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My ebooks The Passion Killers, A Dark Wind of Vengeance, Blood Beyond the Abyss and The Second Layer of Hell (apocalyptic fiction) are now available for download. They are the first four installments in the Path of Survival series. To see additional information, click here .


Do not use any of the information on this page as a substitute or replacement for professional health care. I have no medical training at all. Note that I am not making any suggestions here concerning what anyone else should do. I am merely stating what works for me. What works for one person may not work for another. If you wish to try any of the techniques or methods mentioned here, you do so at your own risk.

I have had knee and back problems for over 20 years, and I'm also prone to get Achilles tendonitis and shin splints. Years ago, I had a fractured vertebra in my neck. However, during the time I have had these conditions, I have hiked the Appalachian Trail, the Pacific Crest Trail, the John Muir Trail, the Long Trail, the Colorado Trail and I've also done extensive hiking and backpacking in the American west, Canadian Rockies, Alaska and Europe. I've lived over 2 years of my life out of my backpack. During that time, I've hiked thousands of miles in terrain ranging from the Mojave Desert to the Scandinavian arctic.

Several friends who are aware of my medical history have suggested that information concerning how I have managed to keep hiking could be of interest to others. Therefore, I have decided to make this information available.

This page has been divided into 7 articles. To see the articles, make a selection below or scroll down.

  • My Hiking Philosophy
  • My Hiking Gear & Clothing
  • My Diet & Exercise Programs
  • How I Care For My Knees
  • How I Care For My Back & Neck
  • How I Care For / Prevent Shin Splints
  • How I Care For / Prevent Achilles Tendonitis

    My Hiking Gear & Clothing:

    I use two sleeping pads when backpacking, a full length Z-Rest and a 3/4 length lightweight Therma-Rest. They weigh 14 ounces each, and I strap them together.

    I use an external frame pack. I usually prop it against a tree or large rock and lean against it in camp. It provides some support for my back. I also place the sleeping pads (strapped together) against the pack so that the two pads are in a kind of "L" shape, and I use the whole ensemble like a chair. When I go to bed, I move the sleeping pads into my tent or tarp.

    When using the pads together, the Z-Rest is always on the bottom (under the Therma-Rest). This way, my Therma-Rest never touches the ground. Using my Therma-Rest in this way, I carried the same one three years on the PCT from Mexico to Canada without puncturing it a single time.

    Using this setup is one reason I can keep hiking even though I have severe lower back problems. Sleeping on a Z-Rest and a Therma-Rest strapped together is not quite as comfortable as sleeping in my bed at home, but it's close.

    I also use the Z-Rest as a cushion for sitting when I stop for breaks during the day. I keep it handy so that I can get to it by just loosening a couple of lashing straps. When I stop for a break, I lean my external frame pack against a tree. I then remove the Z-Rest from the top of my pack frame, unfold it once, and place it directly in front of my pack. Within a few seconds of taking my pack off, I have a comfortable cushion to sit on and a pack to use as a chair-back.

    I've noticed that several folks who have back problems prefer an external frame pack. I've tried several internal frame models, and they all seem to impact my lower back. If I loosen the straps enough to get the lower part of the pack on my hips, it seems to unbalance the pack to the point where I'm having to lean forward to maintain proper balance while hiking. This hurts my back. However, an external frame pack seems to rest on my shoulders and hips; excactly where it should. No part of my external frame pack impacts my lower back, the frame seems to keep it away.

    I also use a sit-pad (or some other type cushioning) as a kneeling pad. Instead of bending my back and / or knees every time I have to remove something from my pack at the end of the day, I kneel on the pad and remove everything at once. When I repack the next morning, I put everything on the ground close to my pack and use the kneeling pad once again while I'm loading my pack. At night, I put this small closed-cell
    foam pad (about 3 ounces) under my pillow. On very cold nights, I put it under my feet.

    When I'm sitting in camp, I put either my food bag or clothes bag under my knees. It seems to take some of the pressure off my lower back.

    I usually sleep on my side. Unless I use a small cushion between my knees to prevent "bone to bone" contact, I'll wake up with some knee pain. For cushioning between my knees, I use a 5 x 5 inch piece of closed cell foam.

    Other than my pack, sleeping pads and sit pad, I try to keep my pack weight as low as possible.

    My shelter is one of our Arapaho Solo models that Brawny made, and it weighs about 27 ounces (without stakes).

