How to Stay Healthy on the Appalachian Trail

Jessica Gehner and her father were being about 1,400 miles into their hike along the Appalachian Path, two-thirds of the way to the southern terminus, when catastrophe struck. They experienced scrambled up exposed rock in the White Mountains and forded swollen spring rivers in Maine with no mishaps, but on a rather easy segment of path around the Virginia town of Daleville, Gehner caught her toe on a root, hyperextended her knee as she fell, and ended up with a style of really serious leg split known as a tibial plateau fracture.

She was evacuated to nearby Carilion Roanoke Memorial Hospital, where she uncovered that her rehab would contain 3 months with no putting any bodyweight on the broken leg, followed by intensive treatment. But by the adhering to spring, she was equipped to resume the hike where she remaining off, and nevertheless address the previous 800 miles to arrive at the finish in time to acquire her spot that fall at the University of Kentucky School of Drugs, which she’d deferred for a yr to hike the path.

This mishap, she now claims, was “the really best matter that ever occurred to me in my whole daily life,” and it altered her specialist trajectory. When she finished medical faculty, she returned to the scene of her accident for a residency at Carilion Roanoke, and commenced a job there in wilderness medicine—studying, amid other matters, what it usually takes to via-hike the Appalachian Path.

I met Gehner previous thirty day period at the Drugs in Extremes conference in Amsterdam, where she gave a pair of talks on her Appalachian Path analysis and the medical needs of via-hiking much more generally. They were being the style of talks where, to be sincere, you hope you will by no means have to use any of the data introduced. But if you’re an enthusiastic backpacker, the figures suggest you will deal with a medical scenario faster or later—so with that in intellect, in this article are a number of of Gehner’s insights.

The Problem

The path passes by way of fourteen states and operates just below two,200 miles conclude-to-conclude, with the precise length in regular flux due to path upkeep. That means you will be having about 5 million methods, Gehner claims: you’re generally begging for an overuse damage. You are going to climb (and, just as torturously, descend) the comprehensive peak of Mount Everest about sixteen times, for a whole of over 450,000 toes.

According to the Appalachian Path Conservancy, via-hikers (this, Gehner insists, is the right spelling) address fourteen.7 miles per day on common, which include the zeroes they rack up on unusual relaxation days. They have packs weighing about 25 pounds, offering them more than enough food items to previous about a week in between resupplies, and shed an common of thirty pounds over the class of the 5 to six months the comprehensive hike generally requires. About 90 p.c of via-hikers head north from Ga to Maine about a quarter of individuals who set out finish.

There are over 250 3-sided shelters along the route, so it’s feasible to hike with no a tent, as long as you have a significant tolerance for vermin and smelly fellow hikers. Gehner slept in a lightweight hammock, but visited the shelters for some social time at meals.

The Health care Troubles

There’s not a whole lot of info on long-length hikers, but the existing analysis implies that it’s a dilemma of when, not if, you operate into difficulty. One particular study back in the late nineteen eighties identified that eighty two p.c of successful via-hikers claimed injuries or health problems, creating them to miss out on an common of about 5 hiking days. In a quarter of individuals instances, they sought medical consideration.

The most typical complications, according the Gehner, are the adhering to:

• acute musculoskeletal agony, like joint sprains and muscle mass strains
• blisters
• gastrointestinal disease
• pores and skin irritation and bacterial infections
• insect bites and vector-borne health problems like Lyme disorder

There are also less typical but much more really serious complications. Fractures, as Gehner identified, will conclude your hike straight away. Hypothermia, lightning strikes, and getting dropped can conclude your daily life.

The Countermeasures

I’m not a medical doctor, so I’m not going to get into, say, the relative benefits of azithromycin versus doxycycline for bacterial bacterial infections and other minutiae that the wilderness medical professionals at the conference were being interested in. But I’ll share a number of of the insights that could possibly be relevant to the relaxation of us.

• For acute joint agony, non-steroidal anti-inflammatories like ibuprofen are a excellent choice. But don’t forget: use them to help deal with an damage, not as a each day “vitamin” to ward off ongoing soreness. 
• Be organized to improvise a splint and possibly crutches, for the reason that it’s really, really hard work to have another person out.
• Gehner’s motto is “Dry toes are sturdy toes.” Alcohol wipes and foot powder can help ward off trench foot after days of hiking in moist conditions, and double-layer socks are excellent for blister avoidance. If you get blisters in any case, address the problem with Tegaderm dressings, or probably just duct tape.
• For gastrointestinal health problems, avoidance is absolutely much better than a overcome, which means washing your hands routinely and consuming clean water. I took a comprehensive look at the options for backcountry water therapy a number of months ago, but Gehner’s assistance for long-length via-hiking is to use a chemical therapy choice, or at the very least have a chemical back-up. Filters and ultraviolet are terrific, but everything with transferring pieces or batteries turns into susceptible over a lot of months of hiking.
• On a equivalent be aware, carry a paper map and a compass, neither of which will ever operate out of batteries. And much better however, know how to use them.
• Hypothermia is a chance even in temperatures as significant as sixty five to 70 degrees Fahrenheit if it’s moist and windy and you’re tired—a probably deadly combination known in the scientific literature as “hiker’s hypothermia.” In that scenario, you require to get warm, but you also require to get fuel into your system. In actuality, Gehner claims, great calories (e.g. sporting activities consume) are a larger precedence than warm water if you have to choose one or the other.

Of class, it’s unachievable to anticipate anything that could possibly possibly go mistaken on an prolonged wilderness excursion. I’d hugely propose having some type of wilderness very first help class (I took a weekend one made available by Outward Bound, for case in point), and ideally acquiring some way of calling for help—because for really serious injuries in the backcountry, all you can truly do is engage in for time though you wait around for rescue. But really do not allow any of that dissuade you from hitting the trails. As Gehner’s tale illustrates, even a undesirable accident occasionally turns out to be a excellent split.

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