Hiking with chronic pain or other disability

[Spring.Bear]

Would love to see conversation around this topic.
Specifically I had Lyme disease pretty bad as a teen and continue to have sporadic pain, sometimes very bad. I have weak joints which makes this challenging. On the other hand my husband has asthma and realized recently carrying the heavy pack is compressing his breathing muscles since he usually has to use a lot of extra muscles to get enough oxygen.

I’m really happy that using trekking poles makes my lower back pain almost non existent (which is huge because it will be excruciating after standing long enough to cook a meal in the kitchen).
Wondering if others regularly hike with braces or other supports
Also what others experiences of accommodating their disabilities while still hiking/thru-hiking in a fulfilling way.

[Traveler]

Having some nasty knee problems over the years, I understand at the molecular level. I too found trekking poles incredibly helpful to ease the tremendous punishment they get hiking in mountains, especially long, steep downhills. I found a good physical therapist who helped a lot when I finally was unable to move around easily, who actually got me nearly pain-free. The exercises, when done right and on a daily schedule has worked very well. I would presume you have probably seen one or two along the way, but if not, this could be a worthwhile avenue. If you have seen a few you didn't "click" with, keep looking, there are some really talented professionals out there.

[RockDoc]

When I did Maine in 2007 there was a sickly older man, trail name "Attilla the Hun". Probably in his 70's or 80's, he was finishing Maine by slackpacking with only a day pack or a small overnight pack, from road to road where he would shuttle his car around. He was really weak, bent over in pain, and walked very slow. We spent the night with him in the old Sugarloaf Ski Chalet. But really, if this guy could finish Maine, a lot of people with health problems can do it too. There are ways to do it without having to backpack and camp much.

[Alligator]

As I have continued to age and experience all of the "joys" that come with getting older, I have recently learned **yet again** that not all of the "joys" are necessarily related to getting older. More than a decade ago I'd say, when my knees were experiencing pain, I chalked it up to getting older. When I finally discussed it with my doctor, the problem turned out to be iliotibial band syndrome (ITB). Traveler's advice about seeing a PT is sound, including finding one that helps you as there are some philosophical differences at times with PTs about the efficacy of certain methods.

I have had back issues in the past, including surgery. Working on your core muscles and stretching/yoga can be helpful there. I use trekking poles but that is to help my knee some, along with a brace. What helps the most for my knee are specific stretching excercises including a foam roller. For your husband, an ultralight or simply a lighter weight backpacking approach sounds like it would help. Even proper packing and pack adjustment could be beneficial, depending on his current skill level. Not everyone understands load lifters, chest strap positioning, or even proper pack fitting and situating a load with a hip belt. Overtightening the sternum strap but leaving the load lifters slack my cause him to pull forward and down in the chest area. Plus backpackers have a tendency to look down at their feet. Proper sized pack situated well on the hips, load lifters snugging the load on the shoulders but not tight, sternum strap just about loose, with head up, that will open up the lungs. A lighter pack in conjunction with a smoother overall ride ought to reduce energy expenditure. That's kind of general advice though, I don't know a particular lot about asthma challenges for backpackers. There's a specific type of backpack that has front and back compartments to distribute the load more evenly but I don't know how beneficial those are for either back issues or asthma. I will throw in one last unusual option for him, a well made wildland firefighter backpack. These are designed to get the weight off the shoulders for working with hand tools, the went though is transferred lower. The best made ones are designed with backpacking elements incorporated. They don't always have a lot of internal volume however and start out on the heavier side.

[Time Zone]

No experience with Lyme, but have long had bad knees (since HS in the 1980s!) and likely suffered a herniated disc in lower back (didn't get an MRI; doc said treatment would be same regardless). Possibly important: my back injury was not from any load bearing activity - save for my own upper body's weight. It was out of the blue, just a bending down motion, that led to it. Nothing in my hands or on my back/shoulders.

For the knees, I'll echo earlier comments - trekking poles have been indispensible for me. Not sure I could hike downhill for long without them.

For the back, well, I am not a big fan of PT generally. My doc said it would be OK if I just rested it as long as I needed/wanted, and then did stuff within my pain tolerance. I did that, and it worked for me.

I would also suggest for general aches and pains - try something different - a different posture/stance, a different backpack frame and distribution of weight (hips vs. shoulders, as well as vertical placement of the belt, the position/tension on the load lifters, and other adjustments). Just mix it up - don't get stuck in a rut, putting wear and tear on your body in the exact same way all the time.

[Coffee]

I recently read Peter Attia's new book "Outlive" and found it very relevant to my goals for the next 20-25 years (I am turning 50 later this year). In order to have a shot at continuing to hike at the pace I prefer, relatively fast, I need to keep doing my cardio work but also take strength training and stability training more seriously. I also need to work on sleep quality. The reality is that muscle mass declines precipitously after 50 - that's the default. To get better results than the default requires doing things totally differently from 99% of society. I'm in a situation right now where I cannot do the hiking that I am currently physically capable of doing. If I want to be able to do this type of hiking in 10-15 years, I need to work at staying in shape every day. I definitely recommend this book for anyone interested in longevity and (more importantly IMO), having a longer health span. I don't mind the idea of not living much past 75 or 80 but I want to be doing what I want to do until very close to that age, and then decline very quickly (hopefully instantly) at the end.

[Siestita]

At age five I had a mild case of polio. Following six months of physical therapy I was pronounced 'cured' because I no long limped. Since then I've never been able to run, swim, or hike as rapidly as other people my own age. Also, I have a relatively low ceiling beyond which increased physical training becomes counter productive rather than helpful. So, at age 73 I now perceive myself to be a "short distance backpacker", a "back country camper" rather than a "long distance hiker" or speedster.

It's fortunate that I love camping out in the woods by myself. These days, compared to me, most other backpackers walk much faster and go considerably further each day. I'm going out into Kentucky's Daniel Boone Forest later this week, walking only about 1 mile per hour while probably not covering more than 10 trail miles over the course of 4 days . I'll do some reading in camp and also a little fishing in Bark Camp Creek. With luck, hopefully I'll still be alive and able to engage in similar nonsense for another 5 or 6 years. In the meantime, dreaming about both future backpacking trips and also trekking that I anticipate doing soon in Mexico and Costa Rica motivates me at home to regularly walk, swim, and do exercises that stretch and strengthen my back and abdominal muscles.

These days trekking poles have become invaluable to me. And, I greatly appreciate ideas that I've learned over the years here on White Blaze about means of reducing pack weight.