    My sleeping bag is a Marmot Hydrogen down-fill model, which weighs 1 pound, 7 ounces. It has about 4" of loft, and is rated to 30 degrees (F).

    I made my own ultralight alcohol cooking stove, pot support and windscreen. Used with a Wal-Mart Grease Pot (as a cooking pot), this system weighs about 6 ounces.

    Brawny made my silnylon rainsuit, and the combined weight of the jacket and pants is about 7 ounces.

    I've switched to Trail Runner shoes for 3-season backpacking. Presently, I'm using New Balance 803's, which weigh a total of approximately 1 pound, 15 ounces in size 13. I also use a high quality pair of footbeds; Spenco's are my favorite. They really make a difference concerning how my feet feel when I'm hiking, and probably also benefit my ankle and knee joints.

    I've also recently made a change concerning my camp / town shoes. I now carry the 1.5 ounce homemade sandals I made from boot inserts. They represent a weight savings of about 6.5 ounces over the Wal-Mart Teva knockoffs I've carried in recent years.

    I use one of our large silnylon pack covers , (about 3.5 ounces) and I also use our silnylon stuff sacks . The stuff sacks weigh 1/4 - 1/2 ounce each.

    My hydration system consists of two 1.5 liter Yuppie water bottles (Evian and the like), one 1-quart soda bottle and one 1-quart, "soft-sided", Nalgene water bottle (3 ounces). The Nalgene is a bit heavy, but its wide mouth design is great for dipping water out of shallow creeks and springs. The one quart soda bottle weighs about an ounce, and the two 1.5 liter bottles weigh about 1.5 ounces each. I use our 3/4 ounce water bottle carriers to secure the bottles to my pack.

    There is nothing unusual about the rest of my clothing or gear, except I substitute an expedition weight Thermax top for a fleece jacket, a trick I learned on the PCT. This saves about 6 ounces of weight and saves some room in my pack.

    My usual clothing list for 3-season hiking is shown below. This is the clothing I had with me when I finished the PCT at the Canadian border on Sept. 17, 2001. When it gets too cold for staying out using these items, I'm usually in the process of checking on transportation to go home (I hope to have individual weights for clothing items posted soon):

    1 coated nylon parka
    1 coated nylon rain pants
    1 Lycra "biker" shorts
    1 nylon shorts (worn with parka in town when washing other clothes)
    1 expedition weight Thermax top
    1 mid-weight Thermax bottom
    2 pair Thermax glove liners
    1 pair Wind-Stopper fleece mittens
    1 pair Trail Runner shoes (worn while hiking)
    1 pair camp / town sandals
    1 long sleeve Cool-Max T-shirt
    1 short sleeve Cool-Max T-shirt
    1 lightweight Thermax balaclava
    1 polar fleece "watch" cap
    1 pair Smart Wool socks
    2 pair Wal-Mart men's dress socks (similar to liner socks)
    1 mesh baseball cap

    My pack weight (without food and water) is usually in the 14 - 16 pound range, depending on the length of the trip and weather I expect to encounter. I'm not as interested in posting minimal and questionable gear lists as I am in having a functional system that will sustain me over long periods of time in many diverse situations, terrains and weather events.

    My Diet & Exercise Programs:


    When I'm at home, I generally utilize a diet low in fat and high in fiber and carbohydrates. I eat lots of steamed vegetables, seasoning them with liquid Butter Buds and a bit of salt. I also eat a lot of fruit, and I like bagels, rice, potatoes, pasta, yogurt and legumes. I generally avoid fried foods. I feel that a high protein, high fat diet does not promote good health and I generally try to avoid a high intake of both. I am convinced that diet can have a profound effect on our overall health. My diet when at home (as opposed to when I'm hiking) is geared toward balanced nutrition, minimal calorie and fat intake and avoiding foods that I feel are not conducive to good health.

    Both my father and grandfather died of colon cancer, and I generally avoid red meat and pork. However, I'm not a total vegetarian. After a difficult day of trail work, I will occasionally stop at a fast food restaurant and have a chicken or fish sandwich with fries and a milkshake. However, unless I'm on a hike, that is about the limit of my junk food intake.

    Concerning fast food, there is one company that actually appears to be concerned about nutrition and fat intake, and that is Subway. Their sandwiches are good and very low in calories and saturated fat.

