Trading My Cane for Trekking Poles: Overcoming Back Pain to Hike the AT

Suffering

Throughout 2021, I struggled with back pain. Early in the year it was mostly just annoying, but in late August the pain suddenly ramped up to intolerable levels.

Over the next three months, my condition continued to deteriorate. I couldn’t stand up straight. Standing and sitting were torture, and lying down was only marginally better. The distance I could comfortably walk shrank from miles to yards to nothing. As my stumbling became worse and my confidence that I could get up after a fall waned, I began to use a cane to get around. Because the pain was constantly high, I had no appetite and lost 30 pounds in 3 months without exercise.

As my physical health declined, my mental health suffered as well. I was already not doing well at the time, but all other concerns quickly took a back seat to the pain. Prescription painkillers eventually became a necessity to get through the day and greatly added to my mental fog and kept me in fear of developing an addiction. I was afraid the pain would never go away, and I could not bear the thought of living with it forever.

Treatment

I knew I needed help, and I desperately took the earliest appointment with a specialist I could find. It was the luckiest appointment I have ever made. Dr. Stephen Knoyer of Positive Movement Spine, Sport, and Rehab gave me an extremely thorough exam and comprehensive treatment. We tried all sorts of treatments: medication (from urgent care), physical therapy, manual manipulation, and dry needling. I had some temporary relief, but the pain always came back and continued to grow. I eventually got an MRI that showed stenosis (bone growth) and bulging discs completely pinching a nerve.

This diagnosis made it clear that my best option was surgery. I again took the earliest appointment I could get and was again rewarded with excellent care. Dr. Raymond Haroun and his staff at Maryland Spine Specialists got me in for a consultation quickly. As I had already exhausted all other less invasive treatments with Dr. Knoyer, I was given the choice of trying a cortisone injection or surgery. I did not hesitate to opt for surgery. After getting insurance approval, Dr. Haroun was able to get me scheduled for surgery on short notice in December before the holidays. On the day of surgery, I was a nervous wreck until I drifted off under anesthesia.

A beautiful sunset two days before surgery.

Recovery

When I woke up, I could tell the surgery had been a success. Right away I began walking as much as I could, building up distance day by day. I was very weak, but it felt great to be able to stand up straight and walk without pain. I continued to use the cane for a few weeks until I was strong enough to not need it. As soon as I was cleared to start physical therapy, I went back to Dr. Knoyer. He laid out a progressive set of exercises to build my strength. Each progression was difficult at first, but it was amazing to see how quickly my strength grew as each progression began to feel easy.

I had been planning to set out on an Appalachian Trail thru hike in May 2022, but had to abandon those plans. With the surgery in December, I was not confident that I would be ready physically or mentally, and the medical expenses had decimated my savings. I did a 50 mile section hike that May in Shenandoah and had the time of my life. That hike proved to me that I really was healed and could live my life again. It also galvanized my desire to undertake an AT thru hike. Now, two years after that fateful Shenandoah hike and two and half years after surgery, I am making that dream come true.

Adjustments

Having a back injury means I am more likely to suffer another one. While my surgery has continued to keep me healthy, there is still a chance I could one day need another. So what am I doing differently to take care of my back while thru hiking?

Training

Everyone who wants to thru hike would benefit from training beforehand, but for me it was a necessity. I’m not starting in perfect shape but I am confident that my training has been sufficient to get me started. My main strategy for training has essentially been just walking as much as possible. I gradually added in walking with my pack and then started incrementally adding weight to the pack. I also found the biggest hill I could find to train on, which was not easy living in a railroad town in the coastal plains of Georgia. By the time I was ready for trail, I was easily carrying 35 pounds in my pack and could walk for as much time as I could carve out of my schedule without taking a break. I have also kept up with some of the physical therapy exercises from after my surgery and added some others. The ones that help me most are: 

• Bird dog
• 90/90 hip stretch
• Kneeling side lunge
• Frog pose
• Cat cow
• Front plank
• Side plank
• Regular squats 
• Hindu squats 

Gear

My kit is set for comfort. While I have tried to eliminate unnecessary gear and save weight, I am not ultralight. The two areas where I have sacrificed weight in favor of comfort are in my sleep system and backpack.

For my sleep system, I am carrying a hammock. With all the necessary accoutrements, it is heavier than my tent setup would be. However, the sleep I get in a hammock is much higher quality. I usually wake up feeling rested and well recovered. On one camping trip I overslept and didn’t wake up until noon, which I’ve never even come close to doing in a tent. 

For my backpack, I’m carrying an external frame pack. You may be hearing the Jurassic Park theme playing in your head, but this is not your granddaddy’s Kelty. I’m carrying the Seek Outside Gila 3500. Being able to transfer the entire load to my hips keeps my back, neck and shoulders feeling great all day. The hipbelt is also the biggest I have been able to find, which is key to the comfortable weight transfer.

Gratitude

While this experience cut me down to my lowest and is something I never want to go through again, I believe it has made me stronger and set me up to complete the AT this year. If I had not been injured and tried to thru hike in 2022, I don’t know that I would have been successful. The lessons learned, patience gained, and lifestyle changes made have made me a more capable and grateful hiker.

In addition to my amazing medical team already mentioned, I have to thank my family, friends, and coworkers who helped get me through the worst time of my life. I especially want to thank my mom, who flew out and stayed with me for several weeks while I recovered from surgery.