Originally Posted by
Time Zone
And a bad one will perform a wallet extraction procedure over a period of weeks. Sadly my experience with PTs is that they often mix in pseudoscience ... you may need to to watch out what your insurance will even cover; I know of one that drew the line at an unproven modality (Low Level Laser Therapy, LLLT) that a PT wanted to do on me that would have been out of pocket expense. Frankly there's often things they cover that are also unproven ... but they are so popular they feel pressure to offer them.
I'm surprised no one has mentioned hiking poles yet. I likely have as well and they have been a difference maker for me, more on the downhill than the uphill. Poles can be dual-use as well, depending on your shelter. And don't forget the option of rest ... and dialing back your mileage goals to be within your pain tolerance.
As for living where it's flat, I suspect there's no good substitute for hiking with a pack uphill. Have you tried a treadmill that can elevate? Or a stairmaster? Or just a set of stairs? That's the closest thing I can think of. As an analogy, I occasionally bike in my hilly subdivision, but I also have bike rollers at home for when the weather is bad for it. But IME it's not as good a workout as going up and down the actual hills. I suspect the same may be true of hiking. For your sake, hopefully not, but it may be the case.