    However, when I'm on a long hike, my calorie and nutrional aspirations are altered dramatically. Bring on the protein, calories and fat! Men seem to lose more weight than women on long hikes, and I usually lose about a pound a week. One of the things I look forward to on these hikes is being able to eat just about anything I want. My metabolism seems to change drastically when I'm hiking. "Raw" food may work for some on the long hikes, but I need all the fat and calories I can cram into my pack. With a low fat, low calorie diet, I wouldn't be hiking long. This is probably because I have a low body fat content to begin with, and don't have a lot of fat reserves to rely on.

    I know of hikers who "bulk up" before going on a long hike. However, I don't believe that this is a good course of action for me. I feel that it is muscles and a good cardiovascular system that gets me up and over the hills. I don't think that having excess weight (stored fat) at the beginning of a hike will do anything except slow me down and put additional strain on my joints, but to each their own.


    One of the great thinkers (maybe Plato, Aristotle or Socrates) once said, "A man is born with two doctors; his left leg and his right". I am convinced that remaining active (as in walking on a regular basis) bolsters the immune system in a way that medical science is yet to explain. I've read that this boost in the immune system may occur simply because of the increased oxygen that gets forced through the lungs. I believe that those who have been into alternative medicine have been quicker to realize this than others.

    It was only about 20 years ago that some medical doctors were saying that there was no evidence that exercise was actually good for us. They were also saying that diet had nothing to do with cancer. Both of these ideas seem ridiculous now. It reminds me of a line in an old Woody Allen movie: "Red meat, college, milk; the sun. They (i.e., "the establishment") said they were all good for us! They lied!"

    I walk several miles in the mountains almost every day. In addition, when I'm training for a long hike, I increase the daily mileage and wear my loaded pack. I feel that these daily walks help control my weight, benefit my muscle / fat ratio and cardiovasular system and bolster my immune system. Of course, we may never know the full benefits of taking a "time out" everyday and enjoying the beauty, quiet and solitude of the natural world for an hour or so. I had a lot of healing to do after I left my 17-year career in corporate management in 1988. The daily walks (and my long hikes) have played an important role.

    In addition, I usually either backpack or do trail work a couple of days per month. Again, the emotional and mental benefits of these activities are probably as beneficial as the physical aspects, which seem substantial. I believe that backpacking and trail work benefit muscles that plain walking won't.

    I also do a light workout with weights twice per week. Because of my lower back problems, I am limited in this regard, however, I don't wish to give it up. I wear my back brace, do lots of warming up and limit my workout to about a half hour using two 15-pound hand weights. These light workouts make a noticeable difference concerning muscle tone and upper body strength. I can tell how much good they do when I have to stop doing them during my long hikes. My muscle tone and upper body strength start to suffer almost immediately.

    In addition, research I have done indicates that muscles that are near an injured body part may get stronger in order to compensate and to "help out" the injured part. Therefore, I feel it is important to keep my back muscles as strong as possible. The trick is to strengthen the muscles without doing additional harm to the injured area. Hence, the light workouts with weights.

    I also do a lot of range of motion exercises. These are very gentle exercises where I just move previously injured body parts around in their usual range of motion. It feels good and I believe it benefits my joints, keeping them limber and helping to avoid inflammation.

    I also do daily stretching exercises for my back. I do not wish to mention specific exercises that I do. Everyone's body is different, and for every back exercise I've tried and found beneficial, there have been 2 or 3 that made matters worse. If I was just starting out with back exercises, I would do a lot of research, and talk with medical professionals who specialize in sports injuries and physical therapy. If an exercise hurts, I stop doing it immediately. I also listen to my body very closely. It will usually let me know whether or not it "likes" a particular exercise.

    When I finish my back stretching exercises, I do some self-massage of my back and neck with analgesic gel (available at drug stores and Wal-Mart). Finding the spots that hurt and massaging them with my fingertips really feels good. I also take some gel on my hikes and use it on my back, neck and feet. It feels great after a long day of hiking.

    My Hiking Philosophy:

    A medical doctor told me I’d never be able to hike the Appalachian Trail and recommended that I not even try. A chiropractor told me in 1991 that I had only about 5 years left to hike. However, a medical doctor saved my Appalachian Trail thru-hike in 1992 by giving me a crash course in tendonitis. I completed the Appalachian Trail in 1992, the John Muir Trail in 1999, the Pacific Crest Trail in 2001, the Long Trail in 2002, the Colorado Trail in 2003, and I’m still backpacking. I've also started a section-hike of the Continental Divide Trail, and I hope to complete it in a few years.

