Doctor Doctor give me the NEWS

20 Sep 2017

It’s been 5+ weeks since I came off of the AT. At first, I thought my knee, feet and leg pains would eventually subside, but they haven’t. The feet are still numb, especially the left big toe. The knees still are painful, especially going up and down stairs.

Dr Visits

After a few weeks of rest, I made the necessary doctor appointments to find out what’s really going on. From the knee xrays, it appears PFPS (Patellafemoral Pain Syndrom) is the primary culprit…in addition to bone spurs in both knees. According to the doc, I have good joint spacing, but the right patella is seemingly more out of alignment which causes MORE pain…good to know. And those bone spurs…not too bad, yet!

Way ahead

After today’s consult with my orthopedic surgeon, the way ahead (at this point) is…

  • Stop all big impact exercises…that means running OUT, but walking (AKA hiking) is still G2G (good to go)
  • Whatever causes pain, Stop It!
  • Continue RICE
  • Wear some braces for activities

As for now, NO knee surgery required

However, we are scheduling an MRI on the more painful Right knee to eliminate any other issues. No need in an MRI on the Left, since we already know about the torn meniscus over there. Also, to help with pain issues, I had my orthotics appointment today as well.

The best news is…it’s not THAT bad. Thank God for That! While the knees still hurt and buckle going up and down stairs, I am Happy ? the diagnosis is what it is. Right now, it’s just going to be some braces to realign my knee caps.


After educating myself on WebMD about knee bone spurs and PFPS, I’ll take the less evasive approach to knee pain. I’ve had too many surgeries already in my 51 years of life and as I get more aged — I like to say refined — I find the idea of going under the knife as less appealling nowadays.

The Meaning

So what does this all mean? Well, it means I can hike as long as I can deal with the pain. Since 5 weeks of little to no activity has helped resolve some pain, I think I’ll continue this plan for a WHILE longer. No need in rushing back on trail to only have more pain related issues arise. BUT…this does mean I can return to hiking my AT Hike at some time in the future. That’s great news, because I have unfinished business out there. I have (no, I need) to finish my AT Hike, even if it’s not a thru hike.


I’d hoped that the foot/shoe orthotics would help align my legs and maybe get rid of all the pain (feet, leg, back), but that may not be the complete fix. With foot issues to be corrected as well as a knee realignment with braces, I should be walking straight as an arrow after putting on all of this hardware.

My only thought right now is… “Do I add these items to my base weight when I get back to hiking?”


When the foot doctor was making my foot molds, he asked about an irregularity in my left foot. In particular, he made note that my left foot turned inward and it must have been that way since I was young. After a little more discussion about my many ankle sprains, it turns out my anterior ankle ligament may need some work.

Turning those ankles

As my blog readers know, I turned my left ankle many, way too many, times on my hike. While my ankles have been an issue (easily sprained) for 25+ years, NO doctor had diagnosed it like Dr Rick Grayson, DPM. I’ve had a previous doc talk about it being an ankle dislocation, about it being drop foot and a few other ideas, but NONE of them took action so I’ve lived with some very unstable ankles. According to Dr Rick, it’s only a matter of time before one of these ankle sprains tears my ligament completely OR it breaks my ankle. Good thing that didn’t happen on a mountain top!

Ankle Diag

Dr Rick thinks if I don’t get this fixed, it will only get worse. I’m not sure how it could get any worse, but… He said as a previous foot surgeon, he would do a Brostrom Ankle Ligament Reconstruction. After talking about the surgery and recovery, it looks like a trip back to my primary doctor and another consult with podiatry is in order with a much needed and overdue surgery!

So what I had hoped was a “let’s just get some hardware” may easily turn into more surgeries. While the left ankle is really bad, it’s a bilateral issue…so maybe two ankle surgeries! We’ll just wait and see…

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Comments 7

  • tj : Sep 25th

    Here is how I avoid ankle problems, and knee problems. I have no ACL, but I’ve found ways to work around it. 7 yrs ago I went in search of answers in the areas you are experiencing issues with. I’m your age as well. Im planning a 2019 thru hike. I will be wearing the Merrell Trail Glove 4, and I carry two sets when hiking, and alternate them daily. It’s completely opposite of the cushy trail show, but it absolutely works well for me. It just takes time to acclimate to it. Research before you go under the blade again. There are ALOT of alternatives, and progressive therapies now that can help even us older guys regenerate. Good luck!

    Check out Mark’s Daily Apple blog as well.

  • Up-n-Ready : Sep 25th


    Thanks for info. I wore Altra shoes for over 400 miles. Thsy didn’t work with the large toebix and zero drop…more natural.

    I’ll wait to see what the podiatrist says…but again Thank You.

  • Thin Man : Sep 25th

    Try going to a good, older, experienced orthopedic Physical Therapist for your injuries. All the problems you are experiencing can be helped without surgery. That should be your very, very last step. Particularly the foot / ankle procedures they are talking to you about. I have seen spotty results from them in my clinics. If the first PT does not help try another. Good luck.

    • Up-n-Ready : Sep 26th

      Thin Man,

      I’m hoping PT will fix it before surgery. However, from what the Podiatry Doc said, I’ve done extensive injury over MANY years of sprains. It may be Too Late for PT to fix the damage in the ankle. I wish a Doc had identified the Real Issue earlier in life.

      As for now, I’m open to ALL OPTIONS.

  • Bob : Sep 26th

    All that realignment will undoubtedly cause spinal changes. I had a patella issue years ago from running more uphill than downhills. It caused a shift of the patella that was reforming a channel in the cartilage. It took a while to straighten that out. Take your time. Hope all goes well and maybe we’ll see you out there.

    • Up-n-Ready : Sep 26th


      Thanks. I already have some back issues so I’m hoping this helps with that as well. Lots of stuff going on with this Old Body.

      I’m hoping the braces help realign the patella to relieve the pain going up and down. If the ankle issues can’t be resolved, I’ll add my ankle braces back into the mix with the orthotics.

      It’s all about alignment…but I think overdoing it caused some of my issues — going too far, too quick and too fast. I guess it would have been better for me to slow down and go much slower when I started this adventure.

      However, here I am…in pain!

      I’m taking it slow for now…but want to finish the AT. Hopefully, the winter weather will be mild and I can get some more hiking in. However, the Almanac says Lots of COLD and SNOW.

  • Jason Hughes : May 3rd

    I wish you the best with your recovery. You could also ask your doctor about exercises to build the arches and muscles of the foot.

    Ankle, knee, hip and back issues start from the ground up. They’re usually alignment issues that need to be addressed biomechanically. Surgery corrects these issues but one usually falls back into old habits of posture and gait.

    You can read more about how to build the muscles of your feet for proper functioning of the system in this illustrative article:

    I urge you to talk to your doctor about appropriate rehab and strengthening exercises. Again, I wish you all the best.


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