hiking.  It’s not just the miles, but the amount of time on my feet—with a heavy pack.  I am joining friends in running a marathon in March. Mostly, I did this to force myself to increase my running mileage over the winter months so that 14 miles a day doesn’t feel awful. Currently, I try to run a ten-mile run every one to two weeks. However, since I started wearing my weighted vest, I have not been able to run more than seven to eight miles after wearing the vest all morning.  Luckily, my border collie Mika is happy to run any distance with me!

Trialing Footwear and Clothing

I am researching and trialing my footwear and clothing.  Just because Equipment Guru 2019 highly recommends Solomon boots, doesn’t mean it’s the best for everyone.  I am a sweaty pig and need clothing that dries quickly.  Despite being sweaty, I get cold very easily, so I still need clothing that is warm.  I have found several “must haves” online, only to find out that I hated them while wearing them with a pack or for more than two hours.  Clothing that chafes can cause burns and blisters.  Boots that don’t fit my foot like a glove or socks that don’t work for my feet can cause blisters.  Poor arch support can result in plantar fasciitis.  Wet clothes can cause hypothermia.  Even having an awareness that the wrong clothing and footwear for my particular body could have injurious effects will help me know right away if I need to try something different.

Hoping for the Best, but Preparing for the Worst (Plan A,B,C…)

I vacillate between being type A and type C- on an daily basis.   Pepper spray, a loud alarm, a knife, and a GPS system with an emergency button. Initially, I got these items to make my loved ones feel better, but I realize that it does also make me feel better.  These items will be on me at all times; even when I drop my pack to pee or get water.  Having worked as a PT in wound care for several years, my first aide kit includes QuickClot, hydrocolloids (dressings that are thin and can be left on for multiple days) and silver (antimicrobial dressing that can be left on for several days).  CPR training is important to me.  In the case of lightning strikes (my personal biggest fear), this can sometimes be the difference between surviving and not surviving. I am also considering taking a self-defense course.


No matter how much I prepare, and how much planning I do, I know there will be tough moments.  There will be days I hurt, days I feel mentally beat, and days I am cold and tired.  I hope on those days that I can remember progress rarely occurs on a steady course.  Nothing I do now is going to make this an easy endeavor.  I don’t want it to be easy.  If it is easy, I won’t feel so proud to have finished it in the end.  I am just trying to prevent any issues that make it absolutely necessary to quit.

The Takeaway

We all have unique strengths, weaknesses, quirks, and stressors.   In the medical system, you have to know the true diagnosis to effectively treat it.  It is the same here.  You have to know your weaknesses in order to address them.  Sure, there are some global recommendations for prepping for a thru-hike, but it really comes down to individual preparation. Other hikers’ blogs have been helpful in planning.  However, I still have to keep my individual needs in mind and avoid liking or disliking something just because it gets good or bad reviews.  For me, this will be my journey and no one else’s.  I want this to be something that I will remember with pride and joy for the rest of my life.  So I am preparing my body in the best way I know how.  If my body can complete this, my mind will be forever fulfilled.

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Comments 7

  • Dawn W : Oct 24th

    I worked with Gwen at a home health agency, she’s one of the greatest physical therapists around!!! Good luck Gwen ??‍♀️?‍♀️??

    • Gwen : Oct 28th

      Thanks so much!!!

  • Donna Cholewa : Oct 24th

    YEY GWENY!! Your prep is meticulous and your attitude is perseverance. You are an inspiration to us all… To Find a passion in life and take It to The Edge!

  • Ruth Morley : Oct 25th

    I just want to thank you and all PTs for what you do to keep the rest of us functioning. I’m currently going twice a week to physical therapy for 3 injuries I incurred during this year’s 900 miles on the AT. Sometimes I feel like I’ll never heal, but my PT hugs me when I’ve cried and we continue. And I see progress, slowly but surely.

    You’re going to handle the challenges of the trail well. I look forward to following your journey. I expect to be healed and finishing Maine next August, so maybe I’ll be seeing you there.

    • Gwen : Oct 28th

      Ruth, thanks so much for your love! I am so proud to be among a wonderful group of coworkers… both those I know and those I don’t. PT’s generally are truly good people who want to make other peoples’ lives better. I hope that your progress, no matter how slow, gives you hope for a pain free active future. I get it. My own rehab felt like it was in slow motion. I am sure you will eventually enjoy a full recovery!

  • kekeinh : Nov 5th

    Awesome vacation locations. Love them. Thanks for posting them.


  • Tokyo Joe : Sep 2nd

    I grew up summers hiking great stretches of the AT in Maine and NH, and loving it ( even non stop rain in June, trench foot and the black flies)! 45 years, 2kids, a divorce , travel and work across many parts of our globe, and many many hours of long distance running which I love, plans to hike the whole AT remains on my bucket list. However, I am facing a hip replacement soon as the hours of running and training have caught up with me. I would love to hear more about Gwen’s experience as a thru higher having done it after hip anthroplasty.
    Thanks and best regards, Tokyo Joe


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