    The fact that I am still hiking is due to 3 things. First, the same doctor who told me that no one with my problems had ever hiked 2,000 miles did convince me to stop doing what was hurting me (jogging and playing tennis and racquetball), and this allowed healing to begin. Second, I took charge of my own conditions and learned all I could about them. Third, I took advantage of this knowledge to improve my hiking mechanics.

    Anyone who has ever watched a baseball game has seen pitchers warm up. Baseball players know better than to pick up a baseball and immediately begin throwing it 80 - 90 mph. When a hiker climbs out of his or her sleeping bag, quickly eats a Pop-Tart while packing up, immediately charges up the next mountain with his or her fully loaded pack, he or she is like a baseball player who starts throwing 80 mph without warming up.

    I take my time in the mornings. I walk around for a few minutes without my pack enjoying the scenery. I do some shoulder rolls and range of motion exercises. When my body tells me it is ready, I leisurely and slowly begin hiking. It takes about a half hour of hiking before I reach "top speed" (a blazing 1.5 - 2.5 mph).

    I've noticed that there seems to be more competitiveness now among hikers concerning speed and miles hiked per day. At times, it seems that many of the hikers are competing to see who can hike the fastest and farthest with the lightest gear.

    I suppose I am of the "old school". I still think of a hike as an opportunity to just enjoy the outdoors, of reaping the benefits of spending long periods of time in the natural world. To me, being "out there" is a quiet, serene time of spiritual fulfillment and enjoyment of the beauty and complexity of nature. I don't let the destination become more important than the journey, and I don't have anything to gain or prove by trying to win some silly and meaningless race.

    I know that I can't "compete" with other hikers concerning hiking speed, and I don't try. When I thru-hiked the Appalachian Trail in 1992 at age 45, about 90% of the hikers were younger and stronger than I was. However, about 85% of them didn't make it to Katahdin. I did.

    How I Care For My Knees:

    Hiking downhill used to really bother my knees. However, with improved mechanics, I usually descend painlessly now, but a lot slower. Especially when going downhill, I am mindful of my “heel strike”. The heel strike is the motion of the foot contacting the ground with each step taken. The lighter or softer the heel strike, the less jarring, torque or force (whatever you want to call it) gets transferred up to the knee. When going downhill, I walk like I’m on hot coals or thin ice, putting my foot down very gently. I avoid like the plague what I call “galloping downhill momentum”. There is a natural tendency to speed up on downhills to compensate for the time it took to go uphill and just because it’s easy and feels good.

    A person who weighs 150 pounds puts 150 pounds of energy on his or her knee with each step when walking. However, when running, the force that hits each knee is approximately doubled. So the same person who weighs 150 pounds is putting more than 300 pounds of force on the knee with each step taken. When taking thousands of steps per day while hiking (and carrying a fully loaded pack), I feel that avoiding a hard heel strike can make a substantial difference concerning wear and tear on the knees.

    When putting my foot down when going downhill, I use a gentle “heel-to-toe” motion. I feel this spreads out the jolt that the knee receives from the heel strike, as opposed to putting the foot down flat, and having all of the jolt hit the knee at the same time.

    I don’t lift my foot off the ground any farther than necessary. The higher my foot is lifted off the ground, the more the knee bends. Basically, the more my knees bend, the more they are going to hurt.

    I use 2 hiking poles, and I really use them when going downhill. If I’m not concerned that the poles may break because of all the force I’m putting on them when I’m going downhill, then I figure I’m not using them properly. Hiking poles are like having extra knees.

    On long, steep, downhill sections, I lengthen the poles, get them out in front of me and lean on them. I put my hands over the tops of them and use them like forearm crutches. I take small steps, and try to make sure that my feet are not extended past the point where the pole tips impact the trail. When my steps extend past the poles, I can feel the dynamics change; weight comes off the hiking poles and goes onto my knees.

    I read somewhere (and I’m not sure of the numbers), that one hiking pole will decrease the weight load on the knees by about 13%, and 2 poles will decrease it by over 20%. I wear out hiking poles on a regular basis, but my knees are enjoying the benefits.

    When going uphill or downhill, I take very small steps. The further my feet are out in front of me, the more my knee is going to bend with the motion of walking. Also, I don't know the physics or dynamics involved, but I also feel that the further my foot is extended from my body, the more weight is going to get transferred to the knee. I believe that the closer to my body that my foot remains, the more the weight is going to stay on the upper leg muscles where it belongs.

