How to Stay Healthy on the Appalachian Trail

Jessica Gehner and her father ended up about 1,400 miles into their hike together the

Jessica Gehner and her father ended up about 1,400 miles into their hike together the Appalachian Trail, two-thirds of the way to the southern terminus, when catastrophe struck. They had scrambled up uncovered rock in the White Mountains and forded swollen spring rivers in Maine with no mishaps, but on a relatively smooth portion of path around the Virginia town of Daleville, Gehner caught her toe on a root, hyperextended her knee as she fell, and finished up with a variety of significant leg break identified as a tibial plateau fracture.

She was evacuated to close by Carilion Roanoke Memorial Medical center, where by she discovered that her rehab would contain three months without having placing any pounds on the damaged leg, followed by intensive therapy. But by the subsequent spring, she was able to resume the hike where by she still left off, and continue to go over the very last 800 miles to get to the end in time to acquire her place that slide at the College of Kentucky College or university of Drugs, which she’d deferred for a 12 months to hike the path.

This mishap, she now says, was “the extremely best detail that ever took place to me in my total everyday living,” and it altered her skilled trajectory. When she completed health care college, she returned to the scene of her accident for a residency at Carilion Roanoke, and begun a career there in wilderness medicine—studying, among the other points, what it will take to via-hike the Appalachian Trail.

I satisfied Gehner very last thirty day period at the Drugs in Extremes meeting in Amsterdam, where by she gave a pair of talks on her Appalachian Trail analysis and the health care calls for of via-mountaineering a lot more normally. They ended up the variety of talks where by, to be genuine, you hope you will by no means have to use any of the information and facts offered. But if you’re an enthusiastic backpacker, the figures propose you will encounter a health care circumstance quicker or later—so with that in mind, listed here are a couple of of Gehner’s insights.

The Problem

The path passes by way of 14 states and runs just less than two,two hundred miles conclusion-to-conclusion, with the actual distance in consistent flux because of to path servicing. That implies you will be using about five million ways, Gehner says: you’re mainly begging for an overuse damage. You’ll climb (and, just as torturously, descend) the full top of Mount Everest approximately sixteen periods, for a full of in excess of 450,000 feet.

In accordance to the Appalachian Trail Conservancy, via-hikers (this, Gehner insists, is the correct spelling) go over 14.7 miles for every day on common, including the zeroes they rack up on scarce relaxation days. They have packs weighing about 25 lbs ., providing them enough meals to very last about a week amongst resupplies, and shed an common of thirty lbs . in excess of the training course of the 5 to 6 months the full hike generally needs. About ninety per cent of via-hikers head north from Ga to Maine approximately a quarter of those who established out end.

There are in excess of 250 three-sided shelters together the route, so it is possible to hike without having a tent, as long as you have a significant tolerance for vermin and smelly fellow hikers. Gehner slept in a light-weight hammock, but frequented the shelters for some social time at foods.

The Professional medical Issues

There’s not a ton of facts on long-distance hikers, but the existing analysis indicates that it is a dilemma of when, not if, you operate into trouble. One study again in the late nineteen eighties located that 82 per cent of productive via-hikers described accidents or diseases, producing them to pass up an common of about 5 mountaineering days. In a quarter of those conditions, they sought health care consideration.

The most widespread issues, according the Gehner, are the subsequent:

  • acute musculoskeletal suffering, like joint sprains and muscle strains
  • blisters
  • gastrointestinal illness
  • skin irritation and bacterial infections
  • insect bites and vector-borne diseases like Lyme sickness

There are also fewer widespread but a lot more significant issues. Fractures, as Gehner discovered, will conclusion your hike quickly. Hypothermia, lightning strikes, and getting shed can conclusion your everyday living.

The Countermeasures

I’m not a health care medical professional, so I’m not heading to get into, say, the relative benefits of azithromycin vs . doxycycline for bacterial bacterial infections and other minutiae that the wilderness health care authorities at the meeting ended up intrigued in. But I’ll share a couple of of the insights that may well be related to the relaxation of us.

  • For acute joint suffering, non-steroidal anti-inflammatories like ibuprofen are a fantastic option. But don’t forget: use them to support offer with an damage, not as a each day “vitamin” to ward off ongoing soreness. 
  • Be well prepared to improvise a splint and maybe crutches, because it is extremely, extremely tricky do the job to have someone out.
  • Gehner’s motto is “Dry feet are sturdy feet.” Alcoholic beverages wipes and foot powder can support ward off trench foot just after days of mountaineering in soaked conditions, and double-layer socks are fantastic for blister avoidance. If you get blisters in any case, deal with the dilemma with Tegaderm dressings, or probably just duct tape.
  • For gastrointestinal diseases, prevention is unquestionably much better than a cure, which implies washing your hands frequently and drinking thoroughly clean h2o. I took a specific glance at the alternatives for backcountry h2o cure a couple of months back, but Gehner’s advice for long-distance via-mountaineering is to use a chemical cure option, or at the very least have a chemical again-up. Filters and ultraviolet are good, but something with shifting sections or batteries turns into vulnerable in excess of many weeks of mountaineering.
  • On a equivalent take note, carry a paper map and a compass, neither of which will ever operate out of batteries. And much better nonetheless, know how to use them.
  • Hypothermia is a risk even in temperatures as significant as 65 to 70 degrees Fahrenheit if it is soaked and windy and you’re tired—a possibly lethal combination identified in the scientific literature as “hiker’s hypothermia.” In that circumstance, you require to get warm, but you also require to get fuel into your system. In fact, Gehner says, awesome calories (e.g. sports activities consume) are a higher precedence than warm h2o if you have to opt for one particular or the other.

Of training course, it is unattainable to foresee all the things that may well maybe go wrong on an prolonged wilderness vacation. I’d extremely suggest using some type of wilderness 1st assist training course (I took a weekend one particular offered by Outward Bound, for instance), and ideally acquiring some way of calling for help—because for significant accidents in the backcountry, all you can actually do is play for time though you hold out for rescue. But never permit any of that dissuade you from hitting the trails. As Gehner’s story illustrates, even a terrible accident at times turns out to be a fantastic break.


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