AKA the self-indulgent egocentric page. I’d click Back if I were you.
If you didn’t already know me, my name is Philip Bichard and I live in London in the UK. Usually a self-employed IT consultant by day I am taking a 6 month sabbatical to pursue a long-held ambition in 2014, namely to hike the complete Appalachian Trail from Georgia to Maine (known as GA-ME, geddit?).
Short version of why I want to hike the AT: because I want to. Oh, you wanted more detail? Well, I feel cooped up for too long after long-term knee problems and am chafing to get ‘out there’ again. I’ve known about the AT for several years, have visited several sections and even summited the final challenge of Mount Katahdin in 2009. I figure since I only have 99.9% left to do so I might as well polish the rest off…
Long version for masochists: after being an athletic student I worked at my career way too hard in my twenties but was able to turn it around in my mid thirties from slothful to pretty fit, mostly through hiking (in Maine) and work in the gym. All was good until I moved up to “two a days” in the gym and immediately felt pain in my knees which became red and made it hard to move properly until they had been rested for a few hours. I gave them a proper rest for several months and they subsided sullenly into the background. I didn’t know how bad they would get until they almost got me killed.
In 2009 I flew into Maine and day-hiked Mount Katahdin with a new friend (Nicole, who is now my logistic manager on the AT hike). A quarter way up I put on my (one and only, for some reason) knee brace and bummed some painkillers off a passing group. Half-way up I was unable to decide which leg deserved to favored with a limp since both were in pain. But the ascent was achievable because you can step up stiff-legged relatively easily.
Once we started to descend from the summit I knew I was in real trouble. My knees had quite literally stopped working (though unfortunately not stopped hurting correspondingly which seemed unfair) so I could barely lift my feet up the level of a street kerb and every step down was like being hit in the knee by a steel bar. So I came down the most rugged of the Katahdin trails (Cathedral) in appalling weather with 20 feet visibility, mostly on my butt and at times I nearly fainted from the pain of stepping down.
After a five hour ordeal we made it back to to car and – incredibly – I was able to at least hobble around the next day. But it showed me that the ‘conservative treatment’ path I had been told to follow was not going to cut it – this thing needed proper treatment.
I had scans but nothing broken, torn or extra-terrestrial showed up so I was told to pursue a non-surgical route with an osteopath. A year of working on my posture, alignment, quad strength, ITB (illiotibial band) and hip flexor flexibility and anything else you can think of – plus 8 cortico-steroid shots directly into the knees – and it was time to test the knees on a hike of Cader Idris in Wales in May 2011.
Suffice to say: once they were pushed the way mountain hiking has a tendency to, nothing had improved. At all. I was forced to swing on my expensive new trekking poles, using them as crutches on the descent, barely able to take a normal step even on flat ground.
I went back to the doctors and this time I insisted on exploratory surgery. After the first consultant said he would file down the side of my knee to allow the ITB to move more freely I got a second opinion. This one promised not to do that but that he would play it by ear when he got in there to have a look. Since the left leg was the worst, we’d start with that one.
When I came round it was explained to me that he had found a highly unusual amount of inflamed ‘plica’ all around my knee. This is soft tissue formed during fetal growth that usually disappears as the baby develops but in maybe 20% of people it remains, to a greater or lesser extent. Then, a bit like an appendix, in a few of those people it can suddenly decide to become enlarged, inflamed and a general nuisance. It presses on the nerve endings of your knee causing great pain and loss of function. Check out the Wiki page on Plica Syndrome if you are really bored at work. In my case it was the worst case of all the worst cases. Anyway, the surgeon removed it all – sucked it out with a vacuum cleaner, no kidding – and fingers were duly crossed that it would actually help. No promises were made.
And, because you can’t operate on both knees at the same time, I then had the other one done 5 months later, in January 2012.
My legs, especially the left one, then withered away to a literal embodiment of that phrase we usually use in jest, ‘just skin and bone’. It was very weird to see your own leg with practically no muscle in it, just ligaments connecting the hip to the knee. Walking, especially using stairs, was somewhat problematic for a while.
And thus began a long and painful process of rehabilitation, daily exercises, weekly physiotherapy sessions and weekly strength training sessions with a personal trainer. You have to work hard to break out of a vicious circle – your leg is so wasted away that all the stress you put on it (when walking, etc.) goes directly through the knee. None of it can be absorbed by the leg muscles because they aren’t there. Which keeps the knee from healing, which keeps you in pain, which stops you working at rehab. And repeat. You have to accept that there is no easy way to get strong again and just push through the pain and build up the leg muscles and it will gradually get better. It’s tempting though to put your feet up on the couch and settle for legs that will get you around domestic life but will never again be strong enough for mountain hiking.
Anyway, after the cold weather of Winter 2012 finally abated I felt there was enough progress to plan a test hike, this time in the UK’s Lake District in June 2013. Two reasonable day hikes in boots while carrying a 10 pound pack sealed the deal and gave me the confidence to plan the ultimate test – hiking the 2200 mile Appalachian Trail at the next possible opportunity, in Spring 2014.
In August 2013 my osteopath rated my left leg at being back to 70% of full health and the right one as 85%. That was about how they felt to me too. Since they were still improving I was happy enough. They might get back to 100%, they might not. If it’s of any interest to someone in a similar position, I could do multiple squat and deadlift sets of my own body weight – 70kg (154lb) before deciding on doing the AT. I still found running quite uncomfortable but I did 5km (3.1m) at good pace on the treadmill before the Lake District trip.
Hiking 2200 mountainous miles on the AT will either make or – quickly – break the knees but I want to find out for sure and this should about do it.