    Hiking poles can be used as brakes on downhill sections of trail, and they can be used for traction on uphill sections. If I really put pressure on the poles when going uphill, I can feel the difference in my knees. It seems that the smaller my steps are, the better this works.

    When hiking, there may be something worse for my knees than taking long steps on a steep ascent (and thereby placing a lot of weight on the joint as the body and pack are being "lifted" uphill with each step), but offhand, I can't think of anything. I once heard that the knee is a joint, not a muscle. I think I understand now what that means.

    I believe it is important to avoid (to the greatest extent possible) placing weight on the knee when it is bent. Think of a metal tent stake that is slightly bent in the middle. Now think of that tent stake as your leg, and the place where it is bent as your knee. If you keep applying weight to the top of the tent stake in increments, eventually the tent stake will reach a point of collapse. You don't have to be an architect to figure out where the structural failure is going to occur.

    I think it is the same with knees. Whatever the weight would be that finally caused the structural failure of the bent tent stake, the stake wouldn't have collapsed if the stake had been straight. I think this illustration points out a fact that we all know; that something straight will bear more weight than something that isn't. However, we normally don't think of this in relation to our knees. I believe this also applies to the spine, and why it is so important to keep the back straight when lifting.

    As much as I'd like to hike uphill and downhill with my knees locked (keeping my legs straight), this does not seem to be my natural body motion. So, I bend my knees ever so slightly.

    When I have to ascend or descend very steep areas (rock scramble on a cliff face, for example) where it is necessary to either pull myself up or lower myself using my arms, I get very protective of my knees. I feel that a worst case scenario in this situation involves having to place a foot a couple of feet above where I am standing, then using that foothold to pull the body (and pack) upward. The stress and weight load on the badly bent knee is awesome, and regardless of how young, fit and strong a person is, that motion can cause an injury.

    Rather than risk injury in a situation like that, I'll find a Plan B, even if I have to stop for a while to figure it out. An alternative plan could involve ascending or descending slightly off trail and finding some hand-holds to use, or taking a completely different route.

    In my opinion, descending a rock face is less dangerous for the knees than ascending. However, when descending, I try to lower myself in such a way that most of the weight stays on my arms and shoulders, and not my knees.

    I usually ascend and descend steps by turning sideways and then stepping up or down. For my particular knee problems, this seems to be beneficial.

    I try to control by body weight. The way I figure it, the less weight I have coming down on my knees, the longer I'm going to be able to hike. I'm convinced that excess body weight is very bad for the joints, in addition to causing a host of other health problems.

    I also use a high quality set of footbeds in whatever footwear I'm hiking in. Spenco's are my favorite. They are expensive but worth it for long distance hikers, or anyone with a history of joint problems. Mainly, I use the footbeds to benefit my feet, but I believe they also help my ankles and knees by acting as cushions and shock absorbers.

    I used knee braces for many years while I was hiking. However, it gives me great pleasure to say that my knees have now healed to the point that generally, I don't need them anymore. When I was using them on hikes, I preferred the Neoprene models (brand name "Ace") that had the open area for the kneecap. They cost $10 - $12 and can be found at larger drugstores and also at Wal-Mart (near the pharmacy, not in sporting goods). The braces were too hot for me to wear for long periods while actually hiking. However, they did provide some warmth and support for my knees in camp (and my experience is that injured knees that are warm and snug are happier than injured knees that aren't). I'd put the braces on after I got cleaned up in camp in the evenings, then wear them as much as I could stand them until I started hiking again the next morning.

    Another thing I do for my knees is using a kneeling pad in camp. Rather than bend my knees each time I load or unload an item from my pack, I kneel on a pad and remove everything from my pack at once. When I reload my pack the next morning, I place everything on the ground within reach. I then use the kneeling pad again while I’m loading my pack. This also makes my back feel better.

    I am reluctant to mention specific exercises that I do, because for every one I've tried that did some good for an injured body part, there were several others that either didn't do any good, or seemed to make matters worse. However, this one was prescribed to me by an orthopedic doctor when I had pain and inflammation in my knee ligaments. It really seemed to help:

    When lying flat on my back on the floor, I tie a weight of several pounds to my ankle. This weight can be most anything; a quart-size plastic orange-juice container filled with water (the kind with a handle) will work. I then bend my foot back toward my torso, and keeping my leg straight, slowly lift my leg almost to a vertical position. I then lower my leg back to the floor and repeat the procedure. I started with a weight of only a few pounds and did only a few repetitions at first, then worked up from there. (I always warm up my knees with non-weight bearing exercises before doing any weight bearing exercises.)

