Hiking Health: An Early Season Set-Back

southdownshike19

Training hike with Oscar, exploring the misty woodland trails of the South Downs- a lovely 13 mile walk that ended painfully.

It has been a long and fairly inactive winter for both of us, so after getting settled in Sussex recently, and with some brighter spring days, it has been hard to contain my enthusiasm to get out and start hiking again! Partly this is driven by wanting to explore our new area and the South Downs National Park, and partly is it to begin training for our 2017 hiking season, which we hope will culminate in doing the GR5 traverse of the Alps in France. Two weeks ago I brought a new OS map and set about planning lots of hikes for my days off, I felt there was nothing to stop me walking as far and as often as possible. I have also been planning some training hikes to gradually prepare us for GR5, notably the South Downs Way and the Isle of Wight Coastal Path, I wanted us to hiker better and stronger than ever this year. One of the things I did to keep active this last winter was to take-up running (Barry preferred cycling), this not only gave me a focus for my energy, it also helped maintain some of that residual GR1 hiking fitness. All was well until about 6 weeks ago when I returned from a run with a painful knee.

I stopped my regular runs immediately, but this injury has continued to irritate and hamper me, and worst of all it is affecting my hiking too. The pain is located on the outside of my kneecap, it is more painful going downhill, and at its worst, feels as if my knee is being pulled apart. It is an intermittent problem, I’ll go for days without a twinge, and then out on a longer walk, it will flare-up a few miles in and make to too painful to enjoy or continue. More recently, the miles I can do before it starts hurting are decreasing, and on some days now, even a 3-5 mile walk can be a problem. I have spent some time in denial about this, refusing to compromise my plans or back off, how could this hit me now just as the spring is coming (?), surely it will just go away with time…but it hasn’t and is showing no signs of improving.

Some internet research led me to believe that I had got Illiorbital Band Syndrome (IT Band syndrome), a fairly common, and sometimes stubborn, injury among runners, hikers and other sportspeople. From what I understand, the IT band is a tough fibrous band that runs from the hip to down and around the outside of the knee, the pain is caused by rubbing on the knee joint and subsequent inflammation. It is often quoted as an overuse injury, but this seems to be only half the story, as the origins of the problem can lie elsewhere in the musculoskeletal structure. Imbalances in this structure, be it in the hips, pelvis, back or even the feet, affects running form and walking gait, and as everything is connected, it can get quite complicated to determine where the source of any problems lie. In normal day-to-day activities my body tends to be able to compensate for any imbalances, but, when I do high impact activities like running or prolonged repetitive exercise like long distance walking, it can exceed its ability to compensate and injury can emerge. I found out that issues such as wearing worn out training shoes (guilty as charged!) can contribute to stresses and trigger injury. In an ideal world, I would have tried to correct any imbalances in gait and form before the problem happened, but like most people, I only responded re-actively once I was in pain.

These battered Brooks Cascadias did at least 600 trail miles last year and were already very worn before I did all my running in them over the winter. Buying new shoes sooner might have helped me to avoid injury.

The information online about IT Band syndrome was a bit overwhelming and it was hard to pin down the exact causes (for me) and possible treatments.  I wanted to get back on track with hiking as quickly as possible but didn’t know where to start. This is what led me to book an appointment to see a sports physiotherapist; I needed an informed opinion on what was wrong and an effective road-map back to recovery. More than anything else I needed to make sure that I did not make anything worse. The physiotherapist would be able to asses my musculo-skeletal structure as a whole, analyse my gait, and hopefully find out where my weaknesses/imbalances were so I could work on them. He would also hopefully be able to alleviate some of the acute symptoms of the IT Band pain by massage and ultrasound.

Rather embarrassingly, the main thing to come out of my appointment was that I have weak ‘glutes’….. in more technical parlance, I need to strengthen my gluteal muscles (which are located in and around the buttocks). This was surprisingly hard to accept initially given all the hiking we have done, but it makes more sense now, and this lack of ‘glute’ strength is apparently also a fairly common problem among sportspeople.  When I hike, I (mostly) only use certain muscle sets, and if this activity is mainly all I do, I don’t activate other muscle groups (in my case the glutes). This means that some muscles are relatively weak and so do not provide the full range of strength and stability needed to endure prolonged or high impact exercise. In my case, working on these other muscle sets and building better core strength will stabilize my pelvis and hopefully lead to better walking gait. A more stable pelvis will help alleviate the over-rotatation at the knee which is irritating my IT band. The upshot of the advice I was given was there is no quick fix, I have to work on building my strength in key areas (through a series of specific strength exercises), ease off of hiking for a while, and focus on some cross training (such as swimming and cycling). The physio also recommended doing Pilates to help with core strength, so I am joining a local class next week.

This last week has been quite challenging and thought-provoking for me on a number of levels. The ability to walk (and to a lesser extent run) as far as I a want, whenever I want, is something that, at my age and fitness level, I tend to take for granted. I also believed that training for hiking by, well,…doing training hikes and some winter running, was enough to build my fitness for going long distances. It never really occurred to me that this most simple-seeming of activities might be more complicated. One reason for this is because I have never seen hiking as a ‘sport’ that needs specialist training, I see it as a natural extension of the walking I already do. Thinking this way meant that I never considered my training and conditioning for hiking in a technical or holistic way, I did not appreciate the range of demands it asks of the body. I also didn’t consider hiking in terms of ‘performance’ as a sportsperson might do do, although thinking about it now, I realize this is wrong.  Walking for weeks on end, doing 15-25 miles daily, carrying a 15kg backpack IS performance! I am expecting my body to perform above its normal range and I can’t take it for granted that it will do this indefinitely without support. This injury has shown that I have ignored the more rounded strength and fitness needed to sustain my hiking (and running) performance.

I think a more rounded approach to training is not emphasized enough in hiking circles, some people are lucky and get away with it, others are naturally more balanced and strong, but for me, I will need to diversify my approach to keep doing what I love to do. Apart from the places we hope to hike and the trails we want to complete, I also want to cover terrain more effortlessly, to go longer and further and have more energy to enjoy the experience- in other words I want to progress and perform better. In the long term the changes I make to recover from my IT band issue will hopefully make me a better hiker, but in the short term, it will mean patience and persistence in altering my approach. More than anything, it is the mental challenge of being limited that I find hardest, and especially the prospect of reigning-in my drive to hike (which is also how I relax and feel good) and possibly compromising on some more immediate plans. The South Downs Way in 4-6 weeks time is not totally off the cards yet, but I will need to use judgement as to whether I am ready and if it is worth the risk. If compromising now means that I am fit to do the GR5 later in the year, then so be it, I need to obey the warning signals now or pay a potentially higher price for it in the future.

Injury does not stop us making plans and preparations though, and in the next couple of weeks I hope to update our gear list for 2017 with the tweaks we have made (or plan to make) to walk lighter and freer this year.

 

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One thought on “Hiking Health: An Early Season Set-Back

  1. Pilates is wonderful – it makes SUCH a difference. However, choosing the right teacher is key. Crowded classes don’t help. I recommend investing in a 1:1 with the teacher, too. She’ll learn your strengths, weaknesses and aims, so can guide you in the classes. I started doing this, and now have monthly 1:1 (£40 for an hour) and daily home practice alone rather than weekly classes (£10) and it’s made a huge difference to pain levels, fitness and strength. I hope your knee is already on the mend. Sx

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