    How I Care For My Back & Neck:

    A famous (I don't recall who) military leader once said, "The logical end to defensive warfare is surrender". There was a time when I sat at a desk for 50 - 60 hours per week, was overweight, got very little exercise, couldn't have cared less about posture and didn't know anything about my back except it hurt. When I'd suffer periodic "back attacks", I'd painfully limp into a doctor's office, dutifully pay my $150 - $200 for office visits, x-rays, pain pills, muscle relaxers and anti-inflammatory drugs, then go home and go to bed as directed.

    This was definitely "defensive warfare". I was reacting to my back, and I was losing. When I finally got tired of it, I did something about it. I learned all I could about my back (and other body parts, like knees) and went on the offensive. I didn't wait for the next back attack. As a result of this proactive approach, my back started reacting to me instead of me reacting to it (it got better and the back attacks stopped). Eventually, I'll lose the "war", but surrender won't come easily.

    I’ve done a lot of research about how folks stay active even though they have back problems. It seems that some of the people who remain the most active are the ones who avoid back surgery and take charge of their own condition. However, I’ve talked with several people who have had back surgery, and I’m convinced that surgery has helped some people (including my own sister).

    However, I’m also convinced that some people have been “sold” an operation that they could have done without. Some of them woke up to find that they were worse off than they were before the surgery. I think it is important to know that there are some options here. Personally, I won't have back surgery as long as I can remain active. Until that day, I intend to walk several miles per day, keep my weight down, make sure my posture is good and do the back exercises I’ve learned that help my back.

    It took me a long time to come to the conclusion that good posture is very important to keeping my back happy. Sometimes when I see a phone cord all knotted up, I think of the nerves that run alongside my spine. It doesn’t take much to straighten a knotted phone cord; just a little pulling motion at the top and bottom, and the knots will begin to go away. I try to apply the same principal to my back. The pulling motion from the bottom is what I call a pelvic tuck. It is the same motion I'd use to try to place my lower back flat against a wall (though not done with as much force). The pulling motion from the top is merely standing or sitting up straight with the idea of extending the spine upward (and the shoulders outward) a few inches.

    I also try to keep the weight of my head evenly balanced. The head is heavy and sits at the top of the spine. If it is not balanced, it can cause my spine to hurt. I’ve read all sorts of stuff about how to accomplish this (keeping the weight of the head balanced). Basically, I think it comes down to one thing; when I am sitting or standing, I try to keep the underside of my chin parallel to the floor. If the head is tilting forward or back, pain in the back or neck may be the result.

    I feel that these 4 motions (pelvic tuck, the motion of trying to extend the spine upward and the shoulders outward and keeping the weight of my head balanced) are very important to the overall health of my back.

    When I lift my pack on and off, I make sure I keep my back straight. I don't lift it in the mornings until I've warmed up my back muscles.

    I wear a back brace on long hikes; the kind that has suspender-like straps and a velcro closure in the front. I tighten the velcro strap whenever I lift my pack on and off, and in camp in the evenings. All other times, I wear the brace with the velcro strap loosened; I feel that it is not good for the back muscles to take too much time off.

    I feel it is very important to have the weight of the pack properly balanced. If the weight of the pack is pulling a person back, normally he or she will compensate by leaning forward at the waist or by bending the back forward. I see this a lot with internal frame packs when a lot of the weight is concentrated in the bottom of the pack. If the pack is pushing the person forward he or she will probably be trying to stand more erect, and will be working against the unbalanced weight. Either way, severe back pain (and injury) can be the result. To make this clearer, here's an illustration:

    Place an object that weighs at least a couple of pounds in your hand. Put your hand out in front of you, bend your arm at the elbow, and position your hand so that the object you are holding is toward the ceiling. If the object in your hand is properly balanced, its weight will be going directly down your arm. It is the easiest way to hold it. It is "balanced". By slightly bending your forearm left or right, you will unbalance the object in your hand, and it won't be as easy to hold. It is the same way with the pack. If the pack weight is balanced, the weight of it will be coming straight down the center of the body. If it is not balanced, the center of gravity will be off, and there will be a tendency on the part of the hiker to lean forward or backward to compensate.

    A somewhat simpler illustration is to just imagine carrying a heavy bag of salt or sugar. If the the bag is out in front, it won't be balanced and it will tend to pull you forward. If you try to carry it behind you, it will also be unbalanced and try to pull you backward. If the weight is centered, the bag will be balanced and much easier to carry. Women seem to have a slightly lower center of gravity than men. For men, the "balance point" will usually be in the vicinity of the top of the shoulders. For women, it will be a bit lower.

    One simple little sentence I read about backs has probably made all the difference in the world. Understanding this little sentence and putting the theory into practice is probably one reason I’m still active and have avoided going under the knife. The sentence is:

    “The back is not a hinge.”

    With my back problems, I feel it is imperative that I bend my back as little as possible, especially when lifting. Instead of bending my back, I keep my back straight and bend my knees instead. Put your hand out in front of you and extend your index finger so that it is pointing up at the ceiling. Pretend the finger is your spine. Bending the finger at the middle is like bending the back (imagine what that does to the vertebras, discs and nerves). Keeping the finger straight and flexing it forward at the knuckle is like keeping the back straight and bending at the knees.

    I walk a couple of miles almost every day. Basically, I think of walking as “use it or lose it” concerning my back. All I have to do is miss a day or two, and I can feel the difference. My back starts to tighten up and hurt, and sciatic nerve pain begins to shoot down my leg.

    I also do back exercises every day. I am very reluctant to mention specific exercises. For every exercise that I have tried and found helpful, there have been several that have made matters worse. I believe that it is important for each person to find the ones that work for them. If a person listens to his or her body, it won’t be that difficult. I don't feel that any exercise should hurt. If an exercise hurts, I stop doing it immediately.

    When I have to lift something, I turn and face it directly (never lifting from the side, or with my body twisted) and bend my knees. Keeping my back straight, I lift with my arms while standing up. I avoid the motion of bending and lifting at the same time at all costs; even to the point of stopping what I am doing until I can figure out "the moves" that my back will tolerate.

    I've learned to get in and out of a car using two motions, not one. To avoid twisting my spine, to get into a car I turn so that I am standing at a 90 degree angle to the car seat (I'm then facing away from the car, with my back towards the car). I then sit down. Keeping my back straight, I lift both my legs at the same time and turn 90 degrees so that I'm in the normal sitting position inside the car. When getting out of a car, I reverse the procedure.

    I keep my weight down. I'm convinced that excess weight puts a terrible strain on our joints (in addition to causing other problems). I am reminded of this occasionally when I carry something heavy (like bags of groceries) up my front steps. I can definitely feel the additional strain in my back and knees from just 20 or 30 pounds of extra weight.

    A friend who is overweight told me that he was considering giving up backpacking because of his physical condition. He said he couldn't carry a pack anymore. I asked him how far he could walk without his pack if he was hiking on fairly level ground. He said a mile or two. I know him well enough that I could suggest that he lose 25 - 30 pounds. I also suggested that he get some lightweight gear. My point was that if he could hike a mile or so in his present condition without a pack, that he could do the same mileage after losing the weight off his body and replacing it with lightweight gear. And there are many beautiful destinations only a mile or so from a trailhead. Also, if an impaired person can walk a mile or so and actually go backpacking, I believe the feeling of accomplishment and elevated self esteem may spur the person on to even greater accomplishments.

    How I Care For / Prevent Shin Splints:

    I had a severe case of shin splints many years ago. Therefore, I think that I am more prone to get this painful condition than other folks. Shin splints occur when tiny tears occur in the tissue that goes laterally across the shin bone. I think of it like this:

    Imagine some thin material (like nylon) stretched laterally across a harder and more durable object (like a tent pole or hiking pole). Now imagine the tent pole or hiking pole constantly trying to go forward, and the nylon getting stretched in the process. Something eventually has to give. What is going to give (tear) is the nylon.

    Now imagine that your shin bone is the hard, durable object and the thin material stretched across it is body tissue. When you hike downhill, the tissue gets stretched. If enough force is put on it, the tissue tears.

    When the tissue tears, shin splints are the result. The way I try to avoid shin splints is through training to build up the muscle tissue in the lower leg, and by hiking slowly (especially when going downhill) and doing moderate mileage at the beginning of my hikes.

    However, if I get shin splints, I know of only one way to care for them, and that is stop hiking. I feel that hiking while I have shin splints can cause additional injury, and the pain will be unbearable. The pain from shin splints has literally brought tears to my eyes. When I get shin splints, I get off the trail until it heals and the pain is gone, it is as simple as that.

    How I Care For / Prevent Achilles Tendonitis:

    I had my first bout of Achilles tendonitis in 1992 when I hiked the Appalachian Trail. It redefined my concept of pain. It struck the 3rd day after I left Springer Mtn., put me off the trail twice, and I was still bothered by it (this is putting it mildly) when I reached Mt. Katahdin after 7 1/2 months of hiking. Believe me, it is nothing to take lightly or fool around with.

    The fact that I was able to complete my hike was due largely to the efforts of an orthopedic doctor who took an interest in my hike and gave me a crash course in tendonitis.

    The Achilles tendon is the large tendon located at the back of the ankle. Flex your ankle so that the front of your foot and toes are pointed toward the ceiling and you'll be able to feel it.

    When we hike uphill, the back part of the foot is lower than the front part of the foot (heel is lower than the toes). Just like the motion indicated above of pointing the toes towards the ceiling to feel the Achilles tendon, this uphill hiking motion causes the tendon to be stretched tight. Occasionally, the tendon will get more of this abuse than it can handle. At that point, it may become painful and inflamed.

    When I began to get severe pain in my Achilles tendons, I got off the trail and went to a doctor. This was a fairly easy decision to make, because I couldn't walk. My hike had temporarily lost its meaning and purpose, anyway. If I ever have pain like that again, I'll do the same thing. However, I will make sure I go to an orthopedic doctor who has experience treating sports related injuries, even if I have to get on a bus or train and travel several hundred miles from the trail to do it.

    One of the first things the doctor did in 1992 was look at my hiking boots. He pulled out one of my arch supports and looked at it closely. He then explained how it appeared to over-compensate for the arch. When it forced the middle of my foot up, it was also forcing the heel down, which was helping to stretch the Achilles tendon. He performed a quick and painless arch support-ectomy on both hiking boots. I was on the road to recovery with a lesson learned the hard way. The doctor suggested that I not use any arch supports for a while, then switch to a set that didn't provide so much lift for the arch.

    He also examined my Achilles tendons and said that other than the pain of inflammation, they were fine (no other injuries or structural damage). I believe it is very important that a medical professional make this determination. A ruptured Achilles tendon is a very serious injury.

    He then explained about how important it is to warm up tendons with slow, gradual use, using the analogy about baseball pitchers warming up extensively before trying to throw a 90 mph fastball. He suggested that I remember that analogy after I returned to the trail, and that I walk around slowly without my pack for several minutes each morning. He also suggested that I start hiking each morning slowly, and gradually increase my hiking speed as my body gets warmed up.

    He also made other suggestions. He said to get rid of my hiking boots, because my tendons would not tolerate the leather rubbing against them with every step. He suggested that I switch to jogging shoes for a couple of months on my hike. I had an old pair of jogging shoes, and had them resoled with Vibram soles. Although I didn't realize it at the time, I'd just created one of the first pair of Trail Runners. I used those shoes for about 600 miles of hiking, then switched to fabric-style hiking boots. I haven't hiked in leather boots since 1992, and never will again. I now use lightweight Trail Runners for 3-season backpacking.

    The doctor also explained how I could use oil (any kind of oil, even vegetable oil) to massage my Achilles tendons in the evenings and mornings. He suggested that I ice the tendons, but explained how important it was not to use ice on them until I was finished hiking for the day. He used another sports analogy, asking me to think about all the times I'd seen athletes put ice on an injured limb, but only after they were finished for the day. When's the last time you saw Michael Jordan ice his knee, then return to a game?

    He suggested that I not do any stretching exercises for my tendons, stating that stretching them is what got them in their present condition to begin with. He suggested that I just walk around slowly in the mornings, and listen to my body. He said that it would tell me when it was ready to hike. He was right.

    In the end, the doctor told me to take a few weeks off and instructed me how to care for my tendons. He told me that I could then go back to the trail, and that if I could stand the pain, I could hike. I could, and I did.

    I still warm up slowly in the mornings. I get twinges in my Achilles tendons now when I'm hiking, but using the above techniques, thankfully it has not reached the point where it has put me off the trail again.

    It would have been very easy for this doctor to merely tell me I had tendonitis, prescribe some medications and tell me to go home and rest. This would have been treating the symptom. However, in addition to treating the symptom, he also treated the cause. The willingness to treat the cause of a problem (in addition to the symptom) is one standard that I now apply to health care professionals. Personally, I feel that someone who treats only symptoms is in the sickness business, and someone who treats the cause and the symptom is in the health business.

    David "Rainmaker" Mauldin